Tuesday, September 16, 2014

Hyperthyroidism

Hyperthyroidism as the name implies is the opposite of hypothyroidism that we looked at last week. Another opposite of this condition is that cats are typically the ones affected not dogs. It also seems to occur mainly in older cats, however it is possible to see it in younger cats.
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Symptoms of this condition include increased appetite with weight loss, vomiting and diarrhea, increased urination, increased respiratory rate, hyperactivity and even aggression. On physical exam a veterinarian may also note an abnormal heart rhythm or murmur. Owners may note that the pet is very thin and the nails are very thickened. Patients can demonstrate one or several of these symptoms.
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To determine if the cat has hyperthyroidism one of the first steps will be blood work. A general blood screening is a good place to start. This should include a complete blood count and chemistry profile as this may be needed in order to start treatment. On the chemistry profile many times there is a liver value (Alanine Aminotransferase or ALT) that will be elevated. While not elevated exclusively in hyperthyroidism, if this is increased along with several symptoms we may become very suspicious of hyperthyroidism. To make the diagnosis a blood sample screening the T4 will be required. There are panels as mentioned with hypothyroidism but many times a T4 can be diagnostic in cats. If elevated in conjunction with these symptoms it is recommended to consider treatment options.
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There are many options to help manage thyroid disease. One of the most popular is a daily medication called Methimazole. This will help lower the thyroid levels temporarily so it must be given daily for the rest of the patient’s life. A newer option is a prescription diet that is extremely restricted in iodine which is necessary for thyroid function. This would have to be fed exclusively with no treats or other food. It is not ideal for patients that spend time out of doors and could ingest other products. Another options that can actually be curative is radio-iodine treatment. While expensive this will prevent the need for life long medication or dietary change. Working with your veterinarian can help determine which option will be best for your pet.
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In addition to managing the thyroid disease, it may also be necessary to work up some of the secondary diseases. As mentioned above many cats will have an abnormal heart rhythm or heart murmur present. A work up with x-rays and possibly an echocardiogram (ultrasound of the heart) may help determine if there is an underlying heart condition as well. It is also recommended to monitor blood pressure and kidney values regularly. Unregulated thyroid disease can actually mask underlying kidney disease and once the thyroid levels come down a patient can start demonstrating symptoms of kidney failure.

For more information on hyperthyroidism you can visit this website.

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