Pallina, hyperthyroid cat. Seeking advice

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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Antonio »

Some nights ago I was watching a TV program, a long interview to a very famous Italian showman. He's 80+ years old, he was interviewed about his career and life.
I was going to turn the TV off, it was midnight, I thought it was a waste of time. I'm glad I didn't.

He was asked what the saddest moment of his life was, and he replied that it was when he was diagnosed with a thyroid cancer, in 1970's. Despite all the meds, he wasn't going to get better and some methastasis were already going around his body.
Then in 1986 Chernobyl disaster happened. Following the disaster and the radiation fall out, some doctors found out that most children, if not all, were born without thyroid or had it destroyed by the radiations of an isotope of iodine. These doctors thought that the radiation of I-131 was destroying the thyroid and came out with some tests that in a few years led to the radioactive treatment for HT in people, and later in pets.

Did you know that? Do we have to be thankful to that disaster if today people and pets can be effectively cured?
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Lilith »

I didn't know that! How tragic it had to happen like that though ...

How's Pallina? Has she had her blood/urine tests yet? Mouse is going next week. The psyllium didn't work out I'm afraid, it was bunging her up, but as it makes a very nice grassy plant I shall be sowing the seed next summer and guess who will enjoy nibbling it? :D

Fusses to Pallina and purrs from Mousey :)
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by booktigger »

What a tragic way to discover a treatment
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Antonio »

Lilith wrote: How's Pallina? Has she had her blood/urine tests yet? Mouse is going next week. The psyllium didn't work out I'm afraid, it was bunging her up, but as it makes a very nice grassy plant I shall be sowing the seed next summer and guess who will enjoy nibbling it? :D
Lilith, I think you have missed my update, the last post in the previous page of this thread :)

How strange about the psyllium... :shock:
How many seeds were you giving her? What I know is that a few seeds once a day are good for moving bowels, too many seeds have the opposite effect.
I was told that 10-15 seeds a day were good. But I have seen that even 25-30 are still fine with Pallina. And they were good for my sweet Lola as well :(
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Lilith »

Ah, missed that ... she seems to be coping though, hope the rest of the reports are ok.

Perhaps I overdid it with the psyllium ... not sure. I give her lactulose a couple of times a week now, in her food; seems to do the trick.

Fusses to Pallina :)
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Antonio »

I have just got the report for Pallina's thyroid, it's been faster than expected.

FreeT4 = 6.08 picomol/l [5-20] (this was 10 two months ago)
T4 = <12.9 nanomol/l [19-65] (it seems that the machine can't read below 12.9, same as in September)

Now I wonder whether this low levels are normal after "only" three months after the treatment, and I should expect to see them raise at the next check up, or something is not going the right way... :?:
The vet that sent the report to me didn't know what to say.

She's still fine, wanted to get some sunshine at noon and had eaten all her food from this morning.

Still waiting for the PARR test report, it should be available by the end of this week, they told me.
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Kay »

if she's eating OK and not overly lethargic I would be inclined to consider her cured of her HT and leave it at that
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Patricia »

Hi Antonio,

Thanks for the update, (I was getting worried) but Pallina seems to be doing fine. Probably better to have too low than too high regarding the thyroid levels. She's obviously happy in herself and is eating ok.
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Antonio »

@Patricia,
how is your HT kitty doing?

Yes, the vet of the lab said the same, it 's better to have low levels than to have high levels.
Yesterday I've sent the reports to the facility in Belgium. I hope they will reply about these low levels. I had already sent them the September report, but they didn't answer... :?:
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Patricia »

Hi Antonio,

Sadly my cat Ginger died from kidney failure the beginning of September, she was 15 years old. She had lost a lot of weight and she gradually stopped eating any solid food, she just ate the juice/gravy from her wet food. I don't think the heat we had this summer helped either. She was taking Vidalta 10 mg. but it was very difficult getting her to take the medication, I did suggest the ear gel to the vet but she was reluctant to try it as she said it was difficult to judge the dose. Anyway it was her kidneys that proved to be the bigger problem and there's no effective treatment for that. The beginning of this year she was fine - I was surprised how quickly she went downhill. She is greatly missed.
I think it is quite normal for the thyroid to be too low after the treatment as it adjusts, if it becomes a problem the vet will advise medication but I think it will be a relief for you if Pallina puts on some weight so I can't see that being a negative aspect. I consulted several forums when I was researching Ginger's health problem, and on one forum they were discussing a centre in Bologna that carries out the radioactive treatment?? Could this be possible? I can't remember which website forum it was or the name of the centre but you had already been to Belgium with Pallina (really brave of you both I thought - I was really impressed) so there was no point mentioning it.
I hope the Belgium vets get back to you soon about your query. Is she still having the Cypro? How is her throat now?
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Antonio »

