Hyperthyroidism in Cats Disease in cats: Hyperthyroidism is caused by a tumor, usually benign, of the thyroid gland that secretes excessive amounts of thyroid hormone. This has many effects on cats



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Hyperthyroidism in Cats

The Disease

Hyperthyroidism is caused by a tumor, usually benign, of the thyroid gland that secretes excessive amounts of thyroid hormone. This has many effects on the body since the thyroid controls many basic body functions such as heart rate and contraction, appetite, weight control, heat tolerance, water consumption, to name a few. When a cat is hyperthyroid, these functions become exaggerated.

Clinical signs

In most cases, they eat with exceptionally good appetites but lose weight. They drink and urinate more. Frequent vomiting (several times a month) and/or diarrhea often occur. Their heart beats faster, and the heart muscle can become thickened (hypertrophied), a state that can lead to heart failure. High blood pressure can occur, and hypertension can lead to further strain on the heart and eye problems (such as detached retinas). Behavior changes such as nervousness, restlessness or even aggression can result. If left untreated, this condition will result in a progressive weight loss and overly stressed organs.

Diagnosis

Cats with these signs are suspected of being hyperthyroid and sometimes an enlarged thyroid gland can be felt along the bottom part of the neck alongside the windpipe. However, the diagnosis is made on the basis of a blood test.

A complete panel and urinalysis are helpful to rule out concurrent diseases, and it is specifically a T4 level or sometimes, a free T4 (done by a different laboratory technique) that diagnoses this condition.

Assessment of the cat's blood pressure is recommended since hypertension is a common complication of hyperthyroidism. Sometimes, this resolves with the treatment of the hyperthyroid state. However, sometimes, it necessitates specific medication to control. As with humans, high blood pressure has several negative side-effects including additional stress on the heart and kidneys and the risk for sudden blindness due to retinal detachment.

Once your cat's condition has been diagnosed, your veterinarian will discuss treatment options. There are 3 treatments, each with advantages and disadvantages.

Medication

The most commonly used medication is methimazole (Tapazole). This can be prescribed through a human pharmacy as a tablet or a veterinary compounding pharmacy as a flavored chewable tablet or a flavored liquid, given orally, or as a transdermal form (a paste applied topically to inside the ear). Depending on the cat's starting T4 levels and the cat's response to the medication, it is given 1-2 times a day.

Side effects

Negative reactions to the medication can occasionally occur: decreased appetite (some leveling off from a ravenous appetite is normal after starting treatment), vomiting, diarrhea and itchiness of the head and neck. Adverse reactions, if they occur, usually happen in the first 3 months of treatment. Monitoring

After starting medication, at minimum, a blood test of T4 levels will need to be rechecked every 3-4 weeks until control is achieved. This is not a time tested and can be done at any time in relation to when the medication was given. It is ideal to do a complete blood panel that includes a T4 level since this allows for evaluation of the cat's other organs. Liver enzymes are often increased with hyperthyroidism; they should go back into the normal range with treatment of hyperthyroidism. When they remain increased or continue to go up, there is concern for concurrent liver disease. The kidney values are evaluated also since some cats will also have mild kidney failure that is "masked" by the hyperthyroid state. In these cases, cats will only "show" their kidney problems once the hyperthyroidism is treated. It also measures platelets and red blood cell counts that are sometimes decreased in numbers by the medication.

Control

Control of hyperthyroidism is achieved when the cat is doing well - no longer vomiting or having diarrhea, is no longer losing weight and is showing no ill effects from the medication and when the lab values are within normal. For most cats, this can include blood tests every 3-4 weeks until the proper dosage is attained.

Long term maintenance

For long term maintenance, a complete physical exam and complete blood panel including T4 and urinalysis and blood pressure measurement are recommended for every 6-12 months thereafter.

Pros of medication

It is relatively inexpensive. Depending on what formulation, how often the medication must be given and which pharmacy is used, costs can vary from $35-$60/month. Cons of medication

The cost of the medication will accumulate over the cat's lifetime since this is a long term treatment. A cat will not become "unhyperthyroid" and thus, is dependent on the Tapazole to suppress the overly active thyroid gland. If the medication is stopped, the cat becomes hyperthyroid again, and the disease process continues.

Blood tests need to be done at regular intervals to ensure continued control of the hyperthyroidism, and these laboratory costs can accumulate (depending on which lab tests are done, the cost can vary from $50-$100 each time). Frequency of testing depends on how the cat responds to the medication and presence of concurrent diseases.

Treatment with radioactive I 131

This treatment permanently treats the cat's condition by eliminating the hyperactive thyroid tissue. This radioisotope works specifically on the thyroid gland and doesn't affect the other organs. This treatment can be done at any time during a hyperthyroid cat's life, even after initiation of treatment with tapazole. Recent blood work and urinalysis is required before referral for this treatment. If a patient has been on tapazole for more than 90 days, stopping the drug for 7 days prior to I131 treatment is required.

