| Overview of hyperthyroidism Preparing your cat for treatment |
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| Overview
of Hyperthyroidism and Treatment Options, Including Radioiodine |
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| What is hyperthyroidism? | ||
| Hyperthyroidism is a disease caused by excess amounts of thyroid hormone in the circulation. In middle-aged to older cats, this is a common medical condition and usually results from one or more benign tumors (adenoma or adenomatous hyperplasia) of the thyroid gland. Carcinoma (cancer) is a very rare cause of hyperthyroidism in cats. Excessive thyroid hormone secretion accelerates most bodily processes and gradually causes one or more clinical signs that are apparent to most owners. The most consistent finding is weight loss secondary to the increased rate of metabolism. The cat tries to compensate for this by eating more (increased appetite). In fact, some of these cats have a ravenous appetite and will literally eat anything in sight! Despite the increased intake of food, however, most cats lose weight. The weight loss may be so gradual that some owners will not even realize it has occurred, or it may happen more quickly. Other signs that the hyperthyroid cat may show include anxiety or nervousness, a rapid, pounding heart rate, muscle weakness, vomiting, diarrhea, increased thirst or urination, heat intolerance (panting), and an unkempt hair coat. Over time, untreated hyperthyroidism leads to deleterious effects on many of the cat's internal organs. Heart disease, muscle wasting, chronic emaciation, and/or severe metabolic dysfunction can develop, ultimately leading to death. Fortunately, the disease is familiar to veterinarians and relatively easy to diagnose. A suspicion of hyperthyroidism is based on the cat's history, clinical signs, physical examination abnormalities, and results of routine laboratory tests. In most cats, an enlarged thyroid nodule(s) can be palpated in the ventral neck, a finding that is consistent with hyperthyroidism. Diagnosis is confirmed by documenting a high circulating thyroid concentration. The aim of treatment is to decrease the excessive production of thyroid hormones as quickly as possible with minimal risk to the cat. Radioiodine treatment accomplishes this better than other forms of treatment, because radioiodine cures almost all cats of this disease with just one simple, subcutaneous injection. | ||
| How can cats with hyperthyroidism be treated? | ||
| Hyperthyroidism can be treated medically, surgically, or with radioiodine. Medical treatment consists of administration of methimazole (Tapazole) one to three times per day. Methimazole treatment usually controls hyperthyroidism, but it is not a cure (ie, the drug will block thyroid hormone secretion but will not remove or destroy the thyroid tumor), and the drug must be given for the rest of the cat's life. Surgery cures the hyperthyroid condition and consists of the removal of part or all of the thyroid gland (the feline thyroid gland consists of two separate lobes). Radioiodine (radioactive iodine; I-131) also cures hyperthyroidism. The procedure for this treatment is relatively simple, consisting of a single subcutaneous injection of a solution of radioiodine. | ||
| Why would radioiodine be used instead of medicine or surgery in a cat with hyperthyroidism? | ||
| Medical therapy works in most cats, but there are several reasons it may not be the best choice. First, some cats are difficult or impossible to pill. Second, mild reactions (eg, loss of appetite and vomiting) are common, and a few cats develop serious adverse reactions to the medication (blood or liver problems). Because of these side-effects, periodic blood tests to monitor the cat's condition are necessary. Finally, some owners may not want to have to medicate their cat for the rest of its life (pills must be given daily), especially if the cat is young or only middle-aged. It is important to remember that medical therapy "blocks" production of thyroid hormone secretion, but the thyroid tumor(s) will continue to grow and enlarge over time. In many cats treated with long-term medical therapy, the tumor volume becomes so great that the medication can no longer effectively block thyroid hormone secretion. Surgery is generally an effective treatment for hyperthyroidism but has disadvantages in many cats. Many cats with hyperthyroidism have heart problems and are higher anesthetic risks. There is also a considerable risk that there will be damage to the parathyroid glands (4 little glands located within or adjacent to the thyroid) during thyroid surgery resulting in hypocalcemia (low blood calcium). This complication can be life-threatening and results in additional hospitalization and cost. After