Carbimazole treatment for hyperthyroidism in cats

Abstract

ABSTRACTThe efficacy and safety of carbimazole (CBZ) was studied in a series of 45 hyperthyroid cats. CBZ was used before surgical thyroidectomy in 34 cats, at a dose of 5 mg administered orally every eight hours. Biochemical euthyroidism, as assessed by a decrease in serum total thyroxine (T4) concentrations into the reference range, was achieved in 31 cats (91 per cent) within a mean (± SD) of 5–7 (± 2–9) days (range, three to 15 days). Clinical evidence of euthyroidism tended to lag behind biochemical evidence but was usually apparent after 14 days. Continuing therapy tended to decrease serum total T4 but not serum total triiodothyronine (T3) concentrations below the reference range but clinical evidence of hypothyroidism was not apparent. In five additional cats, 5 mg CBZ was administered three times between 08.00 and 20.00 hours. Euthyroidism was achieved in only one cat after 14 days, emphasising the need for eight hourly dosing. Clinically observable side effects developed in five cats (13 per cent), two to three weeks after commencing therapy and included vomiting (n y 2) and vomiting and anorexia (n = 3). In three cases withdrawal of CBZ was required. Mild and transient haematological abnormalities developed in two cats (one case each of lymphocytosis and leucopenia). There were significant decreases in serum concentrations of alanine aminotransferase and alkaline phosphatase in those cats achieving euthyroidism (P < 0–001 in each case) but not in those that remained hyperthyroid despite CBZ therapy (P ± 0–05 in each case). CBZ was used as the sole therapy for the condition in eight cats for between four and 65 weeks. A consistent dosage of 5 mg CBZ administered twice daily was necessary to maintain euthyroidism. Adverse reactions were not noted. Chronic medical management tended to depress serum total T4 concentrations below the reference range. Corresponding serum total T3 concentrations remained within the reference range on 15 (88 per cent) of 17 occasions and may explain why the animals appeared clinically euthyroid. CBZ appears to be a safe and effective drug both in the short and long term management of feline hyperthyroidism and can be recommended as the current drug of choice in the UK.