Speaker 1: You were listening to Petlifradio dot com.
Speaker 2: And good morning and welcome Paul on this glorious Sunday
morning here in Los Angeles. I'm sure back east at noontime.
Speaker 3: I'm hoping it's a good day.
Speaker 2: I don't know if you've had some rain in some
parts of the country where our weather's changing a little bit.
It was only in the mid eighties yesterday. So for
those of you who like to get jealous about southern
California weather, please do so, because we're having it pretty
good here. I am your host for the next half hour.
I'm doctor Jeff Werber here with Astavettes with doctor Jeff
here on pet Life Radio and the only live call
in show here on pet Life Radio, which me we
need you to call in because I hope you're alive.
Give us a call at eight seven seven three eight
five eight eight A two. Once again that number eight
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Speaker 3: It's so easy to.
Speaker 2: Get a hold of us whatever you have questions about anything.
For the last oh Before we get to that, of course,
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So anyway, well, last week've got a great guest who's
coming back again next week. Because of technical difficulties, as
they say in our world, we kind of lost about
half of her show. So we have doctor Lenzer coming
back next week on the nineteenth and we're going to
talk some more. So if you have any questions that
you want to save up and you save up the
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can get expensive. So I just think you can join
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doctor Jeff and get free advice. If you're sort of
at that fork in the road you don't know which
direction to take and you're not sure you understand, but
your veterinarian is trying to explain to you, just call in,
send me the email, and we will help straighten everything
out for you and make your decisions.
Speaker 3: A lot easier.
Speaker 2: So over the last several weeks, before last week when
we had a chance to talk about fall allergies with
doctor Lenzer, we also had been doing a series on
problems like vomiting, like limping, that the gamut, the range
of possibilities is so great, and when to really worry,
how to determine, how to differentiate between that which is
really serious and that which may not be so serious,
when you should rush your pet to the veterinarian, and
when you can sit back and try a few things
at home. And if you have any questions about things
like that, please give me a call. We've talked about
skin issues, we talked about gastrointestinal issues, vomiting and diarrhea,
and of course the many many limping, lameness problems that
we see in our pets. And we talked about how
they arise. Do they come on suddenly? Are they slowly progressive?
Is a pet painful all the time? Is only sometimes
that helped kind of sift through the clinical signs, because
often when you get that really thorough history and you
really evaluate the clinical science and the doctor does a
really thorough physical exam, you can mostly weed out many
of the potential problems right away and not have to panic.
Speaker 3: So it makes it really easy for you guys.
Speaker 2: And one of the conditions I wanted to talk about
today is near and dear to me because I actually
have a one of my eight cats is now for
the next till actually the seventeen five more days. He
is all by himself in a remote corner of the house,
in a bathroom. And the reason is is he is radioactive.
And I'm not joking. If I took a guy your
counter to him, it would go off. He is a
radioactive cat. And why why do I have a radioactive cat? Well,
we're going to talk about a fairly common, often misdiagnosed
condition in cats, though I have to say probably much
more is known about it. It was a lot more
of a problem with misdiagnosis thirty years ago when I
started practicing than now, and that is called feline hyper thyroidism. Now,
there are thyroid disorders and dogs and thyroid disorders and cats,
and typically dogs that present with thyroid problems are hypo thyroid.
Speaker 3: We see that a lot.
Speaker 2: For example, Golden Retrievers are very commonly diagnosed with hypothyroidism.
And the typical presentation of a dog with hypothyroidism which
means an underactive thyroid gland. These dogs tend to gain weight.
They are kind of a little more mellow and slow
moving than they used to. They don't really want to
get up and do. They sort of become more of
a couch potato. Sometimes their skin can get a little thin,
they might lose some hair, sometimes get a little greasy.
Speaker 3: We call it separia oliosa. So there are.
Speaker 2: Certain problems that underactive thyroid dogs tend to present with,
and of course we make a diagnosis based on lab work,
and just as a hint, I would hope that most
of your veterinarians know this, but just in case, just
in case, you have an old timer out there that's
fantastic but may not be up to date on everything.