surgery, some cats develop hypothyroidism and require treatment with thyroid hormone pills for a period of time. Finally, there is a considerable risk that the hyperthyroidism will not be cured by surgery, or the condition will recur (ie, the chance for recurrence is much greater than after radioiodine therapy). Radioiodine therapy has some distinct advantages over use of medical or surgical treatment and is considered by most authorities to be the treatment of choice for hyperthyroidism. With radioiodine, the need for anesthesia and the risk of hypocalcemia (the major disadvantages with surgery) are eliminated. Methimazole (Tapazole) treatment is not needed. If drug treatment is being given, it should be discontinued for at least 1 week before radioactive iodine is given in order to enhance the effectiveness of the radioiodine treatment. The major draw back is that after administration of radioiodine, the cat must be kept hospitalized for a period (usually 5 to 10 days). Overall, radioiodine provides a simple, effective, and safe cure for cats with hyperthyroidism, regardless of age. | ||
| How does radioiodine therapy work? | ||
| Normal thyroid function requires oral intake of the element iodine (iodine is commonly added to the diet of both humans and cats). Once ingested, iodine is taken up by the thyroid gland, where the iodine becomes incorporated as part of thyroid hormone. The major effect of thyroid hormone is regulation of the metabolic rate. Although essential for life, excess thyroid hormone is toxic to many organs, including the heart and liver. Untreated hyperthyroidism may lead to death due to heart failure or chronic malnutrition and emaciation. Radioiodine (radioactive iodine; I-131) is a form of iodine that has been made radioactive. In its radioactive state, it undergoes a natural process (decay) in which it gives off radiation. The radiation given off consists of two types: gamma rays (similar to X-rays) and beta particles (electrons). The half-life of 131-I is 8 days; in other words, one-half of the radioiodine goes through this process every 8 days. When iodine is made radioactive and administered to a cat with hyperthyroidism, the thyroid tumor tissue takes up the radioiodine in an identical fashion to that of the normal thyroid gland. This uptake of radioiodine occurs in all abnormal thyroid tissue throughout the body, no matter where the thyroid tumor(s) are located. This is an important feature of radioiodine therapy when one considers that some hyperthyroid cats have thyroid tumors in the chest cavity, where surgical removal is not feasible. Once the thyroid tumor tissue has taken up the radioiodine, the radioiodine emits its radiation, which destroys the overactive thyroid tumor cells. Because the remaining healthy thyroid tissue does not take up the radioiodine as efficiently as the thyroid tumor tissue, radioiodine treatment usually does not damage any remaining normal thyroid tissue. Because any normal thyroid tissue tends to be automatically protected from the effects of the radioiodine, the development of an underactive thyroid gland (hypothyroidism) is extremely rare in cats following radioiodine treatment. The residual (normal) thyroid tissue resumes full function within 1 to 3 months after treatment. An average of 98% of all hyperthyroid cats treated with radioiodine are permanently and safely cured with a single injection! As an added benefit, radioiodine poses no risk to the parathyroid glands, the four small glands located adjacent to the thyroid gland, which are extremely important for maintenance of normal calcium levels in the body. Therefore, a low blood calcium level (secondary to parathyroid damage) never occurs after treatment with radioiodine. This is in marked contrast to surgical treatment, in which damage to these parathyroid glands and the subsequent development of a low blood calcium concentration is extremely common. | ||
| Isn't my cat too old for radioiodine therapy? | ||
| Hyperthyroid cats of any age can be successfully treated with radioiodine, as long as he or she has no other life-threatening medical conditions. In order to rule out any additional medical conditions, a number of screening tests need to be performed by your veterinarian before scheduling an appointment at one of our Hypurrcat centers for the radioiodine treatment. | ||
| Is radioiodine therapy a new treatment for cats? | ||
| Dr. Peterson was the first veterinarian to develop this procedure and treat hyperthyroid cats with radioiodine. He has over 27 years of experience successfully administering radioiodine therapy to cats. It is not a new or experimental treatment; over 5,000 cats have been treated in our facilities. | ||
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Making an Appointment and Preparing Your Cat for Radioiodine Treatment |
