Bubba has been recently diagnosed with hyperthyroidism, following a short period of rapidly-developing symptoms. He is a well-nourished 15 year old cat, having an excellent health history with only a couple of exceptions: a crisis with urinary crystals several years ago, and an idiopathic (undetermined) illness that struck when he was 12. He is also the alpha cat of our now 3-cat household, which was augmented in 2002 by the Guide Kittens Jaspurr and Joey, following the demise of our beloved Shannon in 2001, the previous Guide Cat for this About Cats site.
The Diagnosis
Because of Bubba's age, we keep a very close watch on his health, but this one slipped past us for awhile. He had become unusually grumpy recently, but we attributed this to his apparent dislike of little Joey (although he seems to love Jaspurr). But for the past week, Bubba had spent more time alone, and wanted to go outdoors for increasing periods of time. Bubba has always vomited after eating, but until recently, that had leveled off, due to food changes, and changes in the way it was served.
When he started vomiting several times a day and then went "off" his food, we whisked him to his veterinarian. I suspected IBD, because we had discussed the possibility in the past, so was taken aback when the veterinarian said he could feel Bubba's thyroid glands, and that hyperthoidism was a possibility. The blood panel and T4 panel confirmed that diagnosis the next day. The laboratory results showed a T4 value of 6.5, compared to a "normal" reference range of 0.7 - 5.2. The footnotes to the report indicated that in a cat older than 10 years with clinical signs of hyperthyroidism, a T4 value greater than 2.5 is suspect for hyperthyroidism. This is because thyroid production decreases as animals age.
The Treatment
Bubba was given an antiemitic injection during the first veterinary visit, and was prescribed Reglan for the vomiting. Following the test results, he was started on Tapazole (methimazole), twice-daily, as indicated under "Treatment Options" in this article. He will be re-tested with a full blood scan and T4 panel after two weeks of this treatment. He also was prescribed Periactin to help his appetite.
On just the second day of treatment, I am pleased to say that Bubba is already starting to resemble his "old self" again. He is eating heartily again, after a shaky start. The first meal he was served, after receiving his first dose of medication, he glanced at the food dish, then stared at me, as if to say, "Why do you hate me, Mom"? I couldn't resist taking a photo (above). However, shortly after, he visited the J-Boys' plate and finished off what they had left. I guess "stolen food tastes better" is the rule here, so that will be our feeding plan until his appetite returns in full.
The Follow-Up Visit
In researching hyperthyroidism in cats, I discovered that this disease can mask occult (hidden) kidney disease. So, although Bubba's kidney and liver values are excellent for a cat of his age, we will be relieved if the second blood panel remains consistent. He will also need tests for latent heart disease prior to making a decision. Pilling Bubba twice-daily, at exactly the same times every day is a daunting task, and because of our erratic lifestyle, I'm not sure that would be a viable option for a long-term treatment. We're leaning toward the radioactive iodine therapy, and are lucky to live within 50 miles of the Veterinary Teaching Hospital at U.C. Davis, where it could be performed. However, we really can't make a decision at this time, with so many unknown factors involved.
It's necessary to note at this time the importance of an annual full examination and blood panel for senior cats, a policy that I've preached, but didn't follow this year, for one reason or another. Had Bubba received a full examination when he received his three-year Rabies vaccination earlier this year (by another vet), we could have caught this disease quicker, and avoided the stress of a rush visit to the vet's office.
