18-Year-Old Cat with Hyperthyroidism — Seeking Holistic Guidance for Liver, Heart & Thyroid Support

[lermanrlee]

Hi Dr. Jeff and Holistic Actions Community,
@Dr. Jeff , @Dr. Christina @Dr. Jean Hofve

I'm reaching out for support and guidance for my 18-year-old male cat, Trogdor. He is a black tabby, neutered. He's been treated for hyperthyroidism and is doing very well behaviorally—eating, alert, energetic—15.5 pounds. But I want to ensure I'm doing the absolute best for him, especially when it comes to heart, liver, and long-term thyroid care. I'd love to know if there are any holistic strategies we can incorporate either alongside or in place of his current medications.

• Post-May Medication Adjustment:
  • Due to the elevated thyroid levels, his Methimazole dose was increased to 0.3 mL of a 10 mg/mL compounded formula, twice daily.
• June 2025 Follow-up:
  • Total T4: came down to 1.1 (now within normal range).
  • Liver and heart values were not retested yet due to cost concerns—I plan to do that at his next visit in about 2 months.
  • Methimazole dosage was slightly reduced to 0.27 mL twice daily based on the improved T4

Diet / Lifestyle Notes:

• During the few months leading up to his May 5th lab results, I had been giving him more fish to help stimulate his appetite—he was eating less, and fish got him excited about food again.
  I’ve since stopped the fish completely.
• He alternates between:
  • Primal Freeze-Dried Rabbit
  • Rayne Kangaroo/Rabbit MAINT (Thera-Diet canned food)
• His behavior, appetite, energy, and mood all seem great.

Questions:

1. Are there any holistic supports (herbal, energetic, nutritional, etc.) you'd recommend to gently support his thyroid, liver, and heart, especially while he's on Methimazole? And if so, what are the dosings that you recommend? I see general recommendations, but hoping to get more specific for mine.
2. If his liver and heart values normalize at his next check-up, would you recommend continuing with Methimazole long-term, or would you consider radioactive iodine (I-131) a viable option for a cat his age and health?
3. Could the short-term fish reintroduction have contributed to the elevated liver or cardiac values seen in May?
4. Any thoughts on detox or support protocols that help the body manage Methimazole’s effects?
5. Regarding the mild proteinuria (UPC 0.5): my vet didn’t flag it since his kidney markers and urine concentration were otherwise excellent, but should I be supporting his kidneys more proactively or monitoring this closely?

I’m deeply grateful for your time, insight, and the loving work you all do. Trogdor is doing great. I just want to make sure I’m honoring his vitality with the gentlest, most thoughtful care possible.


Warmest thanks,
Rebecca (Trogdor’s mom)