12 year old Hyperthyroid cat with elevated liver values

[SusanV]

@Dr. Christina @Dr. Jean Hofve @Dr. Jeff
Arwen is a 12 year old spayed tortoiseshell cat. I included a recent pic of her. Her weight is currently 9.8 lbs. She has put on weight since beginning Methimazole in July. The only vaccination is Rabies at 5 months of age when she was spayed. She has always been a very sensitive, fragile cat. She is the love of my life. She is happiest when she has me all to herself. Unfortunately I have 8 other cats, one of who I brought in from outside in January, and he is aggressive. I try to keep him separated from the rest. She has her own room that she hangs out in and generally feels safe there, but sometimes another cat will enter and she hides if she feels unsafe. Her fur is dull and dry. She has been obsessively licking the fur from her front legs for a few years now, but it has increased this year to the point where her belly is almost bald and her back legs are bald on the sides. She was vomiting hairballs a few times per week April - July. This has mostly stopped since starting the Methimazole and her T4 came down. Her appetite is normal. She loves to play with the feather on a pole, etc. when it's just me and her, but is shy around other cats. Her mood is good when she is alone with me, and she tolerates most of the cats except two.
She gets a raw food diet, turkey, rabbit and duck from Hare Today using their supplement added to the food. She had a fecal transplant in May. She is under the virtual care of a homeopathic vet.

Arwen is currently on:
Methimazole 2.5 mg. in AM and 1.25 mg. in PM
Standard Process Feline Hepatic Support 1 tab 2x/day
Standard Process Calming Comfort Pro 1/4 tsp. 2x/day
RX Vitamins Liquid Hepato 1 ml. 2x/day
TruBenefits Fish oil 1 pump 2x/day
TruBenefits Cutaneo 1 caps./day
Animal Biome Skin Rescue 1 caps. 2x/day
Animal Biome Gut Rebuild 1 caps./day

I don't know what else I can do. Any advice you can give would be welcome. Thank you.

 

[SusanV]

My goal is to get her thyroid back to normal holistically. I would love to avoid I-131 therapy and get her off of Methimazole. The homeopathic vet said her prognosis is guarded in a homeopathic sense due to her genetics and history. She has had a couple rounds of antibiotics which caused suppression. She has a "bronchial pattern" and breathes heavy.

 

[Dr. Jean Hofve]

Hi Susan, it is very difficult to treat hyperthyroidism holistically and she is already receiving homeopathic care, so that is the path you should probably stick with. There is nothing wrong with keeping her on methimozole or with I-131, which is the definitive treatment. Here is my take on feline hyperthyroidism.

I'd be more concerned at this moment with her comfort. Her licking behavior is most likely due to stress, but you also say she has a dull dry coat. You may want to consider the flower essence formula Skin Soother for the over-grooming.

The nice thing about flower essences is that they do not interfere with any other medications or supplements.

Another option is to address the entire social situation in the home with Ultimate Peacemaker, a three-formula flower essence set that we have had great success with over the years. It has Bully remedy for the aggressive cat(s), Self-Esteem for Arwen (and any other cats who get picked on), and Peacemaker for the general atmosphere.

 

[Dr. Jeff]

Welcome to HA! Susan.

I'm sorry to hear about Arwen's health challenges and the dia-gnosis of hyperthroidism.

I don't know what else I can do.

Ah, you're doing so much good stuff already!

IMHO, having helped control many kitties with hyperthyroidism, I do not think that the dis-ease needs to affect her long term happiness and quality of life.

We just need to put this diagnostic label into the full context of her energetic equilibrium and internal balance.

If I may ask, who is the vet homeopath with whom you're working?

one of who I brought in from outside in January, and he is aggressive

When did he join your inside household?

From the t4 results it looks like she is quite responsive to the relatively low dose of methimazole that you're using.

She loves to play with the feather on a pole

Would you be able to do short (3-5 min) bursts of play four times/day? These micro-engagements can help her body to be as good as it can be.

I also wonder about the possibility of your getting a window box for the window she hangs out in.

I asked Sage (the HA! AI concierge) to point you to some of our resources, and here's what she said:



"I’m sorry Arwen is dealing with hyperthyroidism. These HA! resources are the most directly relevant, especially for an individualized, whole-cat approach that considers her vitality, stress, and emotional balance.

