Hi, all,
It's been a while since I last wrote about Shannon's thyroid condition. It's been a reall yo-yo of a ride. A whole pill is too much, a half not enough, and three quarters wasn't good either. She was tested yesterday again. She's low again. They are doing tests for her kidneys to rule out other problems but her initial bloodwork showed only the T4 was off.
They want to rule out that she developed kidney disease while she was hyperthyroid. If all is OK and there are no further problems, they are talking about using a topical solution to place on her ears to further regulate the dose since the pill just can't be split any further.
It was mentioned that either surgery or iodine treatment would be a more agressive treatment. At 14, I am afraid of the surgery end. But the Iodine treatment means she has to stay at the hospital for a week. I hate to do that too because she will think she has been abandoned. She's very spoiled. Do they sedate them if they stay like that?
The good news is that she is back up to 10 lbs. Could her weight change (from 7 to 10 lbs. have affected the dose or am I reaching for straws? Anyway, I will let you know what happens with the new blood tests. Any thoughts on her condition? Thanks.
Peg
Update on Shannon
Re: Update on Shannon
Peg, are the pills fairly easy to cut?
I ask because when our doxie, Sammie, ruptured a disc earlier this year, he was on 1/8 of a pill of Medrol...
the vet tech used a pill cutter and cut it with a quick snap into quarters, then carefully set each of those quarters in the cutter and cut eacah one in half again, so make 8ths out of each pill...some may not have been exact, but the dose was close enough...
Just another option to consider with the pills...I presume Shannon is taking Tapazol?...that is what I took for my hyperthyroid, and I think they give it to critters as well, I could be mistaken on that....
I know I had to be tested often and meds adjusted...and I have been in remission for years now...
If it is tapazol, I know my doctor told me that it has a tendency to destroy white blood cells in 1% of the population, so even if I got a sore throat,I had to go in for a white blood count to make sure they were producing as expected...
Just something to remember if she shows signs of illness along the way...
Prayers that something can be found that is a comfortable dosage for her...
I ask because when our doxie, Sammie, ruptured a disc earlier this year, he was on 1/8 of a pill of Medrol...
the vet tech used a pill cutter and cut it with a quick snap into quarters, then carefully set each of those quarters in the cutter and cut eacah one in half again, so make 8ths out of each pill...some may not have been exact, but the dose was close enough...
Just another option to consider with the pills...I presume Shannon is taking Tapazol?...that is what I took for my hyperthyroid, and I think they give it to critters as well, I could be mistaken on that....
I know I had to be tested often and meds adjusted...and I have been in remission for years now...
If it is tapazol, I know my doctor told me that it has a tendency to destroy white blood cells in 1% of the population, so even if I got a sore throat,I had to go in for a white blood count to make sure they were producing as expected...
Just something to remember if she shows signs of illness along the way...
Prayers that something can be found that is a comfortable dosage for her...
Re: Update on Shannon
Peg, there's a tramsdermal application that is used for a variety of treatments, including thyroid conditions. These seem to be helpful for many of our pet patients when pilling or dose adjustments are difficult. I would just suggest however, that your vet is very familiar with these and that he recommends regular testing of the thyroid levels.
Surgery is an option, but the problem with surgery is as with any other surgical procedure, risks of anesthesia, slow recovery, or reoccurance of the thyroid tissue.
Iodine treatment is probably the best option. Yes, this requires she is in isolated treatment, but you have to talk to the vets at the radioiodine center so they can discuss the procedures with you and what to expect. I think once you talk to them, you'll find that their patients recieve excellent care and attention and they strive to ensure the patients are comfortable and happy.
On another note, if you're concerned, or your vet is not giving you enough information or referring you to a specialist, I'd ask for one immediately. Your questions can be best addressed when you're actually getting a consult with the specialist, and once they've examined Shannon themselves. I think the first order should be ruling out impaired renal function or other organ disfunction, but do talk to your vet about getting that consult in the works immediately.
Please, ask your vet for a referral consult, and take it from there. Hang in there, my thoughts and prayers are with Shannon and you,...ask questions, write them down, etc and don't leave the clinic(s) without getting your questions and concerns met!
Surgery is an option, but the problem with surgery is as with any other surgical procedure, risks of anesthesia, slow recovery, or reoccurance of the thyroid tissue.
Iodine treatment is probably the best option. Yes, this requires she is in isolated treatment, but you have to talk to the vets at the radioiodine center so they can discuss the procedures with you and what to expect. I think once you talk to them, you'll find that their patients recieve excellent care and attention and they strive to ensure the patients are comfortable and happy.
