Peer-reviewed veterinary case report
Medical management of hyperthyroidism in cats with methimazole
By Trepanier, Lauren A·Published in Clinical techniques in small animal practice·2006·Department of Medical Sciences, United States·View original on PubMed →
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Original publication title: Medical management of hyperthyroidism.
- Species:
- cat
Plain-English summary
A 10-year-old Siamese cat was diagnosed with hyperthyroidism and started on methimazole, a medication that helps control the overproduction of thyroid hormones. While this treatment works well for most cats, some may experience side effects like stomach upset or changes in blood cell counts. To ensure the cat's health, the veterinarian monitored kidney function and thyroid levels regularly. In cases where oral methimazole caused vomiting, a transdermal version was used instead, which had fewer side effects. The cat's condition improved with treatment, but blood pressure was also managed with additional medications.
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Abstract
Radioiodine is considered the treatment of choice for hyperthyroidism, but in some situations, methimazole therapy is preferred, such as in cats with pre-existing renal insufficiency. Methimazole blocks thyroid hormone synthesis, and controls hyperthyroidism in more than 90% of cats that tolerate the drug. Unfavorable outcomes are usually due to side effects such as gastrointestinal (GI) upset, facial excoriation, thrombocytopenia, neutropenia, or liver enzyme elevations; warfarin-like coagulopathy or myasthenia gravis have been reported but are rare. Because restoration of euthyroidism can lead to a drop in glomerular filtration rate, all cats treated with methimazole should be monitored with BUN and creatinine, in addition to serum T4, complete blood count, and liver enzymes. Transdermal methimazole is associated with fewer GI side effects, and can be used in cats with simple vomiting or inappetance from oral methimazole. Hypertension may not resolve immediately when serum T4 is normalized, and moderate to severe hypertension should be treated concurrently with-atenolol, amlodipine, or an ACE inhibitor. Alternatives to methimazole include carbimazole, propylthiouracil, or iodinated contrast agents.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/16584027/