by Elise
(Virginia)

Dear Dr. Neely,

One week ago my cat became ill, lying in one spot all day, holding a fever, and not eating much of anything. We took her to the vet and after some blood work she was diagnosed with hyperthyroidism. Our vet also said she is a little diabetic.

I really can not afford to run anymore tests at this point, because finances are extremely tight.

He prescribed us Tapazole pills, half of a 5mg pill every 12 hours.

She bounced back for about a week, but the past couple of days she has gone down again. not eating and staying put. she seems to be breathing a little wheezy, and just seems very sick.

We almost had her euthanized last week because we can not afford the expenses, and I'm fearful it may come to that again.

Can you offer any advice? I am torn and wonder if she just needs a higher dose, or if her heart has already been too badly effected.

Thanks so much,
Elise

Dear Elise,

Thank you for writing in with concern for your cat. Unfortunately, there is no way to know what dosage of the feline medication Tapezol will work best for your cat’s hyperthyroidism without rechecking her thyroid level in 3 weeks. Your veterinarian has started your cat on what seems like a normal starting dosage, which was estimated based on your kitty’s initial bloodwork.

Without knowing your cat’s bloodwork values, especially her thyroid level, I couldn’t say for certain whether your cat needs more or less medication. The symptoms you described actually sound more consistent with your cat receiving too much medication or being on too high of a dose, but the only way to know for certain would be to recheck your cat’s thyroid and kidney value in 3 weeks. Fortunately, the follow-up bloodwork shouldn’t cost nearly as much as the initial diagnostic bloodwork did, and your veterinarian should be willing to discuss the price of this blood recheck so you can plan accordingly.

An important part of rechecking your cat’s bloodwork is to also check how your cat’s kidneys are reacting to treatment for her feline hyperthyroidism. Hyperthyroidism gives kidneys extra blood flow, so it can make your cat’s kidneys appear to be working better than they really are. Upon beginning treatment, blood flow decreases, and kidney insufficiency may be more evident. So, when rechecking your cat’s thyroid level, your veterinarian will check her kidney values as well. It is possible that feline kidney disease is causing your cats illness symptoms, too, or at least contributing to them.

The cat breathing problem you described concerns me. Depending on how long feline hyperthyroidism goes untreated, the result can be severe heart disease. As a result of this heart disease, fluid may build up in the cat’s lungs or outside the lungs. This is extremely serious and should be looked at by a veterinarian as soon as possible.

I also want to point out that saying a cat is “a little diabetic” is like saying a woman is “a little pregnant.” Ultimately, a veterinarian needs to decide whether a cat is or isn’t diabetic. Your vet may have simply meant that your cat’s blood glucose was slightly elevated, which is a possibility just from the stress of an office visit. If your cat’s glucose level was within the diabetic range, your veterinarian would have run or recommended running additional tests, including more glucose readings and checking for glucose in your cat’s urine.

I can certainly understand financial constraints, and am sorry to hear that you are presented with such a struggle at this time. I mean this with all gentleness, but if you can’t afford to treat your cat’s health condition(s) and she is having difficulty breathing, it would be best to euthanize her. Breathing difficulties are a sign that a cat is suffering, and although your cat’s health conditions can likely be treated, if you can’t afford to do so, it would be best to put your precious cat to rest.