On another note, if you're concerned, or your vet is not giving you enough information or referring you to a specialist, I'd ask for one immediately. Your questions can be best addressed when you're actually getting a consult with the specialist, and once they've examined Shannon themselves. I think the first order should be ruling out impaired renal function or other organ disfunction, but do talk to your vet about getting that consult in the works immediately.
Please, ask your vet for a referral consult, and take it from there. Hang in there, my thoughts and prayers are with Shannon and you,...ask questions, write them down, etc and don't leave the clinic(s) without getting your questions and concerns met!
..........Traci
Re: Update on Shannon
Thanks, Tambrey and Traci. We have been testing every four weeks and Shannon is taking her pill in treats so she is no problem at all. She is taking Tapezol and I didn't hear anything about the white blood count. She seemed to be doing so well and gaining weight and I thought we were doing fine. All the problems, like the diarhea and screaming stopped and she went back to normal. I have thyroid problems too so the testing is fine with me. I just want to make sure she is on the right track. Does this mean her kidneys could be failing or is it a complication of the medication or the problem itself? The vet said something about her metabolism changing with the different doses of the medication.
Maybe you can tell me something about the dose. When Shannon went in she was 7.13 lbs. The meds were for a cat of her size. Now she is ten lbs. At 7.13 a whole pill was too much but a half not enough. How would that respond to a now 10 lb. cat? Shouldn't the whole pill be better if she is too low now and a little heavier? Can't help being really worried now.
Maybe you can tell me something about the dose. When Shannon went in she was 7.13 lbs. The meds were for a cat of her size. Now she is ten lbs. At 7.13 a whole pill was too much but a half not enough. How would that respond to a now 10 lb. cat? Shouldn't the whole pill be better if she is too low now and a little heavier? Can't help being really worried now.
Re: Update on Shannon
remember that the Tapazol affects only 1% of the population with the white blood count...that is a very low number...but my doctor was one to better be safe than sorry...
I would think that now that she has gained weight, the dosage would and should be adjusted accordingly....but I guess it all comes down to what the numbers are on each test...
I remmeber after one of mine...the doctor called me at home and asked how I was feeling...man I had been up and going going going...the house was clean and I had energy to burn...literally...hahaha...I told him and he laughed and told me to adjust my dosage as my counts had changed alot during that 4 week period...within not quite two years I was adjusted down to nothing and have not been on anything since then...just stayed in remission...although going hyper again would not be so bad...I could stand to lose about 50 pounds...hahaha
keep us posted!!
I would think that now that she has gained weight, the dosage would and should be adjusted accordingly....but I guess it all comes down to what the numbers are on each test...
I remmeber after one of mine...the doctor called me at home and asked how I was feeling...man I had been up and going going going...the house was clean and I had energy to burn...literally...hahaha...I told him and he laughed and told me to adjust my dosage as my counts had changed alot during that 4 week period...within not quite two years I was adjusted down to nothing and have not been on anything since then...just stayed in remission...although going hyper again would not be so bad...I could stand to lose about 50 pounds...hahaha
keep us posted!!
Re: Update on Shannon
Peg, what was the dose for the Tapazole?
The best approach is to start at a very low dose, then slowly increase the dose to a maintenance level, testing is required during this course to gauge the effectiveness of the medication. The first three months are the most critical in medicating and testing to ensure the medication's dose is acceptable to the cat without side effects and to ensure the serum levels are appropriate. An example might be to start a cat on 2.5 mg once or twice a day, with frequent testing, and slowly increase the dose to 2.5 to 5 mg once or twice a day. Also, some cats can only tolerate once-a-day dosing, so ask your vet about this in the event that twice-a-day dosing was not preferrable. This needs to be done carefully though, and in conjunction with testing!
Is your vet only testing the T4, or is he also using the FreeT4? The latter may be more appropriate to test to get a more accurate result. Ask him to test both and see if he finds a significant factor between them.
It is not the medication exactly, that may cause renal changes, it is the body's changes from the thyroid condition that can affect renal function, or, that pre-existing renal function was missed prior to treatment for the thyroid. This is why testing is important during thyroid treatment, it isn't just the thyroid that should be addressed, but all organ function as a whole....a CBC, chemical profile for liver, kidney, heart function etc should also be included. X-rays may be needed if there is any suspicion of heart problems or hypertension.
The transdermal application of the Tapazole might be an option, but be prepared that the desired results may take alittle longer than it would with oral administration with the tablets. The important thing when using transdermal applications is monitoring kitty extremely closely so that the thyroid condition can be assessed properly and that symptoms don't manifest as they were prior to treatment. This would indicate the transdermal would be somewhat ineffective and the dose would need to be slowly increased.
In any event, any side effects should be addressed to your vet immediately, so that testing can be repeated and that the medication can be adjusted. In rare cases, if serious side effects occured, the thyroid medication should be ceased and an alternative treatment approached.
