RAdiation for Hyperthyroid Cat

17 years ago

My 8 year old cat was just diagnosed with hyperthyroidism. His bloodwork for a recent teeth cleaning showed some unusual values (esp. liver values) and at first the vet was somewhat stumped because he is pretty young to be hyperthyroid. The vet is recommending the radiation technique. Two clinics do it in my area. It is $1200. for the whole procedure--pre-op, treatment, kennel stay, post-op. What worries me most is the isolation/kennel stay which I understand can be about 10 days to 2 weeks. Can anyone who had this done share your experience? Thanks.

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Comments (11)

User
17 years ago
One of our cats had this done a month ago. $1200 is exactly what we paid. We dropped him off on a saturday, and got to pick him up the following wednesday. I think it depends on your state regulations, but they check the cat's radiation levels every day, and once levels are considered acceptable, they get to go home.

We were told it usually takes 4 - 6 days. The hardest part was not being able to cuddle him longer than ten minutes a day for 2 weeks after picking him up.

Teddy is doing really well, he is due to go in for his post-procedure blood test next week. He has gained weigh already and seems to be back to normal, the way he was prior to developing hyperthyroidism.
laurief_gw
17 years ago
I'd be very surprised if a cat had to be hospitalized for that long following radioactive iodine treatment. Have you checked with the clinics to confirm that? When you call the clinics, also ask them to describe how the cat is treated during the hospital stay. How much daily interaction is provided by hospital staff? Ask each clinic for patient referrals so you can check with the owners of previous patients and see how they felt about the experience for their cats.

Radioactive iodine is definitely the way to go in terms of treatment, in my opinion. It's just a matter of finding the clinic that offers the best care while your cat is hospitalized.

