Hugh at the vet in Scranton for a checkup, completely unimpressed

Hugh was diagnosed this morning with hyperthyroid, a disease more common in older cats which attacks their major organs and affects their entire system.

From the Winn Feline Foundation website:

Hyperthyroidism (also called thyrotoxicosis) is one of the most common diseases of the middle-aged and older cat. It is a multi-system disorder caused by an increase in the amount of thyroid hormones (T3 and T4) produced by an enlarged thyroid gland. It was first documented in cats almost 30 years ago but the cause of the disease has been elusive. Although the enlargement in the thyroid gland is caused by a tumor called an adenoma, it is non-cancerous.

The most common clinical signs of hyperthyroidism in cats include weight loss, increased appetite (although some patients have decreased appetite), vomiting, increased thirst and urination, hyperactivity, and diarrhea. The high levels of thyroid hormones can cause the development of heart disease, and these patients may have a heart murmur, difficulty breathing, high heart rate and arrhythmias.

Veterinarians will order a blood chemistry panel as well as a thyroid hormone (T4) level in cats suspected of being affected by this disease. It is important to evaluate the health of the other major organs, including the kidneys and heart in these patients. Typically, hyperthyroid cats may have elevations in their liver enzymes. Chest x-rays and cardiac ultrasound may reveal secondary hypertrophic cardiomyopathy. Generally, the cardiac changes will reverse when the hyperthyroidism is treated. In some cases, specific heart medication may be needed to stabilize cardiovascular health. In recent years, it has been recognized that many hyperthyroid cats have concurrent chronic kidney failure that is being masked by the effects of hyperthyroidism. It has also been found that treatments directed at curing hyperthyroidism in these patients could lead to a worsening of their kidney function.

Because the symptoms are common in other diseases, it’s not easy to diagnose. Also, the symptoms vary — Hugh didn’t vomit or urinate or have diarrhea, wasn’t hyperactive and was still eating.

At 7:40 this morning the vet who examined Hugh overnight reported that the blood tests came back normal except for Hugh’s calcium levels were abnormally high, which sent my stomach into knots because I’ve heard this before — from David’s oncologist, when he told me cancer was shutting down David’s systems. But the vet was still waiting for the urinalysis, and he told me to find a clinic to transfer Hugh to because they were going to discharge him (they only do emergency care, not ongoing care; they are referred by vets but can’t refer vets themselves). Hugh was able to pee during the night, but for some reason he couldn’t fully empty his bladder. They did find an object of greater density in his kidney as well, but it wasn’t a full obstruction. An ultrasound would cost another $600 (in addition to the $1,000 I paid already), so it would be in my best interests to find a veterinary clinic with ultrasound facilities. (VEC is more expensive because of all the specialists on staff.)

A couple of hours later the next shift vet phoned and reported that the diagnosis was hyperthyroid, and that they would fax the medical report directly to the next vet and Hugh would be discharged. I went to pick him up and the poor kitty was exhausted. He probably didn’t sleep well during the night, and his right front paw was bandaged for an IV hookup. VEC gave me another bag of saline and Hugh’s X-rays to give to the next vet.

I drove up to St. Clair and over to Bathurst Street, noticing somewhere along the way that my right-turn signal was blinking fast, an indicator that either my right signal or right brake light was out. Argh!

I chose a vet through a referral from Gigi’s Papa, who also boards her there from time to time, and he examined Hugh again after looking at the medical report faxed over from VEC. Hugh’s not in great shape. He’s lost weight (he dropped below 12lbs from 16), his skin is suddenly flaky, and he’s losing his fur. The second vet from VEC also reported a heart murmur, which is a symptom of hyperthyroid, and his heart rate is too high. The current vet confirmed the heart murmur, and says the only way to know if hyperthyroid is the cause of all Hugh’s symptoms is if they put him on medication for it and see if his levels improve. He took Hugh’s other vitals and then set him up in a cage, hooked him up to the IV, and sent some drugs down the line.

As you can probably imagine, this is a little too reminiscent of my life late last year. Except I can’t stay overnight with Hugh like I did with David.

I left Hugh to try and get some sleep while I went to buy some car bulbs. Cue torrential summer downpour. It was so blinding I got as far as the Canadian Tire parking lot and just stayed there until the rain subsided. Strangely, when I started the car again the fast blinking was replaced by regular blinking — a temporarily disconnected wire, perhaps? No idea.

The vet clinic closes at 7pm, so I returned this afternoon to spend some time with Hugh and bring him some treats before they shut their doors. Poor thing hasn’t got the hang of the hobbling yet, so I handfed him some Greenies, which he gobbled hungrily, then I showed him the K/D (kidney diet), which he snarfed in his usual fashion. I’m relieved he’s got his appetite back! He wasn’t thirsty, which is probably because he’s being hydrated intravenously.

Hugh may or may not be able to come home tomorrow, it depends on if his levels improve. Once he’s released, I’ll keep giving him the hyperthyroid medication and in a couple of weeks check back with the vet to see if that’s the culprit behind his various health issues. I already give Hugh medication every day, so he wouldn’t notice a little white pill to control his hormone levels as part of his daily routine. Fingers crossed that’s all he’s dealing with — a chronic treatable illness rather than a terminal one.