ArticleJournal of veterinary internal medicine2026
A predictive algorithm for the optimal daily dosage of thiamazole to control cats with hyperthyroidism.
Article in Journal of veterinary internal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundHyperthyroidism is the most common endocrinopathy in cats and is frequently managed using anti-thyroid medication. HYPOTHESIS/
objectivesTo develop and validate an algorithm to predict the optimal starting daily dose of thiamazole required to control hyperthyroidism in cats. ANIMALS: One hundred eighty-eight client-owned cats with hyperthyroidism for algorithm development (2011-2021) and 45 hyperthyroid cats to validate the algorithm (2022-2024).
methodsRetrospective case-control study. Cats with hyperthyroidism controlled medically using thiamazole within a year since diagnosis were enrolled. Controlled dose of thiamazole was categorized into "≤5 mg" or ">5 mg." Binary logistic regression was performed to explore predictors associated with thiamazole dose. The performance of the final multivariable model in prediction was assessed by receiver operating characteristic (ROC) curve analysis. A cohort of cats subsequently diagnosed with hyperthyroidism and managed chronically with thiamazole were used to test algorithm performance.
resultsAt hyperthyroidism diagnosis, baseline plasma total thyroxine (TT4); (odds ratio [OR] 1.29 [95% CI, 1.19-1.42] per 10 nmol/L; P < .001) and creatinine concentrations (OR 0.83 [95% CI, 0.7-0.96] per 0.1 mg/dL; P = .02) were independent predictors for higher thiamazole dose (>5 mg). The area under the ROC curve was 0.92 (95% CI, 0.88-0.96). In the test cohort, 26 cats controlled on ≤ 5 mg and 19 required >5 mg thiamazole. The predictive model had overall accuracy of 91.1%, sensitivity of 84.2%, and specificity of 96.2%. CONCLUSIONS AND CLINICAL IMPORTANCE: Hyperthyroid cats with higher plasma TT4 and lower creatinine concentrations at diagnosis are likely to require >5 mg total daily dose of thiamazole to achieve euthyroidism.
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