CASE STUDY 3: HYPERTHYROID CAT

GROUP MEMBERS Angela Culp LVT Erick Hiott Maegan Gossett

12 YEAR OLD , DOMESTIC SHORT HAIR, SPAYED FEMALE

Physical ExamTemperature: 101.2 Fahrenheit

Pulse: 175 beats per minute

Respiration: 25 breath per minute

Capillary refill time: 2 sec

Weight: 2.4 kg

Body Condition Score: 2/5

Pulmonary Auscultation: Within normal limits

Appearance upon exam: hair coat was greasy and unkempt . Palpation of intestines show ropy intestines, with a very palpable bladder and kidneys.

Laboratory Test Ordered

Complete Blood Count

Chemistry Profile

Fecal exam (slight diarrhea)

Total T4

T3 Suppression Test

Rabies, FVRCP and FELV current in 2009

WHAT ARE T4 AND T3?

T4 is an active Thyroid hormone. Thyroxine. Affects metabolic, growth, reproductive and immune functions.

Also regulates lipid and carbohydrate metabolism.

Helps control body temperature. Stored in the Thyroid gland. Converted to T3 once released into the blood stream.

T3 is an active Thyroid hormone. Tri-iodothyronine. Affects metabolic, growth, reproductive and immune functions.

Also regulates lipid and carbohydrate metabolism.

Helps control body temperature. Stored in the Thyroid gland.

HANDLING I-131: WHY DON’T VET CLINICS LIKE TO HANDLE THIS?Veterinary Concerns are as follows:

Safety

Training

Cost of the drug

Radiation exposure to the employees and family.

Elimination of the drug is in the urine and feces. Exposure of the drug is high risk for 2 weeks.

I -131, known as radioactive iodine, is used for treatment of hyperthyroidism with a cure rate of 95%.  All cats must have a CBC, chemistry profile, urinalysis and chest and abdominal radiographs performed within 30 days of the scheduled I-131 treatment.  Prior to treatment, 2 weeks in advance, y/d and Methimazole should be stopped and, 1 week in advance, retesting of the thyroid hormone levels should be done. This is to be able to accurately dose the I-131.

PRIMARY AND SECONDARY HYPERTHYROIDISMPrimary Hyperthyroidism

is a disease that affects a felines parathyroid glands to produce increased amounts of the hormone responsible that controls calcium, vitamin D and phosphorus levels in the bone and blood. Increased amounts of parathyroid hormone (PTH) can trigger calcium to be released from bones and tissue into the bloodstream. Elevated levels of calcium in the blood may lead to hypocalcaemia. The imbalanced calcium levels may interfere with the function of organs such as the heart and kidneys.

Secondary Hyperthyroidism

 is a complication of chronic renal disease characterized by the increasing endogenous levels of parathyroid gland hormone (PTH). This disease is more common than Primary Hyperthyroidism. In contrast to primary hyperthyroidism, renal secondary hyperthyroidism tends not to be self-sufficient.

SAFETY AND DISPENSING OF METHIMAZOLE

Take caution on the medications similarity because they may not me similar at all. There is two different types of thyroidism. Her dog could be hypo while your mother may be hyper and that mix up of medications would be bad for either one’s health. You should never take another persons or pets prescription. The concentration and the drug name of the tablet could be different and there could be other drug interactions with other medications.

When it comes to handling medications that are in an envelope she should be careful the dog does not get into that package and take multiples. A safe and reliable container is a child proof container. Some bottles come with a different lid but even if the dog got hold of the bottle she might still be able to ingest multiples due to the bottle being easily operable.

HOW MANY MG OF METHIMAZOLE WILL THE CAT RECEIVE EACH TREATMENT?

The cat has been prescribed to get 2.5 mg of Methimazole each treatment. Do you like both pics or just one

ABBREVIATIONS IN MEDICAL

CHART•BID- twice daily/two times a day•IV- intravenous•mg- milligram•od- once a day•PO- per os/orally•prn- as needed (pro re nata)•q- every•TID- three times a day

WHEN STORING AND HANDLING METHMAZOLE

What is an expired drug? An expiration date is stamped on the side of the drug bottle. This is the date at which the manufacturer can still guarantee the full potency and safety of the drug. After this time you are unable to sell the product to the public.

What should be done with expired Methimazole? Steps to proper disposal

See if there is a medicine take back program in your areaDispose of in your household trash.• Mix medicines (do NOT crush tablets or capsules) with

an unpalatable substance such as kitty litter or used coffee grounds

• Place the mixture in a container such as a sealed plastic bag

• Throw the container in your household trash Before throwing out your empty pill bottle or other

empty medicine packaging, remember to scratch out all information on the prescription label to make it unreadable

Do not discard this drug down the toilet due to it ending up in the water supply

Methimazole should be maintained at room temperature. The acceptable limits for the room temperature are as follows:

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F)..

Store away from light and moisture.

HOW DOES METHIMAZOLE WORK AND WHEN CAN I STOP GIVING IT?Pharmacology/Actions

Methimazole interferes with iodine incorporation, which inhibits the synthesis of they excess thyroid hormones in circulation.

How long do you give this drug?

For lifetime ?

AFTER 2 MONTHS, HOW MANY OUNCES HAS THE CAT GAINED?

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The cat started out with a weight of 5.28 pounds.

2.4 kg X 2.2 lb/kg= 5.28 lb

After 2 months, the cat weighs 5.8 pounds.

5.28 lb X 16 oz/lb= 84.48 oz

5.8 lbX 16 oz/lb= 92.8 oz

92.8 oz-84.48 oz= 8.32 oz

The cat gained 8.32 ounces.

REFERENCES

Romich, J. (2010). Hormonal and Reproductive Drugs. In Fundamentals of pharmacology for veterinary technicians (2nd ed., pp. 288-290). Clifton Park, NY: Delmar Cengage Learning.

Plumb, D. (2011). Veterinary drug handbook (Pocket 7. ed., pp. 886-889). Ames, Iowas: Wiley Blackwell.

http://www.vsecvet.com/services/radioactive_iodine.shtml

http://www.vetinfo.com/primary-hyperparathyroidism-cats.html#b

http://vetbook.org/wiki/cat/index.php/Renal_secondary_hyperparathyroidism

http://carefirst.staywellsolutionsonline.com/relateditems/26,383

http://www.health.harvard.edu/fhg/updates/update1103a.shtml