Pallina, hyperthyroid cat. Seeking advice

[Lilith]

Ah that's interesting, Kay, and especially about the HT centre being in Yorks, as I'm on the point of organising a vet visit for Mouse, who I suspect is showing early symptoms of HT. I'm hoping this can be controlled with meds if so, as she's 15 and a very reclusive cat. I don't think she'd thrive in a centre but amazing that there's one so close to me.

If she is HT, then she's the first cat I've ever encountered with this disease, after over 60 years of living with cats.

[Kay]

http://www.hyperthyroidcatcentre.co.uk/

[Lilith]

Thanks

Btw realise my last comment could be taken two ways - I meant that yes HT does seem to be more prevalent as I've certainly never encountered it before, and there are so many cats mentioned nowadays on the forum with it. If you see what I mean.

Weatherby, that's probably an hour or two's drive from here, though I hope it won't come to that, especially with 2 other cats in the house, I don't think iodine treatment would be practicable. But wish you had a centre that close, Antonio!

[Antonio]

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.

I use the Cat's Best Green Power. It says it is compostable and probably it is flushable too, but I'm to frightened to flush it. I mean, it is a clumping litter, it forms solid balls when in contact with fluids. So I'm terrified by the fact that the litter might clump in the drain!
Storing the bags of used litter isn't the main concern...
I'm thinking about the hotel room where we'll stay the night between the discharge of Pallina from the hospital and the day we drive back home.
And I'm thinking about the rental car... I hope not to cause any trouble to the people who will rent the same car some days later.

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

Thanks Lilith!
I have just booked the hotel in Ghent, they accept pets in the rooms. I still have to book a room midway me and Ghent, I don't think I will able to drive that distance in a single trip, especially with Pallina who might need to stay out the carrier.
The total of the expenses would be around 2,000 euro.
Exactly one year ago I had spent 6,500 euro to cure Lola. Definitely summer isn't my lucky season

[Antonio]

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

The main culprit of this disease is the canned food, especially fish, especially tuna. It seems that the material which covers the inside of the cans might be somewhat toxic.
Then the fish, which stores lots of pollutants from the sea, is also a trigger.
One of the last theories is that the flame retardants that fill our homes (bed and sofa fillings, furnitures and wall paintings) are substances that get on the fur, the cats lick their fur and the damage is done. The advice given is to brush the cats on daily basis and change and wash throws and pillows regularly.

My main suspect is the sun creams I used to put on Pallina's ears for years. She would lick it away right afterwards, so I think that the chemicals in those creams might have damaged her thyroid.

[Kay]

a collection of statistics could perhaps answer some of these questions - for instance, do cats fed a raw diet all their lives get HT? do cats living in houses with wooden furniture and floors, and all natural bedding, get HT?

I suspect vets are making too much money out of treating HT to invest in some serious research, or am I being too cynical?

It's quite an undertaking you and Pallina are going to go through, but you have clearly got it all well planned and thought through all the possible difficulties, so well done you and I hope, and expect, it will all turn out a big success

[Lilith]

Well. I had some news today, both good and bad.

My Mouse, who I suspected was HT, is. She's to start on meds.

But the vet told me that the HT centre in Wetherby keeps cats for 7-10 days (if I remember rightly) and they're only radioactive while they're in the centre - on their release everything is as normal, no isolation/precautions, everything as normal, which is marvellous.

I don't know if this is just the Wetherby West Yorks centre, or whether other centres and their treatment are now the same.

The other option is surgical removal of the thyroid; I will see how she goes and then ask the vet what she thinks would be best for Mouse.

Mousey, knowing nothing of all this, is cheeky, lively, HUNGRY, nudging my hand off the keyboard for attention, tapping me for attention, and lying on her side purring and playing with her tail. 15 year old asbo cat lol.

Much love to Pallina, Antonio, and all the best for the expedition

[Kay]

the owners guide on the Yorkshire site I linked Antonio to has a rather long list of restrictions, Lilith, so I fear your vet has not done his/her research

however, even with restrictions back home, the shorter stay means a lower bill, so it is still good news all round

[booktigger]

Sounds odd there are no restrictions, but a short stay is good. Good luck with the route you decide

[Lilith]

Hi Kay, yes, I was surprised, I mentioned that I was on this forum and knew about the Wetherby centre; I even mentioned about the regulations re storing used litter, but she said that that was all changed now.