And that is that when you're testing for or having
your pet, your dog tested for thyroid disease, there is
the basic test that we've all used over.
Speaker 3: The years, and that's called the T four.
Speaker 2: T four basically is affected by a lot of other things.
So you got to be careful because a lot of
dogs can have another condition, another problem, and then suffer
from what we call sick thyroid syndrome. So when they
present with a low T four value in the face
of some other problems, it may not be true thyroid disorder.
So there is a better test that we use, and
that is called a T four by ed ED stands
for equilibrium dialysis. So whenever you suspect or your vet
gnarians suspects thyroid disease, you want to run that ED
because oftentimes dogs can present with a low T four
regular T four, but a totally normal T four by ED,
and if that's the case, they are not truly hypothyroid.
And as a matter of fact, when they are healed
from whatever condition might have been affecting them, their thyroid level,
their T four regular T flour normalizes becomes normal, and
we realize we did not want to treat unnecessarily and
make our dogs hyper thyroid by giving them a thyroid
supplement when they didn't need it, so we got to
be really careful with that.
Speaker 3: Now. Cats, on the other hand.
Speaker 2: Present with a condition that is called hyper thyroid and
hyper thyroidism is an over active thyroid gland and that
is where But it's interesting, it's not a cancer per se.
Now when people present with a thyroid problem, it's often
a thyroid carcinoma.
Speaker 3: In fact, my daughter had it when she was twenty.
Speaker 2: Five, had a papillary carcinoma and they had to remove
the entire thyroid gland surgically and then because of the
spread and other possibility of spread to regional lymph nodes,
they had to treat with the thyroid medication. So this
is something that is comminent people as well. When they
have a thyroid disorder, they need to have surgery. Cats are,
on the other hand, present with something called benign thyroid hyperplasia.
So the thyroid hormone producing gland, portion of the thyroid
gland starts, certain areas of that land start to overproduce.
It's not cancer and it's just a overproduction of thyroid hormone.
And this typical cat that presents is a cat that
has a eating extremely well but still losing weight, and
they are sometimes very active. However, I have to comment
that as the disease progresses, if it's left unchecked, then
they start getting sick from it. And the same cat
that was over eating yet losing weight now starts to
become a little more sluggish because they're getting too ill.
And there are other conditions that are affected by this
continuous overproduction of thyroid hormone, for example liver and another
thing that happens is there a heartbeat starts to go up.
So years and years and years ago when these cats
would often present to the veterinarian. Of course, the veterinian
would do a thorough workup and do a blood test,
and unfortunately, little was known about the thyroid plant. So
therefore we weren't testing for thyroid, but what we were
testing for testing well, obviously the liver enzymes. So you
see these elevated liver enzymes. You listen to the heart.
The heart is racing. You do any kgs, it's a
normal rhythm, but it's very fast. And doctors were inevitably
treating for two problems. They were treating for heart disease
and they were treating for liver disease, when in fact
it was neither.
Speaker 3: It was the thyroid.
Speaker 2: So back then they're were once diagnosed, the thyroid scans
could be done and the treatment of choice was to
remove the thyroid glands, trying to and this is very
technically difficult as a surgeon, to preserve the pair of
thyroid glands which are basically sitting right on top of
the thyroid. And we were then supplementing with a thyroid supplement,
the same basic thyroid supplement that people use after their
glands are removed, and that's called the human version.
Speaker 3: Is called synthroid. We use something called celloxin.
Speaker 2: There's also many many of their thyrotabs, a lot of
brands out there of thyroid supplement, and we used to
have to supplement the cats. There are some medications that
can be used to sort of modify the effect of
the thyroid gland itself.
Speaker 3: And that's like a band aid.
Speaker 2: If you have a cat that presents at nineteen years
of age already has other problems, you.
Speaker 3: Don't want to subject them to serve now. You don't
want to subject.
Speaker 2: Them to another treatment that is the treatment of choice nowadays,
which is what good old Oreo is sitting in that
bathroom by himself, and that is radioactive iodine therapy. Then
we used to use this medication called methemisol, and methemisol
is something that would make a hyper thyroid cat what
we call you thyroid, meaning normal thyroid.