@Patricia,
what a wonderful kitty you had! I'm so sorry to read that Ginger's at the Rainbow Bridge now :cry:
It must very hard for you since it's a recent loss... I'm still crying over Lola's loss, she died on March 30, this year, but it's still too hard for me.

Regarding the centre in Bologna, I know them very well, unfortunately. I had to go down there (it's about 370 km from here) for two different cases, both for my beloved and sweet Lola.
The first time in November 2011 when she had a carcinoma inside her nose. She was successfully treated at that centre. Beyond every forecast she survived the treatment (very heavy) and the cancer.
The second time was last year in in October, when my Lola was diagnosed with an oral squamous cell carcinoma (please, see this thread, if you wish https://www.catchat.org/felineforum/vie ... =13&t=5813 ). This time, though, we weren't as lucky as 5 years earlier. The treatment was much heavier than the previous one, they told me she could have died halfway through the course of the therapy, but she made it!

That clinic, the only one in Italy, is specifically dedicated to cancers treatment, it's an Oncologic Clinic (this is their website, Italian only http://www.centroncologicovet.it/ ). They do perform chemo and, above all, radiation therapy, but not radioactive treatments.

acceleratore-lineare.jpg
This is their linear accelerator for the radiation therapy on pets. They told me it costs over 1 million euro! :shock:

I called them for Pallina, to ask them if they knew someone in Europe where to take Pallina to. I already knew that in Italy there are no clinics at all for the I-131 treatment. It's a matter of laws and rules.
They took their time and called me back and they told me they didn't know anyone, not even for the scintigraphy.

Then I joined this forum and I was redirected to a Yahoo! Group where I found the address of the clinic in Belgium.
The one to Belgium was a journey that I will remember for sure :)

I'm still waiting for any kind of reply from Belgian doctors, I hope they will write me back.

In the last three or four days Pallina hasn't been well. She started eating less and has vomited in a couple of occasions, last time early this morning...
This morning I gave her a shot of Ranitidine, she has already eaten 3/4 of a can so far. Good, I'd say, but less than her usual.
She's taking 1/4 pill of Cypro since Friday, she is hungrier already a few minutes after the pill, but she's not eating what she should.
In about 10 days time she'll have a check-up US scan for her chest, I will ask the vet to scan her belly as well to see if something is going on down there. She has been suffering from IBD, has a liver issue and had a pancreatitis in April. I think she's having a bout or a new flare of IBD.

Thanks so much for your words of support!!!
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Patricia »

Hi Antonio,

I'm sorry to hear Pallina has been sick, I hope she picks up.
My cat Ginger had a skin cancer and had to have her nose pad removed which she recovered from very well - I think I was more traumatised than her!
I had read that cats that go out are more liable to get sick than ones that live in an apartment. I think that is true. I had a Siamese when we lived in a flat and she lived to 22 years old. Since we've lived in a house with a garden we've had three cats (strays) who lived to an average age of 15. ( I will attach a photo of Whiskey and Mini with Ginger.) But it's difficult to keep them indoors, naturally it's more interesting the world outside, but there's the oil from cars parked outside which they like to lay underneath which can affect their kidneys. Whiskey's favourite place was the roof of the garden shed - and the sun can have fatal effects for them.
Thanks for the info regarding Bologna. I will read Lola's story today from your link.
I used to give Ginger tinned tuna in brine when she was off her usual food. I had tried the Hills y/d diet but she wasn't keen. I tried to give her as much variety as possible, I even gave her raw food sometimes; she would happily eat raw mincemeat and chicken breast for a change.
Fingers crossed for Pallina.
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Lilith »

Hi Antonio, sorry to hear Pallina's having a setback :( I'm ashamed of updating Mouse's thread as she's doing ok - BUT she's a year younger and didn't have to wait for the radio-iodine treatment, which must have made a difference. She had her blood/urine tests today; it'll be interesting to compare the results with Pallina's when they come back from the lab.