So, I don't know. I'd have expected a vet to be clued up, and this particular surgery I've found to be very good.

I'm hoping Mousey can manage on meds but if not I've been thinking that surgery would be quicker and simpler for a cat of her age and temperament but of course I'm a complete novice where HT is concerned, so ... we shall see ...

Thanks Booktigger, and Kay too

[Antonio]

I did know that surgery is another option of treatment, but I've been discouraged by many because of the risks. It requires an anesthesia and the surgery can be risky, the chance of larynx paralysis is present.
That's why the I-131 is the first choice.

As for the post treatment, they told me that the cat will remain slightly radioactive for two weeks after the discharge, though several persons in other forums and the Yahoo Group with the same experience told me that the chance for a person of being contaminated is really low and that people who undergo the same treatment don't have to live separated from the rest of the family.

In the last few days Pallina has been a little more lethargic and less interested in her food. It's been hot here, with high temperatures around 33°C / 91°F, but yesterday was fresh and dry, yet Pallina wasn't very lively. She only wants to eat grass and vomit it later, a clear sign that something is giving troubles to her stomach.
I just rang the vet and he told me to try a round of Cerenia to see if it works.
In less than three weeks we'll be in Belgium, I wouldn't like to have Pallina in a sick condition before the treatment...

[Lilith]

Hi, Antonio, sorry to hear that Pallina's poorly - hopefully the hot weather does have something to do with it.

I've read through the info booklet for the Weatherby centre and am coming round to the idea of the iodine treatment if needs be - the precautions (even if my vet is wrong) aren't as daunting as I feared and aftercare may be manageable. Although I hope Mouse will stabilise on meds. If not, then it's a toss-up between the centre and invasive surgery, with all the pain and recovery that that may entail. Mousey has had anaesthetic recently for a dental and was fine so I'm not worried about that.

Reading through Pallina's thread has taught me a lot too - HT is one of those diseases that you're vaguely aware of but never take the trouble to learn about until it happens to your own cat.

With fusses and best wishes to Pallina - hope she's back to normal soon

[Antonio]

Lilith,
the sad part of the story is that my vets don't know about hyper-T as much as I know, it seems.
All the necessary info I needed to find a centre for the treatment and most of the tips on how to manage the disease I had to find them on the web, because my vets know little or nothing abouth I-131.
I have to thank this forum and the Yahoo Group for all I know now.

Please keep in mind that a sedation without issues is no guarantee that the next one will be as fine, so my humble opinion is to follow the radioiodine route rather than the surgery.
The meds are only covering the symptoms but they will never cure the disease which will keep working under covert and will worsen until a day when the meds won't give any more benefit.
Furthermore the methimazole gives some side effects which in some cases can't be reverted. So I consider the methimazole as the treatment while we're waiting the I-131.
I blame my vets for wasting my and Pallina's time. I asked them to address me to a centre for this treatment in last August, they kept saying they were looking for some info, but they were just trying to hide the fact that they knew nothing.

Anyway, the time has almost come, we'll be done in a few weeks.

[booktigger]

Fingers crossed her sickness is nothing

[Lilith]

Wow, Antonio, I didn't realise you and Pallina have had to wait a YEAR!

I'm just weighing up pros and cons at the moment - if the meds don't suit I'll be having a rethink as no way do I want Mousey to be in any discomfort, and no point in putting her through useless treatment.

Congrats on winning your fight - is Pallina feeling any better today, do hope so, give her a love from me and Mouse.

[Antonio]

Lilith, Pallina ate only one 85g can in the whole day. The vets gave me four syringes of Cerenia, one has been done tonight, the other three are for the next three days.
Just to add in something I gave Pallina a sub-q of Ringer's Lactate, 50 ml.
She's next to me now, she's purring
Hopefully she'll be better tomorrow.

How's Mouse tonight?

[Lilith]

Poor lass - better than nothing I suppose, but she has to keep her strength up; hope she starts to eat more soon.

That Mouse has just screamed at me for supper - and she's got a voice like a Monty Python parrot! First dose of felimazole tonight but paws crossed no sickness etc. though too early to tell.

