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Cat Forum / Health and Behavior / July 2004Update: Buddha's Hyperthyroid Treatment
Finally, after four visits, they got a urine sample from Buddha today. The vet said her urine looks good and does not indicate any kidney problems in and of itself. (He checked it for "specific gravity?") He wrote us a prescription for Tapazole in 10 mg tablets, half of one every 12 hours. He said we should test her blood again in two weeks to see if her kidney function really is fine or was being masked by the hyperthyroid. If it is fine we will schedule her visit to Radcats to receive radioactive iodine treatment. Thanks again to everyone for their help with this--particularly to Phil for persisting until I understood the relationship between hyperthyroid and kidney and liver function I'll post her blood test results in two weeks. > He said we should test her blood again in two weeks to see if her >kidney function really is fine or was being masked by the hyperthyroid. If >it is fine we will schedule her visit to Radcats to receive radioactive >iodine treatment. Mary, that is too soon. You just have back down a little with the need to rush into it. I think a month or two of stable T4 numbers is required to observe renal function. You also may not get the tapazole dosage perfect first time either and an adjustment after the first blood test may be necessary. I think this vet is not really all that experienced in the management of hyperthyroid cats if he is giving you this timetable. So far he has depended too much on outside sources for information and has needed to have too many important facts pointed out. -mhd > > He said we should test her blood again in two weeks to see if her > >kidney function really is fine or was being masked by the hyperthyroid. If [quoted text clipped - 6 lines] > dosage perfect first time either and an adjustment after the first > blood test may be necessary. I agree that two weeks is too soon. Personally, I'd wait a minimum of two months. I don't know how long it normally takes for CRF numbers to become unmasked after hyper-T treatment has begun, but it can (note: doesn't always, though) take a couple of months to arrive at the correct dose of med. Cathy > I agree that two weeks is too soon. Personally, I'd wait a minimum of two months. I don't know how long it normally takes for CRF numbers to become > unmasked after hyper-T treatment has begun, but it can (note: doesn't always, though) take a couple of months to arrive at the correct dose of > med. Thank you, Cathy. I will definitely look into it. If she stays on Tapazole for two months I want her bloodwork done frequently, because I am really afraid that her elevated liver enzyumes may NOT be due to her overactive thyroid, and I would rather not keep her on Tapazole long enough for it to cause further kidney damage. We will test after two weeks, and talk about it then. In the meantime, as I wrote above, I will speak to some other local vets (and maybe a professor at the NC State Vet School could help) and report back on what they say a reasonable length of time might be for her to be on Tapazole to determine how much her overactive thyroid may be skewing her blood values for liver and kidney function. > Cathy > > I agree that two weeks is too soon. Personally, I'd wait a minimum of two > months. I don't know how long it normally takes for CRF numbers to become [quoted text clipped - 8 lines] > cause further kidney damage. We will test after two weeks, and talk about it > then. Yes, this part makes sense to me - to keep very close tabs on her liver enzymes, to make sure the Tapazole doesn't agravate a possibly pre-existing condition, rather than clear it up. And of course alos her BUN & creatine levels, to make sure CRF hasn't been lurking. I thought you meant to do the radioactive treatment after only 2 weeks. In the meantime, as I wrote above, I will speak to some other local > vets (and maybe a professor at the NC State Vet School could help) and > report back on what they say a reasonable length of time might be for her to > be on Tapazole to determine how much her overactive thyroid may be skewing > her blood values for liver and kidney function. Sounds like a good plan. Cathy "Cathy Friedmann" <clfr@adelphia.net> wrote in > > Yes, this part makes sense to me - to keep very close tabs on her liver > enzymes, to make sure the Tapazole doesn't agravate a possibly pre-existing > condition, rather than clear it up. And of course alos her BUN & creatine > levels, to make sure CRF hasn't been lurking. By the way, these were very good. The vet commented on them. I thought you meant to do the > radioactive treatment after only 2 weeks. I did, because that is what he said. I agree that my vet is not presenting well in this case, but I don't want to be hardcore about it. I like him, and feel certain he will use what he has learned to help others and pass it on the the younger vets. He is a good and compassionate caregiver, and near retirement age. I like him enough to give him the benefit of the doubt. He may have gone through a slump and failed to keep up with current literature on hyperthyroidism. On the other hand I love my girls and will now have to be hyper-wary. Thank God for this group. All BS and conflicts aside, you people have really come through when I needed you to help me know what is best for this sweet cat. I won't forget it, and will try to contribute similarly if I can. > Mary, that is too soon. You just have back down a little with the need to rush into it. I think a month or two of stable T4 numbers is required to observe renal function. You also may not get the tapazoledosage perfect first time either and an adjustment after the first blood test may be necessary. I can wait--my sense of urgency is just worry. I want to get this problem cleared up for her as soon as I can. I'm really worried that she has already incurred kidney damage as a result of my not acting last year when she was first diagnosed. > I think this vet is not really all that experienced in the management of hyperthyroid cats if he is giving you this timetable. So far he has depended too much on outside sources for information and has needed to have too many important facts pointed out. This is probably true. I'll look into the matter with other local vets over the next couple of weeks, and, most importantly, speak with the specialists who deal with hyperthyroid cats on a regular basis and see what they think is a reasonable time frame to have her on tapazole to find out if she has underlying kidney problems. Thank you.
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