Question Details
Another Hyperthyroidism Cat
by rcooper - February 28, 2019
My DSH Rudy,female,sweet natured went from 9 to 7 lbs in a month.
early stages, palpable adenoma .Tongue is lavender with a white center coat. I don't have any lab numbers from my vet yet. Chronic feline upper respiratory disease. Used to maintain on Kan Fragrant Jade, and hi calorie nutritional paste. She and her brother have a history of hairballs so I switched from a grain free kibble to a chicken/rice formula 4 months ago. (Trigger for leaky gut?) Resorptive teeth. Surgery 2 years ago for sinus erosion and a few extractions.

I'm an acupuncturist/herbalist , and familiar w the formulas you are using.

Somewhat confused as:
1 you're giving information on certain formula's effects on thyroid hormones and conversion. I was totally unaware of this and wonder where that data comes from.
2 I'm unclear as to the feline disease vs human Graves . Is feline more like human toxic goiter or autoimmun due to leaky gut which I am familiar with

On 2.5 mg methim. For last week, doubling the dose starting tomorrow.

I see a variety of formulas you are using here. I started her on SRT during the day, and ZBDHW. She seemed to get better energy, never having exhibited hyper symtoms..rather more sleeping and hard to get out of bed in the morning. I went to 3x day ZBDHW and it knocks her out. ( 4 drops Temper Fire per dise). She is a heat seeker. Some barbering along upper GB/TH channels which stopped recently.

So, is it possible to catch this early and take it to a euthyroid state?
I don't notice any nodule dissapating Chinese herbal formulas, except one with Sargassum.

Thank you for your input
Replies
by naturevet
March 1, 2019
Hi there,

I think for now San Ren Tang is the place to start. Herbal impact on thyroid hormone conversion becomes more important as cats enter what I call Stage III of hyperthyroidism, which is the Empty Fire stage. The lavender tongue tells me your cat is more likely in the second stage, which is the Phlegm Obstruction stage that ultimately leads to Phlegm Fire if not controlled. You can find more about the staging in the Manual of Natural Veterinary Medicine.

In that text, there is a custom formula that worked well, but San Ren Tang is a good call, because toxic nodular goiter in cats is, as far as I'm concerned, equivalent to Grave's disease in people. That means it appears to have an immune-mediated component driven by leaky gut. We thus have the best chance of heading it off by using anti-inflammatory GI formulas. My first successes were with using Wei Ling Tang, and you could try that. It's more warming that SRT, and the fatigue on ZBDHW suggests she is somewhat Qi or Yang deficient, which Wei Ling Tang and Ping Wei San address.

The sinus issues makes San Ren Tang a better choice for her, thought, so I'd start there. It still has a Gi anti-inflammatory effect. Remember WLT if it doesn't do what you hope, and strive for a real food diet with no starch sources in it. Cats do not benefit from them, even if they are included in recipes you find on line. Commercial raw diets are probably optimal, and you can sprinkle nutritional yeast on a warmed serving of it to entice her to eat it.

Hope that helps. Let us know how it goes

Steve
by rcooper
March 1, 2019
Typo on my part...I was actually giving her Wu Ling San...looking up Ping Wei San, it really looks like her,
Fatigue, nausea/vomiting ( before the hairball formula) , thick w greasy center coat in the past. Sl. Loose stools, heat seeking.

The lavendar, dusky color may have been from having her mouth held open to do small squirting of a granulated herbal rx in there. ( muddy color) When yawning in the past I noticed the creamy center coat surrounded by a fresh pink, not dusky.

I put them on a grain containing formula against every instinct in me. But couldnt find a grain free version. Now I see that instead of focusing on the sinuses, I should have been looking at the whole picture, a spleen encumbered by damp, cold. It snuck up on me.

Shouldn't just think "aging"...rather what is the presenting diagnosis.

Do you think I should order the San Ren Tang for its veterinary application in feline hyperthyroidism ?

Thanks

I happen to have PWS on hand and will try her on it. Comes in 500 mg capsules. Do you have an idea as to dosage for a 7 lb cat?
by naturevet
March 2, 2019
Try Ping Wei San for now and see what happens.

Here are my dosing recommendations, for future reference. Probably 1 1/2 tablets would be better if you can manage it. If using capsules, err on the higher side if she is tolerant of being dosed, and go for two capsules twice daily

Steve
by rcooper
March 4, 2019
Rudy foamed at the mouth while administering PWS. Went back to Wu Ling San which helped her to want some food.

Has been on 5mg of methimazole daily for 3 days. Has developed anorexia, depression, and vomiting.
She is 8.2lbs, so her weight actually went up from 7.

I will order the SRT and WLT this am from a Boston company. Hope they're not snowed out.

