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Methimazole (Felimazole) for Cats: Hyperthyroidism Triage
Clinical Classification & Indications
Drug Class: Thionamide Antithyroid Agent
Approved Uses: Medical management and long-term control of feline hyperthyroidism (thyrotoxicosis) and pre-operative stabilization prior to radioactive iodine (I-131) therapy or surgical thyroidectomy.
Mechanism of Action (Pharmacodynamics)
Inhibits the enzyme thyroid peroxidase, preventing the iodination of tyrosine residues on thyroglobulin and blocking the coupling of iodotyrosines to synthesize T3 and T4 hormones.
Figure 1: Prescription Felimazole (methimazole) tablets. Small sugar-coated antithyroid tablets block thyroid hormone synthesis but require serial complete blood counts (CBC) to screen for bone marrow suppression.
Adverse Reactions & Side Effect Profile
Common / Expected Side Effects
Transient vomiting, inappetence, mild lethargy in the first 4-8 weeks. Idiosyncratic facial pruritus with severe excoriation (bloody self-scratching on the face and neck).
Figure 2: Clinical thyroid slip palpation and endocrine monitoring. A veterinarian evaluates cervical thyroid slip in a senior feline patient alongside laboratory Total T4 diagnostic blood work.
Emergency Red Flag Reactions
Severe bone marrow suppression (leukopenia, thrombocytopenia, agranulocytosis), hepatopathy, or profound elevation in BUN/creatinine indicating unmasked chronic kidney disease.
Clinical Contraindications & Interactions
Do Not Use In: Cats with primary liver disease, autoimmune hemolytic anemia, or severe pre-existing renal disease (Stage 4 CKD).
Strict Rule S1 Veterinary Prescription Directive
VETERINARY DIRECTIVE: Treating hyperthyroidism lowers systemic blood pressure, which unmasks underlying feline Chronic Kidney Disease (CKD). Serial blood chemistry and total T4 monitoring are non-negotiable at 2, 4, and 12 weeks after starting or altering doses. Never administer human pharmaceutical products or adjust dosages without direct examination and bloodwork by a licensed Doctor of Veterinary Medicine (DVM).