Kidney disease + hyperthyroidism treated with diet only

[pskinberg]

Hi, all.

My 18 yr old cat has been successfully treated for hyperthyroidism with the y/d prescription food for 18 months. He isn't a candidate for surgery or iodine therapy, and he is one of the rare ones who is allergic to methimazole

As of January of 2020, he has also been diagnosed with stage 1 kidney failure. He has lost at least 50% of his body weight/muscle mass but is otherwise a pretty happy guy. We go through a lot of kitty litter but he's not vomiting or anything at this point.

Because kidney disease is usually controlled with diet, the vet didn't have any treatment options for us as he is already on a special diet to control his hyperthyroidism. Basically she just sent us home to let things take their course.

I'm wondering if anybody here has had the same experience and can offer any insight as to how and how long I can expect things to progress from here.

Thanks in advance for any replies!

Pam and Ivan the Terrible

[Mollycat]

Hi I hope I have it right that you are Pam and Ivan the Terrible is the poorly chappie!

Don't panic. Stage 1 kidney failure is really very mild and hyperthyroidism usually takes priority over it, as it seems your vet is doing. Without wishing to be too blunt, unless his kidney condition was to progress at great speed from here (which is unusual but not impossible) at 18 years old something else would be likely to get him first.

Untreated hyperthyroidism raises blood pressure and paradoxically this can mask underlying renal failure. Hence it's very common for successfully controlled hyperthyroid cats to suddenly show up with some decrease in kidney function. It could almost be seen as a sign of the success of the y/d diet that this is happening now.

My limited experience of both conditions is my Molly who was diagnosed hyperthyroid aged 11 in November 2018 and was treated by radioiodine the following April. She showed up stage 1 too. In between diagnosis and treatment hers was also controlled with y/d, very successfully. The difference is that because it was short term and against all advice I continued to give her treats of real meat. I did my own extensive reading research and made that decision, it's absolutely not recommended, but the diet still worked for her in spite of it. After her treatment I chose not to put her on the renal diet but to focus on higher protein food to help her rebuild muscle. We are keeping an eye on her levels and continue to make decisions based on her age, quality of life and balancing opposite needs.

I always recommend this website http://www.felinecrf.org/index.htm which if you scroll a long way down the left hand side menu has a section specifically on hyperthyroidism and CRF together. The rest of it is a really valuable resource too, practical, factual and realistic but also supportive and reassuring.

[pskinberg]

Thank you, Molly's mom.

Yea, Ivan is the cat . I'm glad to hear your kitty is doing well so far.

Thank you for the link, I will check it out. Poor guy is just a bag of bones, compared with his former chonky self. But he's very happy (except for about an hour in the evenings where he seems pretty agitated and yowly), very snuggly (probably seeking extra warmth) and just generally wants to be picked up and carried around all the time. It's hard to imagine that he will be able to sustain much more muscle wasting before it becomes difficult for him to get around, but maybe it only progresses to a certain point and levels off? Will be interesting to see what happens!