Case 4, Answer 5a
Try again. Leaving the methimazole dose the same is the best approach to managing her hyperthyroidism. However, although adding calcitriol is a good idea, we first need to decrease her phosphorus concentration to below 6 mg/dl to maximize calcitriol effectiveness and decrease the risk of soft tissue mineralization. Once her phosphorus concentration is decreased, initiate calcitriol treatment because cats do better clinically if calcitriol is instituted early in the course of their renal disease.
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