Hi Patricia and welcome, so sorry to hear about Ginger - that cat went through a lot, poor girl :( My Mouse, who has also been hyperthyroid, is very similar to your Whiskey, lovely pic.

Purrs from Mousey and hope Pallina's feeling better now x
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Antonio »

@Patricia,
I hadn't realized that you live in Tuscany! Shame on me, I'm usually very attentive on other users' locations, not this time.
Would you mind me asking if your'e Italian or you're one of those many British (or Irish, given your cat's name ;) ) who chose Tuscany as their new residence? :)
The picture of your three cats is fantastic? It seems you have no cats at the moment, am I right?

Yes, cats living outdoors have a shorter life expectancy. They are proner to diseases due to the cold, the contagion from other cats, incidents with cars, dogs, other animals, and, like you say, from chemicals. Engine oil and anti-freeze liquids are the main responsible for several cats' death. Then we could count in the action of evil people, those who don't want them crossing their properties and use whatever they have (brooms, sticks, poison, weapons) to get rid of them.
As far as I know Siamese are the most long-lived cats, so no wonder that your indoor Siamese cat lived to 22 years of age. I had read that the average lifespan of a feral cat is 6 years!
Cats with white fur or white areas, especially on ears and nose, are exposed to the sunlight risk, that is skin carcinoma. I have seen white cats with their ears "eaten away" by the cancer, others that had their ears removed to prevent cancer from spreading in their body.
My Lola was a black tortie, and her carcinoma was up inside one of her nostrils. No doubt at all that the sun wasn't to be blamed.

Pallina looked better this morning, she ate with a better appetite.
She had a 1/4 Cypro pill everyday since Friday, and two shots of Ranitidine yesterday and one this morning. It seems they kicked in alright :D
Of course this is not the solution, I hope she feels fine until next week when we'll have a new US scan.

Thanks for your support, Patricia!
Last edited by Antonio on Mon Nov 20, 2017 12:43 pm, edited 1 time in total.
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Antonio »

@Lilith,
don't feel sorry, please. You're entitled to update your post regardless other cats' conditions :D
Glad to read that Mousey is doing fine. I can't wait to read the results from your tests.
I'm still waiting for a possible reply from the Belgium facility... I'm starting thinking that it won't come, though...

Today Pallina was feeling better and was hungrier than in the past days. I don't how much the meds contributed to this condition and what would happen if I suspended them. I'm planning to do a week long course of Ranitidine and some more days of Cypro, I wonder if reducing the Cypro from 1/4 to 1/8 pill could still give her some "push" to her appetite without the side effects of the med (faster breathing rate and yowling ;) )

Kisses to Mouse and Ginger and Whiskey and Mini ;)
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Lilith »

Glad Pallina's better - hope she continues well now, fusses to her and purrs from Mouse x
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Patricia »

Hi to Antonio and Lilith,

I'm pleased Pallina is eating better now. I think you should write again to the clinic in Belgium as your email may have been overlooked as they probably receive a lot of correspondence, it can't do any harm to email them again.
Yes I am English and have been living here since the 80's. It is near Viareggio which is on the coast, we live out of town in the country. I don't have any cats at the moment, to think last year I had three and they all died within a year. Whiskey and Mini died last winter and are buried in the garden, we bought a bush to plant on their grave. Sadly we never found Ginger's body so we couldn't bury her with her two friends. She went out one evening and the next morning she wasn't waiting at the door or in the garden as usual. We looked for her everywhere, in the allotment next door and the fields all around. If it had been winter she would have been sleeping indoors, so it wouldn't have happened.

Best wishes to Pallina and Mousey :)
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Antonio »

Patricia wrote: I'm pleased Pallina is eating better now. I think you should write again to the clinic in Belgium as your email may have been overlooked as they probably receive a lot of correspondence, it can't do any harm to email them again.
Patricia,
I had sent an email to the clinic in Belgium in mid-September to update them about the first post-treatment blood check. Got no reply.
Then I sent them an email with the second blood test about ten days ago. I got a notification that on the same day they had read both my emails. So the first one had been overlooked and was read along with the second one. So, I know they have read them now.
Either they don't think it is necessary to reply (even if I have asked them to reply about the T4 and fT4 low levels) or they still have to do it.
I will wait another week, then I will retry.

