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Peer-reviewed veterinary case report

Medical management of hyperthyroidism.

Journal:
Clinical techniques in small animal practice
Year:
2006
Authors:
Trepanier, Lauren A
Affiliation:
Department of Medical Sciences · United States
Species:
cat

Plain-English summary

Hyperthyroidism is a condition where the thyroid gland produces too much hormone, and while radioiodine is the best treatment, methimazole is often used instead, especially in cats with kidney problems. Methimazole works by blocking the production of thyroid hormones and is effective in over 90% of cats that can handle the medication. However, some cats may experience side effects like stomach upset, skin irritation on the face, low platelet counts, or liver issues, so it's important to monitor their blood tests regularly. For cats that have trouble with oral methimazole, a skin patch version can help reduce stomach problems. Overall, methimazole can be a good option for managing hyperthyroidism, but it requires careful monitoring to ensure your cat stays healthy.

Abstract

Radioiodine is considered the treatment of choice for hyperthyroidism, but in some situations, methimazole therapy is preferred, such as in cats with pre-existing renal insufficiency. Methimazole blocks thyroid hormone synthesis, and controls hyperthyroidism in more than 90% of cats that tolerate the drug. Unfavorable outcomes are usually due to side effects such as gastrointestinal (GI) upset, facial excoriation, thrombocytopenia, neutropenia, or liver enzyme elevations; warfarin-like coagulopathy or myasthenia gravis have been reported but are rare. Because restoration of euthyroidism can lead to a drop in glomerular filtration rate, all cats treated with methimazole should be monitored with BUN and creatinine, in addition to serum T4, complete blood count, and liver enzymes. Transdermal methimazole is associated with fewer GI side effects, and can be used in cats with simple vomiting or inappetance from oral methimazole. Hypertension may not resolve immediately when serum T4 is normalized, and moderate to severe hypertension should be treated concurrently with-atenolol, amlodipine, or an ACE inhibitor. Alternatives to methimazole include carbimazole, propylthiouracil, or iodinated contrast agents.

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Original publication: https://pubmed.ncbi.nlm.nih.gov/16584027/