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16 y/o hyperthyroid cat. Couldn’t find answer on your blog. Can you help?

Hi There: I’ve read the two questions posted on the blog about hyperthyroidism, & their responses, & neither answers my question.

My cat is 16 yrs old, & has had hyperthyroidism for not quite a yr now. We have tried methimazole (first treatment), & the one similar to it (don’t have the bottle in front of me – carbimazole?), which we are doing right now. Neither of these meds have been successful in controling her condition, & both have resulted in horribly sore, scabby, & bleeding ears. She is quite miserable.

Radiocat is not an option for her – at age 16, & having never been out of the house, I’m certain she’d starve herself to death during the waiting period. The closest place to us who can do it is about 1.5 hrs away. If she were 6, maybe, but not at age 16. We won’t consider it – we know her too well, & she would not be able to handle it.

So, I am asking about surgery. Our vet, who is excellent but young, has never done the surgery on a cat before (watched one during vet school, & has done it on dogs). He’s concerned about the close quarters in there, & the possibility of nerve damage. He tried looking for info on whether the surgery has ever been done w/ lasers or not, & couldn’t find anything regarding that. Everyone pushes the Radiocat, & not surgery as much.

Could this surgery be done w/ lasers? Where could my vet find info about it, if it has been done, & by whom? We’re tentatively looking at a surgery date of next Fri, no matter which type of surgery he does. Our poor kitty is quite healthy otherwise, has been all her life, but this is really making her feel awful. Because she’s otherwise healthy, I’m not so worried about the risk of anesthesia, etc, but just making this as easy on her as possible.

Any ideas would be appreciated!

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13 Responses to “16 y/o hyperthyroid cat. Couldn’t find answer on your blog. Can you help?”

  1. Tammy Evans, DVM - Cocoa, FL says:

    It sounds like you are using the topical thyroid medication to control the disease. Unfortunately there have been no studies to prove that topical medication reaches adequate levels to

    control the disease. It is very important for hyperthyroid cats to be medicated orally. There are many options to choose from including tablet, liquid, soft chew, and hard chewable tablets.
    I realize cats can be difficult to medicate and it is stressful, but there are so many options you just have to find what works for you and your kitty. Personally I like the soft chews.
    They are moist and come in a foil packet in chicken, liver, and tuna flavors.

    As far as surgery that is definitely an option, but a difficult decision for a 16 year old cat. I would encourage you to try the oral medications first. There are two lobes of the thyroid
    gland, one on either side of the throat. Usually only one side is abnormal, initially. The down side to surgery is that removing the affected side works well, until the other side becomes
    overactive and they need surgery again. If both sides end up being removed then you have a hypothyroid cat that needs oral medications for hypothyroidism. You also have to worry
    about the parathyroid glands that inevitably get removed with the thyroid gland. The I-131 is such a nice option because it only destroys the overactive, abnormal thyroid tissue and leaves
    behind functioning thyroid tissue. There is a very low chance of the disease returning after the I-131. The isolation period is very concerning though for a cat that has never been away from home.

    Best of luck in your decision.

    Tammy Evans, DVM
    Caring For Life, Inc.
    Cocoa, FL

  2. Patricia Lane, DVM - Marietta, GA says:

    Many veterinarians perform thyroidectomies, but it is a precise surgery in a sensitive area, so you want to have a surgeon who has done the procedure often. The surgery is done less commonly these days because it is usually more expensive and a greater risk to the cat than is the I-131 (radio active iodine) treatment. Lasers are simply a substitute for a scapel blade. In some situations in the right hands they can make the surgery a little faster, but they do not change the procedure substantially.

    Patricia Lane, DVM
    Cat Clinic of Cobb
    Marietta, GA

  3. Kenneth May, DVM - Slater, IA says:

    I would not have this surgery done by someone that has not done it before! It is a very delicate surgery with a few severe complication possibilities even when done by experienced surgeons. I assume since the cat’s ears are affected, that you are using a topically formulated methimazole. I would encourage you to go to the oral form, within a treat if need be , or formulated into a liquid and flavored.

    Dr. Kenneth May
    Sievers Veterinary Clinic
    Slater, IA

  4. Mike Keem, DVM - E. Aurora, NY says:

    Go on the internet to the American College of Veterinary Surgeons website. There you will be able to locate a board-dertified veterinary surgeon with the knowledge and skills necessary to perform a thyroidectomy successfully on your cat. Best of luck in reaching a successful outcome.

    Mike Keem, DVM
    Aurora Pet Hospital
    East Aurora, NY

  5. Lori Coughlin, DVM, Oak Park, IL says:

    Surgery is an alternative therapy, but you might ask your vet if there is a facility that can do a technesium scan first. I recommend this only because some cats that are hyperthyroid have overactive tissue in their chest cavity, which is not accessible by surgery. If it shows all the active tissue in her throat, then surgery is an option. If your vet has access to VIN (Veterinary information network) there is supposed to be a thyroid surgery video that is very helpful. I have only done 1 surgery and have 2 cats that had radioactive iodine (Radiocat has only a 4 day hospitalization) and 2 on the methimazole. Most of my patients are on either oral or transdermal methimazole (the scabbing can be controlled by prednisolone, but then you have to monitor for side effects of a steroid). I don’t have a laser but would think that it would make the surgery have less bleeding. The main trick is to do one side at a time to avoid disrupting the parathyroid glands (vets that do both sides together will usually keep the cats to monitor their calcium levels for a few days afterwards). I hope this answers your questions. I personally love the radioactive iodine, but know it is not for everyone’s cat.
    Good luck!

