My female cat Marmalade has hyperthyroidism with Chronic Renal Failure
although both are medicated daily by me and I crush 1 Fortekor a day
also 1 Felimazole twice a day.

The vet suggested that she has a thyroidectomy but then at her last
blood test appointment the young vet said it's not necessary although
the following day when I received Marmalade's results she'd changed
her mind and said that the operation's a good idea.

I don't think so and don't anything about it although I use the
http://www.fabcats.org/owners/hypert...ism/info.htmlm site a lot.

But what's entailed for a cat in this operation specially with weak kidneys.

A bit of background to this, in November 2008 she was bitten by a fox
and they got infected, it's almost fatal then she got arthritis (cured)
then the hyperthyroidism and CRF

Sorry to ask so many questions when I've just joined.

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The cat on the floor's Marmalade, her son Mischief is the tabby cat.

I assume the renal problems were revealed when the hyperthyroidism was treated? Early stage or more advanced?

Not sure why your vet thought the thyroidectomy was a good idea and what results you refer to. T4 or renal values?

I would discuss the surgery risks and implications for the kidney insufficiency with your vet but I know if it were my cat I would be reluctant to have it done if the CRF was fairly advanced. Mediation is at least reversible and it's possible to balance the two conditions. You do know what the impact of treating hyperT on renal function? Another thing to consider is your vet's experience with this type of operation. This is fairly risky surgery!

The operation is only successful if all the affected tissue is removed-ectopic tissue can be found in the chest for instance. We had an case like this here some time ago where medication had to be resumed post surgery.

Incidentally, Felimazole should not be crushed. It's can interfere with absorbtion of the medication. However, I would try to split the tablets instead. I know a vet was once told this was possible by the manufacturers.

Thanks Ianthi, that is very helpful, Marmalade's hyperthyroidism was
diagnosed early on then 5 months later the CRF was diagnosed as the hyperthyroidism had disguised.
Her kidneys are weak from the CRF and yes I have tried to discuss it with
the vets, the senior one suggested the thyroidectomy operation in March
and earlier this month when I saw the young vet at the appointment I'd
asked her about the possibility of the op. She said "there's no need"
But the following day when she gave me the results she'd changed her mind.

Also it's Vidalta that mustn't be crushed as it's a slow-release pill.
From October 2009 until September 2010 Marmalade was on Vidalta and
she wouldn't eat it so I asked the vet that she be changed to Felimazole
which I crush into her food with the renal pill Fortekor. (I did ask the vet and he agreed it's ok)

I am slowly coming to the conclusion that with her weak kidneys and then the lower blood calcium levels that the op's a bad idea. But I'll give it ages first.

Rosalind

Sorry for such a long post just it's worrying me so much

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The cat on the floor's Marmalade, her son Mischief is the tabby cat.

I think you need to clarify her exact renal status with your vet. True kidney function can only be judged when the T4 is within normal range. If for instance the Hyperthyroid medication is too strong and the T4 is too low then this will impact on the renal values and make them appear worse on paper than they actually are. Conversely when the hyperthyroidism is untreated the kidneys appear to be better! I'm wondering here how long it took to stabilise your cat with the medication? You need to know her current renal status assuming the hyperthyroid is under control.

The low calcium levels are only a risk factor of the thyroidectomy if the parathyroid glands become damaged during the operation-not a side-effect of the surgery. Additionally vets do take precautions during surgery with cats who have renal problems.

Regardless of what your vet has said about crushing the tablets it definitely cautions againt this on the literature. It's also worth noting that since Felimazole is a suspected human teratogen owners should exercise care when handing the the tablets/litter etc.

NOAH Compendium of Animal Medicines: Felimazole® 2.5 mg Coated Tablets for Cats - Contraindications, warnings, etc

ianthi Thanks and I will do my very unqualified best to explain about Marmalade's Renal Condition.
It's disguised by the hyperthyroidism and she had been drinking too much
so peeing too much as well (like over-eating and losing weight with the hyperthyroidism) But her kidneys are OK and have been for every blood
test she's had. But it's her thyroids that don't come up level with some
blood tests. Like last one her thyroid levels should be 45% but where 66%
so I increased the Felimazole
Which I crush in a piece of folded greaseproof paper. Also the Fortekor's crushed.

I have been trying to do a bit of research into the thyroidectomy operation
but the few things that I know about are the low blood calcium levels
also that she'd be hospitalised for 3 to 4 days after the op.
But I'm very worried that the lower blood calcium levels would react
badly with her weak kidneys as well as the General Anaesthetic that
she might not survive. This is worrying me so much and I am very
grateful for you listening to me as well as helping Rosalind as a new member.

My vet told me about this website as do other people I know. It's geniune
www.fabcats.org/hyperthyroidism
www.fabcats.org/crf

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The cat on the floor's Marmalade, her son Mischief is the tabby cat.

I went to the vet this morning with Marmalade for another blood test
for her thyroids and kidneys.

I asked the vet a few questions relating to the thyroidectomy op
and he wasn't very forthcoming so rather unhelpful. I got the feeling
that the vet wants me to make a full decision for the op now but
I'll take until the end of 2011 before I do that because I know
that if I decide yes that Marmalade should have a thyroidectomy op,
that would change her life for ever.

If no then as she is now happy/healthy and with a good appetite for food
also life.

I asked about the possibility of her weak kidneys (CKD) affecting the op.
A. They'd be taken into the op etc.

Q. How would the loss of her weak kidneys be affected by the loss
of her kidneys
A. It's a grey area
(that's his main answer when I didn't get clear answers)

Q. Would she still have to have blood tests after the op?
A. yes every 6 months

Thanks for listening

Rosalind

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The cat on the floor's Marmalade, her son Mischief is the tabby cat.

Not very helpful is he in assisting you with making an informed decision? I agree with you in that if she's OK with the medication etc I'd postpone the operation until a later stage.

Unless the cat shows signs of the condition returning it's unusual to have blood tests following a thyroidectomy every six months.

Ianthi Agreed the vet was very unhelpful and not forthcoming at all,
she's ok eating her medication in her Royal Canin Feline Renal foods daily.

The more that I find out about the side effects and the thyroidectomy
for Marmalade what with her weak kidneys due to Chronic Kidney Disease
(Fortekor) is something that I always keep in mind. I will probably leave
the operation until/if she gets worse.

I am considering looking for another vet. I'm unhappy with their responses now. Using RCVS

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The cat on the floor's Marmalade, her son Mischief is the tabby cat.