|Hills no iodine cat food for hyperthyroid cats

Re: |Hills no iodine cat food for hyperthyroid cats

Robin Grimmer — Wed, 29 Aug 2012 16:52:38 GMT

[quote user="Martin Atkinson"]

[quote user="Thomas Johnson"]Wouldn't chewing the tablets mean he would absorb the drug more quickly, not reduce his absorption, so you'd get a spike in drug levels initially but it wouldn't last the full 24hrs.[/quote] May be something more to do with the whole tablet surviving passage through the stomach or not as the case may be. Felimazole on the other hand retains full pharmacoavailability (good word that) even crushed, its just the public health risk should a pregnant woman in her first trimester decide to snort the powder in mistake for coke or stick her fingers in it and lick them that it could be a problem.

[/quote]

The data sheet for Felimazole says that the tablets shouldn't be split.

Re: |Hills no iodine cat food for hyperthyroid cats

Martin Atkinson — Wed, 29 Aug 2012 16:34:08 GMT

Re: |Hills no iodine cat food for hyperthyroid cats

HMC — Wed, 29 Aug 2012 16:09:02 GMT

[quote user="Thomas Johnson"]

[quote user="Emma Cathcart"]

Owner replied every time she was sure he was taking them and eventually said 'I know he's getting them as I can hear him crunching them when he eats them' - so explained as vidalta not meant to be crushed so was reducing his absorption by chewing the tablets.

[/quote]

Wouldn't chewing the tablets mean he would absorb the drug more quickly, not reduce his absorption, so you'd get a spike in drug levels initially but it wouldn't last the full 24hrs.

[/quote]

I was just thinking that!

My only experience of y/d was a cat who continued to lose weight on it so the owner called Hills. Hills said to feed for the target weight not the current weight (understandably) but the owner then asked if she could just feed ad lib and they said no. It strikes me as rather odd to limit feed for a cat, who is emaciated but hungry...

Re: |Hills no iodine cat food for hyperthyroid cats

Thomas Johnson — Wed, 29 Aug 2012 15:13:29 GMT

[quote user="Emma Cathcart"]

[/quote]

Wouldn't chewing the tablets mean he would absorb the drug more quickly, not reduce his absorption, so you'd get a spike in drug levels initially but it wouldn't last the full 24hrs.

It obviously wasn't working for him anyway, am glad to hear the y/d has helped.

We've got our surgery cat on y/d, she became very depressed on Vidalta, stopped eating and drinking, and developed a generalised lymphadenoapthy. y/d has brought her T4 down from 76 to 34.

Re: |Hills no iodine cat food for hyperthyroid cats

Martin Atkinson — Wed, 29 Aug 2012 14:43:44 GMT

All these latest posts sound impressive but in the light of what has been said about clients getting prescription food off the internet, from a purely cynical point of view, if the cats are pillable then I will continue to use Felimazole as they still have to buy them from me and even if they demand a prescription I can still charge them (comments on other posts about prescription fraud notwithstanding).

Re: |Hills no iodine cat food for hyperthyroid cats

Emma Cathcart — Wed, 29 Aug 2012 11:37:46 GMT

I've been quite impressed so far with the y/d. It's not for every cat no but those that are suitable are doing well on it as far as I can see. One case we've had in particular; 17yo MN DSH with initial T4>150. Onto vidalta and T4 was reduced but still >100 then at next sample was back up at 140 again. Several of us saw the cat and every time we asked re compliance of tableting and could he be spitting them out as was on 20mg SID at this point and seemed to be having no effect. Owner replied every time she was sure he was taking them and eventually said 'I know he's getting them as I can hear him crunching them when he eats them' - so explained as vidalta not meant to be crushed so was reducing his absorption by chewing the tablets. Discussed felimazole or y/d. Started onto y/d and first bloods at 4 weeks showed T4 <50 so sticking with this. Also the cat refused any other types of food after the samples of the y/d we gave him so happy days.

[quote user="Iain McAllister"]

Anyone got any protocols on switching from felimazole to y/d?

thanks

[/quote]

The protocol we've used for switching from felimazole/vidalta was as per Hills recommendations. Stop tablets one day, start food same day and gradually wean from old food to y/d over 1 week then bloods 3 weeks after this (so 4 weeks after stopping tablets).