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| How do I make an appointment for this treatment? | ||
| Please ask your veterinarian to send us (via fax, e-mail, or regular mail) the results of your cat's history, physical examination, x-rays or ultrasound reports, and recent blood work (eg, complete blood count, serum biochemical profile, urinalysis, and serum thyroid hormone tests) so that Dr. Peterson can evaluate whether your cat is a good candidate for treatment. We recommend that these blood tests be done within 30 days of your appointment for radioiodine treatment. If this data is acceptable and no other life-threatening medical conditions are identified, we will then schedule an appointment for your cat's treatment. Please call our appointment line to schedule an appointment. | ||
| What should I do to prepare my cat at home in the week before treatment? | ||
| If your cat has been on methimazole (Tapazole), this drug generally should be discontinued 1 week before treatment with radioiodine. However, in some cats (especially those with a concurrent illness), Dr. Peterson may want you to continue methimazole treatment up to the day of admission for the radioiodine treatment. In any case, if your cat has been treated with methimazole for longer than 3 months, the serum thyroid hormone tests will need to be repeated 5 to 7 days after stopping the medication. We need a current serum T4 reading after methimazole has been discontinued in order to determine the correct dose of radioiodine to administer to your cat. Most other drugs that your cat may be receiving are fine, but please check with our office to make sure that these medications will not interfere with the radioiodine treatment. You should feed your cat normally the week before admission to the hospital. | ||
| My cat has never been boarded or away from home before. What will happen if she becomes depressed or refuses to eat? | ||
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Cat owners/parents can feel confident and worry-free about their decision to place their cat in the care of the staff at Hypurrcat. As cat owners ourselves, we know boarding your cat during his or her radioiodine treatment is typically much more stressful for the owner than the cat. That's why we've gone to every extent to ensure you have peace of mind that your cat will be safe, loved, and have a good time while in our care. To help
keep your cat entertained during their stay at Hypurrcat, we offer a
wide selection of cat videos that are shown on our widescreen TVs within
the treatment room where your cat will stay. The most popular videos
include those with chattering birds that flutter around on the display
and mice and other creatures that run back and forth across the monitor.
These videos stimulate our feline patients as they watch, swat, and
stalk the widescreen. We also
have numerous aquariums containing large, colorful fish, lizards, and
small mammals, which are located in the Hypurrcat facility. For relaxation,
we offer soothing classical music played on our stereo, but we do occasionally
listen to DogCatRadio.com, an Internet radio station that has been a
favorite with some of our guests. During your cat's stay, we understand that you may want to check in on your cat to see how he/she's doing. That's why, at the Westchester Hypurrcat Facility, we offer owners the ability to view their cat on our web cams that view each cat in his or her own individual cat condo. |
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Preparing your cat for treatment |
Hospital Stay During Radioiodine Treatment | |
| What should I do on the day of my cat's admission for radioiodine treatment? | ||
| Please bring your cat to the hospital in an appropriate carrier at the scheduled time. You should feed your cat on the morning of admission to the hospital (fasting is not necessary). | ||
| Should I bring anything for my cat? | ||
| If your cat eats a particular kind of food, we suggest that you bring enough food for a 7-10 day stay as we want to maintain your cat's regular diet during the time of hospitalization. If you want to bring one or more small personal items (eg, a sock or toy) to place in your cat's cage, we do allow it. However, please understand that we cannot return these personal items because of safety concerns of radiation contamination of these items. | ||
| What happens on the day of admission? | ||
| When
you arrive at our Hypurrcat facility on the day of admission, you will
first be asked to read and sign forms entitled "Owner
Information" and "Owner
Consent to Treat their Cat with Radioactive Iodine." If you wish,
you may download these forms, which allows you to fill out the required
information prior to the time of your cat's examination.