Long term maintenance For long term maintenance, treated cats are recommended to have their T4 levels monitored the first and third months post treatment. A complete physical exam with a complete blood panel including T4 and urinalysis and blood pressure measurement are recommended for every 6-12 months thereafter.

Pros of I131

It is a permanent treatment, and it avoids the need for daily medication with Tapazole and eliminates the need for frequent lab testing. It is the treatment of choice for cats that are experiencing adverse effects to Tapazole.

Cons of I131

The treatment is done at only a few facilities with the necessary equipment (a referral can be made for hospitals in the area providing this service).

It can be costly. Total treatment costs are usually around $850-1000. This includes a scan using technetium (not done at all facilities), the I131 injection, general health and radiation monitoring and the stay at the hospital.

After treatment, since the cat and the cat's wastes (urine and feces) are radioactive, they need to be hospitalized for a period of time until their levels drop to an acceptable level. The usual stay in the hospital is 4-10 days during which the cat cannot be visited. Even after discharge, for a period of time-usually 2 weeks, there are certain precautions to be followed such as limiting close contact and extra care with removal of urine and feces from the litter box.

While usually only one treatment with I 131 is needed, occasionally, a second treatment is needed. This is needed in less than 2% of cats. Almost all cats are cured after a second treatment.

Also, while most of cats that have received I 131 will have normal thyroid function after treatment, there are a few cats that have too low thyroid levels (hypothyroid) after treatment. This can occur in less than 5% of cats. If these cats show signs of low energy levels and dull coats with dandruff, these cats will need thyroid supplementation. This medication, thyroxine (Soloxine), is a long term treatment. However, it is less expensive than Tapazole, and fewer medical problems arise from hypothyroidism compared to hyperthyroidism.

Surgery

Surgery can be done to remove the hyperthyroid gland (thyroidectomy). This approach is usually recommended in cases where the thyroid tumor is malignant. Long term maintenance

For long term maintenance, treated cats are recommended to have their calcium levels monitored daily the first 5-7 days post surgery. A complete physical exam with a complete blood panel including T4 and urinalysis and blood pressure measurement are recommended for every 6-12 months thereafter.

Pros of Surgery

It is usually a permanent treatment.

Cons of Surgery

These cats are often at risk with anesthesia. Occasionally, the hyperthyroid tissue can re-grow, resulting in recurrence of the hyperthyroidism, months to years after a successful thyroidectomy. Occasionally, hypothyroidism can result after surgical removal, thus necessitating thyroid supplementation.

Occasionally, inadvertently, the parathyroid glands, responsible for control of calcium and phosphorus levels of the body, can be removed during surgery to result in low blood calcium levels, a life-threatening problem that can result in seizures and muscle spasms. This condition is usually temporary, and calcium supplementation can help treat this, but calcium levels must be closely monitored post-operatively.

Ablation

This relatively new technique is done only at UC Davis School of Veterinary Medicine where ultrasound-guided ablation of the hyperthyroid tissue is done by an injection of ethanol. The technique is considered safe with relatively few side-effects.

Prognosis

Like most other diseases, hyperthyroidism is best diagnosed and treated in its early stages. The prognosis depends on the cat's condition at the time of diagnosis, its response to treatment and the presence of concurrent diseases such as kidney failure, diabetes, liver disease and cancer.

Whatever mode of treatment that is chosen to treat your cat's hyperthyroidism, it is important that you consistently give medication, follow up for necessary tests for monitoring your cat and notice changes in your cat's overall demeanor, energy levels, appetite, water consumption and urine output.

It is important you work closely with your veterinarian in following up with the appropriate tests and advice to ensure control of your cat's disease. Together, you can provide a good quality of life for your cat.

If you have any questions regarding this disease or its treatment, don't hesitate to contact your veterinarian.

The above is general veterinary information. Do not begin any course of treatment without consulting your regular veterinarian. All animals should be examined at least once every 12 months.

About the author: Linda Mar Veterinary Hospital and its cat-only affiliate, Coastal Cat Clinic, are small animal practices located in Pacifica, California. To find a veterinarian or to learn more about the vet clinic and our staff, visit:[http://lindamarvet.com/]


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The Advantages of Neutering Your Male Cat

Most male animals that are not used for breeding purposed are castrated, neutered, so that they can no longer impregnate a female. For cats especially, this is crucial, since there are hundreds of kittens every year that go without homes. There are many advantages to neutering your male cat, and the process is quite safe, so you should consider it if your furry feline friend is male and not yet neutered.

Male cats that have not yet been neutered are called tomcats. Simply put, it can be difficult to live with a tomcat, no matter how well trained he may be. When your cat is not neutered, he will want to get outside as frequently as possible to mate with female cats in heat. This can be disastrous if you live in a busy street with lots of traffic or if your cat is not used to being outdoors. Tomcats also roam a lot, meaning that they may travel far distances in search of female cats, and it is possible for your cat to roam too far and not know his way home. It is also possible for him simply to resist coming home at all, since he will be shut indoors. To protect your male cat, neutering it the best choice.
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Cat Blood Types

Cats have A, B and AB (rare) blood types. Most cats in the United States have type A blood - something like 99% of domestic shorthair cats have Type A blood. This ratio varies from country to country. Other cat breeds have a much higher incidence of Type B blood. As the popularity of purebred cats increases it is likely that the ratio of cats with Type B blood will also increase.

