Hi again
A few weeks back I posted about needing to find a Radio Iodine centre for our lovely girl who is hyperthyroid but can't have the medication, so is currently uncontrolled. She'd had a bad time when, after 3 weeks on Felimazole she developed serious acute liver problems, but seems to have recovered from that, with her blood profile from last week looking greatly improved. However, this last set of results shows something odd (to me, at least).
At point of diagnosis, her TT4 was around 89 (so definitely hyperthyroid); while on Felimazole TT4 was 21 (in normal range). She had to come off Felimazole and a test a few days later showed she was back at almost TT4 80. A month later, still having no treatment, her TT4 had dropped to to 58.7 (high normal). I don't have any experience with hyperthyroid cats and I'm wondering what to think about this - is such a wide fluctuation normal? I think I was expecting her T4 to rise - hopefully slowly - steadily until she can be treated. I wasn't expecting a drop.
Only asking because although she has been very well over the weekend, she's poorly again today, and we're worried about her.
Update on the RAI centre is that we've narrowed it down to two and it will probably be the Hyperthyroid Centre in Wetherby, if we're lucky enough to get that far. We discovered Willows in Solihull only recently, they seem great and would be much easier to get to but Wetherby seem to be looking for a cancellation for her in quite a proactive way, so we'll be ready to go, as long as she's well enough ...
Unexpected drop in T4? (Hyperthyroid)
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MissMidwinter
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Mollycat
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Re: Unexpected drop in T4? (Hyperthyroid)
I don't know - but for me this feels like the ideal opportunity to see what these RI centres are really like when your question is not the usual routine of new patients.
I'm a little puzzled though, presumably you haven't had a firm referral if you haven't decided which yet, but Wetherby seem keen to get you on a cancellation? How long is the waiting list for each of the two? If HT can't be controlled maybe waiting time might need to become a more important factor? What does your vet say?
Also, are you certain the liver issue was caused by the treatment not the disease?
I'm a little puzzled though, presumably you haven't had a firm referral if you haven't decided which yet, but Wetherby seem keen to get you on a cancellation? How long is the waiting list for each of the two? If HT can't be controlled maybe waiting time might need to become a more important factor? What does your vet say?
Also, are you certain the liver issue was caused by the treatment not the disease?
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MissMidwinter
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Re: Unexpected drop in T4? (Hyperthyroid)
Hi Mollycat
Yes, we have a referral to Wetherby (and vet will do one for Willows as well, if needs be). Availability of Radio Iodine seems to be a big problem for all the centres at the moment - I did a lot of ringing around - some have stopped taking referrals, and the others all have waiting lists of weeks or months.
However, as Chess can't have the medication, they (Wetherby) are looking out for a cancellation for her, and are in regular contact. Willows also said they'd find a way to fit her in. Sadly, we were offered an appointment this week, but couldn't take it because she is now very unwell again. She'd been doing really well right up to the end of last week, when she had the vaccination. Blood results were looking much, much better, with the only surprise being the big drop in T4 - which makes no sense to me, but then I don't know much about hyperthyroidism in cats.
Back to the vet tomorrow, and most likely in for a day on fluids. Scarily, our own vet is away until next week. But the vet at Wetherby is going to give us a call to see how she is, so I'll ask about the T4 levels.
Re: liver problems, it's probably a bit of both. The massively elevated levels have plummeted since she came off Felimazole, but are still above normal. Vet thinks this is now within what he'd expect for a cat with untreated hyperthyroidism. Medication, well - she was showing classic signs of Felimazole intolerance - acute liver problems, itching, facial lesions; plus was clearly itchy and unwell for a while after each tablet. I've had these drugs myself and know that they need to be treated with respect; it's serious medication, for a serious disease, and I guess although they do work for most (humans and animals), there's always a risk.
Yes, we have a referral to Wetherby (and vet will do one for Willows as well, if needs be). Availability of Radio Iodine seems to be a big problem for all the centres at the moment - I did a lot of ringing around - some have stopped taking referrals, and the others all have waiting lists of weeks or months.
However, as Chess can't have the medication, they (Wetherby) are looking out for a cancellation for her, and are in regular contact. Willows also said they'd find a way to fit her in. Sadly, we were offered an appointment this week, but couldn't take it because she is now very unwell again. She'd been doing really well right up to the end of last week, when she had the vaccination. Blood results were looking much, much better, with the only surprise being the big drop in T4 - which makes no sense to me, but then I don't know much about hyperthyroidism in cats.
Back to the vet tomorrow, and most likely in for a day on fluids. Scarily, our own vet is away until next week. But the vet at Wetherby is going to give us a call to see how she is, so I'll ask about the T4 levels.
Re: liver problems, it's probably a bit of both. The massively elevated levels have plummeted since she came off Felimazole, but are still above normal. Vet thinks this is now within what he'd expect for a cat with untreated hyperthyroidism. Medication, well - she was showing classic signs of Felimazole intolerance - acute liver problems, itching, facial lesions; plus was clearly itchy and unwell for a while after each tablet. I've had these drugs myself and know that they need to be treated with respect; it's serious medication, for a serious disease, and I guess although they do work for most (humans and animals), there's always a risk.