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Cat Forum / General Topics / February 2004Feline Hyperthyroid Questions & Update on h0p and George (Mast Cell)
Hi all, Thanks to everyone who responded to my mast cell tumor questions. My cat George's tumor was listed as a grade one. I caught it when it was quite small and it was promptly removed back in October. His fur is growing back nicely and subsequent daily checks have revealed no further problems. I have VPI insurance for him but haven't filed yet. I've heard bad things, so I'll let you know if you're interested. h0p is as tenacious as ever but had another neurological episode that hospitalized him a week and a half ago. That, followed by a seizure last night, has slowed him down. It's really disappointing as he was doing so well. All his bloodwork comes back completely normal, and none of the specialists seem to know what's going on. I've read that msm may help to keep down the frequency of seizures and plan to start supplementing his meals with it. Anyone have any thoughts on that? Ceili is doing great at 14 years with her cardiomiopathy. She takes medication once a day and plays like a kitten. Sam is healthy and happy, but at 17 lbs (not fat, just big!) he's afraid of 7 lb Ceili! I was sad to learn two weeks ago that my oldest and first cat, Misty Blue, is hyperthyroid. She started medication last week and will go back for more blood tests next week. I read that feline hyperthyroidism is usually caused by a benign tumor on the thyroid, but I read elsewhere that, though this is usually the case with dogs, in cats it's usually just an enlargening of the thyroid gland itself, so I'm a bit confused as to treatment. It's been suggested that because Misty is only 11 and in otherwise good health, she may be a good candidate for radioiodine therapy. This generally scares the crap out of me, but I want her to have it. I understand that this treatment works by killing off the benign tumorous material on the thyroid, and is generally safe. However, is the problem is caused by an enlarged thyroid gland itself does it still work? If so, how? If anyone has any experiences with feline hyperthyroidism, and especially treatment options, that you can share with me I'd really appreciate it ...especially positive ones! Vets who can offer advice based on their experiences and knowledge would be greatly appreciated as well. Sorry, I know this was long! Alot of people here have been really great to me and I wanted to let them know about all my little ones rather than just asking some questions. Thanks so much! Dee > I was sad to learn two weeks ago that my oldest and first cat, Misty Blue, > is hyperthyroid. She started medication last week and will go back for [quoted text clipped - 9 lines] > problem is caused by an enlarged thyroid gland itself does it still work? > If so, how? I think if you can afford it, radioactive iodine is the way to go. Cats seem to tolerate it very well -- there are no real side effects except for the possibility of winding up needing to supplement thyroid hormones (which happens rarely). Surgery has all sorts of potential complications, and tapazole has lots of side effects. Here's a web site for a company that does I131 treatment (there are lots out there now): http://www.thyrocat.com/inside/radioactive-iodine.html Deborah, DVM On Wed, 11 Feb 2004, CPT (former!) Deborah wrote: > I think if you can afford it, radioactive iodine is the way to go. Cats > seem to tolerate it very well -- there are no real side effects except for [quoted text clipped - 5 lines] > > Deborah, DVM Hey Vet Deb, thanks :) I actually can't afford it, but after having spent seven thousand dollars on h0p alone this year, hey what's a little more debt for my girl?! Misty does have insurance though the day after she was diagnosed I was notified that it has been erroneously canceled due to a "computer glitch." Hopefully that'll be straightened out and help with the costs. Are you familiar with any of the centers that perform the radioiodine treatments? The closest to me is in Baltimore/Catonsville, Maryland, but I'd be willing to take her elsewhere if there's any place that has a particularly great reputation. The internist I spoke with suggested that Misty be on tapazole for at least two months before receiving the treatment. Do you feel that's necessary? I do worry about side effects. I've also read and been told that she may be kept anywhere from five days to a month after treatment! That's quite a difference. Any idea? You're such a nice lady :) Dee The treatment itself consists of one simple subcutaneous injection of I131. The reason the cat has to be kept is to let the radiation wear off to a safe level. With people, they tell you to flush toilets, keep away from pregnant women, etc, but cats aren't so compliant. In our area (metro NYC) most cats are kept 5-12 days, with times getting shorter. The 'cure rate' is extremely high with I131, and it is by far the best way to go if you can afford it. The