Any suggestions? Awaiting a call from vet, thinking of giving some Huo Xiang Zhen Qi Wan, which I have on hand.
by naturevet
March 4, 2019
Stop the methimazole right away, with those kinds of adverse events

Kan Essentials' San Ren Tang and Wei Ling Tang are both pretty palatable. Wu Ling San is fine

You can try the HXZQS. It's cooling, though, and it sounds like your cat is Cold. So I don't expect it to help or to go that well.

Make sure you change the diet as previously discussed

Steve
by rcooper
March 7, 2019
Hi Steve,

Rudy has been off the methimazole since 3/4.

She hasn't wanted food since then. The last 3 nights between 2-6 am has had vomiting episodes.last night just clear phlegm, since her stomach is so empty. She has a history of vomiting in the early morning



I fed her fresh select turkey through a baggie w a hole 3 times, could only get a tablespoon in at a time . Gave her Wu Ling San til the SRT came this afternoon. Gave her 1 g .

I broke down and gave her 2.5mg methim.tonite as it had helped her appetite when we started it at 2.5.

Is at 7.8lbs. Walks to the food bowl and looks like she moght eat and she turns away.

Any ideas to get the appetite up?
by rcooper
March 7, 2019
I wasn't able to finish my post. at 7 pm gave her 2.5 mg of Methimazole out of desperation to get her to eat.
An hour later she devoured a bowl of wet food (or the first time in her life). Her appetite was back. I noticed that a couple of hrs after the SRT she was grooming herself again and that her spirit returned. Huge turnaround overall.

I'm not sure if the Methimazole helped boost her appetite or not. Right now she is purring and sitting on my lap and acting normally. Would it be a good idea to dose daily SRT and every other or third day give 2.5 mg methimazole? I would like to taper off the meds but need some guidelines as to how to determine when.What would I be looking for ?

Rudy's vet is a specialist in thyroid disease and is interested in being kept in the loop.

thanks
by naturevet
March 11, 2019
Sure, that sounds like a good plan. I would even recommend SRT twice daily, not just once

After a few weeks, you can have her weight and heart rate rechecked. If they are improving, then you are off to the races

Steve
by rcooper
March 12, 2019
She has been on SRT 1 pill bid since the beginning.
Every other day methimazole @2.5mg once a day has seemed to maintain her without dips in energy and appetite.

Her spirit came back within her on the second day of herbs. Her coat is fluffy and no sign of greasiness. She is interacting and in her normal routines.

She was 8.4 lbs this am.

Getting some Fresh Pet select beef/chicken in . It's not the best but it's a huge start for a cat that has never chosen any wet food.

So- her nasal discharge 2-3 times a day is v thick green, brown and blood tinged.

I guess I should wait till she is stabilized before I think about symptom relief for that.

I am amazed at this formula, one that I wasn't taught in the course of my herbal training and have never used before.

How did you arrive at this one for all the varying feline issues ?

Thanks!
by rcooper
March 12, 2019
One question--

Do you think a product like Buck Mtn Thyrolyte or a lemon balm, melissa extract would be good to do as well now, or is that used for a later stage of the disease?

It was mentioned that melissa officionalis blocks TSH receptors preventing exogenous stimulation by antibodies formed in response to gut bacteria.

She gets a probiotic daily. Are there strains you recommend?

Thank you
by naturevet
March 12, 2019
I don't have strong feelings about probiotics. Natren seems a good company

Lemon Balm can be used at any stage, if you want to try it now

Steve
by naturevet
March 12, 2019
San Ren Tang can help with the nasal issues. Give it time

As to how I discovered it. Just trial, error and research

Steve
by rcooper
April 3, 2019
Vet visit later today so thought I would update on Rudy.

Dosed 1 pill bid SRT from 3/5 to 3/15. Her weight increased from 7.8 lbs to 8.6 - 9lbs.
I was dosing methimazole 2.5 mg every other day .Appetite was up and down.

I switched from SRT to WLT ( Spleen Support) because she was getting lethargic and low appetite. I started dosing methimazole 2.5 mg every day. She stayed in the 8.2-8.8 lb range. Nasal secretions dried up 95%. Generally was social, purring, and eating.

I bumped up the methimazole to twice a day on 4/1 because she was losing some weight. Down to 7.8 lbs.

A couple of times I suspended the WLT to give SRT when I felt she hit a snag, just to shake things up.Also when I felt hot ears or head shaking due to ear itch. And that helped to get her normalized in those symptoms, and in behavior and appetite. There was less hiding.

Ongoing issues: heavy intake of breath and a puffing out on exhalation.
Reverse sneezing. I cradle her with her head facing ceiling until she swallows thickened mucous. This an old symptom.
Dry hairball hacking. No hairball, just dry. Another old symptom.
Heat seeking.
Slight Bilateral inner canthus horners a couple of days. (This was diagnosed several years ago in R eye)

So- any ideas for labs today other than the standard, and talking points?

Diet needs to improve.
by naturevet
April 4, 2019
Weight gains signal an improvement. The most specific indicator of thyroid function is free T3, although this test is not commonly run. It is possible that you may see a drop even in T4, however.

