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-   -   Hypertheroid Symptoms...Tests Say No (http://www.pets.ca/forum/showthread.php?t=80775)

RGW April 13th, 2012 10:33 PM

Hypertheroid Symptoms...Tests Say No
 
I have a cat who's almost sixteen. She weighed as much as 20 pounds ten years ago. She had surgery to remove a long-growing tumor in December, at that time she weighed 12 pounds. She recovered from the surgery well, but continues to lose weight. Today she weighed in at almost 9 pounds. She has all of the symptoms of hyperthyroidism -- she has a healthy appetite, still has energy, and drinks a lot of water. The vet did several tests of her blood today and says it isn't hyperthyroidism. He said her blood tests were very good, except for a slightly elevated number in her liver (140 instead of 100).
If if isn't hyperthyroidism, if her blood work is fine, what could it be? The vet wants to see her again in a month to possibly run x-rays. She did have diarrhea for a week or two after her surgery, but that was almost 4 months ago. Shouldn't she have gained the weight back?

marko April 14th, 2012 06:13 AM

Welcome to the board RGW!

I'm really not at all sure but could this be related a little bit to being overweight? Would you say your cat was overweight at any point either before the tumour surgery or after?

I ask because 12 to 9 pounds is a significant weight loss...but it may be less significant if the cat was overweight. Would you say your cat has a large, medium or small frame?
Is your vet also suggesting that the cat is now underweight? Is your vet concerned about the cat's weight, or is this mostly your concern?

Myka April 14th, 2012 09:29 AM

So is the cat [I]underweight[/I] at 9 lbs? Maybe the cat was grossly overweight at 20 lbs, and still quite chunky at 12 lbs? Was the tumor sent to a lab for analysis after it was removed? If so, what were the findings? Where was the tumor removed from? What did the tumor weigh?

RGW April 14th, 2012 09:29 AM

She was overweight at 20 pounds, but I'm not sure by what amount. She has what I would call a large frame. The vet wasn't concerned with her weighing 12 pounds in December, but he's concerned by her weight loss since then. She's noticeably thin now, and you can feel all of the bones on her spine when you pet her.

Myka April 14th, 2012 09:30 AM

Oh I see we posted at the same time. So if she is indeed underweight now, is she eating the same amount or is her appetite suppressed?

RGW April 14th, 2012 09:31 AM

The tumor was in her ear. I don't know how much it weighed, but the vet didn't seem to think it explained the weight loss. She's had it since she was young...this was the second operation to remove it (the first time was back in 1999). The tumor wasn't tested for cancer, since the feeling is she would be too old to survive chemo anyway. She isn't acting sick; in fact she has a lot of energy, which is one reason why the weight loss is a problem.

RGW April 14th, 2012 09:33 AM

Her appetite is very healthy. That's another reason why she fits the symptoms of hyperthyroidism, but the blood test was negative.

Myka April 14th, 2012 09:38 AM

If the tumor is malignant, the malignancy could explain the weight loss. I wouldn't be inclined to treat with chemotherapy either. Has she had a CBC done? How are red blood cells? White blood cells? Hemoglobin? The blood tests could be wrong, it's not uncommon with hyper/hypothyroidism. Maybe talk to your vet about treating and see if there is any improvement??

RGW April 14th, 2012 12:16 PM

Thanks for the help. We're probably going to another vet for a second opinion.

sugarcatmom April 14th, 2012 12:30 PM

Do you have the numbers for her recent blood work? Was a urinalysis also done? Depending on what the T4 value is, she could still be hyperT even if the value is within the lab's normal range. Another test to help with diagnosis is a Free T4 done at the same time that the T4 is tested: [url]http://www.vet.uga.edu/vpp/clerk/stortz/index.php[/url]

[QUOTE]Diagnosis of hyperthyroidism becomes more difficult if the T4 and T3 values are within the reference interval. This occurs in approximately 10% of cats with hyperthyroidism.7

Another test for the confirmation of feline hyperthyroidism is the measurement of free T4 concentration by dialysis. The free T4 concentration is that circulating T4 which is unbound to carrier proteins. Free T4 is metabolically active; its measurement could give a more accurate assessment of thyroid function.6 Free T4 is also less likely to be affected by nonthyroidal disease or drug administration than is total T4. The free T4 test is significantly more sensitive in detecting hyperthyroidism in mildly hyperthyroid cats than either total T4 or T3 measurements. However the free T4 test occasionally has a false positive test result, so hyperthyroidism should not be diagnosed solely on the basis of free T4 determination.11 Other clinical signs such as a palpable thyroid nodule, weight loss, etc. (Table 1) also should be present for a definitive diagnosis of hyperthyroidism.[/QUOTE]

RGW April 14th, 2012 03:04 PM

I don't have the test numbers. An urinalysis wasn't done, just blood work.
Unfortunately, the vet gave her a dewormer just in case she had worms...which is now causing her to vomit and have diarrhea. Of course, that's the last thing we need right now (and even after the vomit and diarrhea, she still seems to have energy).

sugarcatmom April 14th, 2012 05:24 PM

[QUOTE=RGW;1037988]I don't have the test numbers. An urinalysis wasn't done, just blood work. [/quote]

Can you call the vet and get a copy of the results?

growler~GateKeeper April 14th, 2012 11:47 PM

What was the Thyroid number? and what was the reference range for these values?

