Hyperthyroidism?

[Phoebe's human]

This board has been so helpful to me that here I am again with another question.

My cat Phoebe had bloodwork done a couple of months ago and turned out to be "borderline hyperthyroid." In a week she's due to go back for a recheck.

Meanwhile she's been having episodes of diarrhea, not overly severe but obviously making her uncomfortable when they happen.

She seems restless too, but the restlessness comes and goes, like the diarrhea.

I understand that these can be symptoms of hyperthyroidism.

Is this a typical way for hyperthyroid symptoms to show up?

[Traci]

How old is Phoebe?

What thyroid panel was done two months ago? Was it a T3, T4, Free T4 or???

Was a complete blood profile done, and if so, was anything significantly altered or elevated? (i.e., liver or kidney enzymes)

It depends on the cat and onset or severity of the thyroid problem. Most cats have weight loss and lethargy, poor coat condition, anorexia or increased appetite, vomiting etc. Since all of the symptoms can mimic other disease conditions, it's important that the full evaluation is used to rule out other conditions as well.

A T4 or Free T4 is useful for diagnosing hyperthyroidsim, but some "borderline" cases require combination testing or "suppression" tests to get a clearer look at the thyroid production during specific times of day (may require a full day at the clinic to measure thyroid levels).

If new testing doesn't reveal anything different, or the vet can't determine hyperthyroidism, and has ruled out everything else, or is not confident, then see a vet who is more experienced in testing.

What IS concerning is the bouts of diarrhea and her nervousness. Have you recently changed her food or anything stressful in her environment? Did the vet rule out other causes to the diarrhea? Did he treat it or take a wait-and-see approach?

[Phoebe's human]

It was a T4 test that was done, and a pre-anesthetic workup included a complete blood profile, with no alterations in liver or kidney enzymes noted.

At the end of December she had all of this done in connection with the dental workup, which also involved a tooth extraction and treatment of an infected ear/perforated eardrum.

So I'd say that the procedure in itself must have been stressful for her. She's 12 years old. Also we moved only 4 months ago, and things at home are still in transition though she seems to have settled in nicely.

I haven't asked the vet about the diarrhea yet but will mention it next Monday--earlier if she takes a turn for the worse.

It was an occasional thing--every few days or so she'd have a lot of BMs, with none in between, and the last ones would be loose but not liquid. Then over the weekend she had a worse spell of it all day, making very frequent trips to her box and always having small amounts of loose stool.

She has been on a diet designed to cut down on her hairball problem. She used to bring up two or three hairballs a month but the diet changes seemed to help.

Maybe now that she's older, she's getting more of the hairball-control type of food than she can handle?

She was getting one dose of Petromalt daily, plus up to 6 hairball-remedy treats a day, plus a teaspoon of baby squash added to her canned food, and half of her dry food was Meow Mix Hairball Control. The dry food is half her diet. The other half is Purina Friskies Senior Pate.

I'm trying cutting out the Petromalt, the baby squash and the treats as well as cutting out the hairball-control dry food (so she's getting one-quarter cup of Meow Mix Indoor Formula once a day plus the canned food-- she gets a total of a half a can a day of the canned).

Thanks so much for your suggestions! I'm glad to know it still might not be hyperthyroidism.

[Traci]

Meow Mix isn't truly a quality food, and since she is bordering on senior now, I'd definately ask your vet about a better diet for her, particularly for her GI health, as some cats as they age, cannot tolerate some foods and aren't able to metabolize them. The canned might also be culprit in that it might not be agreeable to her. Please ask your vet about a diet that is geared for both senior and GI tract metabolism. Also rule out IBD.

Hairball remedy is not intended for long-term use, it should only be used temporarily, like 3 times a week for a couple weeks, not every day for long term.

If you're certain it is hairballs she was vomiting, and not something else (like food, or bile, etc), then start brushing her at least once a week. If she's overgrooming herself, that might be cause for concern (and can be a symptom of hyperthyroidism but can also be a symptom of other things).

She has endured a lot of stress lately, and sometimes it is transient stress, meaning, sometimes cats don't outwardly show their stress until months later. Do all you can to keep her environment peaceful and calm, discuss her diet with the vet, and if she is overgrooming, be certain you mention that to your vet.

[Phoebe's human]

Thanks so much!

She's always been an overgroomer, at least for the 6 years she's been with me.

Actually I comb and brush her twice a day. She's very fond of this routine.

She's half-Himalayan and has quite a bit of hair.

[Traci]

Oh my, she is beautiful!!

[momPaws]

Yes, such a pretty cat.

[Phoebe's human]

On behalf of Phoebe, thank you for the compliments!

The vet didn't even do the thyroid recheck when I took her in on Monday for it because he felt sure that her symptoms weren't typical of hyperthyroidism--and he said her thyroid wasn't enlarged.

I was impressed by a vet who let pass an opportunity to have a $50 test done at my expense! And I think his judgment was good in general.

He also said that nowadays the thinking on hairballs is that there are cats who do a lot of licking but never have hairballs, and others who don't lick so much but have frequent hairballs--and so there may be IBD going on in the cats who have frequent hairballs.

He believes that Phoebe's recent (last 2 months) diarrhea was triggered by the Clavamox she had to take after her ear and tooth infections, and now she's taking FortiFlora for a month to help restore the bacterial flora in her intestine to their normal level.

So far she's been doing much better. He also recommended adding the canned pumpkin or baby squash to her diet as before but cutting out the hairball treats and the Petromalt for the time being.

So if the hairballs continue to be a problem, we'll be looking into IBD more closely.

Thank you again! As usual, the advice here was right on target.

[Traci]

Just so you know, you have to strike a balance with her diet to ensure she is utilizing and metabolizing certain nutrients. Depending on exactly how much squash and pumpkin you're giving on a daily basis may in fact negating what nutrients she's getting from the dry and canned. Again, please ask your vet about a more suitable diet for her age, activity, weight, metabolism, etc.....MeowMix is rather a generic brand that is not exactly a "life-stage" cat food.

[Phoebe's human]

Until recently Phoebe was getting a teaspoon of baby squash once a day, mixed in with the canned food. Since the diarrhea began she's had no baby squash but now that it's resolving, I've added a half teaspoon of the squash a day.

I will definitely ask the vet about a better diet for her. I did touch on the topic when I was there recently but he just said that there were many to choose from.

The vet clinic sells a variety of foods--among them Science Diet, Eukanuba, and one called RoyalCanin that I hadn't heard of.

Thanks again!