I think it would be rare for a cat to gain excessive weight while on Tapazole, although other factors should be taken into consideration. Your vet is correct when he says that metabolism changes are present, and this could account for her appetite, in that, she is feeling better and eating more, or she feels the need to eat more to be satiated, etc. But, any time there is a significance in weight gain (or weight loss), the medication's dose needs to be fully addressed to determine if it should be adjusted.
While her additional weight may help the actual absorption and metabolism of the Tapazole, it is probably unrelated to the thyroid's actual function, as evidenced by the last test result. However, if she continues to gain weight or at an increased rate, your vet should be monitoring this closely along with the medication to see if there is any real relation or if there is something else going on.
So, for now, ask about the FreeT4, talk about the option of once-a-day dosing, get a consult with the radioiodine specialists if you are considering that route. If you are uncomfortable with your vet's experience, or uncomfortable at all with the treatment, do not hesitate to get a second opinion immediately.
The best approach is to start at a very low dose, then slowly increase the dose to a maintenance level, testing is required during this course to gauge the effectiveness of the medication. The first three months are the most critical in medicating and testing to ensure the medication's dose is acceptable to the cat without side effects and to ensure the serum levels are appropriate. An example might be to start a cat on 2.5 mg once or twice a day, with frequent testing, and slowly increase the dose to 2.5 to 5 mg once or twice a day. Also, some cats can only tolerate once-a-day dosing, so ask your vet about this in the event that twice-a-day dosing was not preferrable. This needs to be done carefully though, and in conjunction with testing!
Is your vet only testing the T4, or is he also using the FreeT4? The latter may be more appropriate to test to get a more accurate result. Ask him to test both and see if he finds a significant factor between them.
It is not the medication exactly, that may cause renal changes, it is the body's changes from the thyroid condition that can affect renal function, or, that pre-existing renal function was missed prior to treatment for the thyroid. This is why testing is important during thyroid treatment, it isn't just the thyroid that should be addressed, but all organ function as a whole....a CBC, chemical profile for liver, kidney, heart function etc should also be included. X-rays may be needed if there is any suspicion of heart problems or hypertension.
The transdermal application of the Tapazole might be an option, but be prepared that the desired results may take alittle longer than it would with oral administration with the tablets. The important thing when using transdermal applications is monitoring kitty extremely closely so that the thyroid condition can be assessed properly and that symptoms don't manifest as they were prior to treatment. This would indicate the transdermal would be somewhat ineffective and the dose would need to be slowly increased.
In any event, any side effects should be addressed to your vet immediately, so that testing can be repeated and that the medication can be adjusted. In rare cases, if serious side effects occured, the thyroid medication should be ceased and an alternative treatment approached.
I think it would be rare for a cat to gain excessive weight while on Tapazole, although other factors should be taken into consideration. Your vet is correct when he says that metabolism changes are present, and this could account for her appetite, in that, she is feeling better and eating more, or she feels the need to eat more to be satiated, etc. But, any time there is a significance in weight gain (or weight loss), the medication's dose needs to be fully addressed to determine if it should be adjusted.
While her additional weight may help the actual absorption and metabolism of the Tapazole, it is probably unrelated to the thyroid's actual function, as evidenced by the last test result. However, if she continues to gain weight or at an increased rate, your vet should be monitoring this closely along with the medication to see if there is any real relation or if there is something else going on.
So, for now, ask about the FreeT4, talk about the option of once-a-day dosing, get a consult with the radioiodine specialists if you are considering that route. If you are uncomfortable with your vet's experience, or uncomfortable at all with the treatment, do not hesitate to get a second opinion immediately.
..........Traci
Re: Update on Shannon
Thanks again for your help on this.. The test results are in. Shannon was given a full CBC, chemical profile and both T4 tests. All her organs are functioning fine and again the thyroid is the only thing out of whack. They said for her age she is in remarkably good shape. They are ordering the transdermal to try to alter the dosage more accurately. We'll test again in four weeks. When this began, she was 7.13 lbs. and her levels were high. They gave her a 5mg Tapezal , 1/2 twice a day and her levels went low. So they lowered the dose to half a pill once a day and her level went just a little high. but her weight was now over 8 lbs. So they said give her 1/2 a pill in the morning and 1/4 in the evening and she's now a little low but she is now 10 lbs. So they did more tests to rule out other things. They feel confident they are only working with her thyroid and she is acting more like her old self and eating well again and is back to her original weight of 10 lbs. Shannon was never more than 12 lbs. She's not a very big cat to begin with. The vet seems very happy she is responding to the medication if somewhat uneven at this point. So we are continuing the pills until the transdermal arrives and we'll give that a try. Wish us luck. Thanks again.