Pallina, hyperthyroid cat. Seeking advice

[booktigger]

I doubt they would do the treatment if her kidney values are out. We normally get thyroid tests within a couple of days (most vets do standard tests in-house but not all do thyroid). I've had many cats with high liver values with no cause, but the liver can regenerate itself

[Antonio]

So I should start a treatment to restore partly or totally her kidneys function?
I will talk to the vet.
Thanks!

[booktigger]

You could ask about an ACE inhibitor, but kidney issues aren't curable, so they likely won't want to cure her hyper-t, as it will make her kidneys worse - I know my vet won't do much for hyper-t with kidney issues, as it's preferable to live with hyper-t than wipe out kidney function completely. Diet can help a lot, but I don't know what options you have over there for prescription foods.

[Antonio]

Booktigger, why will a treated hyper-t cause more damages to the kidneys?
Today I called the vets and they told me that the high values for her kidney are most likely caused by a slight dehydration due to her almost continue vomiting and/or the lack of appetite and weight loss.
The advised me about the sub-q's, 50 ml twice a week, but discouraged me about the ACE inhibitor because what it may look like a CKD from the kidney levels isn't supported by the ultrasound scan which showed healthy kidneys.

My sweet cat Lola, which is now at the Bridge, suffered from kidney disease for 11 years and I gave her fluids two or three times a day, sometimes even daily. She also had the Fortekor and would eat renal food. We managed to control the CKD perfectly, she was borderline for all her time.

Pallina can't eat renal food because it's made from proteins that she must avoid.

[booktigger]

Hyper-t helps kidney function because of the increased blood flow. Dehydration only causes increased Urea, it doesn't affect the creatinine, and those values are only slightly raised, so the kidneys would still show as healthy on an ultrasound - Lucy has early stage failure, she's had an ultrasound to make sure the values were CKD rather than anything more sinister (I was paranoid, partly because of Buster and partly because of her age)

[Antonio]

Thanks Booktigger!

@Everybody,
I have had some very good tips from a member of the Yahoo Group for Hyper-T cats, I will probably get in touch soon with the university in Ghent, Belgium, to have Pallina treated.
I will be on holiday in a week time, Pallina will be looked after by two very experienced cat-sitters. They are two lovely girls who know Pallina well, they are students in veterinary medicine, third year of course. I am completely at ease with them.
Pallina has been recently microchipped (uncommon for a cat in Italy) and vaccinated for rabies. I will be able to apply for the EU passport from June 6, though I won't be home by then, so I'm not able to move abroad yet.
Meanwhile I will keep in touch with Ghent and see what tests, blood works or scans they need.
Thanks everybody

[booktigger]

Good luck

[Antonio]

Hi everybody,
I've got an answer from the university in Ghent, Belgium. We have an appointment in early August. I skipped the first offer which was one month earlier.
I will have plenty of time to get all the tests done, get the passport and above all to have Pallina restored to a better condition and with some weight more. We started a therapy to improve her liver levels and a course of sub-q's in the attempt to lower her creatinine a bit.
I'm going to see the light at the end of this tunnel

[booktigger]

Good luck

[Lilith]

Yes, good luck from me and my lot and hope this will be the turning point for Pallina - beautiful girl, many fusses to her

[Janey]

Best of luck for Pallina.

[vanilla]

Wonderful news Antonio!

[Antonio]

Thanks everybody!

Yesterday and today, though, are not so good days for her... she's been eating slowly and low quantity... It's been a week since her last bad day. I think I have to get used to it.

[booktigger]

Sadly, most health issues cause ups and downs.

[Antonio]

The Yahoo group for hyper-T cats that I have joined gives much info on this issue.
In some posts I have read that with certain health condition, like kidneys values a bit higher than the range and with fT4 and T4 out of control like in my case, the I-131 treatment could risky and some facilities might refuse the treatment and ask the cat's owner to continue with the classic methimazole therapy.
As from today we changed the dose of methimazole and hopefully in three or four weeks time we could have a better situation. I have also begun a long course of sub-q's, 50 ml twice a week, to help her with her kidneys.
Hopefully she'll be better before the end of July.
I did the right thing when I picked the second available date for the appointment, August 7 and not July 3. I will have more time to try and fix things!

[Kay]

it can be a slow and patient process trying to get the medication right, but there's a good chance you will manage it, and then the I131 will become an option rather than a necessity, and you can take your time to decide which way to go

[Antonio]

I have the chance to "catch the train" as we use to say here, I wouldn't like to miss it.
I think that the better Pallina is, the easier it will be with the I-131 treatment, so if she gets better in July the I-131 won't be an option, it will be the only thing to do.
Tonight Pallina has a good appetite!

