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Dr. Kara
Dr. Kara, Veterinarian
Category: Cat Veterinary
Satisfied Customers: 16512
Experience:  Over 20 years of experience as a veterinarian.
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My 9 year old Simese cat started losing weight about 3

Customer Question

My 9 year old Simese cat started losing weight about 3 months ago. I took him to my vet who put him on L-thyroxine for thyroid. It didn't help him from what I could tell though. We went back and had his teeth cleaned and 2 of them removed. He had already over time lost some of his top ones. He still didn't get any better and continued to lose weight so I took him to a second vet who said the blood tests they ran said he had an infection and thought it might be from bad teeth and wanted to pull all of his remaining including his canines. I said no and they gave him antiboctics. I have taken him back to our original vet 2 more times and he still believes it is a thyroid problem. The second vet said that dogs have those kind of problems, not cats. He eats but only a very small amount. Other odd things, 1 eye changed color and he has several sores on his neck that have not gone away for over a month. I have spent over $600 so far and can't afford to keep this up much longer and get nowhere. He is down to just 4 1/2lbs now and is skin and bones to me but no one else seems to think it is as bad as I do. I would be forever grateful if you could give me some idea of what is wrong, thank you much, Pamela
Submitted: 1 year ago.
Category: Cat Veterinary
Expert:  Dr. Kara replied 1 year ago.

Hello, my name is***** and I have over 20 years of experience as a veterinarian.
I understand that you are concerned because Sissy Boy is getting very thin even with a normal appetite.

When we see weight loss with an apparently normal or increased appetite we need to worry about disease processes that either don't allow him to digest and/or absorb the food he is taking (such as diabetes, liver disease, primary intestinal or pancreatic disease including cancers) or those that lead to a higher metabolic rate such as hyperthyroidism or cancer.

In an older cat the more common diseases we see include hyperthyroidism (a tumor of the thyroid gland that overproduces thyroid hormones) or if he were drinking more and urinating a tremendous amount, diabetes. Sometimes early on with diabetes we only see weight loss.

Both diabetes and hyperthyroidism are treatable or at least manageable.

Hyperthyroidism is controlled with daily oral medication (Tapazole, also called methimazole) or a very special diet called y/d both of which must be done for the rest of his life or treatment with radioactive iodine to selectively kill tumor cells which is usually a one time therapy. Your second veterinarian is correct in that we don't see hypothyroidism (low thyroid function) in cats, and anyway that would cause weight gain not loss, so I suspect that there was a misunderstanding with your original veterinarian. I suspect that your original veterinarian was treating him for hyperthyroid disease with Tapazole. It's possible that he may have another problem or that his dose of Tapazole wasn't high enough.

Hyperthyroidism is not painful, but elevated thyroid hormones can make them feel edgy or nervous and thus cranky, increase the heart rate and interfere with sleep, like drinking way too much coffee or energy drinks. Long term if left untreated it can lead to heart disease, hypertension, possible eye damage as well as kidney and liver damage. But if caught and treated many of these things can be reversed. His change in eye color can be due to hypertension (high blood pressure) and bleeding in his eye or increased vessel prominence due to hypertension.

Diabetes is controlled with diet and insulin therapy. It too can lead to hypertension and kidney damage, and thus bleeding in the eye.

If his thyroid levels truly were low, and he was losing weight then I would be concerned that he is suffering from euthyroid syndrome. This happens when an animal has a serious life threatening, chronic illness that leads to thyroid gland suppression, and thus low hormone levels. We need to look for the primary disease, not supplement thyroid hormones.

This tends to happen with organ failure, cancer or an over-riding systemic infection. I would be worried about particular types of cancer such as lymphoma, or multiple myeloma. It may also be related to an unusual variant of a viral infection called the dry form of feline infectious peritonitis. All of these can affect the eyes, and cause changes in eye color. That diagnosis may be more difficult to achieve in an inexpensive manner. These disease processes may require more specialized testing.

It sounds like he has had some blood testing done to achieve a diagnosis, but has his blood work been rechecked after starting treatment? If not that should be done to see what sort of effect treatment has had on him.
Ideally he should have a complete blood count and biochemistry profile with T-4 checked as well as a urinalysis. These tests often give us the information that we need.
If those aren't diagnostic then it is time to move on to more specialized testing. I recommend checking vitamin B levels to look for signs of intestinal disease, a test for pancreatic insufficiency called a TLI, and an abdominal ultrasound to look for signs of changes in the walls of the intestines as well as evaluating his organs and abdominal lymph nodes. He may need an endoscopy to collect biopsies of his intestines if they look abnormal.

Dental disease can be uncomfortable, but dental disease alone rarely leads to weight loss. While he may have had rotten teeth and infected gums that alone isn't likely to be the whole problem.

In the meantime you might try feeding him a higher calorie prescription food called Hills a/d or Iams Maximum Calorie from your veterinarian and make sure he has access to plenty of fresh, clean water.
Please let me know if you have any further questions.

Customer: replied 1 year ago.
I stopped the L-thyroxine When the 2n one told me to but after they told me to pull all his teeth out because everything checked out on the texts except that he had an infection I went back to my original vet who put him back on the L-thyroxine 1/2 twice a day for 14 days then half once a day for 16. We are on day 13. Should I ask him to change the med to Tapazole?
Customer: replied 1 year ago.
AIso is there anything I can give him to increase his appetite?
Expert:  Dr. Kara replied 1 year ago.

I think that decision should be based upon what his thyroid levels show.

If he truly has low thyroid hormone levels then Tapazole (methimazole) will only further suppress his thyroid hormone level production, so it should not be given.

I wouldn't supplement a cat with low thyroid levels, I would concentrate on looking for the disease process that is making him sick enough to suppress his thyroid hormone production.

We can use mirtazapine to stimulate his appetite in the meantime and I would feed him a higher calorie prescription food, either Hills a/d or Iams Maximum Calorie, so when he does eat he is getting as many calories as possible.

Expert:  Dr. Kara replied 1 year ago.
I'm just following up on our conversation about your pet. How is everything going?
Dr. Kara
Expert:  Dr. Kara replied 1 year ago.

Hello, I was just checking in on Sissy Boy to get an update and to make sure that you didn't have any further questions. Please let me know how things are going for him, Dr. Kara.