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Cat Forum / Health and Behavior / December 2005Cat with hypertyroidism
All, My twelve year old female cat has been diagosed with hypertyroidism. I'm presented with the two options: tapazole and radioactive iodine. What is the group-think as to the best course of action? Thanks, Rob > All, > > My twelve year old female cat has been diagosed with hypertyroidism. > I'm presented with the two options: tapazole and radioactive iodine. > What is the group-think as to the best course of action? Initially, all hyperthyroid cats should be put on Tapazole for a few months to evaluate kidney function after their T4 levels have stabilized in the normal range. If her kidney function remains normal while her T4 levels are normal, you can consider radioiodine tx. If her kidney function declines while on Tapazole, she is not a good candidate for radioiodine tx. If you opt for radioiodine tx. without a trial treatment with Tapazole, you run the risk of *irreversibly* unmasking underlying kidney failure. Hyperthyroid cats over 12 are at high-risk of having underlying kidney disease despite normal BUN/ creatinine levels. Hyperthyroidism increases blood flow through the kidneys which can make the kidneys seem like they're working better than they are. After hyperthyroidism is controlled, kidney blood flow returns to its normal rate and can unmask kidney failure in cats with underlying disease. You can significantly reduce the risks of your cat developing adverse reactions to Tapazole if you begin treatment with a low dose- e.g., 2.5 mg once a day for 5 days. If no adverse effects develop, the dose can be increased to 2.5 mg twice a day. Recheck her T4 and BUN/creatinine in 7 - 10 days, then in 14 days, then monthly. If necessary, the dose can be increased. Tapazole has a very bitter taste that cats *hate*. You can make your cat much more comfortable and pilling much easier if you put the pill inside a #4 gelcap. Follow the pill with canned food or water to make sure it doesn't get stuck and begin to dissolve in her esophagus. If your cat is difficult to pill, Tapazole can be formulated into several flavored liquids or a transdermal gel that is applied to the inside of the ear flap. Best of luck, Phil > > All, > > [quoted text clipped - 35 lines] > > Phil This was the important thing I left out. Thanks, Phil. I could never have explained it that well. SLURRRRRRRRRP! :) And I mean that with all sincerity. > All, > > My twelve year old female cat has been diagosed with hypertyroidism. > I'm presented with the two options: tapazole and radioactive iodine. > What is the group-think as to the best course of action? Hi Rob! My cat was diagnosed with this a couple of years ago. Tapazole (given in pills 12 hours apart) can control the thyroid hormone levels, but there are side effects and risks involved. I suggest you Google the disorder to read about them. Radioactive iodine treatment is considered by many a "cure" as opposed to just a means of controlling the thyroid hormone levels. However, some cats come through that hypothyroid or with other problems. We have discussed these things at length in this group, so again, Google is your friend. Since my cat (almost 11) is doing really well on Tapazole and I am not having trouble pilling her now, I will probably stick with that. I have her examined and tested regularly to make sure everything is okay. The most important thing is that you address the high thyroid hormone levels as soon as possible. My cat's heart rate was over 300 bpm when she was diagnosed. (The norm for cats is about 150-180.) She developed arrythmia (we think) as began having fainting spells, so is now on beta blockers too. The most dangerous thing about hyperthyroidism, if I recall my vet's words correctly, is that the cat cat "throw a clot." In other words, have a stroke. If I were you I would discuss the potential side effects of Tapazole with your vet, then have battery of blood tests and urine tests to see how her liver, kidneys, etc. are functioning and get her on Tapazole asap. Since her metabolism will slow, she should gain weight fairly soon after being on it. Good luck and keep us posted. >> All, >> [quoted text clipped - 34 lines] > >Good luck and keep us posted. Cybercat, She did have a full-blood panel done and all is well. Weight loss is not a problem as she's overweight to begin with and hasn't seemed to have lost much, if any weight. She was diagnosed by a heart rate of 200 and the t4 value was out of range (I forget about how much). I guess my biggest concern is simple economicss..the cost of the medication. Does it make sense to go the iodine route if the cost of the meds and repeated tests will equal the iodine in about two years? Thanks for the reply, Rob > Cybercat, > > She did have a full-blood panel done and all is well. Weight loss is > not a problem as she's overweight to begin with and hasn't seemed to > have lost much, if any weight. Rob, This is odd, because as your vet probably told you, most hyperthyroid cats are skinny. They have a hard time keeping weight