Hyperthyroidism In Cats

My 3 o'clock appointment was a new patient with the hallmark symptoms of hyperthyroidism in cats ...severe weight loss and bloody diarrhea. The cat, who I will refer to as Calvin, had been to the emergency room 2 weeks earlier, and indeed was diagnosed with hyperthyroidism. My technician informed me that Calvin was in to see us because Calvin's "mom" was out of medication and needed a current blood level in order for me to write her a prescription. My tech said that Calvin had only been on thyroid medication for 2 weeks since he was first diagnosed only 2 weeks ago.

Thinking this would be a fairly quick routine appointment, I headed for the exam room. Hyperthyroidism in cats is such a common disease that I've seen hundreds, probably thousands, during my veterinary career. The diagnosis is fairly simple and the treatment straightforward and very successful. It's one of those diseases that we like to diagnosis in the sense that if a cat has to have something, let it be hyperthyroidism because of its easy, successful treatment.

As I entered the exam room, I said hello to the client and immediately noticed her really handsome, although thin, kitty. He was as sweet as he was handsome, a real pleasure to work with. I admired and petted him as I repeated the the history my tech had given me to my client to verify that I had the facts correct.

As sometimes happens, the history the client told me was different and more extensive than that told to my technician. Calvin's owner told me that her kitty had actually been diagnosed 2 years earlier with hyperthyroidism. He had been prescribed the appropriate medication at that time, but when she got home and tried to give it to him over the next few days, she found it too difficult to do and gave up. He hadn't had medication anytime in the two years since then.

Now he had severe weight loss and bloody diarrhea and wasn't eating at all. The emergency clinic ran a thyroid test, the result of which was the highest thyroid reading I have ever seen in a cat. The doctors in emergency had restarted Calvin on his thyroid medication and instructed his owner to take Calvin to a local vet in 2 weeks for a blood level. And there they were, right in front of lucky me.

As I listened to her story, I had to bite my tongue, freeze an understanding smile on my face, and breathe deeply.

You see, while hyperthyroidism left untreated has serious consequences, if it is treated, the kitty can be cured and lead a normal life and have a normal lifespan. So when I see or hear of a cat that was a known hyperthyroid cat that hasn't been treated, it's very difficult to hear about. You wouldn't believe the number of times an owner has brought her cat in for weight loss and vomiting or diarrhea and as we obtain the blood samples I tell her, "if it has to be something, let it be hyperthyroidism". Hundreds, thousands of times I have said this. And that's because it is so treatable.

Calvin had gone 2 years without treatment all because he was difficult to give pills to. There were several things that could/should have been different about this situation.

(1) The initial vet could have educated the client more thoroughly on the dangers of not treating the cat.

(2) The veterinary office should have had a system in place that reminds them when to check up on patients that have been in. Calvin should have had a phone call asking how he was doing and how was the medicating going and to remind the owner he needed a recheck in 3 weeks.

(3) The owner should have called her vet when she found she couldn't get the pills in Calvin instead of looking at him and saying "He looks fine to me, how bad can it be if he doesn't get his medication?"

(4) The owner should have had Calvin back to the vet for at least a yearly check-up regardless of the hyperthyroid condition. If the kitty had his annual physical, more weight loss would have been apparent and perhaps new bloodwork would have been analyzed showing even higher levels of thyroid hormone. That, perhaps, would have led to the vet properly educating the client about the devastating effects of not treating hyperthyroidism in cats and discussing alternative types of medication that might be easier to administer (liquid, ear gels) or the options of surgical removal of the thyroid glands or radioactive iodine treatment.)

Fortunately, the outcome of this case may still be a happy one. Calvin began medication again, he started eating, and any heart disease he has may still be reversed. This often isn't the case with hyperthyroidism in cats, especially after TWO years without treatment.

I hope you have learned several lessons from this case.

(1)Hyperthyroidism in cats is a serious disease and should never go untreated.

(2) If your vet prescribes medication for ANY condition and you get home and can't get it into your kitty, call your vet for an alternative treatment!!!!

(3) Anytime your vet tells you your kitty has any condition, ask questions. Learn everything you can about it, ask how serious it is; ask what the options are, ask what will happen under various scenarios, go back for rechecks ....in essence, take a very active role in your cat's medical care.

Return From Hyperthyroidism in Cats to Home

Return From Hyperthyroidism In Cats To Cat Case Presentations