[Antonio]

Hi everybody,
I think it's time to give you an update about Pallina, my hyperthyroid cat.
I have been away on holiday three weeks, from June 1st to 23rd. During these three weeks Pallina was home with two lovely girls who would take of her twice a day. I received updates on Pallina, she was fine and was eating alright, two cans of wet food per day.
Since we have come back home Pallina has started eating less, now we are on one and a half can a day. Yesterday she ate one can only, today it seems just the same...
It might seem as our presence puts her off food, probably she gets distracted by more important things like the cuddles or asking to be allowed outside. I guess that she was so bored during our absence that she spent her time at the food bowl.
All the rest seems alright, she's rather active and alert. She looks for cuddles and company. Her weight is the same.

She is still vomiting occasionally, but it's hairballs only in the last few weeks, and the two girls told me the same thing. When I take her outside in the garden she's tempted by the grass and she would eat lots of it if I weren't there to stop her. So at the moment I can't figure it out if she has some hairballs to expel or she has some stomach troubles.

On June 27 we had a blood test. The previous one was on May 15. Her thyroid levels have slightly improved. Her liver levels have highly improved though they are still above the range. The supplement I am giving her is working fine.
No news on the kidney department, the creatinine is still at 2.3.
GPT 292 [23-109] (was 427)
ALP 152 [0-120] (was 218)
GGT 7 [<3] (was 8)
Creatinine 2.3 [0.5-1.8]
BUN 65 [30-65] (was 68)
Cholesterol 285 [65-250] (was 263)

We have applied for the European Passport, we should get it tomorrow morning.
In May Pallina was vaccinated for rabies and had a microchip injected. In Italy the microchip is not usual in cats, it'c compulsory for dogs, though.

We are also waiting for August 7, when Pallina will be treated with I-131 in Belgium (1100 km, 683 miles, from home).
My new concern is the trip to Ghent. How will it impact on Pallina? Lately she gets easily stressed by the short trips to the vets, I can't imagine how she will be upset after hours of driving. I'm thinking about splitting the trip in two, five or six hours per day, but this means we will have to stop halfway in a hotel and I know Pallina too well, she won't eat or drink or sleep for the whole time.
The second concern is about the post treatment... the guidelines are that we will be allowed to play with or touch the cat for very short moments and then wash our hands right afterwards, not to allow her on beds or couches for the first two weeks. Pallina seeks constant contact with us, how will we manage this?

[booktigger]

Glad her liver values are better. I can't advise on the journey or post treatment unfortunately.

[Kay]

How long will she be isolated before you can bring her home?

My Trigger was allowed home after 14 days, and the only rule was that used litter must be stored for a month before disposal - there were no rules about close contact with him

Had I been of child-bearing age I think there would have been rules about no contact though

[Antonio]

Kay, Pallina will be held at the clinic for five days.
She'll be admitted on Monday morning, she'll be visited by two different vets (one of them is an IM doctor) and have a scintigraphy done. Then they will give her the I-131 injection which will be calibrated on the outcome of the scintigraphy. From that moment till Friday afternoon I won't be allowed to visit Pallina.
We'll be back home on Saturday.

The litter of the first two or three weeks has to be stored for three months before disposal. Contact with saliva, urine and feces must be avoided as much as possible. I will have to use disposable gloves to clean the litter box. Then there's the thing of the limited contact with the cat which will be the hardest thing...

[Kay]

we have a short stay centre in the UK now, Antonio

here is a link - they have a lot of info for owners so some of it may be helpful http://www.hyperthyroidcatcentre.co.uk/cat-owners/

[Antonio]

Kay, this is interesting.
My first choice would have been UK, but I was advised to go to Ghent because of their new protocol and short stay.
In hindsight this is the best option for me because I will drive to Ghent. I would have taken a plane to go to UK and I've been told that I could have had troubles on the way back home with a radioactive cat on a flight.
On the hyper-T cats group in Yahoo I have read of people who disregard the post treatment guidelines because they are too restrictive and can be stressful for the cat in the first place.
Any opinion on this? How advisable is it to ignore them?

EDIT: I have also seen their fees. They're more than twice the fee I will be charged for in Belgium!