cost is usually about $1200 in this area. I'm not sure why Tapazole was recommended for a month, but you usually have to be off Tapazole for a week or so before treating with I131. Mark, DVM > On Wed, 11 Feb 2004, CPT (former!) Deborah wrote: > [quoted text clipped - 25 lines] > > Dee *The treatment itself consists of one simple subcutaneous injection of I131. *The reason the cat has to be kept is to let the radiation wear off to a safe *level. With people, they tell you to flush toilets, keep away from pregnant *women, etc, but cats aren't so compliant. In our area (metro NYC) most cats *are kept 5-12 days, with times getting shorter. * *The 'cure rate' is extremely high with I131, and it is by far the best way *to go if you can afford it. The cost is usually about $1200 in this area. *I'm not sure why Tapazole was recommended for a month, but you usually have *to be off Tapazole for a week or so before treating with I131. I recommend a trial of tapazole to make sure that when I suppress the thyroid I don't lose an unacceptable amount of kidney function. Of course, I've never had a client take me up on referral for I-131 anyway :( When I lived in SF, and worked in a small animal practice there, we sent lots of patients to Radiocat - I think it was in Pacifica IIRC. but no one here wants to go for it, I'm not sure why. -- hillary israeli vmd http://www.hillary.net info@hillary.net "uber vaccae in quattuor partes divisum est." not-so-newly minted veterinarian-at-large :) > I recommend a trial of tapazole to make sure that when I suppress the > thyroid I don't lose an unacceptable amount of kidney function. Thanks Hillary & buglady. Hillary, does loss of kidney function happen often percentage wise? > Of course, > I've never had a client take me up on referral for I-131 anyway :( > When I lived in SF, and worked in a small animal practice there, we sent > lots of patients to Radiocat - I think it was in Pacifica IIRC. but no one > here wants to go for it, I'm not sure why. Hmm...The center near me is "Radiocat." I wonder why people wouldn't want to take you up on it. I knew that I wanted to have it for her as soon as I read about it, although I hate the thought of her being alone and scared for so long :/ I'm afraid she's spoiled as hell. Dee *On Thu, 12 Feb 2004, Hillary Israeli wrote: * *> I recommend a trial of tapazole to make sure that when I suppress the *> thyroid I don't lose an unacceptable amount of kidney function. * *Thanks Hillary & buglady. * *Hillary, does loss of kidney function happen often percentage wise? Thyroxine increases GFR. Take away thyroxine, you decrease GFR, generally speaking. So this is expected when you treat hyperthyroidism. The question is only whether or not the resulting GFR allows for acceptable kidney function, which can't be determined until you treat and see what you're left with. *Hmm...The center near me is "Radiocat." I wonder why people wouldn't want *to take you up on it. I knew that I wanted to have it for her as soon as I think Radiocat owns a lot of centers around the country. People around here don't want their cats being away from them for so long, don't like the idea of radiation (many of them have negative associations with it from their own or relatives' cancer treatments), and most weirdly it seems just prefer to do what "everyone else" does, which is treat with tapazole.  Signaturehillary israeli vmd http://www.hillary.net info@hillary.net "uber vaccae in quattuor partes divisum est." not-so-newly minted veterinarian-at-large :) > Thyroxine increases GFR. Take away thyroxine, you decrease GFR, generally > speaking. So this is expected when you treat hyperthyroidism. The question > is only whether or not the resulting GFR allows for acceptable kidney > function, which can't be determined until you treat and see what you're > left with. And you would suggest a treatment course of a couple of months with tapazole to guage kidney function afterwards? > I think Radiocat owns a lot of centers around the country. People around > here don't want their cats being away from them for so long, don't like > the idea of radiation (many of them have negative associations with it > from their own or relatives' cancer treatments), and most weirdly it seems > just prefer to do what "everyone else" does, which is treat with tapazole. I looked at their web site on the first day (which is http://www.radiocat.com for anyone else who might be interested) and saw that they do have a number of treatment centers. Luckily one of them is only about a 45 minute drive from here. I am really concerned about Misty being alone for so long though. Unfortunately I spoiled the hell out of her as a kitten ...heh. she was my first cat and I didn't really know any better. Now she won't eat unless I sit on the kitchen floor and feed her from my hand!. Does the radioiodine treatment require any kind of a special diet? Dee *On Thu, 12 Feb 2004, Hillary Israeli wrote: * *> Thyroxine increases GFR. Take away thyroxine, you decrease