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... and Links to other Animal and Avian Websites! Hyperthyroidism and Hypertension of an Aged Cat Amy B. Worell, DVM, ABVP-Avian CLINICAL PRSENTATION: A 21 year old female DSH (domestic short hair) cat named "Sadie" was presented with a two day history of lethargy, discharge from the eyes, inability to see, and loss of appetite. The pet was an indoor cat with no previously recorded medical problems. On physical examination, the heart rate was elevated with a gallop heart rhythm (called this as the heart rhythm sounds like a horse galloping), the pet had very severe dental disease, was extremely dehydrated, extremely thin, and had bilateral hyphema (which indicates that the front part of the eyes were filled with blood). The pet was admitted into the hospital for a diagnostic workup, hospitalization and fluid therapy. The initial workup indicated that the pet had an elevated amount of circulating thyroid hormone in her system, hypertension or elevated blood pressure and an elevated white blood cell count. Survey radiographs or X-rays showed a generalized enlarged heart shadow. These tests together pointed to a diagnosis of hyperthyroidism and systemic hypertension. HYPERTHYROIDISM IN CATS: Hyperthyroidism in cats most commonly occurs in cats that are 8 years of age or older. Purebred cats are significantly less likely to be hyperthyroid than domestic or mixed breeds cats. The history of cats affected with hyperthyroidism varies, but often may include some of the following clinical signs: drinking more and urinating more, excessive and often voracious appetite, weight loss despite a good to excellent appetite, hyperactivity, vomiting and/or diarrhea, panting, and lethargy. On presentation, the veterinarian may note that the cat is in poor body condition, has an unkempt hair coat, is dehydrated, has a heart murmur or abnormal heart rhythm, and may have thyroid glands that can be felt or palpated. Diagnosis of cats with possible hyperthyroidism is through diagnostic blood tests, which should include a complete blood count, serum chemistries, specific thyroid tests, and a urinalysis. Treatment of hyperthyroidism most commonly involves oral medication or referral for radioactive iodine treatment. The goal with either treatment is to return the pet to a normal thyroid state and to resolve the accompanying clinical signs. HYPERTENSION IN CATS: Systemic hypertension or high blood pressure occurs in both dogs and cats when there is a sustained elevation in the arterial blood pressure. There is no significant age or sex predisposition. However, some systemic diseases commonly associated with systemic hypertension, such as chronic kidney failure or hyperthyroidism; most often occur in older animals. In cats, systemic hypertension most commonly occurs as a complication of another systemic disease, and in the case of "Sadie" as a complication of her hyperthyroidism. The mechanism of systemic hypertension in cats is still poorly understood though. Clinical signs associated with hypertension include lethargy, changes in appetite, acute or sudden blindness, intraocular hemorrhage (hyphema) and seizures. Treatment for hypertension in cats is based on finding and treating the underlying condition, in addition to antihypertensive therapy (blood pressure medication) in some pets. If antihypertensive medication is utilized, then intermittent monitoring of the pet's blood pressure is indicated. TREATMENT OF "SADIE": The pet was treated with topical medication in the eyes, systemic antibiotics, tube feeding to supply nutrition, and a continuous intravenous fluid drip. She was additionally treated with oral medication to lower the level of circulating thyroid hormone and blood pressure medication to lower her systemic blood pressure. Over several days, "Sadie" slowly improved such that she began eating on her own and some of the blood in the eyes was resolving. She was released from the hospital, much improved but not well yet, with a continuation of several medications at home. On a call several days later to the owner, it was noted that "Sadie: appeared to be blind again in that she was bumping into things. A consult to a veterinary ophthalmologist was offered but declined by the owner. A recheck examination of "Sadie" several days later demonstrated worsening hyphema or blood in the eyes and a continuation of the gallop heart rhythm that was noted previously. A cardiac ultrasound was suggested but declined by the owner. The pet was sent home with an additional eye medication with continuation of the previously dispensed medication. The pet was rechecked one and a half weeks later, at which time "Sadie" was seeing better and was improved. Blood work was repeated at this time, which showed normal values on her blood work. Her blood pressure was also rechecked and was within normal limits. "Sadie's outlook is good but guarded as she is a very aged cat. APMC's Links to other Animal and Avian Websites The Morris Animal Foundation Pet Bird FAQ's The Pet Bird Page (Parrots) Electronic Zoo Home Page Ferret Central House Rabbit Society Home Page and Rabbit Care Guide

All Pets Medical Centre/Rolling Oak Aviaries 7606 Fallbrook Ave. West Hills, CA 91304 (818) 883-2600 thevet@yourpets.com

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