Once you have completed the required paperwork, you and your cat will meet with our veterinary medical specialists (including Dr. Mark Peterson, a board-certified veterinarian and veterinary nurse). Your cat will be thoroughly examined and the medical record, laboratory tests, and x-ray and ultrasound reports obtained from your regular veterinarian will be reviewed. Any questions that you have concerning the treatment or long-term care will be answered. Unless testing has just been performed by your regular veterinarian, we will also collect a blood sample from your cat in order to perform pretreatment thyroid tests and kidney/liver profiles. If your cat is judged to be medically stable (after reviewing all of this information), we will treat your cat on the day of admission. |
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| If I'm too busy to drop my cat off for admission to Hypurrcat for treatment, does your facility offer a pick-up and delivery service? | ||
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Hypurrcat does indeed offer a pick-up and delivery service for those cat owners who find it difficult to actually come to our office for their cat's admission. Our pick-up and delivery prices are based on distance from your house/apartment to the Hypurrcat facility. Please call our facility for more information and an estimate of the concerning cost of this service. |
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| What are the facilities like where my cat is going to be kept? Is the cage large? | ||
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Once your cat is judged to be medically stable, he or she will be admitted to the Hypurrcat radiotherapy ward. This unit is specially constructed, and houses only hyperthyroid cats receiving radioactive iodine. These comfortable, quiet accommodations (barking dogs are not allowed in this room!) include "Southwest" décor and housing in spacious and cheery cat condos. The condos have separate "bathroom" compartments and shelves for snoozing. Our timid patients are offered a special cat box placed in the main compartment of the cat condo where they can hide. The ward has bright, natural lighting and contains many plants. For your cat's entertainment, we offer a wide selection of cat videos that are shown on the widescreen TV located within the Hypurrcat treatment room. Birds, squirrels and other creatures stimulate our feline patients as they watch, swat, and stalk the screen. There is also an aquarium containing large, colorful fish, lizards, and small mammals in the Hypurrcat treatment room. For relaxation, soothing classical music played throughout the day; occasionally we listen to DogCatRadio.com, an Internet radio station that has been a favorite with some of our feline patients. |
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| How is radioiodine therapy given? | ||
| Once the dose of radioiodine for your cat has been determined, it is injected in a small volume (1 to 2 ml) under the skin (subcutaneously), exactly like a routine vaccination. There is absolutely no discomfort associated with this injection. | ||
| What happens to my cat during the hospitalization after the treatment has been given? How long is the hospitalization period? | ||
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Once your cat has been treated, he or she need do nothing else but sleep, eat, and play while the radiation within the body dissipates to safe levels. We like to "spoil" all our patients as much as safely permissible. During hospitalization, we provide favorite foods, diversions, and lots of "hands-on" care and affection. We play quiet music for the cats during their stay (most cats seem to like classical or talk radio best). Some owners bring a favorite toy to help keep their cat amused. For your cat's entertainment, we offer a wide selection of cat videos that are shown on our widescreen TVs. Birds, squirrels and other creatures stimulate feline guests as they watch, swat, and stalk the screen. This time of hospitalization is generally much more difficult for the cat owner than the patient being treated. Your cat will be monitored closely while in our care. The cats are fed and monitored two to three times daily by a full-time veterinary technician or a veterinarian during their stay. In addition, we have individual, close-up video cameras (Web cams) directed on each of the cats staying in the Westchester Hypurrcat facility so we can monitor the cats continuously from outside of the treatment room itself. And, you too can "visit" your cat on your own computer by means of these web cams that we have installed in the treatment room. These individual web cameras offer Pan (left & right) and Tilt (up & down) movement features to better view your cat. In this way, you can log onto our web site from your computer to view your cat, allowing you to always be in close contact with your cat, no matter how far away you actually are! Since each cat's metabolism is slightly different, the length of stay varies and is determined by measuring the degree of radioactivity in your cat's thyroid gland with a Geiger counter. Radiation safety regulations require that a cat remain hospitalized until