Methimazole gel - oral use?

Re: Methimazole gel - oral use?

Kate Richardson — Thu, 29 Jan 2015 19:22:29 GMT

[quote user="shanley barber"]Does anyone know if the gi signs seen with oral methimazole are seen in the same cats on the trandermal gel?[/quote]

Yes, side effects all the same

Re: Methimazole gel - oral use?

shanley barber — Thu, 29 Jan 2015 12:15:10 GMT

Does anyone know if the gi signs seen with oral methimazole are seen in the same cats on the trandermal gel? Assuming they are fit with a buster collar to prevent oral intake of the gel? I have a cat that has had significant vomiting and diar after two days of both methimazole and carbimazole. It is in early CRF so surgery and radioactive treatment not an option yet until kidney function sans excess thryoid is known.

Thanks,

Shanley

Re: Methimazole gel - oral use?

Sammy82 — Tue, 13 Jan 2015 17:21:04 GMT

good point, if the cat is allergic to any of the components it probably doesn't matter were you put it.

@Kate (or rather the specialist who gave the advise): Surely normal cats don't have any hairless area in the inguinal region?

Re: Methimazole gel - oral use?

Kate Richardson — Tue, 13 Jan 2015 17:12:48 GMT

Info from a specialist

"Hi Kate,

I think a small amount of ingestion is considered safe, but long term 'treatment' like this would be a whole grey area. I am assuming you are happy that the dermatitis you report is a reaction to the gel, rather than the methimazole. If so, then cleaning the ears between application, or rotating sites to include the hairless areas in the inguinal region may help.

I have sometimes switched back from veterinary licensed products to Neo-mercazole (non sustained release carbimazole) in cases that are otherwise difficult to medicate. Although this was traditionally directed to be given three times daily, twice daily administration was often adequate for many cats, and it seems a lot more palatable than the veterinary preparations. I know this could be difficult in a multi-cat household, but if the cat took it in a small tasty bit of food or Lick-e-Lix for example, relatively quickly it shouldn't be too much more onerous than applying topical gel.

Nicki Reed BVM&S Cert VR DSAM (Feline) DECVIM-CA MRCVS"

Re: Methimazole gel - oral use?

Virginia Campbell — Tue, 13 Jan 2015 16:38:58 GMT

[quote user="emma_j"] has had a severe localised skin reaction to it's use transdermally[/quote]

Won't his oral mucous membranes be similarly annoyed?

Re: Methimazole gel - oral use?

Martin Atkinson — Tue, 13 Jan 2015 11:02:56 GMT

[quote user="Thomas Johnson"]I would consider crushing Felimazole tablets in this situation, my understanding of the reason you're not supposed to is to avoid contact with human skin, but if they've been using the methimazole gel already they just need to take the same precautions when handling the crushed tablets.[/quote]Total common sense yet it is not that common unfortunately. ASAIK the restriction on crushing Felimazole is not loss of bio-availability as it is with carbimazole but the public health risk. If you're worried explain this and get the client to sign an off-licence consent form. Or do what I do say that, 'in theory you can crush the tablets but I didn't tell you'!

Re: Methimazole gel - oral use?

Anthony Dennison — Tue, 13 Jan 2015 09:16:48 GMT

I discovered that the cat who I'd asked about whether his T4 was too low has been having his tablets crushed into his food, so obviously doesn't affect things.

Re: Methimazole gel - oral use?

Thomas Johnson — Tue, 13 Jan 2015 08:56:53 GMT

[quote user="Kate Richardson"]

I can ask on the ISFM forum for you- why won't the owner consider oral medication with the tablets? Why would the gel (if useable in this fashon) twice daily be better than a once or twice daily tablet?

[/quote]

I would consider crushing Felimazole tablets in this situation, my understanding of the reason you're not supposed to is to avoid contact with human skin, but if they've been using the methimazole gel already they just need to take the same precautions when handling the crushed tablets.

Re: Methimazole gel - oral use?

Martin Atkinson — Mon, 12 Jan 2015 18:42:42 GMT

[quote user="ChrisBVSc"]did summit tell you what else it contains?[/quote]Call them and ask they are generally pretty helpful.

Re: Methimazole gel - oral use?

ChrisBVSc — Mon, 12 Jan 2015 17:32:33 GMT

Are there any compounding pharmacies in the UK that make a methimazole oral liquid? I've never used any but it often crops up on American websites about hyperthyroid cats. For example: http://www.vetrxdirect.com/product/view/methimazole-suspension-compounded-for-cats

Just had a look at the summit gel on the shelf, unfortunately it doesn't give the ingredients beyond methimazole - did summit tell you what else it contains?

Re: Methimazole gel - oral use?

Martin Atkinson — Mon, 12 Jan 2015 17:22:40 GMT

Given that when someone put some dye in the gel and it ended up all over the cat's coat where it had obviously groomed itself, it begs the question as to how much is actually absorbed transdermally and how much is absorbed orally. If you have no alternative and the owner is aware it is off-licence and warned of problems unknown then I guess it is worth a try. If not then I put suggest that you can do more for the cat and leave them to their own devices if they won't/cant' agree to surgery or radio-iodine therapy. I would probably have run out of patience with these clients already!

Re: Methimazole gel - oral use?

Kate Richardson — Mon, 12 Jan 2015 15:09:37 GMT