I'm sorry to ead about your cats, such a terrible and sad story :(
I'm sure that Ginger didn't die. Probably she was taken by someone or she found another home. Sometimes it happens. I think she is still fine on the sofa in somebody else's home ;)
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Lilith »

Hi Patricia, so sorry you're catless at the moment; didn't realise :(

However, cats KNOW ... you may have a visitor before long ... :D Happened to me; that's how I ended up with my present lot. Mouse sends big purrs and a toothy kiss to you by the way x

Antonio, that's shocking - your vet needs that info too. I do hope you get somewhere soon. Mouse sends purrs to Pallina x
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Antonio »

Lilith wrote: Antonio, that's shocking - your vet needs that info too. I do hope you get somewhere soon. Mouse sends purrs to Pallina x
Lilith, I think I haven't got your point... What would be shocking? :?:

Pallina is doing much better in the last days.
Anyway we have an ultrasound scan booked on November 30th. I'll ask the vet to check her abdomen as well. Then I will ask them for a complete blood work complete with bilirubine levels. Depending on the outcomes of the abdomen scan, I could also request a new pancreatitis test.

On the following day, December 1st, Pallina will be visited by a new IM vet at a different practice.
I have asked my vets if a second opinion would be reasonable and they gave me two names of very good IM vet. I chose the closest to home.
This vet will be involved in the investigation on the causes of the chest fluid.
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Lilith »

Hi, I meant that it's shocking they haven't replied to your request for info - surely they should have done by now.

Glad Pallina's doing ok - please give her my love :)
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Antonio »

Lilith wrote:Hi, I meant that it's shocking they haven't replied to your request for info - surely they should have done by now.
I remember that their replies were slow even when I was planning the trip to Belgium.
This time they're slower than the usual.
I will give them one more week, then I will write them again.
Glad Pallina's doing ok - please give her my love :)
Done! :D
Thanks, likewise to Mousey ;)
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Re: Pallina, hyperthyroid cat. Seeking advice

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Thanks - Mousey sends purrs :D
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Patricia »

Hi Antonio and Lilith,

Thank you for your kind words.

I look forward to hearing Mouse's results and also the scan results for Palina today - and good luck Antonio with the vet's visit tomorrow. I wish them well. :)
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Antonio »

Hi everybody! :D

This morning I took Pallina to the vets for her chest scan. I chose to fast her because I wanted to ask more tests during the booked visit.

At the chest scan the vet found more fluid in Pallina's chest, he drained 70 ml of fluid, which was discarded, he kept just a sample to be given to the IM vet tomorrow for a protein test (can't remember the name of this test). The vet didn't drain all the fluid, so there was about 80 ml in all.
Nothing wrong appeared in Pallina's chest, her heart is fine both for size and for functions, her sternal lymph node, that was slightly visible and reactive until a few weeks ago, seems to be returned to its normal size and shape. Nevertheless the fluids keep building up. We still don't know what the cause is.

I asked the vet a scan of Pallina's abdomen as well, since she had some episode of belly ache and poor appetite in the last days. The vet found that everything is rather fine down there too. The gall-bladder and the bile duct are fine and clear, so we don't know why her GGT had increased that much on the last blood works. Her spleen is slightly larger than normal, but not worrying. He found signs of IBD in the lower GI tract (as we already knew) and a slightly hyper-echoic liver (we'd seen it before). He did a needle aspiration from the liver and sent that for a cytology. We did the same thing a year ago, without any significative outcome.
He also saw a small amount of fluid building up in the abdomen too, but it was too small to sample it.
Since Pallina's albumines are fine, they can't assess the reason for this fluid.

He also noticed that Pallina's kidneys are a bit smaller each time he scans them, especially the right one.

I asked them to draw some blood and I asked them for a kidney test and a complete liver panel.
Most of the blood works should come in about 5 hours time, the bilirubine test will take some more days because they will send the sample to an external and more reliable lab.