on because their overactive thyroids are revving up their metabolism. They usually have dull or oily fur, too, from what I have been told. What is stranger still is that my cat, just like yours, was fat. She weighted 16-18 pounds at diagnosis, and the vet said she would gain once we corrected the thyroid. I put her on a diet of premium canned food (beef/chicken/meat as a first or second ingredient, not byproducts), a bit too much at first, every 12 hours. (She had been free feeding diet Iams dry.) I cut this back by 1/4 whenever she stopped losing. At her last checkup she weighed 10 lbs. So don't worry, she does not have to gain weight when you correct her thyroid, but you may have to change her feeding. ?She was diagnosed by a heart rate of > 200 and the t4 value was out of range (I forget about how much). I > guess my biggest concern is simple economicss..the cost of the > medication. Does it make sense to go the iodine route if the cost of > the meds and repeated tests will equal the iodine in about two years? As for cost, I get a generic of Tapazole that costs $10 a month. (Without insurance of course, for some reason they do not cover my cats!) Since the radioactive iodine treatment runs $1,200-1,500, it would even out over a few years. To be honest with you, what keeps me from getting the radioactive treatment is that I cannot stand the thought of taking her there and leaving her for weeks. (Different laws about radioactive waste in different states mean that vets keep the cats different periods of time, essentially because their waste is radioactive.) She howls piteously at the vet and I would miss her too much. Also I worry about reported problems with hypothyroidism and other problems. But it would beat pilling twice a day. Listen to Phil, he knows much more than I do about this. >> Cybercat, >> [quoted text clipped - 16 lines] >10 lbs. So don't worry, she does not have to gain weight when you >correct her thyroid, but you may have to change her feeding. Cybercat, I think the weight is because he caught it early when he noticed the heartrate. >?She was diagnosed by a heart rate of >> 200 and the t4 value was out of range (I forget about how much). I [quoted text clipped - 12 lines] >in different states mean that vets keep the cats different periods >of time, essentially because their waste is radioactive.) The place my doctor is high on (had his done there) is certfied for treatment and release in 96 hours. >She howls piteously at the vet and I would miss her >too much. Mine is extremely high strung and I think we would have problems pilling her and getting her to the vet for repeat thyroid tests. > Also I worry about reported problems with hypothyroidism >and other problems. But it would beat pilling twice a day. >Listen to Phil, he knows much more than I do about this. Thanks much, Rob > I think the weight is because he caught it early when he noticed the > heartrate. Makes sense! I'm glad he caught it early. > >To be honest with you, what keeps me from getting the radioactive > >treatment is that I cannot stand the thought of taking her there and [quoted text clipped - 4 lines] > The place my doctor is high on (had his done there) is certfied for > treatment and release in 96 hours. That's pretty good, compared with other places. > >She howls piteously at the vet and I would miss her > >too much. [quoted text clipped - 7 lines] > > > Thanks much, Good luck with her, and keep us posted. Phil guided me through this problem and these decisions with my cat, and she is doing great now, so between him and your vet you are in good hands, and so is your kitty. I > guess my biggest concern is simple economicss..the cost of the > medication. Tapazole is very inexpensive- A bottle of 100/5 mg pills costs about $30-$35. Most cats can be managed on 2.5 mg/twice a day or 5 mg/twice a day. One bottle should last 1 1/2 - 3 1/2 months depending on her dose. I try not to use generics because of variations from batch to batch. As far as treatment options, you may not have a choice. She may not be a candidate for radioiodine. At her age, she's in the high-risk category for underlying kidney disease. You or your vet won't know the status of her kidneys until she's been on Tapazole for at least 2-3 months. And that's still not a guarantee. More than 50% of the cats treated with radioiodine develop renal disease within a year after treatment despite normal pre-treatment BUN/creatinine/USG values. Also, about 30% develop transient hypothyroidism- 10% require long-term supplementation with L-thyroxine. Another factor to consider is that radioiodine tx. is *irreversible*- which means if she develops kidney disease you can't adjust the dosage. OTOH, with Tapazole, you can adjust the dose to strike a balance between an "acceptable" level of azotemia and an "acceptable" level of hyperthyroidism. Mild hyperthyroidism can actually augment kidney function. Also, depending on your state laws, your cat must remain in the radioiodine facility for 1-3 weeks. This can be extremely stressful for an older cat. Does it make sense to go the iodine route