Speaker 3: And that's the other option that we have still to
this day. But I don't like it.
Speaker 2: I don't like it because it's really not fixing the problem.
It's just putting a band aid on it. And a
lot of times there's so much fear that these cats
will not tolerate the treatment or the surgery and I
remember my first hyperthyroid cat that I treated back in
nineteen eighty four was a seventeen year old cat, and
the owners were very, very very nervous about subjecting their
seventeen year old cat to surgery, and I went ahead
and I performed the surgery. This cat did amazingly well,
live to nineteen and a half, which was fantastic. So
as long as a cat, I rememb remember one thing
about age. Age is not a disease. Age is a
factor that we have to deal with when choosing and
selecting certain treatment options, but it itself is not a disease.
You're not gonna say to ninety five year old Grahama
who fell and broke a hip, Sorry Graham, you're ninety five.
Speaker 3: We're not gonna do anything. You're just gonna have to
live like it. Instead.
Speaker 2: What do we do We work theme up, we make
sure everything else is okay, and we consider surgery. So
that's kind of how we treat our cats as well.
So when we come back from our break, because we're
at that time, it goes so quickly, we're going to
talk about the new, the bestest, the way we like
to treat hyper thyroid cats and that is with radioactive iodine.
It is radio radiation and we got to be careful.
There are certain precautions we have to take after treatment,
but it is the way to go. And case in point,
my OREO is doing amazingly well, and when we come
back we'll talk all about it. Stay tuned here and
ask the best with doctor Jeff here on Pete Life
Radio and we'll be back in just a minute.
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Speaker 2: And welcome back and thank you for running here One
Life Radios. Ask the Best with doctor Jeff and I'm
your host, doctor Jeff Web And before the break, we
were talking about hypothyroidism and dogs and hyperthyroidism in cats,
and that's where the thyroid gland becomes a bit overactive.
And typically these cats, as we mentioned, seem to eat
like crazy and they still lose weight. So while we
touched on some of the old fashioned treatment which still
has done a lot today, and that's surgery very effective,
you got to be a little bit careful about the
para thyroid glands which you sit right on top of
those thyghroid glands, and the other thing with surgery, and
this is the one thing that we can get you
into trouble, and that is that even if you were
to opt for surgery, it's still beneficial to do what's
called a syntography. It's a scan that actually can measure
the amount of thyroid hormone, how much iodine uptake as
being these lands are taking up. Why because to go
into surgery, oftentimes you might palpate the neck of a
cat and you can feel the bulging enlarged thyroid gland
either side, and if it's only one, you can actually
remove just the one. And if successfully done so, and
it truly is only one side, you're done. You don't
have to do any supplementation. These cats go on to
do extremely well. If it's bilateral both sides, then you
need to remove both again preserving the parathyroid, preserving the
blood supply to the parathyroid. It's a little challenge. You
have to do a few to really get good at it.
But then again, these cats are going to need supplementation.
The problem lies, however, where you can't always link the
size of the gland with the amount of hormone it's producing.
So you can see a really large gland and why
that looks totally normal and you say, ah, so I'm
in surgery. I'm just going to take off to the
big one because I want the other one to stay.
And hopefully it'll take care of all the thyroid hormone
needs of the cat and we won't have to supplement,
which is great. The problem is you can't always tell
just by looking at the gland whether or not it's overproducing.
There are a number of glands that we've had skin
and that looked and felt normally but actually were also
secreting too much thyroid to normale. And so you're not
going to know it until you've finished surgery and the
cat's up, and then when you find oh my god,
this cat is still hyperthyroid, now you got to go
in for second surgery. So it's always better anyway to
do a scan. So haven't give you enough background. And
I mentioned early in the show that I have my
sixteen year old cat Oreo in a bathroom all by himself,
unfortunately for another week, five more days until the seventeenth.
Why because he is radioactive, his waist is radioactive. We
don't want him hanging around us too much, and we
have to do special litter. I'm using that sweet scoop
because it has to be flushable. You can't throw the
litter away in the garbage. Now, what you can do
if you want it, you can actually store the litter
in a big, big bag in your garage somewhere far
away from everybody for about a month, and then you
can toss it after that.