You mention an elevated liver number what was elevated?

What were the numbers for phosphorus, creatinine and BUN(blood urea nitrogen)/Urea?

chico2 April 15th, 2012 11:30 AM

I was thinking she is diabetic,drinking a lot of water etc..but she was probably tested for that already?

RGW April 15th, 2012 08:23 PM

I'll see if I can get the actual test results. I think he tested for diabetes; I'm not sure if he tested for cancer. Looking at the bill, we were charged for an examination, a CBC, an Abaxis (comprehensive profile), and an Abaxis (T4).

garfinas mom April 15th, 2012 09:39 PM

Try the second opinion
 
[QUOTE=RGW;1037988]I don't have the test numbers. An urinalysis wasn't done, just blood work.
Unfortunately, the vet gave her a dewormer just in case she had worms...which is now causing her to vomit and have diarrhea. Of course, that's the last thing we need right now (and even after the vomit and diarrhea, she still seems to have energy).[/QUOTE]

I wonder about a vet giving dewormer in case of worms. Vet may attribute weight loss to worms? But still can be verified with tests. Why not verify before treating? I would get another opinion before anymore treatments.
The ear is a very sensitive area, a special sense that is directly connected to the brain.

RGW April 16th, 2012 09:32 PM

1 Attachment(s)
Okay, here's a scan of her test results. Thanks for all of the replies.

growler~GateKeeper April 18th, 2012 05:23 AM

First thing that stands out there is the lymphocytes are out of normal low. Lymphocytes being low commonly occur in stressful situations - being at the vet is the #1 cause of low lymphocytes also viral infections, chronic bacterial infection and Cancers will also cause low lymphocytes.

ALP 91 (10-90) Alkaline Phosphatase An enzyme produced by the biliary tract (liver). High levels indicate bone disease, liver disease or bile flow blockage.

An ALP elevation is definitely suggestive of liver disease and requires follow up testing such as a bile acids liver function test

ALT 148 (20-100) Alanine aminotransferase An enzyme that becomes elevated with liver disease

ALT & AST These enzymes elevate relatively easily and are not as important in liver evaluation as ALP elevations but a substantial increase may also warrant follow up liver testing. In the event of hepatic lipidosis or fatty liver, the elevation in ALP is often dramatic

Aside from the recent vomiting due to the de-wormer, has she had diarreah and or vomiting often in the past especially since the weight loss?

I would suggest asking your vet about a Free T4 test and Bile Acids Liver function test. I would be more inclined to ask for an ultrasound rather than xrays, granted it is more expensive but also, more conclusive as they can get accurate measurements for the thickness of the walls of intestines (in cases of IBD) and size, shape and condition of liver, kidneys, pancreas etc. An ultrasound also allows them to check closer into any area of concern that was not previously noted right away, where an xray usually would require a second set if they wished to examine something closer or they would suggest an ultrasound.

An increase in ALT is not associated with HyperT but can be elevated in cases of Liver disease incl but not limited to Hepatic Lipidosis (fatty liver which is a quite serious condition), pancreatitis or IBD. Based on symptoms it doesn't sound like pancreatitis.

A free T4 is more definitive than the regular T4 test, often times if the Thyroid is over active it can mask the symptoms of others such as kidney issues

With the low lymphocytes and the elevated ALT I would be inclined to look closer at IBD as the cause of the symptoms :2cents:

RGW April 18th, 2012 10:04 PM

"Aside from the recent vomiting due to the de-wormer, has she had diarreah and or vomiting often in the past especially since the weight loss?"

She's had occasional diarrhea and vomiting, but it mostly died down after she recovered from the antibiotics given to her during her surgery. I think most of her vomiting since then has been hairballs. This is what I found online on IBD, is it an accurate source?
[url]http://www.vet.cornell.edu/fhc/brochures/ibd.html[/url]

She also had an eye that was occasionally cloudy in the week or two before she went to the vet. The dewormer seemed to make it better, so is it possible she had worms as well? Thanks for the info.

growler~GateKeeper April 20th, 2012 01:28 AM

Yes that is a reliable source for info.

Not sure I've ever heard of cloudy eye issue being related to / cleared up from a de-wormer, so not sure on that aspect but I suppose there always is the possibility of our pets having worms.

Regardless of whether the weight loss, blood test results & other symptoms are from worms or IBD or something else it would be a good idea if you could discuss the whole scenario with your vet to get his/her recommendations on where to go from here. :goodvibes:


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