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Cat Forum / Health and Behavior / July 2004

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Can Hyperthyroidism CAUSE High Liver Enzymes ...

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Mary - 19 Jul 2004 20:10 GMT
in cats with no liver damage?

This is apparently the question.

Talked to my vet today, and he will agree that Buddha should have Tapazole
before the ratiation treatment if I can find an article that says that
hyperthyroidism can cause high liver enzyme readings in blood tests when
there is no real liver damage present.

He already knows that hyperthyroidism can cause liver damage and that this
is what the elevated enzymes in the last test might mean.

He agrees that hyperthyroidism can mask kidney disease by indicating normal
kidney function in blood test, when there is actually kidney disease present
that shows up after thyroid hormone levels are brought back to normal.

Is this clear? I am searching for an article that says that hyperthyroidism
can cause elevated liver enzymes in the absence of real liver damage--so
that when Tapazol is used to bring thyroid hormone levels back to normal, we
find that liver function is actually normal.

Any help will be greatly appreciated. We see him this afternoon.
zuzu22@webtv.net - 19 Jul 2004 21:10 GMT
This article says that it does:
http://www.veterinarypartner.com/Content.plx?P=A&C=&A=516&SourceID=42

Megan

                                   
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Mary - 19 Jul 2004 22:17 GMT
> This article says that it does:
> http://www.veterinarypartner.com/Content.plx?P=A&C=&A=516&SourceID=42
>
> Megan

Thank you. By the time I got to his office my vet had found an article that
says so. Now all Buddha has to do is have a urine test and she can go on
Tapazole. (We tried today but her bladder was empty.) I take her back in the
morning to have another go at collecting urine.

If she is shown to have normal kidney function after she is on Tapazole for
a while (we have not discussed how long) we can go ahead with the
radioactive iodine treatment.

I appreciate everyone's help with this. Although in a perfect world all vets
would know everything there is to know, I am still happy with mine because
he at least listens. Now that he knows, he can try other cats who show
elevated liver enzymes on Tapazole to make certain their hyperthyroid is not
masking kidney disease.
Cathy Friedmann - 19 Jul 2004 22:47 GMT
> > This article says that it does:
> > http://www.veterinarypartner.com/Content.plx?P=A&C=&A=516&SourceID=42
[quoted text clipped - 9 lines]
> a while (we have not discussed how long) we can go ahead with the
> radioactive iodine treatment.

This osunds like a good plan, to me.

My *guess* is that at least a couple of months will be considered.  It often
takes a while for the thyroid levels to get to normal levels, & the dosage
sometimes needs to be fiddled with.  In the meantime, blood will be drawn
periodically to check the various levels.

> I appreciate everyone's help with this. Although in a perfect world all vets
> would know everything there is to know, I am still happy with mine because
> he at least listens. Now that he knows, he can try other cats who show
> elevated liver enzymes on Tapazole to make certain their hyperthyroid is not
> masking kidney disease.

No one person can know *everything*, no matter their credentials &/or level
of intelligence.  It'd be impossible for a medical doctor, & then vets need
to know about more than one species!  This is also what I like about my main
vet: she is very intelligent, reasons things out & also explains her
reasoning to me, looks up whatever is not crystal-clear in her mind, when
prudent thinks beyond the practice where she is & will reach out to other
specialists in different locales for info - referred me to an vet
internist/oncologist, & called a liver specialist at Cornell, & will look
further into something if I bring it up as a possibility.  (As long as it
doesn't turn out to be ludicrous!; in which case she'll - nicely &
patiently - explain to me why it can't be thus-&so.)

Cathy
Mary - 20 Jul 2004 00:15 GMT
> My *guess* is that at least a couple of months will be >considered.  It
oftentakes a while for the thyroid levels >to get to normal levels, & the
dosage sometimes needs >to be fiddled with.  In the meantime, blood will be
drawn
> periodically to check the various levels.

Makes sense. I will want them to check fairly regularly, because I'll be
worried that she really may have liver disease that the Tapazole may
exacerbate. Every two weeks seems reasonable. I'm sure he will tell me and I
will pass it on when he does.

> No one person can know *everything*, no matter their >credentials &/or
level of intelligence.  It'd be impossible >for a medical doctor, & then
vets need to know about >more than one species!

Absolutely. I don't buy into the "Doctor as a Supreme Being" BS, so I don't
expect him to know everything. He just said, "have you got an article that
demonstrates this? I don't know *everything.*" I think another vet might
have blustered or "pooh-poohed" me when I brought this up.