Speaker 3: So anyway, what's.
Speaker 2: Going on is that my Oreo was a cat that
we rescued at about we figured four to five days
of age, with some littermates, obviously sixteen years ago. Two
of the littermates died within a day. They were literally starving.
They were found under a woman's house. She heard this
sound at night when it was all quiet in the house.
It sounded like little kiddies. So she took asked her neighbor.
Her neighbor's little boy, like.
Speaker 3: An eleven to twelve year old kid.
Speaker 2: She gave him a flashlight and said, can you go
unto the house and just see what this noise is?
So this for this kid was an adventure, so he said, yeah,
So what.
Speaker 3: Does he do?
Speaker 2: He finds four little kiddies huddled together. Mom was nowhere
in sight. They took the kiddies, brought him to us.
They kept looking for mom. Mom never came back. The
fear was Mom was either killed by a car eaten
by a coyote. Who knows what happened. So the two surviving,
they were so weak we literally needed round the clock care.
They were too weak to even nurse on a nursing bottle.
We had to stomach tube them to feed them. And
so the two ended up doing very well. After about
a week of being stomach tube fed, they started to
respond to the the bottle.
Speaker 3: They were able to suckle on the.
Speaker 2: Nursing bottle, and then we started to give them solid
food when it was time, et cetera, et cetera. Anyway,
I gave one to my sister and I kept one.
Now I had no idea what they were because you
could find they would fit in the in one hand.
Speaker 3: They were so small.
Speaker 2: Well, this little teeny ten black and white cat turned
out to what looks like to me is a mix
between a main coon because he's got that huge thick
tail and a Norwegian forest cat. And if anyone knows cats,
these are both very large cats and obviously Oreo black
and white I know, not very creative. Read the book,
and he is well turned out to be a twenty
two pound monster and the sweetest cat. In fact, it
was so funny because our routine was in the morning,
I would take him to the bathroom and that's where
I had all the setup. I had the stomach too,
but I had the food at everything. And if I
tell you, for years and years and years, every single morning,
when I would get up and go take your shower
in the mouth, he would run into the bathroom and
follow me like you figure, oh my god, I'm.
Speaker 3: Gonna get food again. This is great. He loved to eat.
Speaker 2: And even though he continued to love to eat, I
noticed over the last oh maybe a month or two
that he seemed to lose a little way, and I
figured out, you know what, it's his age. So it
was time anyway to bring him in for his annual
senior physical, which I take blood work and I do
your analysis. I take X rays and now, mind you,
a year ago, when he was fifteen, he was perfect.
So that's how this disease did come up. It could
come up that fast. So I take his regular tests
and his normal thyroid, as we mentioned before in the
first half of the show, his.
Speaker 3: Normal thyroid was high. Normal was four. He was four
point five, not that big a deal.
Speaker 2: And the T four by ED, which is a much
better test, much more sensitive, takes an extra day to
come back. Took it back and it was greater than
one hundred. I said, oh my god, he is hyperthyroid.
Everything else perfect, his liver, his kidneys, everything perfect. So
call a colleague of mine, a friend of mine who
actually went to school with me. He was graduate a
year after me, who started doing He got his master's
and he does the scanning, the sintography, and the radioactive
iodine treatment for cats, which is the best way to go,
by the way. So took Oriy over to him, and
sure enough his scan shows this red hot thyroid gland
one side, and he had to stay in the hospital
for a few days over by him, and they actually
gave him radioactive I one th one, which the thyroid
gland takes up iodine and the radioactivity. And what's so
cool about this particular treatment it only goes after the
hyperplastic part.
Speaker 3: It doesn't touch the normal gland.
Speaker 2: So after successful treatment in ninety five, ninety six percent
of the case is the cats need nothing else, They
don't need any supplementation. They do just perfect. So did
the treatment, and when I brought him home, they give
you a long list of things you have to do
because he's still radioactive. So it's the special litter. He's
got to be by himself.
Speaker 8: You know.
Speaker 3: I can go in and iPad them.
Speaker 2: They say for me petting him and holding him for
one hour is kind of like being subjected to four
or five X rays.