Just a thought. A bottle of 45 Felimazole (to be given twice a day) has cost £36. *** Aagh edit, there are 70! That works out at roughly £12 per week (no, it works out at much less!) sorry guys my maths! quite apart from vet visits and tests, and this will continue till the end of Mouse's life if she stays on meds. The stay at the centre is estimated at up to £1800, which sounds pretty horrendous, but, if successful and if I have my facts right, would mean no more meds and pilling and presumably far fewer check-ups/tests. If Mousey lives to be 18 or 19, and there's no reason why she shouldn't, going to the centre, although involving a large lump sum, could work out as cheap, if not cheaper, than meds. Or are my maths lousy?

As I say, at the moment just weighing up pros and cons and not totally sold on any one option, but it does make me think ...

Good luck with Pallina, hoping her appetite improves - paws crossed.

[Antonio]

Lilith,
don't about UK, but over here the vets usually give "human" meds when possible. It's against the law, but they do it.
Over here the Felimazole 2.5 mg, 100 tablets, costs 24 euro (£17.70), but we can use the Tapazole 5mg 100 tablets that costs 5 euro (£3.85). I can have the Tapazole tablets divided in small fractions at the local pharmacy according to the dosage the vet prescribed.
Currently, with the dosage I have to give, a 100 tablets package could last 8 months.
But we switched to the transdermal gel, 25mg/ml in syringe, purchased from a compounding pharmacy. Each syringe is 7 euro (£5.38) and lasts 12 days, but it doesn't give side effects, mainly to the GI tract. And I don't have to fight to drop that fraction of pill down Pallina's throat

The I-131 treatment I am scheduled for will cost around 900 euro (£690), so I think you could look into the same centre to have Mouse treated. Including the trip to Belgium would be cheaper than what you have been quoted.

Pallina ate and drank a lot this morning. last night she had an injection of Cerenia, then I gave her a sub-q of Ringer's Lactate. It seems it worked

P.S.: I had sent this post 4 hours ago, it didn't appear!

[Lilith]

Hi Antonio, VERY pleased to hear Pallina's so much better, long may it last!

Wow, bit of a price difference re meds. I've found the Felimazole 2.5mg on Viovet for £39 per 100, as long as the vet will let me have the script to order them, which is an improvement, but I'm thinking (at the moment) that it might be far better to get it all over with and get a referral to the HT centre. Belgium's a LOT cheaper but unfortunately I can't travel, and I think it would terrify Mouse. Pity, as I wouldn't mind seeing Belgium

If we do get to the West Yorks centre I'll start a thread of her own for Mouse and stop hijacking yours lol.

All paws crossed here for Pallina's continued improvement, that's great news

[booktigger]

Wow, that's an amazing price - my neighbour used the Transdermal gel, and I think it was around £25 a tube, and had to be ordered specially. Lilith, the vet should give you a prescription, I got one with Sam, but they wanted to wait till we had the correct dose, but once we did, it was a 3 month supply per prescription.

[Antonio]

The compounding pharmacy does require a prescription for the syringes, no prescription, no med.
The pharmacy wants a week notice because it takes time to have the compund ready, and they usually do all the prescriptions in a single day. Usually I asked the vet for a couple of months supply, this time I asked for two only syringes (every syringe is 1 ml, it's the kind of syringe for insuline) because I won't need them anymore, I hope!

@Lilith, sorry to read you can't travel, but I do hope the the West Yorks centre may help you.

[Antonio]

Hi all,
A bit of update.
Pallina hasn't been very good lately. She got 4 injections of Cerenia in mid-July because she was prone to nausea and vomiting, she bounced back quickly and started eating again. Until last weekend when she went downhill again. She was clearly suffering from nausea and stomach ache. The vet handed me five more syrnges of Cerenia that I'm giving her every night and he also prescribed a course of Ranitidine. So far I have witnessed very little improvements, but in fairness I have to say that most of the issue must be in the very hot weather we are having over here. It's 36°C at the moment here.
I have four feral kittens in my courtyard, a feral mama cat thought to bring her litter to my house because she thought they would have been well taken care of
These kittens aren't eating too much either, so I think that the high temperatures are playing their role in the issue.
Of course Pallina's HT is a big burden on her GI system as well, and I can't wait to have her treated.

Today is Thursday, it 2:50 pm in this moment here, in 48 hours time we'll be driving to Dijon, France, where we'll stop for one night before driving again to Ghent, final destination.
Pallina will be treated with I-131 on Monday, she'll stay in isolation until Friday, then we'll be drive back home. Most likely we'll stop halfway again.