>This is also what I like about my main vet: she is very >intelligent,
reasons things out & also explains her
> reasoning to me, looks up whatever is not crystal-clear >in her mind, when
prudent thinks beyond the practice >where she is & will reach out to other
specialists [snip]

She sounds a lot like my vet. He takes the time to explain things to me and
he LISTENS to me. Best of all I can tell he genuinely cares about the
animals, and he is pretty good at choosing techs who clearly do too. I can
tell by the way they handle the animals, the way they look at them and talk
to them. It's not phony "patronize the stupid client," either. I have seen
the latter in other vets, as well as a helluva lot of techs who obviously
cared nothing about the animals.
zuzu22@webtv.net - 19 Jul 2004 21:25 GMT
Here's another link that has a sample blood profile of a hyperthyroid
cat that also shows elevated liver enzymes:
http://www.lbah.com/Feline/hyperthyroidism.htm

Megan

                                   
Signature


"The only thing necessary for the triumph of evil is for good men to do
nothing."

-Edmund Burke

Learn The TRUTH About Declawing
http://www.stopdeclaw.com

Zuzu's Cats Photo Album:
http://www.PictureTrail.com/zuzu22

"Concerning all acts of initiative (and creation), there is one
elementary truth the ignorance of which kills countless ideas and
splendid plans: that the moment one definitely commits oneself, then
providence moves too. A whole stream of events issues from the decision,
raising in one's favor all manner of unforeseen incidents, meetings and
material assistance, which no man could have dreamt would have come his
way."

- W.H. Murray

hamandcheese@betweentheknees.com - 19 Jul 2004 21:40 GMT
>Here's another link that has a sample blood profile of a hyperthyroid
>cat that also shows elevated liver enzymes:
>http://www.lbah.com/Feline/hyperthyroidism.htm
>
>Megan

And this is the clincher...

"After 2 weeks of treatment the thyroid level (arrow at top) and liver
enzyme levels (lower arrows) have shown a significant improvement."

-mhd
Mary - 19 Jul 2004 22:27 GMT
> And this is the clincher...
>
> "After 2 weeks of treatment the thyroid level (arrow at top) and liver
enzyme levels (lower arrows) have shown a significant improvement."

This is great. I am so glad she is not as old as many hyperthyroid cats are
when diagnosed, because she is stronger and there are apt to be less
complications with both the medication and the radiation. I just hope we
find that her renal and liver function are normal after the round of
Tapazole.

I mentioned that I found it odd that she shows none of the really classic
"outer" symptoms of hyperthyroid, such as an unkempt-looking coat and a low
weight. The doctor pointed out that in addition to her elevated heart rate
(300 bpm) and thryroid hormone level (10+) she LOOKS like a hyperthyroid
cat. I asked what that meant and he said "she looks hyper-alert." This is
true, and part of what has always made her so funny to watch. When she plays
her reflexes are super fast, and she never has that "heavy lidded" look most
cats do. This is the cat who, when I hold her a minute too long, stares at
me wide-eyed and stiff-arms me, curls her lip back and bitches at me. No
growl, no hiss, just "Meh meh meh, mmmrowwllll!!" Another part of the
syndrome is irritability. Buddha gets comfortable on my lap on the couch and
if I move she rips off a mean meowwwll and HISSES at me as she gets down.
Very reactive. Thanks for your help. Let's hope we can get a urine sample
tommorow and get her started on Tapazole.
Phil P. - 20 Jul 2004 02:09 GMT
> in cats with no liver damage?

All the links I previously provided stated hyperthyroidism causes increases
in liver enzymes in at least 75% to 90% of cats.

Once again:

http://www.vet.uga.edu/vpp/clerk/stortz/
http://www.lbah.com/Feline/hyperthyroidism.htm#patho
http://www.marvistavet.com/html/thyroid__signs__symptoms_and_d.html
http://www.gcvs.com/imaging/feline_hyperthyroidism.htm
http://www.winnfelinehealth.org/health/hyperthyroidism.html
http://www.axiomvetlab.com/EF%203-0.html
http://cvm.msu.edu/vth/spe/sts/procedure/Hyperthyroidism2.ppt

Also, I think you may have been mislead about the risk factor of Tapazole
causing liver damage.  In a study of 262 cats receiving Tapazole for up to
1000 days (Peterson, Kintzer, and Hurvitz; J Vet Intern Med, 1988),  only
*1.5%*  of the cats developed hepatopathy.   Therefore, in the
risk-to-benefit ratio, the benefits far, far, outweigh the risks.

Also, the "Adverse Effects" listed for a drug does not mean every cat taking
the drug will develop all or even any of the adverse effects.  Even if one
cat in a million developed a particular adverse effect, that adverse effect,
however extremely unlikely, would still have to be included in the list.

I hope this clears up any misunderstandings you may have about Tapazole.

Phil
 
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