if the cost of > the meds and repeated tests will equal the iodine in about two years? After the first 3 months, you can recheck her T4 levels every 2-3 months or when signs of hypo or hyperthyroidism develop. A complete feline thyroid panel costs about $35; just T4 costs about $10 and a T4/T3 combo costs about $20- depending on how much your vet marks up the lab bill. Radioiodine is more economical only with cats under 10-12 years of age. Radioiodine tx. is generally the safest and most effective treatment, actually, cure, for hyperthyroidism, but it certainly isn't without serious risks nor as economical as it may seem. >I >> guess my biggest concern is simple economicss..the cost of the [quoted text clipped - 4 lines] >day. One bottle should last 1 1/2 - 3 1/2 months depending on her dose. I >try not to use generics because of variations from batch to batch. Phil, Where do you get yours from? >As far as treatment options, you may not have a choice. She may not be a >candidate for radioiodine. At her age, she's in the high-risk category for [quoted text clipped - 4 lines] >pre-treatment BUN/creatinine/USG values. Also, about 30% develop transient >hypothyroidism- 10% require long-term supplementation with L-thyroxine. You sound very knowledgable on the subject. Are you a vet by chance? >Another factor to consider is that radioiodine tx. is *irreversible*- which >means if she develops kidney disease you can't adjust the dosage. OTOH, [quoted text clipped - 4 lines] >Also, depending on your state laws, your cat must remain in the radioiodine >facility for 1-3 weeks. This can be extremely stressful for an older cat. Apparently the facility I was referred to is certified to do it all in 96 hours. >Does it make sense to go the iodine route if the cost of >> the meds and repeated tests will equal the iodine in about two years? [quoted text clipped - 4 lines] >$20- depending on how much your vet marks up the lab bill. Radioiodine is >more economical only with cats under 10-12 years of age. She's about 13.5. You've given me alot to think about. My only remaining concern is actual pill delivery. I travel several times a month so it would leave my wife to pill her herself. I worry about how that will work out given how much a fuss we've with her in the past (the cat, not the wife :) ) Thanks so much, Rob > >I > >> guess my biggest concern is simple economicss..the cost of the [quoted text clipped - 8 lines] > > Where do you get yours from? I get our drugs from a vet supplier- but you can order 100/5 mg brand Tapazole- not a generic with just a script from your vet for about $40- which breaks down to $12/month- .20 a dose or .40 a day (@ 2.5 mg/b.i.d.) http://www.candrugstore.com/custdrugsearchAtoZlist.asp?search=T > >As far as treatment options, you may not have a choice. She may not be a > >candidate for radioiodine. At her age, she's in the high-risk category for [quoted text clipped - 6 lines] > > You sound very knowledgable on the subject. Are you a vet by chance? No. I have a hyperthyroid cat and worked with several hyperthyroid cats in my shelter. > >Another factor to consider is that radioiodine tx. is *irreversible*- which > >means if she develops kidney disease you can't adjust the dosage. OTOH, [quoted text clipped - 7 lines] > Apparently the facility I was referred to is certified to do it all in > 96 hours. We have a facility in my state with the same policy. Most states have a 1-3 week requirement but I think the laws might be changing to 7-10 days in some states. > >Does it make sense to go the iodine route if the cost of > >> the meds and repeated tests will equal the iodine in about two years? [quoted text clipped - 6 lines] > > She's about 13.5. You've given me alot to think about. My hyperthyroid cat is 12.5 . Her kidney function has been stable and well within the normal range and her USG has been >1.050 for the last 3 months that she's been on Tapazole. Although she's considered an 'ideal' candidate for radioiodine tx. I'm very reluctant to opt for the tx. I had her scheduled for quantitative renal scintigraphy (Planar Renal Scintigraphy) by which individual and total kidney function is measured noninvasively while she's awake, but I cancelled the test. Even PRS which is the most accurate test for renal function available can't predict what her post-treatment kidney function will be a year after tx. Most of the cats that developed renal failure after radioiodine also had normal kidney and USG values. At her age, its just not a risk I'm prepared to take with her. If her hyperthyroidism ever becomes life-threatening and nonresponsive to Tapazole, or she develops adverse reactions, I'll certainly reconsider my decision. Too many cats have been successfully managed with Tapazole for life for me to justify taking the risk with radioiodine. My only > remaining concern is actual pill delivery. I travel several times a > month so it would leave my wife to pill her herself. I worry about > how that will work out given how much a fuss we've with her in the > past (the cat, not the wife :) ) Not a problem. Tapazole can be