I wish to thank you for all the tips in managing this issue so far!
I will update you soon!!!

[booktigger]

Good luck and I do hope her recent vomiting doesn't affect her treatment.

[Lilith]

Wow - so looks like you have additions to the community/household? It's true, they know where to come

I thought it was about now that you were setting off to Ghent - bon voyage and have a safe journey and good luck to you and Pallina from Mouse and me - I hope the centre in Ghent is as good as the Wetherby centre, if so she'll be in good hands

[vanilla]

Good Luck with the treatment!

You can maybe keep Pallina cool by placing a frozen bottle of water wrapped in a towel in the cat carrier. I hear the temperature in Italy is getting very hot!!! :O Keep safe!

[Antonio]

Vanilla,
yes, it's really hot over here in the last few days, 35°C where I live, felt like 38°C. It's still 32°C at 10 pm!
Somewhere else in Italy it's 42°C, but because of the high humidity the felt temperature is 55°C !

I will keep the car cool with the air conditioning, but I know that in Belgium the temperatures are around +22°C , it will be easier for all.

I'll keep you posted.

[Mayday21]

Good luck, drive safely. Hope all goes well. Maybe the temps you're experiencing bodes for a very hot summer here. We've had days 26 & 27 degrees & it's winter!! Vivian

[Antonio]

Hi everybody from Ghent!
We left home on Saturday afternoon and stopped in Dijon, France, after 500 km. On the following day we proceeded to Ghent where we arrived at 6:15 pm. The hotel in Ghent is wonderful!

This morning I had the appointment at 9 am , but I waited in the waiting room till 11:10 before they called me.
There were more people for the same thing. One couple and their cat from Dusseldorf, Germany, others from Holland. The couple from Germany were there for the second time, they had treated the other cat two years before and he was fine now.
Everybody comes here for the low price!

Pallina was visited by several vets but the one who would do the I-131 treatment and with whom I had the appointment.
The first IM vet found a heart murmur in Pallina and wanted to investigate further because before the treatment a scintigraphy will be done and Pallina will have to be sedated. They want to make sure there are no problems.
So they ran an ultrasound who revealed that the heart is fine, only a slight heart murmur, consistent with her pathology, but they also found a small amount of liquid around her heart, that is unusual according to them.
So they asked me for the authorization for an X-ray, I agreed. The X-ray was scheduled for the late afternoon, so they told me that I could leave and they would have called me later.

They called me a few minutes ago and told me that also the X-ray sees a small amount of liquid around her heart, but it also sees a mass in her thorax.
I know that in some cases the thyroid tumor can grow down the thorax... I had read that wasn't very usual though... The I-131 has been put aside at the moment. Tomorrow morning they will run another ultrasound and try to draw a bit part of that fluid to understand its nature and they will also investigate on that mass.
Because Pallina will be radioactive for four weeks after the treatment they want to be sure that it is nothing that requires an urgent investigation from my vets, because in this case Pallina wouldn't be treatable for anything else...

I'm so scared...

They had a look at the last blood works and according to them everything is quite fine for the treatment, but because the T4 is high and the renal levels are a bit high too, the chance to have a damage to the kidneys post treatment is high.
They asked me why I waited a year before coming here, I replied that my intention was to do the treatment as soon as possible but my vets told me they were gathering news and info about it before giving me an answer. But that answer never came because they never started gathering info!
In their opinion, with the levels of T4 and kidneys Pallina had last year, that would have been the perfect moment to intervene.

Tomorrow at 11 am they will call me again to tell me what they have found and to discuss with me about the opportunity to go ahead.
My opinion is that I'd like to go on with the plan, 4 weeks will go by quick and we'll be able to investigate more with my vets later. I do not want to miss this opportunity! Next time could be even later!

Please, think of us!

[Lilith]

Oh ....

If only you hadn't been kept waiting all this time! I think your vets have a lot to answer for but hopefully Pallina will win through, I do hope so. Coincidentally my Mouse has a slight heart murmur too, it was noticed a couple of years back, and in this condition their hearts, as the vet at the Wetherby centre said, have got a lot of hard work ...

All paws crossed here and Shahi python is crossing his tail and Mousey is sending special purrs and good vibes to Pallina, well, we all are too x

[Mayday21]

Hi as Lilith posted same from me here without Shahi's tail. Many fusses to Pallina. Gathered she travelled well. Vivian