the radioactivity has dropped to very low levels that pose no threat to other pets or family members. The usual period is from 5 to 10 days (average, 7 days). When the level of radioactivity being emitted from your cat is below the level allowable by law, you will be contacted and an appointment will be made to release your cat back to your care. Arrangements can also be made for owners who wish to have their cat stay a longer period in our Hypurrcat facilities. Before your cat is discharged, we will repeat the thyroid function tests to gauge the success of the treatment. We will also repeat the serum kidney and liver profiles to determine if any changes in these parameters have occurred following treatment. We will remain involved in your cat's recovery and will review the results of treatment with your veterinarian. |
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| How can I check on my cat's condition during treatment? Is visiting allowed? | ||
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Due to radiation regulations mandated by the Department of Health and the Nuclear Regulatory Commission, visitation is not permitted. We will call you daily to provide you with a progress report during your cats stay with us. If you ever have any questions or concerns, you can also call us to check on the status of your cat. Although direct visitation is not allowed, our Westchester Hypurrcat facility does have it's state-of-the-art web cam system, with individual close-up cameras for each of the cats! In this way, you can log onto our web site from your computer to view your cat, allowing you to always be in close contact with your cat, no matter how far away you actually are! |
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| Can I remove my cat from the therapy facility before the end of the treatment period? | ||
| No pet can be removed from the facility until the level of radioactivity has decreased to a level that has been deemed to be safe by our radiation safety officer, and as mandated by the State Department of Health and the Nuclear Regulatory Commission. | ||
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Why will some treatment facilities releases my cat back to me after only 3 days? Why does Hypurrcat generally keep them in the hospital for a longer period? |
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States differ regarding the level to which a cat's radioactivity must fall before the cat can be released back to the owners. Some states, including New York State, have more stringent release criteria than other states and require a slightly longer hospitalization period. In other words, New York State requires that the cat excrete more radioiodine (via the urine and feces) and therefore be less radioactive than some other states. Please remember that these release criteria are meant to protect you and your family as well as other pets in the household from untoward effects of radiation emitted from your treated cat. Some cat owners are lead to believe that because these facilities allow for earlier release from the hospital than we would at Hypurrcat, their cat is somehow "less radioactive" or "safer" than the cat would be in the same time period following our treatment at Hypurrcat. This is simply not the case. Please understand that the doses administered to cats in all facilities are similar. If these cats are released back to the cat's family sooner than we would do at Hypurrcat, you and other members of your household will be exposed to more radiation than you would have been if the cat had not been released so quickly. |
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| What
happens during severe inclement weather situations (i.e., a severe snowstorm)?
Will my cat still be cared for by one of the Hypurrcat staff members? |
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| All of our staff members (nurses and doctors) drive all-wheel drive or 4-wheel drive vehicles, enabling them to travel in very severe weather. Hypurrcat also has sleeping accommodations for its staff, so they can stay at the hospital during such emergency situations if necessary. | ||
| Are there any side effects or risks of therapy? | ||
| There are almost no side effects from this treatment. Since the radioiodine is specific in its site of action (i.e., at the thyroid tumor), there is no hair loss or increase in skin pigmentation as may be seen with other forms of radiation therapy (cobalt radiation). Some cats seem to experience mild discomfort of the thyroid region (resulting from an inflammation of the thyroid called thyroiditis) at the beginning of therapy, but this resolves itself spontaneously and does not cause a major problem. If thyroiditis does develop, we may treat your cat with medications to mitigate any pain or discomfort if we feel that it is necessary. Once your cat is back at home with you, there may be a period of readjustment during the return of normal thyroid function, and your cat may be quieter and less active than normal. Because your cat's metabolic rate will return to normal after treatment, he or she may not need to eat as much food as before therapy. A change in voice may develop after treatment, but this is extremely rare. Also very rarely a cat will develop hypothyroidism (underactive thyroid gland) after treatment with radioiodine, which is easily controlled with natural thyroid hormone supplementation. Overall, side effects are extremely rare. Radioactive iodine, despite its somewhat scary title, is considered the "gold standard" for safety and efficacy in treating hyperthyroid cats. The greatest risks are to the doctors and staff who work in the thyroid treatment facility on a long-term basis. However, with stringent safety regulations, protocols, and monitoring, this form of therapy is safe for both the cats and the caregivers! | ||
