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Management of Feline Hyperthyroidism with Methimazole
Hyperthyroidism is the most common endocrine disorder in felines, with a disease prevalence of approximately 0.33%.The pathophysiology of feline hyperthyroidism is most commonly due to a benign hyperplasia of the thyd gland that leads to an increased production of T3 and T4 in the affected animal. This adenomatous hyperplasia is responsible for 98% of cases of feline hyperthyroidism. Markedly increased thyroid hormone concentrations can lead to significant systemic consequences and death if left untreated. With such a widespread prevalence in the feline population, an efficacious and easy to administer method of drug delivery is needed in the therapeutic repertoire of the veterinarian.
Methimazole is an antithyroid drug that concentrates in the thyroid gland and inhibits the enzyme thyroid peroxidase, which disrupts the oxidation of iodide (I-) to iodine (I2). Methimazole is efficacious and has less adverse drug reactions than the other antithyroid medication commonly used, propylthiouracil. Common ADRs to methimazole therapy are vomiting and anorexia, however this is associated with giving the methimazole by mouth. Compounding pharmacies have the capability to produce transdermal methimazole products that are both efficacious and easy for the owner of the animal to administer.
Aside from the ease of administration for the owner, applying the methimazole transdermally allows for an avoidance of hepatic first pass metabolism and the ability to use a smaller milligram dosage than the oral route. In our practice, we commonly use dosages ranging from 2.5 – 5mg once to twice daily, with our pharmacists also demonstrating proper application and safety techniques for the owner at the time of medication pick up.
Bruyette, D. Management of feline hyperthyroidism. Today’s Veterinary Practice 2014 July/Aug p38-41
Lécuyer M, Prini S, Dunn ME, Doucet MY. Clinical efficacy and safety of transdermal methimazole in the treatment of feline hyperthyroidism. Can Vet J. 2006;47(2):131-5.