GFR, generally *> speaking. So this is expected when you treat hyperthyroidism. The question *> is only whether or not the resulting GFR allows for acceptable kidney *> function, which can't be determined until you treat and see what you're *> left with. * *And you would suggest a treatment course of a couple of months with *tapazole to guage kidney function afterwards? Well, I'd probably treat for a month, recheck everything, and then see where we are and decide how to proceed from there, but there are probably a lot of different opinions on this. *floor and feed her from my hand!. Does the radioiodine treatment require *any kind of a special diet? I don't think so. Signaturehillary israeli vmd http://www.hillary.net info@hillary.net "uber vaccae in quattuor partes divisum est." not-so-newly minted veterinarian-at-large :) > I've never had a client take me up on referral for I-131 anyway :( > When I lived in SF, and worked in a small animal practice there, we sent > lots of patients to Radiocat - I think it was in Pacifica IIRC. but no one > here wants to go for it, I'm not sure why. Nor have our clients. Probably due to cost ($1,200 IIRC), distance from here (2 hour drive) and time they require for hospitalization (6 weeks). My sister went through that for her thyroid cancer and had to avoid my children at Christmas as well as my friend with CF awaiting lung transplant. Now, if I had a cat at home (and I had no kids) it would be easy enough to put it in a crate while visitors were here. My sister, however, wasn't so accepting of the crate option. ;-) -Sharon > > I've never had a client take me up on referral for I-131 anyway :( > > When I lived in SF, and worked in a small animal practice there, we sent [quoted text clipped - 3 lines] > Nor have our clients. Probably due to cost ($1,200 IIRC), distance from here > (2 hour drive) and time they require for hospitalization (6 weeks). I can get past the cost, it's the least I can do for her ...but SIX WEEKS? I'm not prepared for that. I was told that the time had lessened? Dee > I can get past the cost, it's the least I can do for her ...but SIX WEEKS? > I'm not prepared for that. I was told that the time had lessened? According to hubby vet, that's what the facility keeps them for that is closest to us. I would bet that the length of time varies. I wouldn't take my word as being the standard. And I assume that each case may vary depending on home situations. Find out what facility your vet refers to and contact them directly for information. Don't rule anything out until you've had all your questions answered to your satisfaction. -Sharon > According to hubby vet, that's what the facility keeps them for that is > closest to us. I would bet that the length of time varies. I wouldn't take > my word as being the standard. And I assume that each case may vary > depending on home situations. Find out what facility your vet refers to and > contact them directly for information. Don't rule anything out until you've > had all your questions answered to your satisfaction. I just re-read the websites that states there's a minimum 7 day stay required by law ...but the same site states that they're usually kept 3 - 5 days after the injection, so I'll definitely be in contact with them. I've learned to do alot of research and ask alot of questions when it comes to health concerns. Thanks Sharon. Dee *> I can get past the cost, it's the least I can do for her ...but SIX WEEKS? *> I'm not prepared for that. I was told that the time had lessened? * *According to hubby vet, that's what the facility keeps them for that is *closest to us. I would bet that the length of time varies. I wouldn't take *my word as being the standard. And I assume that each case may vary *depending on home situations. Find out what facility your vet refers to and Probably also depending on local regulations for radiation safety. Signaturehillary israeli vmd http://www.hillary.net info@hillary.net "uber vaccae in quattuor partes divisum est." not-so-newly minted veterinarian-at-large :) ospam.com> wrote: > *> I can get past the cost, it's the least I can do for her ...but SIX WEEKS? > *> I'm not prepared for that. I was told that the time had lessened? [quoted text clipped - 5 lines] > > Probably also depending on local regulations for radiation safety. Ah. Could be. Thanks. -Sharon > Date: Wed, 11 Feb 2004 23:32:56 GMT > From: MARK LERMAN <pomonamark@optonline.net> > The 'cure rate' is extremely high with I131, and it is by far the best way > to go if you can afford it. The cost is usually about $1200 in this area. > I'm not sure why Tapazole was recommended for a month, but you usually have > to be off Tapazole for a week or so before treating with I131. Thanks so much Mark! I understood that the reason for keeping her on the medication for a couple of months had to do with kidney function. Umm....as I understood it, something to do with hyperthyroidism causing high blood pressure, causing increased urination - and that if the