Hyperthyroidism is commonly found in middle-aged and older cats. This disease is caused by too much thyroid hormone in the blood stream. The increase in thyroid hormone is most often secondary to enlargement of the thyroid gland. Fortunately in most cats the enlargement is due to a non-cancerous tumor called an adenoma. Rarely, cats may develop hyperthyroidism from thyroid adenocarcinomas, which are cancerous and can spread. Although hyperthyroidism can make cats very ill, treatment options are available.
What is The Thyroid?
The thyroid is a glandular, butterfly shaped organ that secretes thyroid hormones called T3 and T4.
Where is The Tyroid?
The thyroid is located in the front of the neck. Veterinarians will often move their fingers down the front of a cat’s neck in an effort to detect an enlargement of the gland. Additional functional thyroid tissue may also be located throughout the neck and upper thoracic regions called accessory or ectopic thyroid tissue.
What Does The Thyroid Do?
Both the primary thyroid and the accessory tissue secrete hormones. These hormones regulate how the body utilizes food and converts it to energy.
How Does The Thyroid Work?
The thyroid gland is controlled by a small structure located at the base of the brain called the pituitary gland. The pituitary gland regulates the amount of thyroid hormones found in the blood stream. The pituitary signals the thyroid gland to make more hormones when blood levels of the hormone are low and signals the thyroid to decrease hormone release when the blood levels are high.
What Happens in Hyperthyroidism?
Too much thyroid hormone causes an increase in metabolic rate. Metabolic rate is how fast or slow the body’s organs work. An increase in metabolic rate places additional demands on all the organs of the body and can cause a cat to feel sick.
What are Some Symptoms of Hyperthyroidism?
- Weight Loss
- Increased appetite
- Increased thirst
- Increased urination
- Matted or greasy coat
Initial signs of hyperthyroidism are often mild, but worsen as the disease progresses.
How is Hyperthyroidism Diagnosed?
A blood test showing an increase in the thyroid hormone, T4 is the most common method of diagnosis. A few hyperthyroid cats will have a normal T4 and additional blood tests to look at alternative forms of the thyroid hormones may be suggested to help confirm a diagnosis.
Cats with hyperthyroidism often suffer additional problems including heart disease and hypertension, or high blood pressure. Hypertension can damage the heart, kidneys and brain. Treating hyperthyroidism may resolve or lessen these secondary problems.
What are The Options for Treatment?
Surgical removal of the thyroid gland
- Long-term treatment or cure in most cats
- Hyperthyroid medication is typically not needed after the gland is removed
- General anesthesia required
- Risk of damage to nearby parathyroid glands, critical to regulation of calcium levels in the blood
- Supplemental hormone may be needed in cats without adequate functional accessory thyroid
Medications for hyperthyroidism work by limiting the production and release of thyroid hormone.
- Medications are readily available
- Medications are shown to be effective when given by mouth or on the skin (transdermal)
- Lifelong treatment is required to control the disease and is not a cure
- Most require a minimum of twice daily dosing
- Side effects can include anorexia, vomiting, fever, anemia, and lethargy
- Transdermal formulations may result in localized reactions
- The drug dose will likely need to be modified using routine blood work
Radioactive iodine is absorbed by the thyroid gland and destroys the tissue.
- The therapy can be curative
- After one to two weeks of treatment, most cats have normal thyroid levels
- Does not require anesthesia
- No collateral damage to the nearby parathyroid glands
- Side effects are few and not serious
- Radioactive substances do require specialized licensing and training to administer
- Cats are hospitalized for the therapy and visitors are typically prohibited
- In rare, persistent cases a repeat treatment may be suggested
- Thyroid hormone levels may become too low and the cat may need to be given a supplement
A prescription diet available as Hill’s® y/d Feline Thyroid HealthTM has severely restricted amounts of iodine, without which the thyroid cannot produce excess thyroid hormone. The use of this diet is very controversial.
- Exclusive feeding of this diet can result in normal thyroid hormone levels in eight to 12 weeks
- Cats that are not candidates for surgery or radioactive-iodine therapy and cannot be medicated may benefit from this diet
- Available in dry and canned forms
- Iodine, an essential element, is below recommended levels for daily intake by adult cats
- Long-term effects of insufficient iodine levels are unknown.
- Not curative
- Cannot be combined with any other form of food to be effective
- Cat must remain on the diet permanently to avoid relapse
- Households with multiple cats may need to offer multiple diets or supplements
- Some cats refuse the food
Before beginning any treatment, a full blood panel and urinalysis are recommended. These tests are likely to be repeated during and after treatments to ensure thyroid levels are in the normal range and to monitor for damage to other organs. Commonly, hyperthyroid cats have concurrent kidney disease which may only become apparent during treatment for hyperthyroidism. The presence of kidney disease may alter the recommended course of treatment.
Most veterinarians consider radioactive-iodine therapy the best choice when the cat is a good candidate. Surgery also has the potential to be curative, but has increased risk. Lifelong medication and potentially dietary management are also avenues to consider. Surgery and radioactive-iodine treatments have the largest upfront costs, but long-term management with medical therapy or specialized food has the potential to be as expensive over the cat’s lifespan. Treating hyperthyroidism in cats is potentially curative or manageable for long periods of time.