Hyperthyroidism in Cats

Sursa https://www.vetmed.wsu.edu/outreach/Pet-Health-
Topics/categories/diseases/hyperthyroidism-in-cats

This information is not meant to be a substitute for veterinary care. Always follow the instructions
provided by your veterinarian.

Hyperthyroidism is the overproduction of thyroid hormone by the thyroid glands. Hyperthyroidism

occurs most commonly in older cats and is rare in dogs. The average age of cats with hyperthyroidism is
13 years of age; only about 5 % of hyperthyroid cats are younger than 10 years of age. There are 2
thyroid glands located in the neck. One or both of the glands can enlarge and overproduce thyroid
hormone. Involvement of both glands is more common than involvement of one gland. Thyroid hormone
affects the function of most organs in the body, so the signs of hyperthyroidism are quite variable.

Signs of hyperthyroidism can include:

 weight loss

 increased appetite

 increased activity and restlessness

 aggressive or "cranky" behavior

 a poor hair coat

 a fast heart rate

 increased water drinking

 increased urination

 periodic vomiting

 increased amount of stool or diarrhea

 occasionally difficulty breathing

 occasionally weakness

 occasionally depression

A diagnosis of hyperthyroidism is made when the level of thyroid hormone is increased in the
blood. Most hyperthyroid cats have very high levels of hormone but some cats will have signs of
hyperthyroidism with normal or only slightly increased levels of thyroid hormone. Thyroid hormone
levels can vary over time so it may be necessary to check blood levels several times or perform a
different test called a T3 suppression test. The enlarged thyroid gland(s) can often be felt in the neck. If
the diagnosis is not obvious by blood tests, a nuclear medicine scan of the thyroid glands can be
performed at certain specialty veterinary practices. The cat is given a small dose of a radioactive
compound that travels by the blood to the thyroid glands. Hyperactive thyroid glands accumulate more
of the compound than normal glands. After this test the cat must be hospitalized for a few days while it
clears the radioactive compound from its body.
A nuclear medicine scan of the thyroid glands.

Both thyroid glands are abnormal in this cat and take up the radioactive compound. The other black spot
is the stomach lining which will also take up the compound.

A blood panel and urinalysis are also performed to screen for abnormalities in other organs such as liver
and kidney that may be present due to the advanced age of the animal.

High levels of thyroid hormone may cause heart disease. The heart may appear enlarged on x-ray or
ultrasound and may show abnormal electrical activity on an ECG (electrocardiogram). Heart disease may
cause fluid to build up in or around the lungs. Cats with serious heart disease and hyperthyroidism need
to be treated for both diseases. The heart disease will reverse in many cats after successful treatment of
hyperthyroidism. There are three types of treatment for hyperthyroidism:

 life long oral anti-thyroid medications

 surgical removal of affected thyroid glands

 treatment with radioactive iodine

All three treatments will reduce thyroid hormone levels and the signs of hyperthyroidism. Discuss the 3
options with your veterinarian. If your pet has other diseases, one treatment may be better for your cat
than another.

The anti-thyroid pill is methimazole, also known as Tapazole. Methimazole is given one to three times
daily and must be continued life long. It takes several weeks for methimazole to reduce blood thyroid
hormone levels to normal. If methimazole is discontinued, thyroid hormone levels will return to high
levels over a few weeks. Methimazole may be used to reduce thyroid hormone levels to normal before
surgically removing the thyroid gland(s). Cats with heart disease may be too sick and fragile to
anesthetize for surgery in which case methimazole can be given until the heart improves and the cat is
stronger. Some owners (and their cats) find it difficult to give pills daily and may decide, after starting
anti-thyroid pills, to later have their cat treated with radioactive iodine or surgery. Methimazole may
produce side effects in cats including depression, vomiting and lack of appetite. These signs usually
resolve without stopping the medication. A more serious side effect is the development of low blood cell
counts which are more likely to develop during the first 3 months of treatment. Blood cell counts should
be evaluated every 2 weeks during the first 3 months. If blood cell counts decrease methimazole is
stopped and another treatment method should be considered. Enlarged thyroid glands can be surgically
removed. Methimazole is given for 1 to 2 months before surgery so that thyroid hormone levels are
normal at the time of surgery. If both glands are enlarged, they can both be removed and most cats will
still produce enough thyroid hormone by a few thyroid cells scattered through out the body to prevent
hypothyroidism (abnormally low thyroid hormone levels). A few cats will become hypothyroid and may
need to take thyroid pills. Surgical removal of the thyroid gland(s) can usually be performed without
complications. Occasionally complications may develop including damage to the parathyroid glands,
which are closely attached to the thyroid gland, damage to nerves close to the thyroid gland or damage
to the voice box. Parathyroid gland damage causes low blood calcium that may cause seizures. Low
blood calcium is treated with calcium or vitamin D. Nerve damage causes abnormal size of the pupils of
the eyes and droopy eyelids. Damage to the voice box causes a change in voice.

Some cats will remain hyperthyroid after surgical removal of the thyroid glands. These cats have thyroid
cells in abnormal locations, including inside the chest cavity where surgical removal is difficult. This extra
thyroid tissue is called ectopic thyroid. If you and your veterinarian decide that surgery is the best
treatment option for your cat, a nuclear medicine scan (described in the diagnosis section) could be
performed at a specialty veterinary practice before surgery to see if your cat has ectopic thyroid tissue. If
ectopic thyroid tissue is seen on the nuclear medicine scan, then a different treatment, either
methimazole or radioactive thyroid treatment should be selected. Cats that have had surgery may have
recurrence of hyperthyroidism. Blood thyroid hormone levels should be measured once or twice a year.
Treatment with radioactive iodine is only performed at selected specialty veterinary practices.
Radioactive iodine is given intravenously and will accumulate in the abnormal thyroid tissue killing the
abnormal thyroid cells but sparing the normal thyroid cells. Radioactive iodine will also accumulate in
ectopic thyroid tissue. Radioactive iodine treatment is very effective and rarely causes hypothyroidism.
The cats do not have to be placed under anesthesia for the procedure. The disadvantages of radioactive
iodine treatment include the need to travel to a facility that offers this treatment and the need for the
cat to remain hospitalized until the level of radioactivity decreases to a safe level as determined by the
state radiation control office (usually 1 to 3 weeks).

Radioactive iodine treatment of hyperthyroid cats is available at Washington State University.

Older cats with hyperthyroidism often also have kidney disease. Treatment of these cats is a delicate
balancing act. Hyperthyroidism can actually improve kidney function by increasing blood flow to the
kidneys. Some cats with kidney disease will show a worsening of kidney function after treatment for
hyperthyroidism. Talk to your veterinarian about monitoring kidney function in hyperthyroid cats.