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Old June 24th, 2008, 03:52 PM
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Dr Lee Dr Lee is offline
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catnbudge,

While the coughing and vomiting may be secondary to the tartar in the mouth, it would seem more likely that it is secondary to the hyperthyroidism. Also you mentioned that as you increased the tapazole, the both decreased. Coughing and vomiting are not common clinical signs with cats with even severe periodontal disease.

With these clinical signs and the severe tachycardia (high heart rate) the hyperthyroidism is not being regulated well at this point. How many mg/ml (concentration) is the tapazole (methimazole)? That may help out.

Most cats require 2.5mg to 5mg by mouth every 12 hours for regulation. This of course needs to be taken in light of pet's weight, renal (kidney) status, thyroid levels and clinical signs.

I also am concerned that there is likely hypertension caused by the increased cardiac output secondary to the increased heart rate and contractility of the heart. Some sources have reported 15% of these cases, if unregulated, leading into congestive heart failure.

I would ask your veterinarian about blood pressure. If high, your cat can be placed on amlodipine (also called Norvasc) which is often a once a day medication. Often as the hyperthyroidism becomes regulated by finding the right tapazole dose for your pet - the patient can permanently come off of the amlodipine. But while the hypertension is present, your cat can feel much better, it can reduce the clinical signs and help protect the heart.

I would also recommend Omega 3 fatty acids. They can help the body deal with not only the diseases but also the medications.

While I think Convenia is a safe and effective antibiotic, I have some concerns with its use in your pet. The medication lasts with antibiotic affect for 14 days and can persist in measurable levels in the body for up to 65 days. If your cat had an adverse reaction, it may take a while for the clinical signs to resolve. In a 16 year old patient with two to three serious disease to manage, a medication that sits that long, could have some risks.

Again, since I have not met your cat, I cannot be sure. It is possible the dental disease is the culprit, but I sure would like to address the hyperthyroidism clinical signs and the likely hypertension as a primary focus.

Also here are the links to Convenia

www.convenia.com
http://www.convenia.com/pdfs/Conveni...nformation.pdf
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Christopher A. Lee, DVM, MPH, Diplomate ACVPM
Preventive Medicine Specialist With a Focus on Immunology and Infectious Disease
myvetzone.com
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