There is no "universal donor" blood type in cats - a very small amount of the wrong blood type can kill a cat if is is sensitized to the blood. This can be an issue in some cat breeds. In particular, British Shorthair, Cornish Rex and Devon Rex cats, where the percentage of Type B cats is much higher, perhaps as high as 50%. Other breeds with significant percentages of Type B blood include the Abyssinian, Himalayan, Japanese Bobtail, Persian, Somali and Sphinx breeds. (preceding information from Urs Giger, University of Pennsylvania, Kirk's XI).

If a Type B queen (mother cat) gives birth to Type A kittens, severe reactions can occur in the kittens
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Lab Blood Work Tests for Cats

Cats require blood work tests when they need to diagnosed for different diseases. Blood tests are widely used in veterinary medicine. The results are measured against normal values, which are typically present in healthy pets; these values differ across species. The lab test results may be influenced by certain drugs, so always inform your vet about the medication of your pet prior to blood tests. Prior to certain blood tests, your cat should fast.

Complete Blood Count
The complete blood count is a blood test that is very frequently employed to inform the vet about the amount of different types of cells in the blood flow of the cat.

The red blood cell count as well as the white blood cell count and the hemoglobin are important values to determine the condition of the cat. Red blood cells transport the oxygen to the vital organs, while white cells help fighting infections.

A low red blood cell count can indicate anemia, while a high amount of white blood cells can indicate an infection or a viral disease.

Platelets help the blood to clot. If the platelet count is low the cat may have a destroyed bone marrow or an autoimmune disease.

Hematocrit or packed cell volume (PCV) may also measure the red blood cell count.

Commonly Performed Blood Tests There are numerous tests that can be performed on a cat to determine his health condition. Some tests will show how a particular organ functions, while other tests will give a general overview.

The following tests are most commonly performed in felines:
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Tonkinese Cat and Kitten Information

The Tonkinese is a beautiful cat with a medium build, short hair coat and brilliant eyes. Their coat is soft and comes in a wide variety of colors, all of which are recognized for show purposes. Colors can be solid and pointed. Given the striking resemblance, pointed Tonkinese are often mistaken for Siamese cats. The nickname Tonk is used quite often.

These are energetic cats and will seek out ways to amuse itself, sometimes to the point of being mischievous. Tonks enjoy the company of favored humans and their warm affectionate nature makes them great companion cats. Intelligent and playful, the Tonk displays a fun loving curiosity, with individual personality.

History
The Tonkinese are said to be a cross between the Burmese and Siamese. Some say that they were first established in Canada, others say that they have been around for hundreds of years and still more say that they came to England in the 1800s as the Chocolate Siamese. The Tonkinese received championship recognition in 1984.

The ancestor of all domestic cats is the African Wildcat, the genus Felis Lybica. This genus is comprised of smaller cats. Cats are thought to have been domesticated with the advent of farming and the storage of grain. The grain attracted rats and other vermin which naturally attracted wild cats. As time evolved, certain of these cats were domesticated for the mutual benefit of both cat and man. The African Wildcat has certain features which is obvious in the housecat of today.

Health
Cats who reside in the house should generally visit the veterinarian yearly, unless health problems are evident. Cats who enjoy the outdoors may need to see the vet as many as four times a year. When you take your cat to the vet, be sure to bring along a fresh stool sample so the vet can do a fecal exam to check for internal parasites such as tapeworm, round worm, whip worms and hook worms. The vet will also check for external parasites such as fleas, ticks and ear mites.

Any vet check should include a dental examination and a cleaning if necessary. Cats who are eight years of age or older are considered geriatric and additional blood and urine tests may be necessary to screen for any health problems. At about six months of age, the kitten should also be examined for sexual maturity and decisions about birth control should be made.

Behavioral Traits
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Grooming Tips for Preventing Matted Cat Hair

Matted cat hair is entangled hair that ends up in tight knots. Long haired breeds are more susceptible to the condition than other pets. Cat hair is divided into three categories as each type of hair performs a certain role. The types of cat hair include awn hair, down hair and guard hair. The various function of cat hair involves protection from environmental contaminants, heat and cold. The uppermost layer of cat hair also determines the color of individual pets.

Cat Hair Conditions
Cats shed their fur during specific periods. However, fur loss that's caused due to skin conditions such as alopecia, dermatitis or skin allergy needs medical treatment. Although cats routinely groom themselves to maintain their fur coats, pets also develop conditions such as cat hairball due to the ingestion of hair during routine grooming. Pet owners should thus groom the cat with a brush to avoid excessive self-grooming and cat hairballs. Cats that appear sick or lethargic may avoid their routine grooming which in turn leads to matted hair. Thick knots are difficult to detangle with a comb and may cause the pet pain, if the mats are located towards sensitive areas of the body.

Tips to Separate Matted Cat Hair
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