Pallina, hyperthyroid cat. Seeking advice

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Antonio
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Antonio »

Lilith wrote:Hey Antonio, good luck. I'm not an expert but it seems to me that white cell levels do fluctuate in both cats and humans which is probably why they plan to repeat the test - hope she stabilises. Mousey sends loving purrs x
Lilith,
The lymphocytes that they have found were in the fluid taken from Pallina's chest, so first of all they would like to assess why some fluid builds up in her chest, and then why this fluid has lymphocytes.
Thanks for the loving purrs :D
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Antonio »

Hi everybody,
Some updates about Pallina.
She's doing rather fine, she's eating her usual 2 cans each day, though yesterday she only ate one. There are days when she has less appetite than her average, but I'm used to that now and do not worry about it unless she's not eating her usual for more than two days in a row.
She loves basking in the sun on the pavement around the house.
I have noticed that she eats more after she has been out for some minutes. The backyard is catproof now, I can leave her alone for a long time without worrying about her escaping. It took me some weeks to find all holes and faults in the previous fence around the yard, but now it seems rather safe.

I'm taking care of a feral cat too in the front section of the yard. Yesterday Pallina got to reach her bowl and ate some of her wet food, just a wee bite because I saw her going there. This morning I found that tiny amount of food vomited on the kitchen floor.
What is amazing is that last night she ate more of her own wet food. She managed to vomit only the little bite she stole from the outside cat's bowl. I wonder how she was able to discriminate it :shock:

Still no thyroid report... They told me that it could have been sent to me as late as Monday, today. I hope they are right!
This story of the thyroid reports is tiring me. Everytime I have to wait for them for a week or more.

At the end of September we'll have another chest ultrasound done to investigate on Pallina's heart and to check whether the fluid is still building up in her chest.
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Lilith »

Hey that's good news :D

That's extraordinary - 'oh, that wasn't my bowl Oh dear ...!' (Barf) 'Right, THAT'S my bowl!) Cats eh? :lol:

Mouse is up and down with eating/vomiting too sometimes, but as well as recovering from the HT these are elderly cats; they can have off-days I reckon. But Pallina really sounds to be doing well and I hope they stabilise this chest cavity situation - all paws and tails crossed here and lots of purrs and hugs! x
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Antonio »

I would like to show you my Pallina a week after the treatment in Belgium :D
This photo was taken with my smartphone on August 17th.
Pallina 08_17.jpg
Here she's in the backyard, her favourite place, under a shrub, one of her favourite spots, especially during this hot summer (well, now it's feeling more like October...).
The net in the background was newly laid to prevent her escapes while not supervised.
The shavings on her front legs from the blood tests and injections during the stay in Belgium are well visible. They're still there even after a month.

She hasn't changed much from the photo in the first page of this thread ;)
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Mayday21 »

Hi Antonio she's a cutie & love her tail markings. Fusses to Pallina. Vivian
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Lilith »

Aww bless her - she looks well though I remember you mentioning the slightly raised coat ... not surprising, but she does look feisty and fit nevertheless :D

It takes AGES for shaved patches to grow back :( ... legwarmers?

Mousey sends love and purrs as always - she's got a bald throat, I will have to knit her a little scarf ... :)
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by vanilla »

If I hadn't known what Pallina has been through, I'd say she looking very healthy!
Scritches under her chin from me! xxx
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Antonio »

Lilith wrote:Aww bless her - she looks well though I remember you mentioning the slightly raised coat ... not surprising, but she does look feisty and fit nevertheless :D

It takes AGES for shaved patches to grow back :( ... legwarmers?

Mousey sends love and purrs as always - she's got a bald throat, I will have to knit her a little scarf ... :)
Thanks Mousey :D
Her coat was only slightly stringy and unkept. Hyper-T cats usually have a bad coat, but I think that due to her apathetic, hence unusual, hyperthyroidism with different symptoms than usual hyper-T cats, even her coat wasn't that bad.
Thyroid also regulates fur/hair growth, so probably it will take a longer time for it to grow back. Furthermore elder cats grow fur slower.