Laurie
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My 16 year old Barney was diagnosed with hyperthyroidism last spring. I had switched vets as I didn't feel confident in the one they were going to (the last physical exam she gave him was cursory at best) and they now go to a cat's only vet clinic that is just up the street from our province's veterinary college. As soon as the new vet saw Barney and felt him, she noted that he had the obvious signs of weight loss (in 2001 he was 16lbs and when she weighed him he was 12 lbs) but she also noted that he'd lost muscle tone, which apparently is a huge red flag for hyperthyroidism. He would eat his crunchy food like a pig but wasn't gaining weight, he was throwing up too, he was also very hyper - he'd tear around then stop to wash himself, tear around some more then stop to wash...see the pattern? He also has a heart murmer, but he's had the murmer for years (I think I first found out about it 10 years ago). Murmer apparently is a classic sign of hyperthyroidism. We elected for medication as well as opposed to the radioactive iodine - Barney is a very social cat and the way the vet described it, he'd go to the lab at the vet college where he'd have his treatment, be segregated for 1 to 2 weeks, then come home but would have to continue to be segregated until his radioactivity dissipated - that's just not something we could put him through. So he's on Tapazole 1/2 pill in the am and 1/4 pill in the pm. He's gotten very good about taking them, I think he knows he feels better. He's not the hyper crazy thing he once was, he's much quieter, though that could be age related. He eats and his weight is stable. He has his T4 numbers tested often - I think they are doing it again at the end of the month. He's also on a medical diet, vet only food (our other cat is in the early stages of kidney disease so they are both on vet food). Definitely a T4 test will tell you if Clancy has this condition. And at his age, if I were you I would opt for the radioactive treatment. It will be costly, I think we were looking at $1500 or something like that, but in the long run it would be better. Good luck finding a new vet. If you haven't settled on a clinic already, maybe seek out a cat's only vet. It's so nice being able to go to a vet that does nothing but cats - it's less stressfel for them for appointments and the vets are specialists in feline medicine as opposed to having to know everything about all animals. tess Here is a link that might be useful:
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I've seen a LOT of hyperT cats and I can remember exactly 1 that was under 10 years old at time of initial diagnosis. And this was a 1.5 year old siamese that was a total sicky-poo from day 1 and he had repeated elevated T4 plus tc-99 scans to confirm hyperT as nobody in his/her right mind would believe hyperT in a 1.5 year old cat. I wouldn't even TEST for it in a 7 year old cat unless I was completely at a loss for cause of symptoms and had run every other blessed test in the book. And even then, I would probably insist on tc-99 scan to double confirm, or even triple because I'd probably run the T4 at least twice- once as diagnosis and second time while on tapazole with a resolution of clinical signs to confirm normal T4. So I *have* to ask how were the previous 2 diagnoses made? A second possibility is that you cat has a very rare thyroid carcinoma. Most thyroid tumors in cats are adenomas, which are benign and respond extremely well to usual doses of I-131. However I remember a cat who we initially treated at age 20, and T4 did not return to normal at 30 day recheck. We repeated treatment and T4 went down but was still not normal. Finally we did a biopsy of the thyroid and it was carcinoma not adenoma and we treated her a 3rd time at a MUCH higher dose which was curative at 1 year post treatment. I agree with the others- get a diagnosis first. I can think of about a million different reasons for a cat to have weight loss and nervousness, and hyperT is not amongst the first 999,999 at age 7 or even at age 9. I truly wonder about those diagnoses and how they were done. At age 11 I can believe hyperT but unless he has a thyroid carcinoma I can't make this case make sense. We treated on average 4 cats per week with I-131 when I was a tech, which I did for 9 years. I have a very good memory for things out of the ordinary and am positive that I would have remembered treating a 7 year old cat, and retreating at 9 years if it had happened. It just didn't though. I am sure that the youngest we saw was that siamese and after that I think the youngest was 11 at first diagnosis. The only confirmed carcinoma was in that 20 year old cat. I can think of a couple of repeat I-131 treatments but they were all in older cats (12+ years) who failed to respond at the 30 day recheck. I even remember a cat who had both thyroid glands removed by the referring DVM and owner was thinking about suing for malpractice because cat was STILL hyperT. But we did a tc-99 scan which proved there was hyperT thyroid tissue in thoracic cavity and we did the treatment and he was fine for 3 years at least. I know you are totally distraught over your poor cat. Has he ever had diarrhea or vomiting, or weight loss despite an increased appetite? These are what I would consider hallmarks of hyperT4, not just weight loss (unless appetite was increased as well) and nervousness. I mean, cats are nervous species and if not eating of course weight loss ensues but inappetence is NOT a sign of hyperT4. Please get a diagnosis on your kitty. I hope you can get records of previous treatment including full labs and diagnostic T4 along with post-treatment T4. We usually got T4 level at 30 days, 60 days, and 1 year post-treatment and only with normal t4 for all 3 rechecks did we call the treatment a success. We were 98% successful, and we treated a LOT of cats.