| What about the development of kidney disease? Can't radioiodine cause my cat's kidney function to worsen or even fail? | ||
| In cats with hyperthyroidism, both the blood flow to the kidneys as well as the glomerular filtration rate (GFR) are higher than normal. The underlying mechanisms for the increased renal blood flow and GFR may be related to the increased cardiac output and hypertension that hyperthyroid cats commonly develop secondary to their disease. As might be expected, renal blood flow and glomerular filtration rate decrease toward normal after successful treatment of the cat's hyperthyroidism, as cardiac output normalizes and hypertension resolves. In some hyperthyroid cats, however, successful treatment is also associated with increases in blood urea nitrogen (BUN) and serum creatinine concentrations, two blood tests that indicate that kidney disease is present. This effect seems to be independent of treatment modality (ie, it occurs with methimazole, surgical thyroidectomy, or radioiodine). Although the exact incidence of such deterioration in renal function is still being investigated, we can estimate some worsening in kidney function will occur in about 20% of treated cats. Thus, hyperthyroidism, by increasing the blood flow to the kidneys, can mask preexisting, "hidden" renal disease that may become clinically apparent only after return of normal thyroid function. Because treating the disease will result in a drop in the blood supply to the kidneys, this can cause a worsening of kidney function after treatment for hyperthyroidism in a cat with kidney disease. Because it is sometimes difficult to identify which hyperthyroid cats have concurrent kidney disease, we will measure your cat's serum kidney tests on the day of admission to our Hypurrcat facility. If we find any indication of kidney disease, we will begin prophylactic measures to control the concurrent kidney disease while your cat is being treated in our Hypurrcat facilities. No matter what the pretreatment results revealed, we repeat the serum kidney tests again on the day of discharge so we can compare the pretreatment test results to those obtained after treatment to determine if kidney function has deteriorated. Again, development of kidney disease (if it does occur) is not caused by the radioiodine itself but rather by the fact that the hyperthyroidism is resolved and renal blood flow has decreased. | ||
| What happens on the day of discharge of my cat from the Hypurrcat facility? | ||
| When the level of radioactivity being emitted from your cat is below the level allowable by law, you will be contacted and an appointment will be made to release your cat back to your care. At that appointment time, you will be given detailed information about the radiation safety precautions that should be taken for the first 2 weeks after your cat is discharged. You will be asked to read and sign a form entitled "Release Information for Owners of Cats Treated with Radioiodine," which provides detailed instructions about how to safely care for your cat during this period. | ||
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Preparing your cat for treatment |
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| What happens after the isolation period is over and I take my cat home? What precautions do I need to take? | ||
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Upon discharge, your cat will still be minimally radioactive. Even though the level of radioactivity is very low (much lower than the level at which human patients are discharged from the hospital), you should still exercise prudence during this period in order to protect you, your family, and your other pets. All of the remaining radioactivity in your cat will gradually disappear over the next 2 weeks (through radioactive decay and excretion into the urine). One should try to maintain an arm's length distance (a yard) from the treated cat whenever possible. For the first 2 weeks after release, we recommend limiting close contact with your cat to less than 10 minutes per day. This includes not allowing your cat on your bed during the night while you sleep. If you cannot avoid close, prolonged contact during the day or cannot prevent your cat form sleeping in your bed with you at night, we recommend that your cat be boarded either at our Hypurrcat facility or with your regular veterinarian during this 2-week period. Young children or pregnant women should not be allowed to have any prolonged or close contact with your cat for the first 2 weeks after discharge. If you or a family member is pregnant or close contact between young children and your cat cannot be avoided, we recommend that your cat either remain at a Hypurrcat facilities or be boarded with your veterinarian during this 2-week period. |