kidneys have been affected lowering her blood pressure too much might make elimination difficult. Does that make any sense? As I said, she was only very recently diagnosed and we haven't even been to the second vet visit yet. The problem has definitely been caught early, as she was in for a full exam for her insurance in July and there was no problem then. Dee Unfortunately, any treatment for hyperthyroidism lowers the blood flow through the kidneys (actually, it brings it back to normal), so if the cat has poor kidney function, it can go into renal failure after treatment. Hyperthyroidism is very common in our area, so we've had many of our clients elect I131. A thorough evaluation of kidney function is in order before any treatment, especially so for older cats. If a cat has borderline kidney disease and only slight hyperthyroidism, we often won't treat for hyperthyroidism and monitor both thyroid and kidney function as well as cardiac function. Mark, DVM > > Date: Wed, 11 Feb 2004 23:32:56 GMT > > From: MARK LERMAN <pomonamark@optonline.net> [quoted text clipped - 15 lines] > > Dee *treatment, especially so for older cats. If a cat has borderline kidney *disease and only slight hyperthyroidism, we often won't treat for *hyperthyroidism and monitor both thyroid and kidney function as well as *cardiac function. You know, I was going to say that. :) But then I read the hyperthyroidism discussion on VIN....it's kind of complex, but in a nutshell someone was saying that while the hypermetabolic state increases renal blood flow, this MAY be helpful for renal function but if we consider the "hyperfiltration theory," then maybe it isn't, and it may be better to attain euthyroidism and then deal with any uncovered renal insufficiency later, and not "hide from it". Now, I am the first to admit I haven't done any further reading on the subject. I'm going to have to, though, because this whole discussion (in the feline library under "additional rounds" on VIN) has me sort of confused! I'll have to look up the DiBartola study that was referenced. Signaturehillary israeli vmd http://www.hillary.net info@hillary.net "uber vaccae in quattuor partes divisum est." not-so-newly minted veterinarian-at-large :) > You know, I was going to say that. :) But then I read the hyperthyroidism > discussion on VIN....it's kind of complex, but in a nutshell someone was [quoted text clipped - 3 lines] > attain euthyroidism and then deal with any uncovered renal insufficiency > later, and not "hide from it". ..........Certainly the choices are not good, whichever way you go. I've had an HT cat, but never a cat in renal failure. The holistic vet I took the HT cat to said he had 4 cats he was trying to treat who all had RAI and ended up in renal failure. I don't think this means that the rate of this happening was high, only that he was getting the tough cases. As to not treating hyperthyroidism (speaking of not using any of the conventional methods), there's a number of things you can do holistically that may help the body deal with HT, but of course cannot fix the problem. buglady take out the dog before replying > > You know, I was going to say that. :) But then I read the hyperthyroidism > > discussion on VIN....it's kind of complex, but in a nutshell someone was [quoted text clipped - 12 lines] > methods), there's a number of things you can do holistically that may help > the body deal with HT, but of course cannot fix the problem. I've had 2 elderly cats with hyperthyroidism and both had kidney issues. I went the tapazole route with both of them, with limited success. With the first, back in 1986, I was going to go the I131 at UT Knoxville but his BUN was so high they refused to do it and taught me how to give fluids. By the time the next cat was diagnosed in the mid 90's, we chose the tapazole because of the condition of the kidneys. I've got a 9 year old that was tested today - that just seems so young to me but we'll see. Kate > I've got a 9 year > old that was tested today - that just seems so young to me but we'll > see. > > Kate Best of luck with that Kate. Dee > > I've got a 9 year > > old that was tested today - that just seems so young to me but we'll [quoted text clipped - 3 lines] > > Best of luck with that Kate. Thanks, Dee. I just got the results back and his T4 is normal. In fact everything is in the normal ranges except for the GGTP which is low. I'm wondering why just the T4 was tested - I thought TSH was the better test. His vet is out of town until Thursday so we saw her associate and her stand is now to wait until the regular vet gets back. Frustrating, because I still don't know what's causing the personality changes (restless) the voracious eating and the weight loss. Kate > Thanks, Dee. I just got the results back and his T4 is normal. In fact > everything is in the normal ranges except for the GGTP which is low. I'm [quoted text clipped - 3 lines] > because I still don't know what's causing the personality changes > (restless) the voracious