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35 TheSouthShoreMagazine.com is very common in older cats and usually results from a benign enlargement of the thyroid gland. The enlarged thyroid gland then secretes thyroid hormone in excess, and we see the resulting clinical signs - including excessive drinking and increased hunger combined with weight loss and possibly increased vocalizing/ agitation. Some cats also suffer from increased vomiting and/or diarrhea. Owners often report that their cat is very hungry, but cannot keep weight on – or even starts to lose weight – in spite of a ravenous appetite. The diagnostic workup includes measuring thyroid hormone (T4) levels, and sometimes an additional blood test called Free T4 if the initial results are in the "grey zone." Other conditions can cause similar clinical signs, so we also check (among other things) blood glucose levels and kidney values and make sure that the pet is not a diabetic or in renal failure. Furthermore, this diagnosis often highlights the importance of performing yearly blood work in older pets. Sometimes, we diagnose a pet that has very few clinical signs, but it is still important to treat them since untreated hyperthyroidism can lead to other issues, as well as damage to the heart and kidneys." As for the treatment, Dr. Ficociello says that the most common therapy prescribed is methimiazole, which is a drug that is given to cats twice daily to decrease the level of thyroid hormone in the body. This medication usually comes as a pill, but it can be made into a liquid that can be given orally, or a gel that is applied to the ear of the cat. Dr. Ficociello cautions that some cats can be difficult to medicate. She says that some cats can be difficult to medicate. She also states that while this is a good treatment, some cats do have reactions to the medication, and therefore other treatment options have to be considered. These options include using a newer food called y/d made by Hill's Pet Nutrition, which limits the amount of iodine available to make thyroid hormone. In order for this diet to be effective, however, the cat must eat only the y/d and nothing else, which can be tricky for cats that may be picky eaters or in households where other pets may have to be fed other special diets. Unfortunately, Dr. Ficociello says that there are no known measures that can be taken to prevent hyperthyroidism in cats. She also said that veterinarians began to recognize this condition in the 1970s, with the first case being diagnosed in 1976; whether the increased number of cases that were diagnosed was because veterinarians started to look for it more, or that the disease actually did become more prevalent is still under debate, but there is no question that hyperthyroidism is more common today than it was 40 years ago. So, what should you do if you suspect that your cat may be hyperthyroid? According to Dr. Ficociello, she would advise that you speak with your veterinarian and have blood work done to evaluate for this condition as well as the others mentioned above. "The I-131 treatment is great for cats that can't tolerate medications or for owners that can't get the medications into them. For a cat that may live another five-to-ten years, it will also likely be more cost-effective in the long run. In about 95 percent of cases, a single injection of this radioisotope is curative, and the cat's thyroid hormone levels will return to normal. Rarely, some cats with cancerous growths of the thyroid may fail treatment (they benefit from surgery), and some cats also fail after the first treatment and need another injection." Dr. Ficociello said that the cats receive the I-131 injection on a Monday and remain at the hospital under their care until they are cleared to return home. When the cat can be released from the hospital is determined by how rapidly their level of radiation falls; this averages around a 4 to 5 day stay in the hospital. She warned that the owners must take certain precautions for two additional weeks at home after the cat is released or, as an alternative, board the cat at VCA South Shore for two weeks. During hospitalization, the cats stay in a special ward in the hospital that is quiet and serene, and most of the cats have done very well. Before scheduling this therapy, the doctors at VCA South Shore will thoroughly explain all aspects of the treatment when the owners come in to meet with one of the internists. When asked what she would do if her cat was diagnosed with hyperthyroidism, Dr. Ficociello said that she would do the I-131. She said that it is a "great option and that our radiologist, Dr. [Diana] Rosenstein, has worked tirelessly to get the program up and running. The credit goes to her, for sure!" VCA South Shore Animal Hospital Acupuncture Avian and Exotic Animal Medicine Cardiology Dentistry Dermatology Diagnostic Imaging (X-Ray, Ultrasound, CT and MRI) Emergency and Critical Care Medicine Internal Medicine Neurology and Neurosurgery Oncology Ophthalmology Pain Management Rehabilitation Therapy Surgery (Soft Tissue and Orthopedic) Wellness SERVICES AVAILABLE: 595 Columbian Street South Weymouth 781.337.6622 www.vcaweymouth.com Although patients are seen on an appointment basis; Monday–Friday: 7am–9pm, Saturdays: 9am–5pm and Sundays: 9am–4pm, appointment times for the various specialty services will vary. The hospital is open 24 hours a day, 7 days a week for emergencies.