Dog ate chocolate?

ask a vet

Hyperthyroidism and IBD.

Species: Cat
Breed: Mackerel Tabby
Age: More than 15 ye
We adopted Mo 10 years ago from the Humane Society. She was about 6 years old at that time. She's been a wonderful, social, cuddly, sweet cat.

About 3-4 years ago, she started pooping outside of her box on the floor once in a while. We blamed it on a too-dirty litter box, and once, the vet squeezed her anal glands and the problem went away.

In December/January, Mo started pooping more and more on the floor and even on our bed (where she also sleeps). At this point we increased scooping her box from once a day, to multiple times a day, without any result.

We took her to the vet in January. She was diagnosed with hyperthyroidism and prescribed the prescription food.

However for the past four years Mo has been unable to tolerate any change to her diet of Iams Indoor Weight & Hairball Care. We tried repeatedly to slowly ease into a more healthy food, but with no success. Always puking and pooping problems.

It was the same with the prescription diet, so we had to go back to the Iams.

The pooping problems became worse and she continually pooped in the bed, on the floor, and finally even on our sofa! We had to block her from the bedrooms and cover the living room furniture with cardboard. Mo would have drips of poop down the back of her legs and also on the floor around the house. Not ideal!

We took her to a new vet who prescribed Methimazole, 2.5mg twice a day. And also Flagyl metronidazole 50mg twice a day to help the diarrhea. (This vet also finally squeezed her anal glands, as we requested. They were very impacted.) We put the medication in pill pockets and fed at 6 am and 6 pm.

The pooping problem was immediately better.

As soon as the diarrhea medication ran out after 10 days, the pooping problems were back. (She also had some unusual throw-up during this time and perhaps even before.)

We contacted the vet who prescribed another 10 days of the diarrhea medication. This medication just ran out a couple days ago, and we are back to the pooping problems.

We can't afford to keep going back to the vet for the $160 visits for blood work and medication adjustment, particularly when it seems that they will not offer good results. (If we had hope of a solution, we might be able to make it work for one or two more visits.) The radiation treatment is not possible for us.

So we now feel like we're out of options and must now euthanize our beloved cat. But before we do that, we'd like to get a second option from you on two points:

- Do you agree with the dosage of 2.5 mg of Methimazole twice a day? Or is it perhaps too much?
(Mo is a small cat: about 8-9 pounds at a healthy weight, though she is down to 5 pounds 4 ounces right now.)

- If there is a chance that this medication might work to control her hyperthyroidism, it is very possible that her pooping problems would still remain unresolved?

Thanks so much for your help.

Online vet, Dr. Marie

Dr. Marie replied:

Sorry to hear that you are experiencing these frustrating problems! No one likes dealing with poop issues in cats!

You may want to ask your vet about the possibility of Mo having inflammatory bowel disease (IBD). It is very common in cats and can cause everything from vomiting to diarrhea and even constipation. Unfortunately it can be hard to diagnose, as the only way to accurately diagnose it is to get intestinal biopsies which can be quite expensive.

Often, if I have a cat patient who has symptoms like yours does I will do a trial of a very small dose of prednisone. What the prednisone does is help with inflammation in the bowels. (An alternative is to use a drug called budesonide - they both work well.) If this is working, then I will get the cat down to the smallest dose that is effective. Often this means giving 1/4 or 1/2 a pill every other day.

Another possibility for these symptoms is intestinal lymphoma. This is a cancer that affects the intestines. It is impossible to know the difference between lymphoma and IBD without doing biopsies. If this is lymphoma you may see a temporary improvement with the steroid (prednisone) but eventually it would stop working. In my experience, IBD is way more common than lymphoma.

The metronidazole that Mo was on serves many purposes, but one thing it does is help with intestinal inflammation. This is most likely why the problem came back when the medicine was stopped. I'm not a fan of staying on metronidazole long term though...I usually prefer the steroid as mentioned above.

Regarding your question about the methimazole dose, this really depends on her T4 level. When I put a cat on methimazole I always want to recheck her T4 blood level a few weeks later. If the T4 is too high or too low then I modify the dose. If it is good, then I still want to periodically check it every 3-12 months (depending on how the cat is doing.) But yes, I do have a number of cats that do very well on 2.5 mg twice daily.

If her T4 level has not been checked, it is certainly possible that she is not getting enough medicine and is still hyperthyroid. Hyperthyroid cats can indeed have intestinal issues. But, my guess is that the intestinal problems are really IBD and not related to the thyroid.

I hope this helps and I hope she does better soon!

Dr. Marie.

Do you have a pet website? Interested in learning more about SEO for Wix?

Check out our dog age calculator and cat age calculator.

Want to receive pet coupons, vet advice and info on new pet products in your inbox?

* indicates required

We'll only send you great stuff, never spam. Unsubscribe any time.

Disclaimer: Although Dr. Marie is a qualified veterinarian, the information found on this site is not meant to replace the advice of your own veterinarian. and Dr. Marie do not accept any responsibility for any loss, damage, injury, death, or disease which may arise from reliance on information contained on this site. Do not use information found on this site for diagnosing or treating your pet. Anything you read here is for information only.

Search for similar questions:

ask a vet

Popular questions...

Vomiting kitten. My 4 week kitten was abandoned by his mom when he was a few days old. He is very... (8453 views)

Are lumps related to seizures? Hi, Amber is 10 years old. Since she was young she had frequent seizures, as she... (13580 views)

Swollen carpal pad. Dear Dr. Marie: About 5 weeks ago, my wife and I noticed that the carpal pad on our... (38350 views)

Hair loss and hyperthyroidism. Dear Dr. Marie, I have had my cat Cody for five years. He was a stray cat who was... (21492 views)

Dog scratching and biting. My dog has recently started scratching and biting at himself excessively, I have... (21155 views)

Coughing cat. My cat has had a horrible cough for two or three months and the vet doesn't know... (6968 views)

Sore neck Hi Dr. Marie, You've been helpful in the past, so I thought I'd ask you another... (6885 views)

Meibomian gland adenoma? This past week Murphy (4 year old Irish Setter) developed what I thought was a small... (250177 views)

Does my dog have cushing's? Hi Dr. Marie, I took my almost 10 y/o lab to the vet because she has been waking... (8208 views)

Benadryl for swollen snout? my dogs face around the snout has become swollen not sure why but im guessing its... (24460 views)

See all questions...

Dr. MarieDr. Marie is a veterinarian who practices in a busy animal hospital in Ottawa, Ontario. She created Ask A Vet Question as a resource for good, accurate veterinary advice online. Dr. Marie treats dogs, cats, hamsters, guinea pigs, and rats. She has been a vet since 1999.

Is an online vet visit just as good as a trip to your veterinarian? No! But, many times, asking an online veterinarian a question can help save you money. While Dr. Marie can't officially diagnose your pet or prescribe medications, she can often advise you on whether a vet visit is necessary. You can also ask Dr. Marie for a second opinion on your pet's condition.