formulated into a transdermal gel that's applied to the inside of the ear. As long as your cat lets your wife touch her- she can medicate your cat. Tapazole gel comes in clearly marked syringes- just apply .1 ml to your finger and rub it into the inside of her earflap. After about 20 minutes, wipe off any excess. You must wear a finger cover or exam glove so you won't absorb the Tapazole through your skin. I prefer the finger covers so the cat can still feel my touch. http://www.maxshouse.com/Drugs/tapazol_gel+finger_cover.jpg Best of luck, Phil >> >I >> >> guess my biggest concern is simple economicss..the cost of the [quoted text clipped - 15 lines] > >http://www.candrugstore.com/custdrugsearchAtoZlist.asp?search=T Thanks for the link. 1800petmeds wants over $1 a pill. Was quite a shock when I did the math. >> >As far as treatment options, you may not have a choice. She may not be a >> >candidate for radioiodine. At her age, she's in the high-risk category [quoted text clipped - 11 lines] >No. I have a hyperthyroid cat and worked with several hyperthyroid cats in >my shelter. I appreciate someone with personal experience who can make me think. Thanks. >> >Another factor to consider is that radioiodine tx. is *irreversible*- >which [quoted text clipped - 15 lines] >week requirement but I think the laws might be changing to 7-10 days in some >states. I think for now, we're going to go the Tapazole route and see what the kidney function does and how she takes to the pill popping. >> >Does it make sense to go the iodine route if the cost of >> >> the meds and repeated tests will equal the iodine in about two years? [quoted text clipped - 27 lines] >successfully managed with Tapazole for life for me to justify taking the >risk with radioiodine. My mother did three cats. >My only >> remaining concern is actual pill delivery. I travel several times a [quoted text clipped - 5 lines] >applied to the inside of the ear. As long as your cat lets your wife touch >her- she can medicate your cat. Any idea where you can get that gel made up? >Tapazole gel comes in clearly marked >syringes- just apply .1 ml to your finger and rub it into the inside of her [quoted text clipped - 7 lines] > >Phil Thanks so much for all the info, Rob > >I get our drugs from a vet supplier- but you can order 100/5 mg brand > >Tapazole- not a generic with just a script from your vet for about $40- [quoted text clipped - 4 lines] > Thanks for the link. 1800petmeds wants over $1 a pill. Was quite a > shock when I did the math. A buck a pill??? That's probably why so many people think radioiodine tx. is cheaper. > >No. I have a hyperthyroid cat and worked with several hyperthyroid cats in > >my shelter. > > I appreciate someone with personal experience who can make me think. > Thanks. Experience is the best teacher. > I think for now, we're going to go the Tapazole route and see what the > kidney function does and how she takes to the pill popping. I'm glad to hear it. That's the smart play. Radioiodine tx. is the first choice tx for young cats (<10) and the 1-2% of cats that have thyroid carcinomas or hyperfunctioning ectopic (noncervical) thyroid tissue- or cats that develop severe adverse reactions to Tapazole. But for older cats, Tapazole is the wisest choice. Too many cats have been > >successfully managed with Tapazole for life for me to justify taking the > >risk with radioiodine. > > My mother did three cats. You'll have plenty of moral support! ;) > >Not a problem. Tapazole can be formulated into a transdermal gel that's > >applied to the inside of the ear. As long as your cat lets your wife touch > >her- she can medicate your cat. > > Any idea where you can get that gel made up? Any human compounding pharmacy. All you need is a script from your vet. The transdermal gel is a little more expensive, but well worth it. Initially, your cat may take a few days longer to respond to the gel than to the pill because the medication has to make its way through the skin before it reaches systemic circulation and the thyroid glands. But after that, the efficacy is the same or perhaps even a little better. Just make sure you wear a finger cover or exam glove! ;) If you ever have to give your cat Tapazole pills, be sure to put the pill in a #4 gelcap- otherwise pilling will be a nightmare. Tapazole tastes nasty. > Thanks so much for all the info, Your welcome. I hope it helps. Best of luck, Phil >> >I get our drugs from a vet supplier- but you can order 100/5 mg brand >> >Tapazole- not a generic with just a script from your vet for about $40- [quoted text clipped - 8 lines] >A buck a pill??? That's probably why so many people think radioiodine tx. >is cheaper. That's the reason for my heart attack when I started this research. >> >No. I have a hyperthyroid cat and worked with several hyperthyroid cats >in [quoted text clipped - 13 lines] >cats that develop severe adverse reactions to Tapazole. But for older cats, >Tapazole is the wisest choice. We should be starting in the next couple of days. This should be quite an adventure :) >Too many cats have been >> >successfully