Speaker 3: So it's not the end of the world.
Speaker 2: I don't spend that much time with him, but I
go in and I pet them, and I play with
them a little bit, and I brush them and I
give him food. Boy, his appetite, well, it never really changed.
But now the hope is that as his thyroid levels
drop because of the radioactive iodine, that he will actually
get and use the calories that he's eating. So he
is just an amazing cat.
Speaker 3: Still.
Speaker 2: By the way, the bathroom I'm keeping him in it
is that bathroom that he remembered as a little kiddie,
so he's very comfortable there and it is the way
to go. So if you are the take home lesson
that I'm going to give you about feline hyperthyroidism is
the following. Number one is make sure your cats check out.
Do that senior physical, and I would recommend I hope
more and more and more veterinarians are now doing it.
The cases that have been misdiagnosed, it's because they weren't
doing it.
Speaker 3: And that's the following.
Speaker 2: Every time from the time the cat is seven or
certainly eight years of age or greater, and your veterinarian
is going to run a senior physical on your cat,
make sure they include both the T four and the
T four by ed equilibrium analysis.
Speaker 3: Don't do just the one.
Speaker 2: To understand that these cats that might have high liver
enzymes and very rapid heartbeats, nothing is wrong with the
liver or the heart. It's all because of the hyperthyroidism.
But there is one catch to these cats, and that
is the following.
Speaker 3: This is a disease of old cats.
Speaker 2: And the other major disease of older cats, probably the
disease that is going to kill more older cats than
any other disease is kidney failure. But because of the hyperthyroidism,
because the blood the heart rate is going faster, so
the blood is being pumped faster and more frequently through
the filtration system of the kidney. If that filtration system
is weak, but the blood gets to go through twice
or one and a half times instead of just one
time per cycle. Then even whatever the kidney missed the
first time, they're going to pick up on that second pass.
So what happens is the disease is that we link
to kidneys. The enzyme changes, notably the increase in B
when blood urre and nitrogen, creatinine, and phosphorus are going
to be reduced, those values in hyperthyroid cats falsely reduced.
So what happens is as soon as you normalize the
thyroid gland and the thyroid hormone and the heart rate drops,
et cetera, all of a sudden, the kidney disease that
seem to not be there can start showing up. So
we always recommend and warn that if there are any
signs of early kidney disease elevated enzymes despite the hyperthyroid state,
most likely they're even worse than what the blood work
may have shown, and precautions need to be taken as well,
and you can go through those with your veterinarian as
far as subcutaneous fluids at home, special diet, et cetera,
et cetera.
Speaker 3: So that's the.
Speaker 2: Only thing that you have to know when you're dealing
with hyperthyroid cats or treating them. Be it because from surgery,
be it from the medication that's going to just decrease
the effect and counteract the effect of the increased thyroid hormone,
or because in my opinion, the best treatment of choice
is the radioactive iodine. That understand that during the course
you might uncover some of the underlying hidden kidney problems,
So keep your minds about on that too, and make
sure to discuss these many options with your veterinarian. So anyway,
once again, that's all that we have time for. Nobody,
nobody called. I guarantee people out there listening have had
animals with vomiting diarrhea problems, have had limping problems, and
I know have had cats with thyroid problems, and I
do want to hear from you. We can talk about it,
and that the more we talk about things like this,
the more we are helping other listeners here on pet
Life Radio. So there's no downside picking up the phone,
giving us a call, sending me a text, joining in
on the conversation, and it will only not only benefit you,
but hopefully will benefit our list benefit our listeners as well.
So anyway, next week we have doctor Lenster coming back
and we're going to talk some more things.
Speaker 3: We're going to talk about some of our.
Speaker 2: Pet peeves and.
Speaker 3: We will see you then have a great week.
Speaker 2: Thanks again to cong and Pro Sense Pet Products for
sponsoring our show, and we'll see you next week, same time,
nine am Pacific time and noon back East.
Speaker 3: I'm doctor Jeff Werberg.
Speaker 1: Seem Let's Talk Pets every week on demand only on
petlight Radio dot com