Most relevant hyperthyroidism resources​

1. Feline Hyperthyroidism ebook​

Download: Hyperthyroid Cat

This is the most comprehensive resource. It covers:

• Common signs and causes of feline hyperthyroidism
• TT4, free T4, TSH, blood pressure, kidney, and heart evaluation
• Conventional options, including methimazole, radioactive iodine, surgery, and iodine-restricted diets
• Nutrition, carnitine, fish oil, CoQ10, acupuncture, Chinese medicine, and homeopathy
• Individualized constitutional care and quality-of-life assessment
• A case example involving Thyroidinum, Sepia, Chinese herbal support, nutrition, and heart support

The ebook emphasizes observing the whole cat—not just the thyroid number—including appetite, weight, activity, warmth, mood, sociability, sleep, and response to treatment.

2. HA! Empower Hour: Hyperthyroidism​

Watch: Hyperthyroidism

This webinar discusses:

• Why hyperthyroidism is common in older cats
• Possible environmental and dietary influences
• Thyroid testing and blood-pressure concerns
• Conventional treatment choices
• Integrative approaches, including homeopathy
• A case study involving individualized care
• Questions about fish oil, dental disease, and hyperthyroidism

3. Endocrine Diseases Toolkit​

Download: Endocrine Diseases Toolkit

This broader guide places hyperthyroidism in the context of:

• The endocrine system and HPA axis
• Stress and environmental influences
• Diet and lifestyle
• Lab interpretation
• Herbs, nutrition, homeopathy, and energy medicine
• Supporting overall vitality rather than focusing only on one abnormal test

4. HA! Endocrine webinar collection​

Browse the endocrine webinars

This is useful for exploring related topics such as detoxification, thyroid support, endocrine balance, and adrenal health.

Resources especially related to energetic equilibrium​

The HA! materials describe several approaches that may be considered with a qualified holistic or integrative veterinary professional:

• Constitutional homeopathy: selected from Arwen’s complete pattern of physical and behavioral signs—not solely from the diagnosis.
• Traditional Chinese Veterinary Medicine: acupuncture and individualized herbal formulas may be considered.
• Nutrition: fresh, balanced, moisture-rich, species-appropriate food, with careful attention to maintaining weight and appetite.
• Carnitine, fish oil, and CoQ10: discussed as supportive nutrients, particularly when the heart is under metabolic strain.
• Stress reduction and environmental support: predictable routines, comfortable resting areas, gentle enrichment, reduced household stress, and close observation of her emotional state.
• Reiki, flower essences, and Rescue Remedy: mentioned in HA!’s general endocrine-support materials as complementary approaches intended to support calm and balance.
• BEAM tracking: keep notes on Arwen’s Behavior, Energy, Appetite, and Mood , along with weight, thirst, urination, vomiting, breathing, and sleep.

A useful daily record might include:

Area	What to note
Behavior	Affection, irritability, hiding, vocalization
Energy	Restlessness versus fatigue; sleep quality
Appetite	Amount eaten, vomiting, food preferences
Mood	Contentment, anxiety, sensitivity to household changes
Body	Weight, breathing rate, heart-related signs, coat condition
Elimination	Thirst, urination, stool consistency

Because hyperthyroidism can affect the heart, blood pressure, and kidneys, holistic support is safest when coordinated with veterinary monitoring. Periodic thyroid values, kidney testing, blood pressure, weight, and cardiac assessment can help ensure that Arwen’s energetic and emotional improvement is not occurring while an important medical complication progresses. I hope these resources help you build a thoughtful, individualized plan for her.

 

[SusanV]

Welcome to HA! Susan.

I'm sorry to hear about Arwen's health challenges and the dia-gnosis of hyperthroidism.

Ah, you're doing so much good stuff already!

IMHO, having helped control many kitties with hyperthyroidism, I do not think that the dis-ease needs to affect her long term happiness and quality of life.

We just need to put this diagnostic label into the full context of her energetic equilibrium and internal balance.

If I may ask, who is the vet homeopath with whom you're working?

I'm working with Dr. Judy Stolz. She's wonderful.

When did he join your inside household?

He joined the household in March of this year. I've tried flower essences (Pet Essences New Home / Group Living & Jackson Galaxy's Stress Stopper), and an animal communicator for Bear, combined with healing sessions and haven't noticed any difference. Here is Bear, playing with Arwen's toys in Arwen's room, lol. He stalks her and attacks everyone that walks by him, lying in wait, then he hides under something so I can't pick him up to separate them.

From the t4 results it looks like she is quite responsive to the relatively low dose of methimazole that you're using.