I have paid for the visits, tests and scans of today. I also had something left behind, like the PARR test done three weeks ago. For those who can be interested, the PARR test costs, over here, 150 euro, and it's the most expensive item in the today's vet bill.

Tomorrow I could have more answers to what is going on in Pallina's chest.
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Re: Pallina, hyperthyroid cat. Seeking advice

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I do hope the tests show some reason for this, so at least you have answers. Hopefully the kidney size will just be age related (I assume he mentioned that one is smaller than the other anyway?)
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Re: Pallina, hyperthyroid cat. Seeking advice

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booktigger wrote:I do hope the tests show some reason for this, so at least you have answers. Hopefully the kidney size will just be age related (I assume he mentioned that one is smaller than the other anyway?)
The vet didn't mention anything about her age, but yes, one kidney is smaller than the other one.
Namely, the right one is 2.85 cm, the left one is 3.14 cm.
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Patricia »

Well Antonio, there doesn't seem to be anything particularly negative that has come out from the tests, nothing to worry about. I assume you haven't heard from Belgium otherwise you would have mentioned it. When they have analysed the fluid from Pallina chest maybe you will have a clearer picture but she sounds ok in herself and I assume her throat is better now.
I'm sure you would have paid a lot of more for these tests in UK, although pet owners often have insurance there, it is still expensive to pay the premiums. I hope you have some good news today from the other vet.

A stroke to Pallina :P
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Antonio »

Yesterday I received the reports for the blood test and the needle aspiration of Pallina.
The CBC report is perfectly fine.
The chemistry shows high liver and kidneys levels (I'm also writing the levels at the visit on Nov 9)
ALT 312 (was 336) [10-60]
ALP 272 (was 239) [10-150]
GGT 4 (was 34) [0-10]
BUN 42.7 (was 41) [10-30]
Crea 2.2 (was 2.0) [0.5-2.0]

The citology for the needle aspiration says:
Tissue sample with traces of blood, good cellularity and cells preservation. Some hepatocyte aggregates are visible. Most of them contain good amounts of small cytoplasmic vacuoles, optically empty (possible lipidic material), normal looking nucleuses. Some lymphocytes are adjacent to the aggregates.
Cytologic framework consistent with a suspected hepatic lipidosis at its early stage.


I wonder why Pallina should have a HL, she has no visible symptoms of that.

This morning I should have taken Pallina to the IM specialist. He could have explained me some hidden aspect. I have just received a phone call from his assistant to let me know that he's sick and can't be at the practice today... I've been waiting for this day for 8 days. I have no words... :twisted:

I had also to hand the IM vet a sample of the Pallina's chest fluid... It's stored in my fridge, will it still be good in a week time?
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Re: Pallina, hyperthyroid cat. Seeking advice

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Antonio wrote:Yesterday I received the reports for the blood test and the needle aspiration of Pallina.
The CBC report is perfectly fine.
The chemistry shows high liver and kidneys levels (I'm also writing the levels at the visit on Nov 9)
ALT 312 (was 336) [10-60]
ALP 272 (was 239) [10-150]
GGT 4 (was 34) [0-10]
BUN 42.7 (was 41) [10-30]
Crea 2.2 (was 2.0) [0.5-2.0]

The citology for the needle aspiration says:
Tissue sample with traces of blood, good cellularity and cells preservation. Some hepatocyte aggregates are visible. Most of them contain good amounts of small cytoplasmic vacuoles, optically empty (possible lipidic material), normal looking nucleuses. Some lymphocytes are adjacent to the aggregates.
Cytologic framework consistent with a suspected hepatic lipidosis at its early stage.


I wonder why Pallina should have a HL, she has no visible symptoms of that.

This morning I should have taken Pallina to the IM specialist. He could have explained me some hidden aspect. I have just received a phone call from his assistant to let me know that he's sick and can't be at the practice today... I've been waiting for this day for 8 days. I have no words... :twisted:

I had also to hand the IM vet a sample of the Pallina's chest fluid... It's stored in my fridge, will it still be good in a week time?
HL would cause the increased liver values, but it's not common at all. Her increased kidney values would explain the decrease in kidney size, it is unfortunately common when hyper-t is treated.
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