Sounds more and more like an anxious cat, but has the vet done a U/A to rule out urinary tract disease, and did the bloodwork include a full chem panel with liver enzymes? I've seen some cats act *really* weird and turns out they were in liver failure. Also seen some strange manifestations of lower urinary tract disease. And of course, I've seen some strange cats.

If liver and urinary disease are ruled out, my favorite anti-anxiety drug in cats is transdermal amitripyline. You just rub the med into the ear and it gets absorbed through the skin. Doesn't cause sedation like some other meds, either. May help with the pulling hair out, and for lower urinary tract disease (not infection though) as far as pain relief and such.

Hope he feels better soon.

I have been to the vet and had so many things done that at this point I don't know what's been done to whom. He has been on amytrip and pulled him off bec we thought maybe it was depressing his system and making him not eat. I didn't get home in time to call the vet and ask if we ought to put him back on or something. Poor guy--he's never been like this! This cat has been known to lie purring in my arms 5' away from some strange handyman operating a powertool. I know he's not all that old, but honestly, in the past year I've started to wonder if he was have the cat equivalent of Alzheimers.

I have been to the vet and had so many things done that at this point I don't know what's been done to whom. He has been on amytrip and pulled him off bec we thought maybe it was depressing his system and making him not eat. I didn't get home in time to call the vet and ask if we ought to put him back on or something. Poor guy--he's never been like this! This cat has been known to lie purring in my arms 5' away from some strange handyman operating a powertool. I know he's not all that old, but honestly, in the past year I've started to wonder if he was have the cat equivalent of Alzheimers.

One of the common side effects of methimazole in some cats is severe itching, esp. of the face and neck. In some cases, the itching can be so severe that the cats end up scratching large wounds in themselves.. If your poor boy is feeling constantly itchy, that could certainly explain his jitteriness and hiding. This is something you need to discuss with your vet. Your vet may recommend stopping methimazole and administering corticosteroids to stop the itching.

If you don't already have them, ask your vet for copies of all of your cat's bloodwork, both that which has already been run and any that will be run in the future. You need to be able to see the results for yourself so that you'll know exactly where your cat's blood values are in relation to the "normal" values.

well, that would make sense--he started getting twitchier about a week after first going on the meds. As a survivor of MAJOR cases of Poison ivy, I can certainly relate! Is there an alternative to the thyroid medication? He has to have something--he couldn't survive with the levels of hyper that he had. The steroids might boost his appetite for a while too, so that would certainly be a plus. I was going to call the vet tomorrow anyway so now I have some knowledgeable questions! Thanks so much.

Take the cat to another vet. If there is a vet medical school near you, go there. they have specialists.

Methimazole is never recommended for long term management of hyperT, though it is used that way in many cats. It is a very strong drug with potentially lethal side effects, and the longer it's used, the greater the risk. Also, methimazole does not cure hyperT. It just manages it.

The only cure for hyperT is radioactive iodine. It's an expensive treatment, but over the lifetime of a cat as young as yours, it would be a lot more economical than the medication and regular blood testing required with methimazole. Side effects with radioactive iodine are also considerably less than with methimazole.

You can read all about radioactive iodine at the links below. Both facilities linked are in NC:

http://www.thesoundcat.com/radioactiveiodine.html
http://www.cvm.ncsu.edu/vth/clinical_services/internal/hyperthyroid_cat_clinic.html

WEll, I think though Laurie is correct in saying the ideal treatment in Iodine 131 (radioactive iodine, the standard treatment for the same problem in humans), long term methimazole, in the vast majority of cases, is well tolerated by cats and the likelihood of serious problems with methimazole are rather rare. I have treated many hundreds of hyperthyroid cats over the years and though the argument of economics is also often correct, many owners simply cannot put out the $$ needed in a lump sum to have this treatment done. And most of my patients on methimazole do quite well and have very few side effects. I would say only 15-20% of my clients end up going the radiation route, though almost are happy they did it in the end (certainly less hassle in the long run in most cases).

What you should know is that treatment is not always succussful the first time, either and a small percentage may need a sedond or rarely a third treatment (costly!!).

Also, the 'side effect' of renal failure, which the hyperthyroidism can mask, is harder to deal with once you have blasted the thryroid gland into oblivion, than it is if you have a cat on methimazole (which you can adjust the dose of accordingly). Fortunately most of the specialists who do this radiation procedure warn owners of this potential problem, but still it is a drag when it occurs.

Also saying the only cure is radiation is not true, either. Surgery, the old 'gold standard' before radiation became commonly available, usually cured these cats. It however, is fraught with a moderately high incidence of complications if done by vets who do not have a great deal of surgical expertise (sometimes more than just the thyroid gland is removed and that is bad). And if there is thyroid tissue elsewhere (not common, but it occurs) then those cats are often not that much improved. STill, most cats that undergo surgery by an experienced surgeon will ultimately be 100% cured. I do not usually recommend that route, particularly now that radiation is ony a bit more expensive but far safer.

Lzrddr's point about masked renal disease is why it's extremely important to run a methimazole trial and bring the cat to euthyroid (normal thyroid levels) BEFORE pursuing I-131 treatment, if possible. Since uncontrolled hyperT can mask renal failure, it's impossible to determine the true condition of the kidneys via bloodwork until the thyroid levels are back in normal range. Once the cat has achieved euthyroid on methimazole, THEN AND ONLY THEN will bloodwork provide an accurate assessment of kidney function.

Many or most I-131 clinics require a methimazole trial to assess kidney function before accepting a patient for 1-131 treatment. If underlying renal disease proves to be present, then I-131 is generally not recommended, and hyperT is managed with medication.

Radioactive iodine doesn't affect or "blast into oblivion" normal thyroid tissue. It destroys only diseased thyroid tissue, leaving healthy tissue unaffected and able to regain normal function after treatment. In most cases, enough healthy thyroid tissue is still present to allow for a return to normal thyroid function following I-131 treatment. Occasionally, however, there is so little healthy thyroid tissue left that the cat becomes hypothyroid, requiring daily thyroid supplementation following treatment.

Laurie

We switched Isaac to the gel form of the drug and put him on steroids for some itch relief and appetite boost. The dr said he's always had good results using the gel. I would prefer the iodine treatment and found 2 places within driving distance, but both the vet and I feel that he needs to gain back some weight before we do the treatment. He seems to feel better and is eating and drinking. I think he is still itchy--he seems to groom more than normal and is still doing the ear twitchies. I also found a raw spot in front of one ear yesterday. Hopefully that is left over from the oral meds, but in case it isn't, is there anything ya'll recommend to ease those bad spots until we can get the treatment?