    Lori Coughlin, DVM
    The Cat Practice
    Oak Park, IL

  6. Philip McHugh, DVM, NC says:

    Why laser? Laser surgery is not needed and may even be contra-indicated. Many, many DVMs have done the surgery with scalpel and lots of blunt dissection. I have.
    Surgery carries a recurrence rate of up to 50%.
    Radioactive Iodine cures 95%. If cost is not an object (and no problem if it is), give your cat a little more credit and go with the Iodine. Can’t starve in 3 days.

    Philip McHugh, DVM
    Park Veterinary Hospital
    Durham, NC

  7. Mack L. Barney, DVM - Fairfield, CA says:

    Hello,

    I sympathize with you for your cat’s condition. I have done surgery for years on dozens of cats with hyperthyroidism, up to 19 years of age. It is almost always successful. I currently do the surgery with a laser, on a low setting. With magnification, I can direct the beam between the thyroid and the parathyroid tissues, gently cauterize the vessels, and avoid the nerves. The procedure is fairly quick, and the cats typically recover very quickly and gain all their normal weight back within 1-2 months. Before lasers, I did many of them also with standard surgical procedures, and the percentage of entire success is well beyond 90%. I believe that radiation is better in situations where the thyroid tissues occur elsewhere in the body, but in the vast majority of cases, surgery is great.

    Good luck to you.
    Mack L. Barney, D.V.M.
    Barney & Russum Animal Clinic
    Fairfield, CA

  8. Sarit Dhupa, BVSc - San Marcos, CA says:

    Hello

    Surgery is definitely a good alternative given the circumstances. If your veterinarian is not comfortable with the surgery, I strongly suggest that you contact a board certified surgeon in your area. Try the “find a surgeon” link at the American College of Veterinary Surgeons web site. http://www.acvs.org

    Best of luck!

    Sarit Dhupa, BVSc, DACVS
    California Veterinary Specialists
    San Marcos, CA

  9. Mary Juber, DVM - Gales Ferry, CT says:

    Hello,

    The surgery to remove the thyroids is really not as difficult as it may seem. I have done several, and the cats do very well. It is not difficult to locate and leave behind the parathyroid gland, which the cat needs.

    ALL the cats that have this that I have examined are old cats. This is not a contraindication for surgery. The cost of the surgery will pay for itself by the savings in medication costs and side effects of the medication.

    M. Juber, DVM
    Gales Ferry Animal Hospital
    Gales Ferry, CT

  10. John B. Symes, D.V.M. - Mobile, AL says:

    Hyperthyroid Cat Owner,

    I have been in practice for nearly 30 years and have lost track of the number of thyroid glands that I have successfully removed. It is a relatively straight forward and simple procedure once you have one or two under your belt. There is a nerve that needs to be avoided but this can be accomplished easily once it is identified. The trouble comes when both glands are affected and one attempts to remove both at the same time. There are two smaller glands called the parathyroid glands, which control blood calcium levels, at least one pair of which MUST be preserved. If only one gland is to removed, then this is really not an issue. But if both glands have pathological changes, the surgeon must take extreme care to leave one set of parathyroid glands.
    This takes skill. So, if your vet is truly a novice, it might be best to have someone with experience to do this and have him/her observe the procedure in order to get their bearings. After that, they will be better equipped to handle this relatively simple surgery.

    I hope this helps,

    John
    John B. Symes, D.V.M. (aka “Dogtor J”)
    Beltline Animal Hospital
    Mobile, AL

  11. Anonymous says:

    Thanks for the responses.

    To clarify: My cat was on the oral versions of both the methimazole & carbimazole, & both made a mess of her ears.

    Our vet did indeed opt to try the laser surgery on our cat, & it was a definite success. (He’d done it on dogs before, just not on cats.) The left side of her thyroid was about 4X larger than it should have been, & he removed it w/ no problems. At age 16, our cat did very well during the surgery, spent one night, & came home the next day, all her blood work looking excellent. She will have her stitches out the day after Thanksgiving. She has already gained .5 lbs since her surgery, & seems to be heading back to normal in her behavior, eating habits, etc.

    My vet may be young, but he’s excellent, & he did a fantastic job once again for us.

    Thanks again!

  12. Anonymous says:

    My 19 YO cat has been on Methamazole for a year now. Recently he has had a very itchy face and his eyelids are red and inflamed. This has been going on for a month now. Could this be a result of the Methamazole and if so, what can I do about it?

  13. Ariel Valyo, DVM says:

    Yes, facial itching can be a reaction to Methimazole. Cats that have this reaction cannot take this drug. Please consider an alternative form of therapy – radioactive iodine or surgery. Methimazole can also sometimes have adverse effects on the cat’s bone marrow and unmask kidney disease so your cat should also have a CBC and a blood chemistry checked for both of these problems.

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