Our question this week was:
Dear Dr Doctor, My black DSH Muffie is age 16 an afflicted with a second episode of hyperthyroidism. At 13 she had a successful surgery, but now there's a nodule on what's left of her thyroid, and her thyroid level is a sky high 13. The kicker is that otherwise she is a very healthy cat - no kidney failure no diabetes, etc. The vet who operated the first time said that surgery is not an option this time, due to the risk of unhappy complications of the parathyroid. Sadly I don't have the $1000 for RadioCat. The only option to euthanasia is to try her on Tapazole once more. Twice she has reacted badly by becoming unable to keep any water or food down. Q1: Do you think I could start her on the teeny inyest of doses, and then step up by the same amount after a few weeks as long as she is not vomiting? Gradually getting her to the max therapeutic dose? Q2: is there a med that she could take along with the Tapazole that would control the vomiting?
Hi - thanks for your email. You wrote that your cat had surgery for hyperthyroidism years ago and the disease has returned. The recommendation for treatment was radioiodine but you can't afford it at this time. The medication used to treat hyperthyroidism (Tapazole) caused your cat to vomit in the past and you would like advice on what to do.
I think in this situation you could try small doses of tapazole and work up to a therapeutic normal dose. You could try a drug like Pepcid or Reglan in conjunction with the tapazole medication to try to prevent the vomiting.
They also make a topical tapazole (transdermal medication). This medication comes is a paste type formulation and is commonly used on the ears. However, I don't believe the absorption of the medication is reliable but you could discuss this as an option with your vet. I don't know if this would create fewer side effects as opposed to difficulty you had with oral administration.
It would be a good idea to do the tapazole anyway before you would even consider doing the radiocat treatment to ensure that the kidney function will be okay when the thyroid levels are at a normal level.
An article that might be helpful to you is Hyperthyroidism in Cats.
Best of luck!