Meanwhile I had the thyroid report from the lab, I received it on Wednesday.
The fT4 level is now 10 (range 5-20 pml/l), was 30.7 one week before our trip to Belgium.
The T4 level is now 12.9 (19-65 nml/l), was 124. This is lower than the minimum, I wonder if this undershoot was expected. I have sent the report to the vets in Belgium, waiting for their reply.

In these days our morning temperatures have dropped a lot. We had around 18-20 °C until a few days ago, Pallina loved to have a short walk in the backyard before I went to work. Now, with 10-12 °C she prefers staying inside and have a walk in the afternoon :D
I am taking it as a sign a working thyroid. A hyperthyroid makes subjects feel warmer than normo-thyroid subjects. Pallina was always lying on fresh spots until a few weeks ago. Now it seems she's feeling colder.
Last edited by Antonio on Fri Sep 22, 2017 8:56 am, edited 2 times in total.
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Antonio »

vanilla wrote:If I hadn't known what Pallina has been through, I'd say she looking very healthy!
Scritches under her chin from me! xxx
Thanks Vanilla! :D
As a matter of fact she never looked sick, apart from very few occasions when she had some stomach issues.
She never wasted too much, she hadn't a bad coat. And she has always looked younger than her age :)
She still jumps high and is active.
All the vets who met her in the last two years couldn't believe she was 15 or 16 :)
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by booktigger »

Glad you got her results back, will be interesting what they say about her being under the minimum
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Lilith »

Hi Antonio, sorry I didn't mean any criticism about her coat by the way; it was just that I thought you said it was a bit raised after her treatment (and not surprisingly after all that went on, and the travelling in the heat too.) I don't think it looks unkempt, and she still looks nice and chunky - as you saw from her pic while at the clinic, my Mousey is a skinny object lol, typical HT cat though hope that's changing now.

We're still waiting for Mouse's results. I wonder if Pallina's will stabilise with time? The treatment is pretty drastic after all and she hasn't been a typical HT case ... I wonder if it would be worth asking the clinic in Ghent for more info about lower thyroid levels. Someone must know, somewhere.

She seems to be getting on very well in any case - I wish Mouse would be more adventurous. She went downstairs this morning (BIG adventure) and ate 2 breakfasts lol. (There are little dishes all over the house, so nobody goes short; the gingers are getting very spoilt too.)

It hasn't been particularly hot here this summer, but that is one of the first things that alerted me to Mouse's HT; I would notice her lying in a cool dark place such as on the landing; she still prefers her horribly Spartan cardboard box in the back bedroom and I'm hoping she too will want a warmer bed soon.

All the best and purrs from Mousey and me :)
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Antonio »

Lilith, I'm sorry that you feel sorry for something that never happened. Don't worry, Lilith, I'm perfectly fine! :D
I wasn't offended at your words, I was just saying what the situation of Pallina's coat looked like :D
God, this is what I love about English speaking people, the extreme kindness and sense of respect for others! Why can't we Italians be like you? :oops:

I sent an email with all the blood reports of the last week to the doctors in Ghent. I'm waiting for a reply that could come in a few days. I think they receive thousands email a week!

Pallina is getting more and more voracious. She is still eating two 85 grams cans a day, but rather than nibbling at her food a bit at the time as she used to da in the last year or so, she eats most of the content in a single or two trips to the bowl. So this is a change and I hope this was expected too.

Lots of kisses to the brave Mousey ;)
Come on, Mouse, come out of your room, the world is waiting for you ;)
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Antonio »

booktigger wrote:Glad you got her results back, will be interesting what they say about her being under the minimum
Yes, booktigger, I am very interested in reading from them about this low level. I might think it's something like a rebound, it has gone low to raise a little later :?:
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Lilith »

Ah Antonio, thanks - I was just worried that I'd been a bit tactless ... :oops:

Hey that's great the way she's eating and hope Ghent can give you some info. Bless her, lots of love to her :)

Mousey, today, took a giant step for Mouse-kind ...

