Hyperthyroidism - doc says meds will not control it

amg1978July 4, 2013

My cat is 12. Back when he was 10, I noticed he was licking his fur off in a lot of places so I took him in. Well, they said it was allergic, gave him a shot, but because he only weighed like 8lbs the vet did blood work. The licking thing did end and his coat is beautiful, but the vet told me he had hyperthyroidism. We went on a methimazole treatment where I give him 1/4 of a pill twice a day. He had his bloodwork re-done a month later and all was well. 1.5 years later I took him in for blood work and the vet said his kidneys are working fine and thyroid is all within spec, etc. said he is A-OK

However, he has told me that this routine of giving him the pills won't help him with a long life. He said that he needs radiation therapy (said it'd cost me about $1000 to $1100) or else he prob will live max to around 17-18.

Otherwise, my cat is 100% solid. He plays, runs around, feels fine, looks great, no issues. He did put weight on after the methimazole and is like 9.2lbs now but he will never be a "big" cat.

So is all this true? Even if his bloodwork shows great and I take him in to re-check every year or so, should I really be taking him in for radiation right now?

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I'm not sure what you mean by "or else he prob will live max to around 17 or 18." You seem to be saying that the vet told you that the cat may live to 17-18 with the methimazole. That's pretty much a full live span for cats, in general.

Radiation is an alternative to the constant pilling and typically works extremely well in most cats (95%). Unfortunately my cat was one of the 5% that needed the radiation again. And then the second didn't work so he was one of the tiny percentage that needed it 3 times. So far he's holding steady.

So you've got choices.

    Bookmark   July 4, 2013 at 6:14PM
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Hi. I put my darling cat Lela on the methimazole treatment with the goal of getting her weight up so that we could do radiation. She had some other complications and never did get her weight up, and we were not able to radiate her because of it. She died at about 10-11 in November 2011 (she was a stray, so I am guessing on age). I think you should feel fortunate to have a prognostication of 17 or 18, although I have heard of cats living longer. You have options as the previous person said. I wish very much that Lela could have had a few more years. Good luck.

    Bookmark   July 4, 2013 at 9:11PM
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Yes, yes--get the radiation! It is sooo worth it for an otherwise healthy cat. I had three cats that had it. Two were quite old (17 and 18), but healthy, and turned out to have latent kidney disease. But it gave them a few more years. My last cat was only 12 when diagnosed with hypothyroidism, and I had it done. I was worried it was a death sentence as he did have some signs of kidney disease also. But he managed to live for 7 years after that, so it gave him a really long good life. The vets in my area that do it will do any follow up radiation needed for no charge (mine never needed that). It's very easy on the cat, and you just have to follow simple guidelines on poop disposal for a bit afterword.

    Bookmark   July 4, 2013 at 9:14PM
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Are you quite positive he didn't say WITH the radiation he might live to 17 or 18?

    Bookmark   July 4, 2013 at 10:02PM
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I would never tell a client their cat may live to 18 no matter what we did for the thyroid disease... that is really going out on a limb. Average age for a cat to live is about 14... so 18 would be quite a bit beyond that. Not sure how one can guess that as the ultimate age.

Either way, radiation treatment can 'cure' these cats while methimazole treatment is only a management option, and sometimes the tumor that is secreting excess thyroxin can grow, spread and ultimately kill the patient. Here in Los Angeles, there is so much competition for thyroid patients that the cost of treatment has been dropped down to $450... nice! Radiation treatment is simple, painless and very safe... but it does require an sudden out-of-pocket expenditure, that though is usually less than one will ultimately pay on methimazole and testing, methimazole is something one can pay slowly for over time, making it a tad easier on the budget. Still, radiation is the preferred choice... that is what people with this condition always get treated with.

    Bookmark   July 5, 2013 at 4:06AM
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Methimazole only manages hyperT. It doesn't cure it. I-131 (radiation), however, CURES hyperT in more than 95% of cats. It's important to note than methimazole is a very strong drug with potentially very serious side effects. Many cats can take methimazole for years without any apparent problem, but some cats can develop life-threatening liver damage or other serious side effects. So, the treatment of choice for hyperT is I-131, if you can afford it..

That said, I have had four hyperT cats (two currently), all successfully managed on medication. One of my current hyperT cats has been on medication for a little over 4 yrs and is still going strong (she's 19 yrs old now). But I would have had her treated with I-131 if I could have managed it.


    Bookmark   July 5, 2013 at 9:14AM
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I sent lzrddr an email through this site. I am in north san diego so LA isnt far, and $450 vs $1000-$1100, I'll drive 1.5 hour for $600, thank you very much :)

hopefully he/she replies.

thank you all.

    Bookmark   July 5, 2013 at 6:36PM
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I had a hyperthyroid cat on methimazole for many years. He lived a good long life and had no ill effects from his meds. I was given the option of radiation at the time but the vet said he was not a great candidate due to the fact that he was a "hard-to-handle" cat at the vet office - I had to have him knocked out to draw blood (he was a sweetheart at home). My vet and I both decided to try the meds and I have never regretted my decision.

I would probably consider changing vets if I were in your shoes. I think it is appalling that suddenly your vet is telling you that your kitty needs radiation to live a long life - especially when your blood tests are fine. I am here to tell you that my kitty was on methimazole for years and was elderly when he died. He had a great life.

    Bookmark   July 5, 2013 at 11:47PM
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Most cats will tolerate Methimazole, but about 20% will not (at least orally). Of those 20%, about 15% will do better on transdermal Methimazole (more costly, but super easy to apply- on the ears). Still, that leaves 5% of cats that don't do well on methimazole no matter what. .. but many cats can go one to live a long, relatively normal life on methimazole. But as Laurie pointed out, it is a life long treatment, not a cure. Cures are nice if you can afford them or they are available to you. The radiation is a single SQ injection, nothing more... but most places will 'require' multiple radiographs with a gamma camera to monitor its progress, and will have to house a cat for a few days (though no handling needed during that time other than the few xrays taken)... they just can't go home because of the mildly radioactive urine. I have sent multiple fractious cats for radiation therapy and so far no problems. But I agree with renee that methimazole is certainly a good alternative for treatment (way better than doing nothing, that is for sure).

    Bookmark   July 6, 2013 at 4:02PM
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lzrddr: I give it to him twice a day and it's super easy to open his mouth and toss it on back. It's a routine for me and it is no biggy. When I go on vacation I just ask someone to toss one of the tiny chunks (I chip the pill in to 1/4's) in his food. If he misses a few days the vet said it wasnt a huge deal, it's more about the long-term effects. His liver, kidney functions all good and thyroid all good. vet said we should do a full panel every year ($250) and check just thyroid every 6 months ($85 or so). so that is why he said I should just do the radiation for $1000.
When I told him I was fine with giving him the pills for the next 10 years or however long he lives, he then tells me that no, the pills wont prolong his life, it's just a temporary fix before we do radiation, so if I don't do the radiation, basically he is doomed. I found that strange. Good to see all of your responses.

lzddr: if the price worked for me, I'd drive up your way and have the radiation done. But otherwise I'll stick w the pills i guess.

    Bookmark   July 6, 2013 at 4:35PM
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I'd stick with the pills...I would also find a new vet or at the very least, get a second opinion.

    Bookmark   July 6, 2013 at 4:54PM
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