managed with Tapazole for life for me to justify taking the [quoted text clipped - 3 lines] > >You'll have plenty of moral support! ;) She's got a dog now ! >> >Not a problem. Tapazole can be formulated into a transdermal gel that's >> >applied to the inside of the ear. As long as your cat lets your wife [quoted text clipped - 12 lines] >Tapazole pills, be sure to put the pill in a #4 gelcap- otherwise pilling >will be a nightmare. Tapazole tastes nasty. I assume you can get this at a pharmacy as well? All, Well we got our first couple of doses of Tapazole into the kitty. I found a drug store that had a couple of gel capsules on hand and it helped the process. I only have a few as they are absolutely impossible to find. I found one drugstore that would order them for me, but it will be a couple of days. My wife will be stuck pilling capsuleless for a day or two as I will be away. Rob > All, > > My wife will be stuck pilling > capsuleless for a day or two as I will be away. Rob, I have to pill my kitty twice a day, and after trying many things have found this method to work best with her. (One of her medicines is Tapazole, which as Phil mentioned is very bitter, the other is a beta blocker.) Because I feed canned twice a day I pill when I feed her, to make it easier to remember. I let her begin gulping down her canned food, then I swiftly interrupt her by lifting her head up and back using my left hand (cat is looking right) over the top of her head, fingers holding her by the corners of her mouth, opening her mouth that way and with one finger from my right hand (the hand with the pills in it) and quickly and gently tossing the pills [this is the important part] as far back the MIDDLE of her throat as I can. (If it goes to the side they can work it out onto their tongue, then they taste it, hate it, drool, foam at the mouth, etc. A bad scene.) Then I hold her head up for a little bit, gently rubbing her throat. She nearly always swallows in a hurry so she can get back to her food! I hope this helps you and your wife. (I also have to close the pocket doors to the kitchen after I put the food down so she won't try to run away. It saves me the traumatic "chasing her down" if I get busy with something else before I can pill her.) >> All, >> [quoted text clipped - 21 lines] >up for a little bit, gently rubbing her throat. She nearly always swallows >in a hurry so she can get back to her food! We've worked it so that she gets wet food immediately after pilling. This has the added benefit of making sure she isn't hiding the pill. >I hope this helps you and your wife. (I also have to close the pocket doors >to the kitchen after I put the food down so she won't try to run away. It >saves me the traumatic "chasing her down" if I get busy with something >else before I can pill her.) We close off the bedroom (if she gets under the bed, it's all over). The pilling, for now is done in a closed bathroom. > >I hope this helps you and your wife. (I also have to close the pocket doors > >to the kitchen after I put the food down so she won't try to run away. It [quoted text clipped - 3 lines] > We close off the bedroom (if she gets under the bed, it's all over). > The pilling, for now is done in a closed bathroom. I know how hard this is in the beginning. It gets easier--on you and on the cat. I might get easier once you know the cat but they get smarter. My rumble takes a pill 2x a day he knows some how he knows that I am coming to give him a pill. He can be laying next to me and I take my medication no problem but I get his pill he is gone like a shot and hides for hours. I have to hide the medication through out the house and snag him when he ain't looking; you try that with a cat. Pill pockets he spits the pill back out, can't crush it he won't touch it and the other cats would eat it. Hide it in other food he is such a little devil he will eat the food and leave the pill in a obvious place ( I watched him do it). I catch him no problem pill gone by the count of 3 with a lot of loving afterwards. They can be such little devils. Matthew >> >I hope this helps you and your wife. (I also have to close the pocket > doors [quoted text clipped - 8 lines] > I know how hard this is in the beginning. It gets easier--on you and on > the cat. > I might get easier once you know the cat but they get smarter. My rumble > takes a pill 2x a day he knows some how he knows that I am coming to give [quoted text clipped - 7 lines] > gone by the count of 3 with a lot of loving afterwards. > They can be such little devils. Matthew, you do not mention giving him the pill while he is eating, which is what I am describing above. My Boo did all of the things you describe, and pill-giving was an ugly thing. It's totally different now. Try it if you haven't. > I might get easier once you know the cat but they get smarter. My rumble > takes a pill 2x a day he knows some how he knows that I am coming to give [quoted text clipped - 7 lines] > gone by the count of 3 with a lot of loving afterwards. > They can be such little devils. Matthew, you do not mention giving him