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1238.e2 Hyperthyroidism: Treatments

Hyperthyroidism: Treatments
VetBooks.ir Advantages and Disadvantages of Common

Hyperthyroidism Treatment Methods
Medical Therapy (Typically Methimazole)
Advantages: Readily available; generally effective at controlling disease; initial
costs moderate; can be used in severely affected cats for stabilization before
other forms of treatment; requires no time away from home; no anesthesia
required; noninvasive; requires a few weeks to become euthyroid
Disadvantages: Not curative; requires daily drug administration 1 to 2×
daily (oral or topical); requires ongoing monitoring, including CBC, biochemical
profile, and T 4 ; adverse drug reactions, including those that are easily controlled
(e.g., gastrointestinal upset) and those that are intractable (e.g., self-induced
excoriations) or serious (e.g., agranulocytosis, hepatopathy)
Surgical Therapy
Advantages: Can be curative; readily available; does not require pet owner to
administer any medications
Disadvantages: Requires general anesthesia; invasive procedure with pos-
sibility of surgical complications; requires hospitalization; potential for treatment
failure if thyroid tissue remains; potential for recurrence of disease necessitates at
least occasional T 4 monitoring; potential for hypoparathyroidism with hypocalcemia
(temporary or permanent); initial costs high
I131 Therapy
Advantages: Usually curative with single treatment; very few adverse effects
directly related to radioactive iodine; does not require pet owner to administer
any medications; noninvasive; very rapid control of thyroid hormone production;
may not (or may) require brief sedation
Disadvantages: Requires special facilities; requires hospitalization; requires
radiation isolation, during which time it may not be possible to give necessary
treatments; can cause hypothyroidism (rare); initial costs may be high, but
limited follow-up monitoring required, so long-term costs may be less than
other forms of treatment
Dietary Therapy (Iodine Restriction)
Advantages: Readily available; initial costs moderate; requires no time away
from home; does not require pet owner to administer any medications; no
anesthesia required; noninvasive
Disadvantages: Not curative; most useful when clinical signs are mild;
requires restricting cat’s access to other foods as even small amounts of other
foods (treats; dog food; consumption of prey) interferes with efficacy; requires a
few weeks to become euthyroid; requires periodic monitoring of T 4

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