She nicked Emily's igloo in the front room! :o :lol:
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Antonio »

Today Pallina had a new scan for her chest.
She was found with some fluid in her chest at the visit in Ghent, they asked me to repeat the scan a month later, so we did it on Sept 11th and the vet drew about 55 ml of fluid from her chest.
Today the vet (a different one) did the scan. He said that her heart is fine, isn't enlarged or else. There's a hint of a murmur but not to the extent of being worrying, it's so faint and almost invisible.
But her chest was full of fluid again. They drew about 105 ml of fluid this time, it's a lot of fluid, and it was pressing on her lungs.
According to the vet this amount of fluid should have made her breathing difficult, but I didn't notice any difficulty neither did the vet both with his eyes and with the instruments. So this is strange.
The fluid was orange/pinkish and murky, cloudy, as the other time.

This ruled out that the fluid originates from a heart disease or failure. Her heart is fine and perfect. In the case of a heart failure the fluid would have been clearer, nearly transparent.

The vet also measured the specific weight of the fluid, 1.025. This ruled out the FIP that would have given a heavier fluid.

So this would leave us with a probable diagnosis of lymphoma, but the vet didn't see any enlarged lymph node. He only saw a slightly larger lymph node in the mediastinum of Pallina's chest, but the vet says that its small size does not justify the fluid in her chest. So they can't determine what's going on!
A sample of this fluid was saved for testing. I had to take it to the lab myself to make sure I can have the report tomorrow around 8 pm.

The vet told me not to worry. The last time a vet told me not to worry I began a long nightmare with an oral squamous cell carcinoma for Lola! :cry:

Pallina is still doing fine, I see no bad signs or strange behaviour. She eats two 85g can of wet food a day, she drinks regularly, uses her litter normally and she's lively and active.
I weighed her before going to the vet, she was 3.170 kg, but when I weighed upon returning home she was 3.070 kg (due to the fluid drawn from her chest), so she's gained 200 grams in 16 days. This sounds good.

I hope to have a proper answer to this issue!
The vet told me "do not wrap your head in bandages before you break it", a typical saying in this part of the world, meaning "do not worry for something that hasn't happened yet".

I look forward to having the report tomorrow.
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Lilith »

All that fluid in that little chest ... :o

I bet she feels better without that; hope you get more info from the report. It IS encouraging that she's well and lively and eating well but you do want to know why the fluid's there.

All the very very best and Mouse sends purrs and good wishes too :)
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Antonio »

Lilith wrote:All that fluid in that little chest ... :o

I bet she feels better without that; hope you get more info from the report. It IS encouraging that she's well and lively and eating well but you do want to know why the fluid's there.

All the very very best and Mouse sends purrs and good wishes too :)
I don't know if she's feeling better now, because she wasn't feeling bad before that.
She sleeps fine, eats avidly, drinks always the same amount of water daily, uses the litter regularly, makes her usual chores and is lively and alert.
I've never noticed a different breathing pattern or rate (believe me, I have always kept my eyes on her every single minute of her life!), so I don't know whether all that fluid was bothering her, though I'm inclined to think that it was kind of a bother.
I haven't seen any change in her behaviour after the fluid was removed.

Pallina has suffered (someone says it never goes away) from IBD.
I have read that it can turn to lymphoma. My question is, would an intestinal or gastric lymphoma give fluids in the chest?
An ultrasound scan was done to her abdomen on Sept 12, all was clear and fine, so the idea of a lymphoma in the lower part of the body has no basis.

Any idea?
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by booktigger »

How puzzling - will be interesting to see what an analysis shows. At least it isn't affecting her, which is the main thing.
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Re: Pallina, hyperthyroid cat. Seeking advice

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Pallina is still fine but I'm not at ease, I'm really worried.
The report for the fluid came with a number of lymphocytes in it, just like the other one. But no diagnosis has been issued. They would have liked to do more tests, like another scan or an x-ray, but I have decided that I'm in charge of the case now and I decide what is to be done and what is not.

I called another clinic and tomorrow morning we'll be there for a CT scan. The ultrasound scans revealed a small reactive lymph node behind her sternum, and nothing else. But I fear that something is being missed.
During the CT scan, if they see something, they will try to get a needle aspiration. They also told me about a different test on that fluid, the name of this test I forgot. These could be the only ways to give a name to whatever she has. In 24h time we'll be there.

I'm terrified, tbh... :(
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Re: Pallina, hyperthyroid cat. Seeking advice

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Fingers crossed the CT scan gives you some answers
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Antonio »

Pallina 2017_09.jpg
She looks fine, doesn't she? ;)
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Lilith »

She does - like a kitten, bless her, and very fit.

