The 'Joy' of Medicating Cats
I recently diagnosed one of my own cats with hyperthyroidism (remember Victoria, the huntress?). Despite having a good appetite, she was losing weight, and her bouts of the "cat crazies" — flying about the house as if her tail was on fire for no apparent reason — were increasing in frequency.
These are classic signs of hyperthyroidism, and being an astute cat owner and veterinarian, it took me only, oh I don’t know, maybe six months or so to put two and two together. Sorry, Vickie!
Anyway, I finally ran some blood work on her, and the diagnosis was about as clear as they come. Her total thyroid level was 18.4 ug/dl, and normal is 1.2 – 4.8 ug/dl at the lab I use. Yikes.
Hyperthyroidism is very serious (among other things, it often leads to a potentially fatal form of heart disease), but it can be treated very effectively. The first step is to get the thyroid hormone levels down into the normal range using a drug called methimazole. Other treatment options are available (more on this next week), but first you want to make sure that the hyperthyroidism isn’t covering up the existence of other health problems, particularly kidney disease.
So, I ordered Vickie some methimazole and then had the eye-opening experience of trying to give her the pills twice a day.
I can hear some of you laughing, but honestly, I had forgotten how much "fun" this can be. Of course, as a vet I have to give my feline patients medication, but it is entirely different when you are doing it every day, with your own cat, and can’t delegate the task to a highly-skilled veterinary technician.
Things started out pretty well. I could hide the tiny pills in a little canned cat food, an unexpected treat for Vickie, and unwittingly she would wolf them down. But, as her appetite returned to normal, she caught on to me. I began to find the little pink pills at the bottom of the bowl.
Next, I bought some specialized treats with built-in pockets to hide the pills, and at first these worked well. I’d give her a couple of empties along with the one containing the methimazole and she didn’t differentiate between them. She must have bitten into one too many pills, though, because with time she’d sniff these special treats and walk away, whether they contained the medicine or not.
I finally had to resort to prying open her mouth and tossing the pill onto the back of her tongue. This really wasn’t too difficult. After all, I do have some experience, and Vickie is a sweet and relatively cooperative cat. The seriously unfun part was chasing her around the house twice a day in order to catch her, and then, once she was cornered, watching her cringe as I swooped down the like a hawk to pick her up. This quickly became a serious issue in our relationship.
Thankfully, a few months have passed at this point and repeat blood work and some other testing has shown that Vickie is otherwise healthy. I only have one more week of methimazole to go before her appointment for I-131 (radioactive iodine) treatment, which should cure her of her hyperthyroidism. With any luck, we’ll be done with the pills for good.
This whole experience has made me more respectful of cat owners who are willing and able to medicate their pets on a daily basis. If you ever find yourself in this position, there are some options out there that can make the experience a little easier for everyone involved. Compounding pharmacies can formulate most oral medications into tasty liquids that are easier to give than a pill or that can be mixed with food. Some drugs, including methimazole, can even be made into a gel that you can rub onto the skin of a cat’s ear.
Wish Vickie luck. She’ll be hospitalized for a few days and then in solitary confinement at home for two weeks, but after that life should be back to normal for all of us. I’ll let you know how it goes.
Dr. Jennifer Coates
Pic of the day: Peter Hermes Furian / Shutterstock