My next step was deciding how to treat him. A couple of options to control hyperthyroidism are using lifelong medications or a prescription diet. The diet wasn’t a viable option in my household. If Pez ate the prescription diet she’d become very ill and separating the two cats for meals would not be easy. The medication comes in two forms: a tablet and a cream. The cream is the easier of the two forms as it is placed on the ear, but this wasn’t an option either as Pez grooms Nigel and ingesting the cream would not be good for her. So I was left with, Felimazole™, the pill. It needs to be given by mouth every 12 hours.
Two other treatment options were available to me. I could have his thyroid gland removed, which is only recommended in extreme cases. The other option was radioactive iodine treatment, which can cure hyperthyroidism in as little as one treatment. This treatment isn’t suitable for all cats so they need to undergo preliminary testing to see if they are a good candidate. If they are healthy enough to undergo treatment, they have to stay in the hospital until they are no longer expelling radioactive waste, typically 10-14 days.
The main factors in my treatment decision were cost and how much of an impact the treatment would make in my life. Nigel is easy to pill so it certainly wouldn’t be a huge undertaking to do it twice a day, every day, for the rest of his life. It would add an extra level of difficulty and cost if we were to go out of town. Gone are the days when my husband and I could leave the cats alone for 24-48 hours. Nigel’s medication schedule means that I either needed to find someone to come to my home twice daily to pill him, or he needs to board somewhere while I was out of town. The radioactive iodine treatment wins in this category since it means life would go back to the way it was before daily medications. Cost wise, the medication isn’t expensive, but when you factor in the annual T4 testing to ensure the dose is still effective, the cost of boarding if I was away, the long term cost is pretty close to the one time cost of the radioactive thyroid treatment.
For me, the decision was easy. Nigel was referred to the Veterinary Medical Center at the Western College of Veterinary Medicine as they are the only clinic in Saskatoon that can work with the radioactive iodine. He was on a wait list for a while, so in the meantime he is got Felimazole™ twice a day. He wasn’t upset about it because it meant that he got treats after taken his pill, and treats are always good.
This is why preventative diagnostic testing is so important, no matter the pet’s age. The workup that was done on Nigel found a problem before it was truly a problem. It meant that I wasn’t surprised when he was diagnosed with hyperthyroidism four months later. The high normal result on his T4 test allowed the vet to give me a list of things to watch for at home to indicate it was time to retest. I knew his behavioral changes were because he was getting sick and not because he was old and senile. It gave me time to research hyperthyroidism so I knew what I wanted to do when it came time to make a decision. It gave me answers to why he wasn’t jumping like he used to. Now he gets a glucosamine and Omega 3 supplement to help him get around better. I’ll continue to do annual wellness workups on my pets so I can stay ahead of any problems that may be starting; problems that I can’t see yet.
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For more information on hyperthyroidism, please speak to your vet.
Written by: Chantel Steele RVT, Martensville Veterinary Hospital.