[Kay]

if it were me, I would obey the rules regarding cat litter and contact with other people, but ignore most of the ones regarding my own contact with her

access to outdoors wasn't a problem for me, as I have an enclosed area for the cats, but from the cat's point of view that would be the most difficult rule if free access was the norm - but then again after treatment it is best to keep a close eye on the cat as much as possible

it's a very successful treatment, and Pallina will probably sail through the experience - she will probably find the journey the worst part - I took Trigger to a centre a three hour drive away, and on the way back he peed on the rug he was lying on, which had then to be thrown away, so I recommend taking bin bags with you in case you need to secure anything she has contaminated

[Mayday21]

Hi Antonio great news about Pallina & treatment. I ledft Elsa @ the clinic for 3 weeks - the 1st week was when she was being treated & in isolation, and as she would have to be isolated at home from Mayday & me with litter disposed re Hazchem protocol was not viable for me. For 2 weeks I visited her everyday but only for 10mins & they gave me a stop clock. Kay's idea about bin bags is excellent. Cats generally don't like travelling - the nun's choir I call it but talking to her & as it's a long trip (for you not necessarily for us here ) she'll settle. Are you able to give her meds to sedate her before you head off. Keep us posted & fusses to Pallina. Vivian

[Antonio]

if it were me, I would obey the rules regarding cat litter and contact with other people, but ignore most of the ones regarding my own contact with her

access to outdoors wasn't a problem for me, as I have an enclosed area for the cats, but from the cat's point of view that would be the most difficult rule if free access was the norm - but then again after treatment it is best to keep a close eye on the cat as much as possible

it's a very successful treatment, and Pallina will probably sail through the experience - she will probably find the journey the worst part - I took Trigger to a centre a three hour drive away, and on the way back he peed on the rug he was lying on, which had then to be thrown away, so I recommend taking bin bags with you in case you need to secure anything she has contaminated

So you say that I should take care that others don't touch Pallina but I could ignore that rule?
I haven't understood the rule about not allowing them outdoors. Would a treated cat be more vulnerable in an open space, or is it just not to contaminate other spaces?
Is a plastic bag enough to make the environment safe from pee and else? Or should I use a (metal) bin as well in the car?

As I said, I will drive to Belgium. The vets at the Ghent University told me that a flight could be too stressful for a cat, furthermore a possible scan of the cat on the way back at the airport could reveal the radioactivity and we could be denied the boarding.
I have no car at the moment, a crazy old man drove into my car a few weeks ago, my car is damaged beyond repair. I will have to rent a car to drive up to Ghent. How will this treatment impact on a rental car?

Cats generally don't like travelling - the nun's choir I call it but talking to her & as it's a long trip (for you not necessarily for us here ) she'll settle. Are you able to give her meds to sedate her before you head off. Keep us posted & fusses to Pallina. Vivian

I have asked both my vets and the doctors at the Ghent University and they weren't able to advice me on this, so I don't know what to do.

[Kay]

the people at Ghent will be able to advise you when the time comes

have you tried Feliway spray on Pallina? I see the UK vets use it, and I found it made a big difference to my Trigger, who always panicked and messed in his carrier until I started giving it a good Feliway spray before he went in to it - he did his 3 hour trip for his treatment without making a sound, and without any accidents

[Antonio]

Yes, I spent a fortune on Feliway.
First as a tranquilizer for her carrier (both hers and my Rainbow Bridge cat's) for her trips t othe vet. I had bought the spray version, it didn't change anything...
Then in the plug-in version to try and relieve the stress when the vet told me that she was licking her belly to bare skin because of stress. I purchased three diffusers to plug in different spots of the house, then three bottles every 4 weeks for 6 months, to no avail...

I also fostered three kittens several months ago, one of them was a real little devil, she was scared, so I used the Feliway spray for about two months in the bathroom where they were confined. Nothing...!

However I will have a further try this time. And of course I could need it in the hotel rooms where we will stay during the journey

[Lilith]

Hey Antonio, all the very very best!

Just one thing occurs to me and that is about the rule that used litter has to be stored for a month ... ewww!

If humans can use the loo as normal after this treatment (which I understand they can) wouldn't it be possible to use a flushable cat litter (if Pallina doesn't mind) and then you'd only have to store used gloves, cleanup materials etc.

I use a litter upstairs called 'World's Best' and this IS flushable; have had no problems with it. I'd use it downstairs too but my youngest cat Molly uses the downstairs tray and insists on fuller's earth litter.

The thought of, on top of this expedition (no other word for it) with the amount of planning, expense, stress, time, worry, having to store a ... well, s*itload of litter ... the mind boggles!

Again all the very very best and hope the treatment works for Pallina

[Kay]

Flushable litter is indeed what the Hyperthyroid Centre in Yorkshire recommends, Lilith

I wonder if any serious research is going on to discover what is causing this increase in feline HT though? The fact that the UK now has a specialist centre shows how prevalent it is becoming