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The amount of hospitalization required depends upon the radiation regulations of each individual state. In NC it used to be 10 days, but when we got a new radiation safety officer for the state it was reduced to 3 days (and we considered that a major triumph). Downsides to methimazole/tapazol: some cats do not respond. The drugs do not cure the disease, only control the symptoms. At the prices we charge where I work, it takes about 2 years of monitoring and drug costs to equal the cost of I131. So in an older cat, if you expected him or her to live less than 2 years, monitarily it would be less expensive to go the oral route. Then again, we've treated 20 year old cats who have lived for several more years. There is the whole issue of pilling a cat twice a day for the rest of its life. If doing that would mess with a good pet-owner bond, I do not think it is worth it. Why make a cat miserable twice a day for the rest of its life? Some cats develop a bad facial puritus, causing them to literally scratch the skin off their face. There is a transdermal formula of methimazole for cats who do not like to be pilled, and it has much less of the puritus side effect, but costs much more than the pills. Getting the right dose of methimazole is an art in and of itself. The cat has to be monitored with routine thyroid panels until stabilized (usually at least one T4 about 3-4 weeks after starting methimazole) and then several times a year. If your cat is not so good for blood draws, that can be a major downside. Downsides to I131: it takes about 30 days to see a result in the T4 level. If the cat has any kidney disease at the time of treatment, it will get worse once the hyperthyroid state is removed. With methimazole, you can play with the dose to keep the cat slightly hyperthyroid and remove most of the negative effects of that disease (diarrhea, weight loss, hypertension, heart murmurs, etc) while still benefitting the kidneys. However once you nuke the thryroid, there is no going back. Some people say it's better to manage a mild form of 2 diseases; others think it's better to cure the hyperthyroidism and just manage the kidney disease like every other cat. Some vets will start a cat on methimazole and retest the kidneys a few weeks later. If nothing changes as far as kidney values, then they say it's OK to do the I131. Others jump right in with I131. You do have to discontinue the methamizole for at least 3 days before doing the I131, or the cat will be temporarily hypothyroid which as I understand it makes them feel like crap. If the cat is not medically stable at the treatment time, sometimes the stress of being in isolation even for just a couple of days can send them over the edge. Cats that do well boarding tend to be fine with the isolation. Cats that never leave home, have never boarded, tend to not do as well. It's OK for a couple of days if there isn't anything else going on- most recover just fine. But for the cat on the edge of decline already, putting them in a boarding situation for even a day can literally kill them. Make sure you use a vet that is experienced at dosing I131. While The Animal Hospital has been doing I131 for many years, there are a couple of places in the area that are not as experienced. We treat probably 200 cats/year; one clinic in the area treats maybe 10 a year. There are problems associated with both underdosing and overdosing I131 that more experienced vets can avoid. I know where I work, we end up retreating only 1-2 cats/year (0.5-1.0%). Some places have much higher retreatment rates. You get a discount for retreatment, but it ain't free because the I131 is so expensive. Spiritual gardner- I am surprised that you have a hyperthyroid dog. It is extremely rare in dogs and almost 100% due to a very malignant thyroid tumor. Most dogs do not live longer than a few months past diagnosis, even with surgery and chemotherapy. Are you sure your dog is not hypothyroid, which is very common?
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Wow, that really stinks. I totally guessed he had a different problem, but being hyperthyroid is better than my guess (which was cancer). It's really rare for a cat to need a second I131 treatment, but then again it's really rare for such a young cat to become hyperT4. I suspect most older cats die of something else before having a chance to become hyperT4 again. I did a quick google scholar search and couldn't find anything about stats for younger cats and recurrence of hyperthyroidism. I did find a reference for an 8 month old hyperthyroid cat, and during my time as a tech for RadCats we treated an 18 month old cat. But nothing was written in the literature about long-term follow up for the young cat, except her became hypothyroid after treatment. And I don't know about the young guy we treated except he made it through fine and had a normal T4 the following year. As far as why he's hyperT4 again, he just grew another thyroid tumor, either a benign adenoma or a malignant carcinoma. The I131 destroys all active thyroid tissue, which in theory, is all the diseased thyroid tissue (benign or malignant, doesn't matter). However it cannot destroy *future* tumors. As far as why cats become hyperthyroid to begin with, most if the research now is focusing on environmental and food toxins. There was some research into an autoimmune problem, and some about a genetic reason, but most likely the cause is multfactorial. I went to a talk about hyperthyroidism in cats while in school, and from what I remember, she was talking about metals in fish and canning materials that suppressed thyroid tissue long-term and basically wreaked havoc on the autoregulation of thyroid hormone, eventually resulting in hyperthyroidism. The research is still on-going, and unfortunately it's hard to get grant money for it because 1) cats in general don't earn as much research money as dogs and 2) hyperthyroidism can be managed relatively easily. Here's an abstract from the AVMA journal that says cats who eat fish or giblets foods tend to be hyperT4 more than control cats: http://avmajournals.avma.org/doi/abs/10.2460/javma.2000.217.853 Here's a review article about hyperthyroidism http://ecommons.library.cornell.edu/bitstream/1813/11446/1/2006%20Lynn.pdf As mentioned before, methimazole can be used to suppress thyroid hormone, as long as your cat doesn't have a reaction to the medication. It's available for oral and transdermal administration. So not being able to do a 3rd I131 treatment doesn't mean your cat can't be treated. I couldn't find any specific studies done on the effect of radioactive I131 in cats. I know that having treated cats for many years, and being exposed to several doses every week, I never was even close to legal radiation limits. Of course I also never injected myself with it either! I linked a general article on I131 below; it has some references. You can also google beta particles and gamma rays for information on the type of radiation I131 produces. Only the beta particles stay in the cat, and they only penetrate up to 5mm tissue. I found another abstract regarding survival times. On the good side, cats treated with I131 live longer than cats treated with methimazole. On the bad side, the younger the cat is, the more quickly it died regardless of treatment. http://avmajournals.avma.org/doi/abs/10.2460/javma.228.4.559 Of course cats with pre-existing renal disease didn't fare too well no matter what treatment was used. I hope Basil beats the odds and has a long happy euthyroid life after this treatment.
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bbaird
17 years ago
Look for a prior thread called "Hyperthyroid in cats". Lots of answers there.