eating and the weight loss. We took in a 14 year old stray last October, Ceili :) My vet detected a heart murmer and was almost positive that she had hyperthyroidism, but her T4 came back negative. We took her to a cardiologist who also felt that she myst be hyperthyroid, and performed the tests again. Negative again, yet she displays all the signs. My vet said that sometimes they can show a false negative (for reasons that aren't quite clear to me). I'm glad to hear that all your bloodwork came back ok! Dee her > T4 came back negative. We took her to a cardiologist who also felt that > she myst be hyperthyroid, and performed the tests again. Negative again, > yet she displays all the signs. My vet said that sometimes they can show > a false negative (for reasons that aren't quite clear to me). .......There was a study done where they drew blood numerous times during the day and thyroid function test results were different in some of the blood draws. buglady take out the dog before replying > ..........Certainly the choices are not good, whichever way you go. I've > had an HT cat, but never a cat in renal failure. The holistic vet I took [quoted text clipped - 4 lines] > methods), there's a number of things you can do holistically that may help > the body deal with HT, but of course cannot fix the problem. Thanks again buglady, Hillary, and Mark. I'm a bit surprised to hear of the number of renal failure cases. Both the vets I've spoken with have assured me that there's no danger involved with the radioiodine procedure other than the small chance of the cat becoming hypothyroid. Am I being naive? Dee *I'm a bit surprised to hear of the number of renal failure cases. Both *the vets I've spoken with have assured me that there's no danger involved *with the radioiodine procedure other than the small chance of the cat *becoming hypothyroid. Am I being naive? The I-131 in and of itself is not toxic to the kidneys. It's just that there is a measurable percentage of cats who, when you treat their hyperthyroidism appropriately by *any* method, will turn out to have some significant renal insufficiency and who may then develop renal failure. This is because, in my understanding, the hypermetabolic state promoted by hyperthyroxinemia, if you will, increases the glomerular flow rate (blood flow to the kidneys, essentially), and when you take that away you can find that the kidneys were actually benefiting from that state. Signaturehillary israeli vmd http://www.hillary.net info@hillary.net "uber vaccae in quattuor partes divisum est." not-so-newly minted veterinarian-at-large :) > The I-131 in and of itself is not toxic to the kidneys. It's just that > there is a measurable percentage of cats who, when you treat their [quoted text clipped - 4 lines] > flow to the kidneys, essentially), and when you take that away you can > find that the kidneys were actually benefiting from that state. Thanks Hillary, I think I'm beginning to understand things a little better. Hopefully the fact that we caught the concition early on will mean that her kidneys haven't been affected too much yet. Dee ....BTW Hillary did you know that your class notes are still in Google cache? I ran across one today and oddly enough it dealt with hypo-hyper thyroid problems. You noted that the professor in question said that 15-20 years ago (plus 7 more years!) hyperthyroidism was not very prevalent in cats. His response was who knows why. Got any thoughts on that now? buglady take out the dog before replying * *"Hillary Israeli" <hillary@hillary.net> wrote in message *news:slrnc2pmnn.g1r.hillary@manx.misty.com... * *....BTW Hillary did you know that your class notes are still in Google Well, they're still on my webserver, so I figured sure, Google is indexing them :) *cache? I ran across one today and oddly enough it dealt with hypo-hyper *thyroid problems. You noted that the professor in question said that 15-20 *years ago (plus 7 more years!) hyperthyroidism was not very prevalent in *cats. His response was who knows why. Got any thoughts on that now? Yes. I think I still don't know why. I have heard theories out the wazoo - ranging from cat food to environmental toxins to increased surveillance and all kinds of wacky ideas - but nothing that actually makes any sense. BTW, I don't think it's odd that my notes dealt with thyroid problems! I mean, the thyroid and its malfunctions WERE covered in class :) -h. Signaturehillary israeli vmd http://www.hillary.net info@hillary.net "uber vaccae in quattuor partes divisum est." not-so-newly minted veterinarian-at-large :) > Well, they're still on my webserver, so I figured sure, Google is indexing > them :) ...........you must have rearranged something then, as I could only view the cache, not the real page, so I thought you'd taken them down. 15-20 > *years ago (plus 7 more years!) hyperthyroidism was not very prevalent in > *cats. His response was who knows why. Got any thoughts on that now? > > Yes. I think I still don't know why. I have heard