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Background  Iatrogenic hypothyroidism ( IH ) after treatment of hyperthyroidism can impair renal function. No study compared the efficacy of measurement of serum free thyroxine by equilibrium dialysis ( fT 4ed) or thyroid‐stimulating hormone ( TSH ) concentrations for monitoring cats receiving methimazole.    Objectives  To (1) compare the ability of total T4 and  fT 4ed concentrations in conjunction with  TSH  to define thyroid function in hyperthyroid cats receiving methimazole, (2) determine the prevalence of  IH  in cats receiving methimazole, and (3) examine the relationship between thyroid axis hormones and serum creatinine concentration.    Animals  One hundred and twenty‐five serum samples from hyperthyroid cats receiving methimazole and total T4 concentrations ≤3.9 μg/ dL .    Methods  Total T4,  fT 4ed, and  TSH  concentrations were measured to evaluate thyroid status and serum creatinine concentration was measured to assess renal function. A low total T4 or  fT 4ed concentration in combination with an increased  TSH  concentration defined IH.    Results  Forty‐one cats (33%) had increased  TSH  concentrations. Of cats with total T4 and  fT 4ed concentrations below the reference range, 68% and 73%, respectively, had  TSH  concentrations above the reference range. Only 18% of cats with a normal  TSH  concentration had an increased serum creatinine concentrations as compared to 39% of those with increased  TSH  concentrations ( P  < .001).    Conclusions  Free T4ed does not identify more cats with potential  IH  as compared to total T4. The  IH  prevalence was approximately 20%. Measurement of  TSH  may be more helpful in indicating that azotemia, if present, is at least in part related to  IH . Investigation is needed to define  TSH  assay utility in identifying possible subclinical  IH .

Evaluation of Thyroid‐Stimulating Hormone, Total Thyroxine, and Free Thyroxine Concentrations in Hyperthyroid Cats Receiving Methimazole Treatment