the pill while he is eating, which is what I am describing above. My Boo did all of the things you describe, and pill-giving was an ugly thing. It's totally different now. Try it if you haven't. "Hide it in other food he is such a little devil he will eat the food and leave the pill in a obvious place ( I watched him do it)" He will eat the food and spit the pill out or take the pill and leave it right in front of me with a look of whatcha you going to do now. He is a little devil but he makes life interesting the chase is part of life :-) >> I might get easier once you know the cat but they get smarter. My >> rumble [quoted text clipped - 19 lines] > pill-giving was an ugly thing. It's totally different now. Try it if you > haven't. > "Hide it in other food he is such a little devil he will eat the food and > leave the pill in a obvious place ( I watched him do it)" > > He will eat the food and spit the pill out or take the pill and leave it > right in front of me with a look of whatcha you going to do now. He is a > little devil but he makes life interesting the chase is part of life :-) No, NMR. I am not talking about hiding it in his food. You feed him his wet food, then you wait until he has had a bite or two and pill him. If he is like my cat he will swallow the pill without a hassle so he can get to the food. I have done that before he will spit the pill back up and drop it in front of me and give me the look of hah. When I can grab him I turn him around butt to the chest neck back open mouth drop pill and massage throat and give him some lovin. Count to 3 it is all over except when he runs the chase is on :-) Check your e-mail :-) >> "Hide it in other food he is such a little devil he will eat the food >> and [quoted text clipped - 11 lines] > like my cat he will swallow the pill without a hassle so he can get to the > food. > All, > [quoted text clipped - 6 lines] > > Rob Try to drop the pill as far back as possible without it touching the tongue. You might want to wash the pill down with tuna water in an oral syringe- it will help mask the taste until you get the gelcaps. You should still follow the pill with water or canned food even after you get the gelcaps to make sure the pill clears the esophagus. Check out my site: http://www.maxshouse.com/Medicating_Your_Cat.htm Phil >> All, >> [quoted text clipped - 12 lines] >the pill with water or canned food even after you get the gelcaps to make >sure the pill clears the esophagus. Phil, Hopefully the new capsules will be in today or tomorrow. In the meantime, I was able to find some No1 capsules and only use the top portion and pinch it shut. We always follow up with some wet food as a reward and to ensure she's not pocketing the meds. Thanks, Rob >Check out my site: > >http://www.maxshouse.com/Medicating_Your_Cat.htm > >Phil Rob, The tapazole can also made into a liquid formula with different flavors. My cat was recently diagnosed (last week) and so far has gobbled his liver flavored tapazole with a little wet food with no problem. The only thing I worry about is whether or not he will continue to eat his laced food once the meds kick in and his appetite isn't as ravenous. Good luck, Cathy >Rob, > [quoted text clipped - 4 lines] >continue to eat his laced food once the meds kick in and his appetite >isn't as ravenous. Cathy, How much more did it cost than in pill form? The poor little girl has been through so much this last, I want to minimize trauma if it's affordable. >Good luck, >Cathy Thanks so much, Rob It sounds like the liquid is more expensive than the pills... I paid $48 for this bottle that I really don't know how long it will last since I've only been giving it for one week. He gets 1ML per day and at this rate, it looks like the bottle *may* last only 3 or 4 weeks. I didn't think to ask. I was ready to just go for the radiation treatment because I didn't want to stress him out trying to give him a pill every day and I honestly didn't think he would like the liquid but so far so good. My vet recommended I try the meds first and recheck his T4 in 3 or 4 weeks. He did say that if I decided to do the radiation, then they would have to do an x-ray and some other tests to make sure he didn't have any underlying problems with his kidneys. I think if I continue with the meds, I will try to find another less expensive source, i.e. a different pharmacy. >It sounds like the liquid is more expensive than the pills... I paid >$48 for this bottle that I really don't know how long it will last [quoted text clipped - 10 lines] >I think if I continue with the meds, I will try to find another less >expensive source, i.e. a different pharmacy. Cathy, Thanks. Let me know if you find a better price out there. We've had some better success popping the pill just after she wakes up. Rob As posters have said, it depends on the individual cat and on you. My cat was on Tapazole for many years and did just fine. She died of cancer at age 17 last year. Gail >>> All, >>> [quoted text clipped - 49 lines] > Thanks for the reply, > Rob
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