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Therapy of Feline Hyperthyroidism - Medical Versus Radioactive Iodine
R. Neiger
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Key Points
Therapy of feline hyperthyroidism is accomplished with drugs or surgery but the best option is to use radioactive iodine. Success rate is 95-98% with few cases needing a second treatment. Hypothyroidism is exceedingly rare. Complications, such as renal failure, are not as common as thought and despite azotaemia radioactive iodine can be given.
Feline hyperthyroidism is the most common endocrine disorder in elderly cats. The exact reason for this problem is unknown but various environmental influences (litter, diet, antiparasitic drugs, etc.) have been thought to be involved. Most cats have either adenomatous hyperplasia or a uni- or bilateral adenoma of the thyroid gland. Carcinoma of a thyroid gland is rare (2-3% of hyperthyroid cats).
There are various therapy options available for treatment of hyperthyroidism, most commonly drugs, surgery of radioactive iodine. Methimazole or carbimazole(a pro-drug of methimazole) act by blocking intrathyroidal conversion of iodothyronines into T3 and T4. The drug must be given live-long which might be a problem in certain cats. Animals developing side-effects to one of these medications should not be treated with the other as cross-sensitivity can occur. Side-effects with methimazole usually occur within the first month of therapy and include GI upset (anorexia and vomiting are the biggest problems), facial scratching and agranulocytosis. Reactions usually subside within 2 weeks after stopping medication but re-occur if the drug is reintroduced. Most gelenic forms are oral, but transdermal ointments are available in some countries. [...]
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