I can only imagine how you must be feeling - I have a 19th nervous breakdown about Mouse when there's nothing wrong at all! I'm using the psyllium for her by the way, will update re that in a while.

Someone I know who had to have a (benign) lymph lump removed was told that a biopsy was the only sure way of diagnosis, so looks like you're doing the right thing.

All the very best and all tails and paws crossed here for a hopeful result! Fusses to her and Mousey sends purrs x
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Mayday21 »

Hi Antonio hope things go well ... fusses to Pallina. She looks happy. Will monitor your posts. The famous four from Oz also send fusses & purrs to Pallina & Mousey. Vivian
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Antonio »

We are at the clinic for the CT scan... They have already done an x-ray and saw a mass in her chest, behind her sternum. It seems that the mass is bigger than it was seen in the ultrasound a week ago. The CT scan is being done right now.
I'm desperate.
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Lilith »

Aww Antonio, thinking of you and I think i can safely say so is everyone else reading this. Big hugs and to Pallina too, we are all with you in spirit x
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by vanilla »

Antonio wrote:Pallina 2017_09.jpg

She looks fine, doesn't she? ;)
She looks gorgeous! Such a pretty little girl. Sending Pallina lots of positive vibes. xx
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Re: Pallina, hyperthyroid cat. Seeking advice

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The visit and the tests lasted more than in the past. Usually I was out at noon, this time they let me go at 2:30 pm!

The vet who runs the CT scans listened to the story of Pallina, from the hyper-T diagnosis, to the therapies and to the I-131 treatment, and was astonished to hear that someone, the first she had ever known of, had gone along that path.
She read all the reports I had with me, then Pallina was taken to the X-ray room. I was her assistant in the process, they gave me a lead robe to protect me from the radiations and helped her hold Pallina on the table.
The image showed a large mass behind her sternum and according to the vet that was an enlarged lymph node. It was many times bigger than the one shown in the ultrasound scan of the past week. In her opinion it had grown quick and that was really bad.

Then they gave Pallina the anesthetic and the CT scan began, I couldn't be there and had to wait in the waiting room.
An hour later the vet came back to me and asked me to follow her to the scan room where she showed me the mass in the chest on the computer screen. It wasn't a lymph node, it was a large amount of fluid that she had drained a few minutes before, 120 ml this time, much more than the amount the other vet drained last week.
This fluid is building up faster and faster!!!

From the scan the only thing that she found was the same lymph node that was detected with the US scan, same size, same position. No other nodes are visible anywhere from the nose tip to the tail.

She made a needle aspiration from that node and we're waiting for the result. She also prepared a sample of that fluid for a special test with a difficult name. They don't do that test in house, so while we were waiting for Pallina to wake up, she sent me to the Veterinary University where they can do this test. The university is about 20 minutes from the clinic.
The doctor at the university was waiting for me, took the sample and told me that tonight or tomorrow morning we should have the report.
This report, along with the needle aspiration, should give us the name of what Pallina has, because the CT scan wasn't enough to understand her problem. So far they don't think it's a lymphoma, but don't know what it is.

She prescribed me a diuretic to allow Pallina to get rid of those fluids, the name of the med is Dimazon, tablets.
When we got back home she started breathing strangely, like a rasping breath from her throat. But it wasn't constant, in some moments I could hear it, in other moments I couldn't.
I suppose it is something to do with the vent tube they put into her mouth/throat during the scan.
If when I go back home she's still rasping then I'll take her to her usual clinic.

That's all.
What a day! :!:
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Lilith »

You're not kidding! VERY thorough though, and all paws crossed here for good news tomorrow!

Yes, the tube they put down their throat can cause a sore throat; hopefully that will heal soon.

All the very very best!
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Re: Pallina, hyperthyroid cat. Seeking advice

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Poor you and Pallina, I do hope you can get to the bottom of this fluid, and it is something easily dealt with
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Re: Pallina, hyperthyroid cat. Seeking advice

Post by Mayday21 »

Hi Antonio it looks like you & Pallina are being very well looked after. Sending +Ve vibes for her & breathing settled. Vivian
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