Re: |Hills no iodine cat food for hyperthyroid cats

Helen Wallace — Tue, 21 Aug 2012 21:06:03 GMT

Well, I've just got t4 back on a patient who started this 4wk ago... 24 down from 190 when on tabs (O was very compliant but cat was not). I'm very impressed, was not expecting that level of control... and no I don't work for Hills

Re: |Hills no iodine cat food for hyperthyroid cats

mariette asselbergs — Tue, 21 Aug 2012 15:43:26 GMT

She is doing just brilliantly. The owner is reluctant to have her blood taken again, since it is an old, frail and very much loved cat on an isolated farm and the last time she almost died in the restraint for bloodsampling. I would also be curious, but since she is doing so well clinically, gaining weight even, I go with the owners' request of leaving her be for now.

Mariette

Re: |Hills no iodine cat food for hyperthyroid cats

angie hibbert — Tue, 21 Aug 2012 09:25:41 GMT

Hi Mariette,

How is your patient doing now? I would be really interested to hear how she does and to know how well the diet manages to control her hyperthyroidism given the extremely high T4 levels. Have you got any follow up T4 levels now?

Best wishes,

Angie

Re: |Hills no iodine cat food for hyperthyroid cats

mariette asselbergs — Tue, 31 Jul 2012 13:19:35 GMT

In beginning of June my 19 year old farm cat patient came back in a hyperthyriod crisis, shaking as if having parkinson, heart rate 280, skin and bones. Bloods showed T4 > 300. Ordered food (both dry and wetfood), and tried vidalta. Vidalta made her vomit, but she loved the food. Already 2 weeks later she had lost the shakes and was much calmer and owner just phoned that she has a "second life" on the food alone (no pills). So it definitely seems to work. (I have no personal interest to promote this!)

Mariette

Re: |Hills no iodine cat food for hyperthyroid cats

Bob Russell — Sat, 28 Jul 2012 10:50:56 GMT

We are finding more and more clients are buying so called clinical diets on-line. Sadly many of the vet run sites seem happy to give near clinical advice that some owners seem to consider enough!

We have had a couple of owners recently being advised to start on a clinical diet only to be told they are already on them!

Re: |Hills no iodine cat food for hyperthyroid cats

Julian Earl — Fri, 27 Jul 2012 23:07:33 GMT

[quote user="Rajat"]

What I am trying to say is in the absence of glomerulo-nephropathy (I think I just made up a new word!) and significant proteinuria causing insults to the renal filtration apparatus including the tubules, can you provide a reference to support the statement that protein in the diet is directly toxic to the tubules?

[/quote]

Yes, I think so, but not here at home where I am now. I'll try and remember to look it up tomorrow when I'm back at the practice. It was from some CPD so it may be a referenced reference!

Re: |Hills no iodine cat food for hyperthyroid cats

Rajat — Fri, 27 Jul 2012 22:19:46 GMT

Re: |Hills no iodine cat food for hyperthyroid cats

Rajat — Fri, 27 Jul 2012 21:41:02 GMT

[quote user="Julian Earl"]it is established that protein is toxic to the tubules,[/quote]

Julian do you have a reference for this?

Re: |Hills no iodine cat food for hyperthyroid cats

Julian Earl — Fri, 27 Jul 2012 19:20:45 GMT

[quote user="Martin Atkinson"]

[quote user="Julian Earl"]Whilst renal disease is often a chronic inflammatory and fibrosing disease, it is established that protein is toxic to the tubules, and this is the main reason for protein restriction in these patients AFAIAA.[/quote] I understood that it is phosphate which is toxic to the renal tubules the protein restriction and provision of higher quality proteins is primarily to reduce the toxic metabolites of protein metabolism like ammonia building up because the inefficient kidneys in renal disease are unable to clear them. Being as a high proportion of older cats with hyperthyroidism are likely also to have renal disease, masked by the increased renal perfusion due to hypertension secondary to hyperthyroidism or clinical, a protein restricted diet would be beneficial in more cases than not.

[/quote]

It is both. The phosphate is the more important of the two but protein precipitation in the tubules is toxic in that further renal damage results. But yes, I suspect that a reduced protein diet would be beneficial to a lot of older cats regardless of obvious clinical renal disease.

Re: |Hills no iodine cat food for hyperthyroid cats

Martin Atkinson — Fri, 27 Jul 2012 14:10:13 GMT

Re: |Hills no iodine cat food for hyperthyroid cats

Iain McAllister — Fri, 27 Jul 2012 13:25:52 GMT

Anyone got any protocols on switching from felimazole to y/d?

thanks

Re: |Hills no iodine cat food for hyperthyroid cats

emerald — Wed, 04 Jul 2012 18:08:55 GMT

We had one hyperthyroid cat who kept getting blood dyscarias on thyroid medication. She is now doing well on the diet.

