Coping With Animal Health Problems

My 11 year old female calico cat “Missy” has always been a poor eater and a bit on the thin side (boney spine). She is an indoor cat and has always been “low activity”. About a 1 1/2 yrs ago we moved cross country and she underwent extensive testing for travel papers. The Vet did a thyroid panel (normal), CBC and clinchem panel as well as urine and stool. At the time, the blood work was fairly normal, though she was a bit dehydrated, but because Missy was bright eyed and normal appearance, there was not follow-up (FYI, she is nervous with travel and salavates excessively when visiting vet).

Recently, her coat became greasy and her eyes, though bright, were staining. She also appears lethargic and has consipation (which is fairly chronic for her). She also is vomiting more frequently and often it is undisgested food, no clear hariballs. I brought her to a new vet, explained her history, my concerns and her changes (mainly the eyes and coat). We did a CBC, Clinpanel and thyroid panel. The total thyroid was high (~7.0) but T4 free was high end of normal (49). She also appeared slightly dehydrated (slightly elevated protein, but again, she salivated excessively on trip over). The vet is now recommending thyroid treatment (we will probably go with ablation because cat is difficult to pill), but before she will do ablation, she is requesting to perform extensive scans to “rule out” other underlying cuases, including: abdominal and chest X-ray and abdominal ultrasound. It seems a bit excessive and is costly and will require 2 seperate visits/anasthesia.

I’m trying to figure out what would be the most “telling” and cost effective next steps. I don’t want to appear cheap but the $$$ are adding up and I don’t have a clear sense of what will rule-out intestinal lymhoma or IBS vs. atypical symptoms of hyperthyroid.