I'm just worried about the long-term effects of methimazole on her liver.

Would you be able to do short (3-5 min) bursts of play four times/day? These micro-engagements can help her body to be as good as it can be.

I love this idea. It's much easier to fit into my schedule!

I also wonder about the possibility of your getting a window box for the window she hangs out in.

I never thought about a window box. Great idea, and I'm looking at them online now. She would love this. I do have a larger catio around the back of the house, but this would give her something all her own.

I asked Sage (the HA! AI concierge) to point you to some of our resources, and here's what she said:



"I’m sorry Arwen is dealing with hyperthyroidism. These HA! resources are the most directly relevant, especially for an individualized, whole-cat approach that considers her vitality, stress, and emotional balance.

Most relevant hyperthyroidism resources​

1. Feline Hyperthyroidism ebook​

Download: Hyperthyroid Cat

This is the most comprehensive resource. It covers:

• Common signs and causes of feline hyperthyroidism
• TT4, free T4, TSH, blood pressure, kidney, and heart evaluation
• Conventional options, including methimazole, radioactive iodine, surgery, and iodine-restricted diets
• Nutrition, carnitine, fish oil, CoQ10, acupuncture, Chinese medicine, and homeopathy
• Individualized constitutional care and quality-of-life assessment
• A case example involving Thyroidinum, Sepia, Chinese herbal support, nutrition, and heart support

The ebook emphasizes observing the whole cat—not just the thyroid number—including appetite, weight, activity, warmth, mood, sociability, sleep, and response to treatment.

2. HA! Empower Hour: Hyperthyroidism​

Watch: Hyperthyroidism

This webinar discusses:

• Why hyperthyroidism is common in older cats
• Possible environmental and dietary influences
• Thyroid testing and blood-pressure concerns
• Conventional treatment choices
• Integrative approaches, including homeopathy
• A case study involving individualized care
• Questions about fish oil, dental disease, and hyperthyroidism

3. Endocrine Diseases Toolkit​

Download: Endocrine Diseases Toolkit

This broader guide places hyperthyroidism in the context of:

• The endocrine system and HPA axis
• Stress and environmental influences
• Diet and lifestyle
• Lab interpretation
• Herbs, nutrition, homeopathy, and energy medicine
• Supporting overall vitality rather than focusing only on one abnormal test

4. HA! Endocrine webinar collection​

Browse the endocrine webinars

This is useful for exploring related topics such as detoxification, thyroid support, endocrine balance, and adrenal health.

Resources especially related to energetic equilibrium​

The HA! materials describe several approaches that may be considered with a qualified holistic or integrative veterinary professional:

• Constitutional homeopathy: selected from Arwen’s complete pattern of physical and behavioral signs—not solely from the diagnosis.
• Traditional Chinese Veterinary Medicine: acupuncture and individualized herbal formulas may be considered.
• Nutrition: fresh, balanced, moisture-rich, species-appropriate food, with careful attention to maintaining weight and appetite.
• Carnitine, fish oil, and CoQ10: discussed as supportive nutrients, particularly when the heart is under metabolic strain.
• Stress reduction and environmental support: predictable routines, comfortable resting areas, gentle enrichment, reduced household stress, and close observation of her emotional state.
• Reiki, flower essences, and Rescue Remedy: mentioned in HA!’s general endocrine-support materials as complementary approaches intended to support calm and balance.
• BEAM tracking: keep notes on Arwen’s Behavior, Energy, Appetite, and Mood , along with weight, thirst, urination, vomiting, breathing, and sleep.

A useful daily record might include:

Area	What to note
Behavior	Affection, irritability, hiding, vocalization
Energy	Restlessness versus fatigue; sleep quality
Appetite	Amount eaten, vomiting, food preferences
Mood	Contentment, anxiety, sensitivity to household changes
Body	Weight, breathing rate, heart-related signs, coat condition
Elimination	Thirst, urination, stool consistency

Because hyperthyroidism can affect the heart, blood pressure, and kidneys, holistic support is safest when coordinated with veterinary monitoring. Periodic thyroid values, kidney testing, blood pressure, weight, and cardiac assessment can help ensure that Arwen’s energetic and emotional improvement is not occurring while an important medical complication progresses. I hope these resources help you build a thoughtful, individualized plan for her.

Thanks so much for these resources!!! Looks like I have a lot of reading to do.

 

[Dr. Jeff]

You're welcome!

We're here for you whenever we can help.