Feline hyperthyroidism is the most common endocrine disorder in middle-aged and older cats. It occurs in about 10 percent of feline patients over 10 years of age.
Hyperthyroidism is a disease caused by an overactive thyroid gland that secretes excess thyroid hormone. Cats typically have two thyroid glands, one gland on each side of the neck. One or both glands may be affected. The excess thyroid hormone causes an overactive metabolism that stresses the heart, digestive tract, and many other organ systems.
If your veterinarian diagnoses your cat with hyperthyroidism, your cat should receive some form of treatment to control the clinical signs. Many cats that are diagnosed early can be treated successfully. When hyperthyroidism goes untreated, clinical signs will progress leading to marked weight loss and serious complications due to damage to the cat’s heart, kidneys, and other organ systems.
CLINICAL SIGNS
If you observe any of the following behaviors or problems in your cat, contact your veterinarian because the information may alert them to the possibility that your cat has hyperthyroidism.

• weight loss despite a normal or increased appetite
• increased urination, more urine in the litter box
• increased drinking or thirst
• defecation outside of the litter box
• increased vocalization
• restlessness, increased activity
• vomiting
• diarrhea
• rarely, lethargy and a lack of appetite
• poor hair coat, unkempt fur

DIAGNOSIS
Twice yearly examinations of your cat may allow early detection of hyperthyroidism,  as well as other age related diseases. During the physical examination, your veterinarian may discover increased heart and respiratory rates, hypertension, a palpable thyroid gland, and loss of muscle mass. Routine screening of laboratory tests and blood pressure may detect abnormalities before clinical signs (bulleted list to left) are advanced. Blood testing  can reveal elevation of thyroid hormones to establish a diagnosis of hyperthyroidism. Occasionally, additional diagnostics may be required to confirm the diagnosis. Because hyperthyroidism can occur along with other medical conditions, and it affects other organs, a comprehensive screening of your cat’s heart, kidneys, and other organ systems is imperative.

MANAGEMENT AND TREATMENT OPTIONS
If your veterinarian diagnoses your cat with hyperthyroidism, he or she will discuss and recommend treatment options for your cat. Four common treatments for feline hyperthyroidism are available and each has advantages and disadvantages. The choice of therapy can depend on factors such as the cat’s age, other disease conditions, treatment cost, availability of treatment options, and your veterinarian’s recommendation.

Radioiodine therapy – commonly called I-131 by your veterinarian. This treatment consists of administering a small dose of radioactive iodine which only overactive thyroid tissue will absorb. The radiation destroys the abnormal cells while the normal thyroid tissue continues to function. Even though this radiation exposure carries minimal risks for you and your cat, special facilities are required for treatment, and specific isolation protocols need to be followed after discharge. The advantages of I-131 treatment are that it can be curative and there is no anesthesia, surgery, or risk of drug reaction. The disadvantage is that few facilities provide this therapy and referral to a specialized treatment center is often necessary.

Medical therapy – anti-thyroid medications will control the disease and block the excess production of the thyroid hormone; however because this medication does not cure the disease, your cat must take it for its entire life. Your cat may also receive the drug as a short-term measure, prior to surgery or anesthesia, or if radioiodine therapy is not available right away. Advantages of medical
therapy are a low initial cost, readily available treatment, and no hospitalization. Disadvantages include the need for medication, potential for adverse drug effects, and long-term costs of treatment.

 

Thyroidectomy – a surgical technique which removes all or part of the thyroid  gland. The advantage of surgery is that it can be curative and eliminate the need for life-long medication. The disadvantages of surgery are that your cat requires general anesthesia and not all cats are good surgical candidates. Additionally, varying complications of surgery may occur including damage to nerves and blood vessels of the neck, damage to the parathyroid gland function, and recurrence of hyperthyroidism as unrecognized tissue can be left behind by even the best surgeon.
Nutritional therapy – involves feeding a special diet restricted in iodine content to  control the production of thyroid hormones, which may manage some cases of feline hyperthyroidism. Advantages of dietary therapy include low initial costs and ease of treatment. Disadvantages include complicating factors if the cat has other diseases or conditions, takes other medications or supplements, or does not find the taste appealing; also long-term costs of feeding a prescription diet, and the challenges of
feeding this diet in multi-cat households.

MANAGEMENT GOALS
In general, all cats with hyperthyroidism need to be treated. The goal of therapy is to restore normal thyroid function and minimize side effects of treatment without creating lower than normal levels of thyroid hormones (referred to as hypothyroidism). On-going monitoring of your cat after any treatment is very important, as well as routine veterinary checkups with your veterinarian. If you have any additional questions, concerns, or notice any sudden changes with your cat, please contact your veterinarian immediately.

For more information on feline hyperthyroidism, visit www.catvets.com/fht

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