I said:
My cat had radioiodine treatment just 2 years ago.

I had to leave her at the treatment center for 9 or 10 days.
I thought I'd die, but, in the long-run, it was the right choice.

When she got home, I was supposed to keep a safe distance from her for a month (impossible as I have a studio apartment). I had to use flushable litter (no problem, I use World's Best anyway) for the same month.

Two years later, my cat's levels are fine.

Your cat will be fine. The procedure is non-invasive. After a day back home, your cat will probably forget the whole thing.

My cat was just 6 years old.

Feel free to email me with any questions.
Rudebekia
Original Author
17 years ago
From what I was told by my vet yesterday, two clinics in town do the radioiodine procedure. One keeps the cat isolated for 10 days to two weeks (or until the readings go down; my vet said 10 days was about average) and the other clinic keeps the cat up to four weeks! My vet also stated that besides how to dispose of litter, there are no restrictions (ie. hugging or sleeping with the cat) when it comes home. My biggest concern with my cat is that he is such an absolute "people cat"--a really needy lover boy
--that I hope the isolation doesn't harm his spirit. I'll definitely check out how much interaction he will get. Thanks for the info. about the other thread, bbaird, and, boy, your cat was young, too!
bbaird
17 years ago
My cat's also a lover girl. Very love-dovey. I boarded her for the first time over Thanksgiving for 4 days. When I got her home, she clung to me like Saran Wrap for days. I felt awful. I know she thought she was abandonned.

Both when she was boarded and when she had been isolated for the Radioiodine treatment, she was very quiet and scared. They told me that she was a tough cookie because she was so quiet and stoic, but, I know that she was scared and confused. Usually, she's a real blabbermouth.

With that said, you have to do what's best for your cat in the long-run. He'll be confused and sad for the time he's isolated, but, after being home for a few hours, he'll forget about it. He'll be okay. Call the treatment center each day to ask about him.

Also, give them a blanket or tee-shirt that smells like you (used, not washed) to put in his cage (you won't get it back, so, don't use a good one). Bring your own food (if they don't have your brand). If you give him wheatgrass at home, bring a pot of it for his cage-- a toy, too.
doubleshot
17 years ago
I did it years ago, so my memory is imperfect. I thought the cat only stayed there until the radiation level got down to a certain amount. Maybe there for 4-5 days? We were then to keep him isolated at home - had him by himself, disposed of his litter in a certain way, and not hold him for longer than so many minutes at one time. Did that for about a week.

And had a complete cure for his problem. It was not that big of an imposition. Later, I treated a cat for this condition with pills instead of the radiation (very very old cat, and we didn't think she would live long enough to justify the cost of the radiation. Turned out to sadly be correct). Anyway, after that, I greatly preferred the radiation process and results. Good luck!
User
17 years ago
Hi Marita...
One of my friend's cats went through this a few years ago. I do believe she was able to go and visit her cat during this period she was at the vet's. Her cat (a very old kitty) did very well after the procedure. It's harder on the people than the cats in many ways, think.
Take care...
bbaird
17 years ago
"I do believe she was able to go and visit her cat during this period she was at the vet's."

They're in solitary behind leaded walls.
Rudebekia
Original Author
17 years ago
Basil goes in to the hospital tomorrow. I think I've done all my homework--read everything I could on the procedure and asked the vet lots of questions. I will miss him so much for the ten days or so that he'll be gone. The kennel has nice big cages, with perches. They play soft music and techs come in twice a day to feed/change litter/and interact with the cats. If anyone is interested in how it goes, feel free to revive this thread.
bbaird
17 years ago
He'll be fine. So will you :)
mokanee
17 years ago
Just a note: if you do bring in a shirt or towel from home, make sure you tell them you want it left in HIS cage!
I left my two cats at a kennel for about 2 weeks quite a few years ago and left them with one of their favorite towels (they had "adjoining" cages which was nice) but when I got back there was someone else's stinky old towel in my babies kennel!! Apparently they routinely collect all the towels and wash them and then arbitrarily put any old towel into any old kennel. I was soooo mad!

PS. I asked them to find my towel but they never did. SOOOO mad. Sigh.

I truly hope that Basil fully recovers after this and you go on to enjoy at LEAST another 10 wonderful years together!

RAdiation for Hyperthyroid Cat

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