theories out the wazoo - > ranging from cat food to environmental toxins to increased surveillance > and all kinds of wacky ideas - but nothing that actually makes any sense. ......the one that makes the most sense to me is the leakage from the polycarbonate lining of canned cat food - bisphenol-A - an estrogen mimic. > BTW, I don't think it's odd that my notes dealt with thyroid problems! I > mean, the thyroid and its malfunctions WERE covered in class :) ......Oh, yes, I see, didn't mean that! It's just that I was looking up something about pseudohermaphradism (?? can't remember the real ending of this word!) in dogs and the page on thyroid popped up - as you'd referenced this as the topic of the last seminar. Just thought it was funny considering HT was being discussed. buglady take out the dog before replying * *"Hillary Israeli" <hillary@hillary.net> wrote in message *news:slrnc2s4p5.or1.hillary@manx.misty.com... *> Well, they're still on my webserver, so I figured sure, Google is indexing *> them :) *...........you must have rearranged something then, as I could only view the *cache, not the real page, so I thought you'd taken them down. My webserver changed its IP adress today, that's all. Give the DNS a chance to propagate and get back to me :) *......the one that makes the most sense to me is the leakage from the *polycarbonate lining of canned cat food - bisphenol-A - an estrogen mimic. But, it happens to cats who eat dry food too! Signaturehillary israeli vmd http://www.hillary.net info@hillary.net "uber vaccae in quattuor partes divisum est." not-so-newly minted veterinarian-at-large :) > I think if you can afford it, radioactive iodine is the way to go. Cats > seem to tolerate it very well -- there are no real side effects except for [quoted text clipped - 3 lines] > does I131 treatment (there are lots out there now): > http://www.thyrocat.com/inside/radioactive-iodine.html ............The biggest negative is ending up with a cat in renal failure. Hyperthyroidism sometimes masks renal problems. Although most facilities are very picky about who the candidates are, this sometimes still happens and must be taken into consideration. buglady take out the dog before replying My cat (now age almost 17) has been on Tapazole for about 5 years now with no side effects. After she was stabilized on the meds, I took her in every 6 months to check her bloodwork. Gail > > I was sad to learn two weeks ago that my oldest and first cat, Misty Blue, > > is hyperthyroid. She started medication last week and will go back for [quoted text clipped - 19 lines] > > Deborah, DVM > My cat (now age almost 17) has been on Tapazole for about 5 years now with > no side effects. After she was stabilized on the meds, I took her in every 6 > months to check her bloodwork. > Gail Good to know Gail, thanks. My vet said this was usually the case as well, but suggests the radioiodine treatment as actually being the best option. Dee I had one of mine treated by Radiocat in Northern VA. I brought him in a Monday morning and picked him the next Saturday. It "cured" it. SignatureLarry (Owned by seven cats: two grey, one black, white, black and white, and grey and white) > > > My cat (now age almost 17) has been on Tapazole for about 5 years now with [quoted text clipped - 6 lines] > > Dee > I had one of mine treated by Radiocat in Northern VA. I brought him in a > Monday morning and picked him the next Saturday. It "cured" it. Thanks Larry, that's what I want to hear! :) The more I think of her being alone all that time in a strange place though...oh boy :/ Dee > > I had one of mine treated by Radiocat in Northern VA. I brought him in a > > Monday morning and picked him the next Saturday. It "cured" it. [quoted text clipped - 3 lines] > The more I think of her being alone all that time in a strange place > though...oh boy :/ Yes, I certainly balked at that as well. Best wishes to you both. Kate > > The more I think of her being alone all that time in a strange place > > though...oh boy :/ > > Yes, I certainly balked at that as well. Best wishes to you both. > > Kate Thanks Kate! Next vet visit is Thursday and we'll know more then. Dee > treatment. It's been suggested that because Misty is only 11 and in > otherwise good health, she may be a good candidate for radioiodine > therapy. This generally scares the crap out of me, but I want her to have > it. We have a hyperthyroid cat, Sir Max the Fearful, discovered at about age 16. He's doing fine on methimazole (Tapazole), and we've chosen to keep him on that instead of doing radioiodine, because Max gets terribly anxious when he's parted from his people. He gets to be a travelling cat at times, because he needs his meds, so we take him along. The price of methimazole has gone up about 50-70% since we started treatment a couple of years ago. Check around on prices, as it can vary a lot from source to source, should you keep her on meds. Kay Lancaster kay@fern.com 1 |
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