Diet change away from processed foods will probably help dramatically with many of the complaints (e.g. nasal obstruction, hacking, etc.)

Steve
by rcooper
April 4, 2019
Update on labs.
6 Wks ago total T4 was 4.9
yesterday it was 3.9

I had just dosed her with 2 days of 2.5 mg Methimazole bid. Could the drop respond so quickly?

The reason I ask is that I want to keep her on the lowest dose necessary. Can it be doase every other day? 5 mg divided dose?

Another question: Is there a way to treat this Root and Branch with another formula for dissipating nodules?

Hai Zao Yu Hu Tang comes to mind. I was reading a paper by Dr. Mark Peterson who states that it isn't established that High iodine is the problem but that it may be that these cats might actually need iodine. ( re the sargassum, laminaria ).

Did I read him incorrectly? Do you think a formula like this would be counterproductive ? If so, can you recommend one that maybe has a scrophularia tone to it without the seaweeds?
She wonders if oyster shell (calcium) might be a problem.

Thanks
by rcooper
April 4, 2019
She meaning the vet.
btw she was extremely pleased with the results
by rcooper
April 4, 2019
Other labs:
High Sodium, TCO2, Creatinine Kinase, WBC's and Monocytes.
Low ALT

don't know how to interpret w Chinese diagnostics
by naturevet
April 5, 2019
Hi again,

The methimazole may have contributed to those readings, for sure, but if weight gains began prior to its use, then it's probably mostly the herbs.

As to whether an iodine-supplementing nodule-dissolving Chinese approach can benefit, I have my doubts. It was discovered and used for iodine-deficiency goiter, but iodine supplementation in hyperthyroid cats can sometimes make the situation worse rather than better, making them more prone to thyroid storms. I've heard of very high iodine doses being used to try to suppress thyroid gland activity, but these carry the same risk

In the end, hyperthyroidism in its early stages in cats is most likely a GI issue, creating a leaky gut, just as it is in people. Approaching it from that angle, which includes fixing the diet, is the best chance at a cure

It's also possible to just surgically remove the nodules, but without correcting the diet, the problem will come back

Steve
by rcooper
April 5, 2019
I'm thinking I should just dose meds and herbs based on weight.
Doing SRT 1 PILL BID and meds 2.5 mg BID every other day. Switching to once a day in between.

Affect is great, back to her routines.
Will find a 50-70% protein, 5-10% carb, 30-40% fat wet food to build muscle and weight.

WLT was better for sinus mucous.


Palpation showed a large R lobe adenoma. Hope it can go down. Don't know if it's possible. Doc would be shocked!
by naturevet
April 5, 2019
Freeze dried or real food diets (even canned fish or roasted chicken for now) is better. Canned cat food likely still too processed to be curative
by rcooper
April 13, 2019
Rudy has taken a turn for the worse. Her weight hovers around 7.4.
She is sleeping through the day. Didn't eat at all yesterday. ..

Roasting a chicken today.

Had to go back to 2.5 bid methimazole bid.
On WLT 1 bid.

Not much sinus mucous, or sneezing but snorting, and heavy breathing .

I wonder why the downturn when she was doing so well. Will not eat any wet food, so she looks dehydrated.
by rcooper
April 13, 2019
I did try freeze dried Primal turkey nuggets. No go.
by naturevet
April 14, 2019
With sinus issues, San Ren Tan is usually the better choice. it is also a bit more anti-inflammatory, which may be why the WLT isn't quite doing it. We suspect a low grade IBD to be the cause of hyperthyroidism, causing the production of anti-thyroid antibodies

You might want to bump up your dose of the herbs, too. That is another option when things are going well, but not well enough.

The Manual of Natural Veterinary Medicine specifies a spin on Wen Dan Tang that may work better than WLT or SRT. Lastly, if she is becoming Yin deficient, then she may need Yi Guan Jian. A look at her tongue should tell you whether she is entering that phase

Lastly, if the tumor is simply too big to expect to revert to normal, then surgical removal can reset the whole system and eliminate the need for methimazole. At that point, a real food diet and perhaps WLT may prevent any recurrences. If there is a veterinarian in your area comfortable in doing the surgery, that is sometimes the easiest route forward, if the tumor has become quite large

S
by rcooper
April 15, 2019
SRT gave more mucous than WLT in the 3 times I tried to use it.

Is It 11 ingredient Wen Dan Tang that you mean?

Tongue is dusky w a dirty thick coat. No yin vacuity signs. More phlegm damp and qi deficient.
Fur is not greasy though. normal.

So I will try 1 pill of WLT for now 3x a day until I hear back on the WDT.

Thanks so much
by naturevet
April 15, 2019
No, it's a formula particular to feline hyperthyroidism when they are still in the Damp stage. I don't have the book handy, but you can find it online

S
Reply to this question.
You must be logged in to reply

© 2021 - CuredCases.com         Problems with this site? Contact: webmaster@curedcases.com