• Cats may present in a "thyroid storm" with severe tachycardia, open-mouthed breathing, hypoxia, and a "panic-attack" mental status. These cats may become aggressive and/or hysterical with handling.

c. Acute Management

• Reduce stress! Too much handling or restraint (blood draws, catheter placement, radiographs) will exacerbate catecholamine release, and can precipitate a stroke or a fatal cardiac arrhythmia.

• Give supplemental oxygen and cage rest. Do not attempt to place an oxygen face mask on a hypoxic 'thyroid storm' cat!

• Start a beta-blocking agent ASAP. Propranolol is the drug of choice because it blocks both the peripheral and cardiac effects of thyrotoxicosis, while more cardiac specific beta-blocking agents (e.g. atenolol) do not block the peripheral effects. Dose: Cat 1 - 2 mg/kg BID - TID; Dog 0.2 - 1 mg/kg BID - TID, to effect.

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Causes(in humans):

* Infection: lung infection, throat infection or pneumonia
* Blood sugar changes: Diabetic ketoacidosis, insulin-induced hypoglycemia
* Recent surgery to the thyroid
* Abrupt withdrawal of antithyroid medications
* Radioactive iodine (RAI) treatment of the thyroid
* Excessive palpation (handling/manipulation) of the thyroid
* Severe emotional stress
* An overdose of thyroid hormone
* Toxemia of pregnancy and labor

Thyroid storm is treated with a combination of antithyroid drugs, blockade iodine drug, beta-blockers, and treatment for any underlying non-thyroidal illness or infection that may be contributing to the thyroid storm.