dutch85 -- we had this procedure done for our Sally March 29th and she is doing great despite the beginnings of kidney failure (she is 17.5). Our clinic here in the Seattle area does NOT require the long hospitalization -- in fact -- she was in the clinic just about 24 hours! Our vet does a different dosage per cat (not a standard dose) and Sally's was pretty small so he released her the next day. We could see a difference almost immediately! She regained much of her lost muscle and over time went up one pound (we caught it pretty early so wasn't all that thin). Most of all we could tell she just felt soooooo much better.
There is a great yahoo group for people with HyperT kitties -- http://pets.groups.yahoo.com/group/feline-hypert/
If there is any way you can have the procedure for your kitty, I would strongly recommend it -- even if the hospitalization is a week. It is a virtual cure -- and any separation will be well worth it.
And I know kitties get alot of spoiling in those clinics!!!

I have no experience dealing with hyper thyroid in cats, but plenty with dogs.

I know you can't compare the two as far as meds etc. go, but I wonder why you are not using medication to control the problem. I've had two dogs with the problem and daily medication takes care of it.

Of course, cats can be a challenge to pill.

SG

My cat has been on Tapazol and then Methimazole and they each worked for a short time and then she began having muscle weakness. A blood test showed her thyroid was not responding as it should. Since she is in good shape in all other ways (the heart murmur and elevated liver enzymes are consistant with the thyroid condition), it was recommended she have the treatment. I feel surgery is too risky and since I had the same procedure done to myself about 7 yrs. ago, I woudl rather do the I-131.

My sister's persian had the procedure about a year ago. Unfortunately the kitty only lived about 6 months after. Kitty never really recovered and just continued to decline. She was at the clinic (in Chicago) for about 5 days. She handled being isolated very well. My sister and her husband would spend time with her especially at meal times so she would be sure to eat. My sister mentioned recently that she would go the oral medication route if she had it to do again. Good luck with whichever you decide.

Thanks. There is a lot to consider. I don't want to do anything to harm her. Yet, if I do nothing, she will continue to decline and maybe have heart failure. I read very good things about the I-131 and have had it myself, but I am afraid there is a sinister background.

Wow! Six months! That's not too encouraging. I do want to do what's best for her but I am frightened I will not make the best choice. This is so hard.

Well please don't get my post wrong. How effective any treatment is will depend on the individual animal. Who knows what underlying health issues will effect the outcome and determine the time she still has with you.

Ask meghane if there is a down side to giving the oral medication. Ask her if you try that and it doesn't work for whatever reason, can you go with the radioactive iodine? I wish you the best. There were some people who posted success and the vets believe in the RI treatment.

The original poster explained above that he had tried Tapazole and there were side effects. My 17 year old kitty is hyperthyroid and is managed well with the Tapazole. Not sure what I would have done if that hadn't worked as he is CRF and has other issues. But Dutch85's cat is otherwise healthy, so radiotherapy sounds like a good solution. I will add that a friend had this done for her cat a few years ago and he passed away of other causes 3 months later. I'm sure younger cats can have many good years when the therapy is successful.

My kitty is hyperthyroid and has been doing very well on Tapezole. I went through the same quandry that you are currently experiencing when he was diagnosed.

I decided to try the Tapezole primarily because I did not think he would do well being isolated and handled by strangers. He is a "hard to handle" kitty at the vet and she even thought he wasn't a good candidate because of that.

I was apprehensive about pilling my kitty twice a day. I wasn't sure that I would be able to quite frankly - he can be quite a handful. Well - not only does he take the pill with no fuss whatsoever but he will go and sit by the kitchen sink and wait for his pill when it is time. It's almost as if he knows he needs that pill.

Just gather information and choose what you think is best for your kitty. There is no right or wrong answer.

Best of luck to you and keep us posted!

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?

