Feline Hypertrophic Cardiomyopathy / Hyperthyroidism – 7/9/09 – 8/31/09

We pick up where we left off in the previous post on HCM.  I was waiting for the blood test results to return to see if Skip had Hyperthyroidism which can be a cause of HCM.

Skip had two pills to take in the morning and one in the evening.  Luckily he is fairly easy to pill, but the problem we had was that one of the pills in the morning was very bitter.  If I missed, he would taste it and then wouldn’t want to take any more pills.

I made it a point though to give Skip his pills at the same time every morning and within a 2 hour window in the evenings.  The key to any medicine is consistency.  Plus like most cats, Skip loves routine.  The more you stick with a routine, the more willing he is to participate.  Now Skip wakes me at 5:30 am to remind me that it is about time for the morning routine to start.  In the afternoons he starts around 5:30 pm (sometimes earlier) to let us know that it is about time for his afternoon routine.  The morning wake up call can be a pain, but you know I’d rather he do that than I over sleep and had forgotten to set the alarm.

After a weekend of holding my baby constantly, Monday finally came.  I received a call from the I-Cat vet who gave me the results of the tests.  The reason the I-Cat vet was calling me personally instead of an assistant was that Skip’s primary Thyroid level was still within the normal levels, but his Free T4 was not.  They cannot diagnose Hyperthyroidism based just on the Free-T4 number, and need clinical signs as well.

The I-Cat vet asked me some questions about Skip’s behavior.  Basically, for the past 6 months boyfriend and I noticed that Skip had started hollering at nighttime.  Usually, Skip is the kind of cat to go to bed with you and be real quiet.  Plus Skip would have these bursts of energy and go running through the house.  Trust me Skip used to be the calm kind of cat, so running through the house was unusual.  Skip had also been chowing down on the food.

The I-Cat vet said that’s enough for him to make the diagnosis and that Skip was indeed a candidate for the I-Cat therapy.  He explained there were 3 treatments: pills, surgery, or I-Cat treatment.  My thinking was that Skip takes enough pills now and that we don’t need any more.  With surgery, there could be complications and more recovery time and there was no guarantee they’d get it all.  Plus it was expensive.  If I spent just a bit more, Skip would not have to be opened up and would just receive a shot which in most cases gets rid of the tumor.  To me it was a no brainer to go with the I-Cat Treatment.  I was then contacted by his assistant and got Skip in for the next I-Cat date July 31st.

You’re probably wondering what in the world an I-Cat Treatment is.  Here is a link to their website: http://www.i-cat.info/index.html . Basically, most of the time Hyperthyroidism is caused by a tumor in the Thyroid.  I-Cat vets inject radioactive I-131 into the cat (this is also a treatment for humans) which only attacks the tumor in the Thyroid and eradicates it which brings the Thyroid levels back to normal.

I felt that we had caught the hyperthyroidism fairly early.  Only about 6 months had gone by since the first clinical symptoms.  Granted, this was plenty of time for damage to be done to Skip’s heart, but my mind said we caught it early enough for Skip to live for many years.

Skip had to stay the night at the Care Center and then we could pick him up the next day in the afternoon. I worried about him stressing out overnight because he’s never stayed any where other than Grandma’s house on the off chance I go out of town without him.

It was a real long night and a real long day waiting for the phone call to come that his I-131 levels were low enough for him to come home. Once the call came, we headed to PetSmart to get the required kitty litter and off to pick him up.

It was funny at the Care Center a guy came out with Skip in a box. We couldn’t see him in the box, so I asked if we could open the top; just so that I could make sure it was my baby in there.  I knew due to the radioactivity that they would not want him to expose everyone there.  I just wanted to see him.  It would really stink if we drove 45 minutes home to find out they gave us the wrong cat. 🙂

It was Skip, and so we packed him up and headed home.  They give you all kinds of literature saying what you can do and what you can’t do due to the I-131 radioactivity.  One thing you have to change to is using flushable kitty litter.  Let me just say…gross, but safer for you, so that you do not have radioactivity sitting in your trash can.  They also say to limit petting to 5 minutes and wash your hands right afterward.

Plus I was to not get his saliva on my hands.  Let me ask…how in the world do you pill a cat without getting saliva on your hands?  He needed his heart medicine.  I made sure I thoroughly washed my hands afterwards.  At the time, I was down due to knee surgery, so boyfriend was doing the cooking.  We did also make sure Skip stayed off kitchen counters.  That was tough.

The one that got me was the no sleeping with Skip until a couple of weeks had passed. This was the one rule I ignored.  My baby had just been traumatized overnight and they wanted to tell him he couldn’t be held for hours on end or sleep with him.  His feelings would have been hurt.  I know he’s just a cat, but cats have feelings too.

My background is that I worked at a company that determined if cancer was caused by exposure to radionuclides, so I was willing to risk that I-131 wasn’t going to hurt me at the level it was given.  Higher levels would have caused more concern.  I don’t recommend everyone doing this.  I’m simply explaining a tiny bit of my thought process for ignoring the last directive.

Since I was working from home due to my knee surgery, it helped me to keep an eye on Skip.  He seemed calmer.  He got to where he really liked having mommy at home.

One concern that came up was where they shaved Skip’s back; he could just reach the shaved portion with his tongue which is really rough.  He licked it so much he caused a core to appear.  I called the Care Center and they said to go out and buy baby t-shirts and put on him.

Not that was fun.  How do you know what size a cat wears?  Skip is a rather long and tall cat.  We found that the 12 and 18 months old t-shirts were what fit best.  Skip was rotten though, he figured out how to step on the end and then walk straight out of the t-shirt.  We actually watched him do it.  It took him around two minutes to get it off the last time. 🙂  The little brat.

All that you have to do is make sure that the t-shirt is long enough to cover the shaved patch (plus an inch) and cut the bottom off.  Once we did that, he couldn’t walk out of it.  I have to say Skip was stylin’ in his t-shirts.  He didn’t really care for him, but he looked real good in the red t-shirt.  While I would never make my pet wear clothes without a good reason, I can to a certain small degree see why people dress their pets up.

After 3 weeks, I had to take Skip to my vet to get a blood test to see if his Thyroid levels were back to normal.  On Monday August 31, 2009 his results returned and his Thyroid levels were fine.

Hooray! Now all we needed was to get the next ultrasound results in October to find out how fast his HCM was progressing.  I imagine a lot of people might ask why I would spend so much money on I-Cat treatment when you had no idea about the HCM.

My response is that I believed that the Hyperthyroidism was causing the heart condition to progressively get worse.  Yes, I could have done pills until October, but that’s not an exact science and Skip already had to be conditioned to taking his heart meds and I didn’t want to add another one.

This is another good place to stop.  I will write the next part soon and it will probably cover up until today.