Re: |Hills no iodine cat food for hyperthyroid cats

Julian Earl — Sat, 23 Jun 2012 16:16:54 GMT

[quote user="Rajat"]

I had the impression senior and renal diets were mildly restricted in protein but with higher quality protein in the mix which was maybe more bio available and so on. I wonder whether the improvement you are seeing in these renal cats may be due to the additional goodies such as EFAs in renal diets along with restricted phos which helps them to feel better reduce azotemia and eat more hence put on weight?

I didn't think renal disease in cats can be prevented just by protein restriction, my impression was that it was an inflammatory/degenerative condition in older cats which was not related to diet, but happy to be further educated and corrected on the subject

[/quote]

I am sure that the increased weights are due to a multipliicity of factors: increased EFAs, attention to dehydration, reduced renal parameters especially phosphate, and temporary improved renal function generally. Senior diets seem to be a "half-way house" to a full renal diet so may well have benefits for many old cats bearing in mind the frequency of renal disease in these old cats.

I agree about the protein cause/effect, sort of. Whilst renal disease is often a chronic inflammatory and fibrosing disease, it is established that protein is toxic to the tubules, and this is the main reason for protein restriction in these patients AFAIAA. Whether both the preference and requirement for high protein diets in normal cats contributes to the frequency of the disease in old cats I am not sure, but it is an interesting challenge if so!

Re: |Hills no iodine cat food for hyperthyroid cats

Rajat — Sat, 23 Jun 2012 15:33:10 GMT

Re: |Hills no iodine cat food for hyperthyroid cats

Julian Earl — Sat, 23 Jun 2012 15:28:17 GMT

[quote user="Rajat"]

[quote user="Julian Earl"]Might the reduced protein not be okay for the old cat? Also, once the thyroid is under control then they won't be catabolic.[/quote]

I am not sure it would, as cats rely so heavily on protein for energy production, and these cats are already so protein deficient/low muscle mass due to catabolism. Also, to put the muscle back on once they are not catabolic they will need more protein than the diet provides. I would have preferred a higher protein content, but I am not a nutritionist, this is just my impression from a little I have read about feline nutrition thats all.

I have tried the diet on 2 cats, both have refused to eat it so far!

[/quote]

Replying to both you Rajat and Alet.

I was thinking that 1 in 3 cats develop renal disease so protein restriction may be beneficial on that basis. Most senior diets are slightly restricted in protein, even for cats so it is striking the right balance between reno-protection and providing an energy source that becomes important. Cats on protein-restricted renal diets will increase in weight for a good six months or more IME before catabolic losses start the downward trend again. Maybe this diet will allow that, plus help with HTism?

Re: |Hills no iodine cat food for hyperthyroid cats

James Laidlaw — Sat, 23 Jun 2012 14:19:20 GMT

[quote user="Lorna McHardy"]

[quote user="Rajat"]

I have tried the diet on 2 cats, both have refused to eat it so far!

[/quote]

Ah well... remove the steak, and that dinner just loses half its appeal!

[/quote] Only half? What are you, vegetarian or something?

Re: |Hills no iodine cat food for hyperthyroid cats

Kate Richardson — Sat, 23 Jun 2012 14:04:09 GMT

[quote user="Rajat"]

Worth having a look at the back of the bag/can - the protein content + sources are pretty poor especially for the dry. Seems pretty poor for the older skinny cat who is already in a catabolic state. I can see how it would be good for some cat owners tho.

http://www.animalendocrine.com/yd/

[/quote]

My understanding of the diet from Hills is that it is essentially a senior diet, the only difference being that it is iodine restricted.

Other euthyroid cats in the house can eat it, but should be given a meal of regular food each day as well.

The only 2 concerns I have are (1) it will be available without prescription over the internet- concerned re owners self diagnosing their cats and concerned that they may not follow through with regular rechecks to monitor if they can obtain the diet without a prescription and (2) albeit rare, if the cat has a thryoid adenocarcinoma rather than benign hyperplasia, that the diet will be effective in controlling T4 levels- I have been alerted to 2 cases in the past 12months with an adenocarcinoma due to poor control despite increased doses of medication.

However I still believe it to be a great new addition to the therapeutic options for hyperthyroidism

Re: |Hills no iodine cat food for hyperthyroid cats

Lorna McHardy — Sat, 23 Jun 2012 13:45:18 GMT

[quote user="Rajat"]

I have tried the diet on 2 cats, both have refused to eat it so far!

[/quote]

Ah well... remove the steak, and that dinner just loses half its appeal!

Re: |Hills no iodine cat food for hyperthyroid cats

Rajat — Sat, 23 Jun 2012 13:28:44 GMT

[quote user="Julian Earl"]Might the reduced protein not be okay for the old cat? Also, once the thyroid is under control then they won't be catabolic.[/quote]

I have tried the diet on 2 cats, both have refused to eat it so far!