I also have a 17 year old hyperthyroid kitty, Barney. He's been on Tapazole since April 2005 and does just fine. We only had an issue with him once when his meds caused an allergic reaction to a brand of Iams kibble (they must have adjusted the formulation between bags) and he developed bald patches and scratched himself raw in a few places. Changed to vet kibble and it cleared up immediately and he's been fine ever since. That reaction happened 4.5 months after he'd started treatment and in my vet's opinion was an isolated reaction as opposed to something that will be recurrent. He's doing well on Tapazole, he has no problem taking his meds - the pills are so small that they aren't a big deal. His buddy Oscar's Fortokor tablets for his CRF are giant compared to the Tapazole. I thought about the radiation treatment at the outset of diagnosis but also decided that he wouldn't respond well to confinement - he's Mr. Sociable and we knew he wouldn't have tolerated segregation well. If he hadn't responded to meds then I would have had it done since there would have been no choice but since his thyroid is under control with meds and the vet is happy with his numbers then he'll stay on pills. I know he may need his dosage changed at some point but they monitor him closely for that - his T4 bloodwork is done twice a year (once as part of his annual Wellness exam and the second time at the half year to ensure his numbers are staying okay). Once his thyroid was under control they were able to ensure that other things were okay. Last year at his half year bloodwork they noticed his kidney values were starting to go - but that's age related, not hyper-t related.

Cost has nothing to do with our treatment options. We don't have kids - the boys are our kids (one of my vets always asks me when she sees me without them "how are the kids doing?!"). Just bloodwork comes to maybe Cdn$225/year (that's for both his entire Wellness blood panel and the half year T4) with meds being less than Cdn$60 for 70 pills - less than Cdn$1/day (I spend more than that on coffee!). He's on 3/4 pill a day - 1/2 in a.m. and 1/4 in p.m.

Lots of things to think about to decide on the best treatment for your kitty.

tess

I don't know the answers, but wanted to wish you luck. I do have a friend who had the treatment done on her cat and was thrilled with the results.

My cat is hyper-t, but she is also in CRF, so not a very healthy cat and who knows how long she has. Interestingly, the vet says that her hyper-t has helped to keep her kidney disease in check somewhat. It was better for us in the long run that her hyper-t was not real well controlled, but then again all the health issues must be hard on this poor old kitty.

I wish you and your kitty the best of luck.

Thank you all so much for all the information. My cat's tests are in and she is in fine shape, kidneys are fine and the vets feel the I-131 is perfect for her. Over time, since the meds didn't control her HyperT, her heart would fail. On Methimizole, she experienced muscle weakness and was falling. I am agonizing over the choice to have this done, even though I have had the treatment myself. I'm learning about the restrictions after the treatment. Much more in animals than in people. One minute I am fine with doing it and the next I'm afraid once it's done, if things go wrong it will not longer be able to be fixed. Should she not make it through the procedure for any reason I will always think she would have lived longer if I'd not done it. It's agonizing! I do appreciate any prayers you can offer for her that I make the right decision. Thanks so much.

Hi. I hope this post isn't too late.

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.

Feel free to email me with any questions.

dutch85 -- try to remember that the I131 is a CURE, where the pills are only a control. Your cat's hyperT could get worse, and over time as she ages her kidneys could start to have problems. Our cat was at the very beginnings of CRF, and I didn't want to wait to have the treatment until it was too late. As bbaird noted it is not invasive, my vet just gave her a sub-cutaneous (under the skin) injection of the I131. I really could see the difference in her right away. My husband and I believe its entirely possible she would not be with us right now, if not for this treatment. (like I mentioned she is 17.5). I just took her to the vet yesterday (our longtime vet is retiring and we wanted to say goodbye). Our vet said Sally looked really really good. She weighs 10.2 -- at the time of her I131 she weighed 9.5. And even though she has beginning kidney problems, she is staying hydrated on her own pretty well.
Her only big problem right now is spinal arthritis and we've starting to give her glucosamine for that.
Good luck and please keep us posted.