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| What do I need to do with the cat litter after my cat is discharged from a Hypurrcat Treatment Center? | ||
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Much of the residual radioactivity will be eliminated through your cat's urine and feces. Therefore, during the first 2 weeks after your cat has been discharged from the hospital, soiled litter should be discarded in the sanitary sewage system (toilet) or stored until it is no longer radioactive. During this initial 2-week period, you must never put waste collected in the regular trash! The ideal situation is to dispose of all soiled cat litter and waste collected during the first 2-weeks after your cat's release from our facility down the toilet. For this purpose, one must use a flushable litter. Although many brands of flushable litter are acceptable, we use the "World's Best Cat litter" at our Hypurrcat facilities, so your cat will be accustomed to that brand. (For more information, see www.worldsbestcatlitter.com). Suitable litter may be found at a local pet store or the world's best cat litter may be purchased from our Hypurrcat facilities. The box should be scooped at least once or twice each day. Disposable plastic gloves can be worn when changing the litter to help prevent hand contamination. After flushing the litter, your hands should be washed thoroughly. Once this 2-week period is over, the litter pan and scoop can be cleaned and the soapy water flushed down the toilet; it is not necessary to discard these items. If you cannot flush the soiled litter down the toilet because your home has a private septic system, the radioactive cat litter can be stored for a 3-month period to allow it decay down to background radioactivity. To store the litter, all soiled litter collected for the first 2 weeks after discharge should be placed into a garbage bag (double-bagged) and tied securely. The double-bagged soiled litter should be placed into a large trash container and closed with a tightly locking lid. During the time you store the container, place it in an area where it cannot be reached by small children, pets, wild animals, etc., (eg, a basement, garage, or yard). Do not place it in your kitchen, bedroom, or other frequently occupied areas. After storing this litter for a 3-month period, the bagged cat litter can be disposed of as regular trash or garbage because it will no longer be radioactive. |
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| These precautions seem like my cat is hazardous to me. How dangerous is it? | ||
| The amount of radiation remaining in your cat is extremely low. The amount of radiation you might receive from your cat would be roughly equivalent to that received when you fly round trip across the country. In fact, if your cat were a person they would receive up to 10 times the dose of radioiodine and would still go home on the same day of treatment. The major reason for this discrepancy between cats and people is that human patients always flush their waste down the toilet, thereby removing any radioactive contamination from the home environment. In contrast, cats generally need to use a litter box, thereby increasing the risk for radiation contamination. Because the vast majority of the radioiodine has already been excreted into the urine and feces during the first 5-10 days after treatment (while your cat is boarded in our Hypurrcat facilities), the risk of contamination after your cat returns home is minimized. Therefore, while these discharge instructions may seem alarming, they are offered as an extremely cautious and conservative approach. If you or any of your family were to receive radioiodine therapy, the restrictions after treatment would be much less severe. If our instructions are followed, you and your family will receive almost no exposure whatsoever from the small amount of residual radiation in your cat at time of discharge. | ||
| What precautions do I need to take for my other pets? | ||
| The amount of radioiodine that your other pets will receive by contact with your cat or by using the litter box is negligible. If you have multiple cats sharing the same litter box, however, we do recommend that you clean the box at least 2 to 3 times a day to remove the contaminated litter clumps from the box. Based upon federal and state guidelines, you do not need to quarantine your cat from other pets. | ||
| What aftercare will my cat need? Will my regular veterinarian be contacted? | ||
| Following treatment and discharge of your cat from our facility, we will repeat the thyroid function tests to gauge the success of the treatment. Before discharge, we will also repeat the serum kidney and liver profiles to determine if any changes in these parameters have occurred following treatment. We will remain involved in your cat's recovery and will review the laboratory test results and results of treatment with your veterinarian. After discharge of your cat from our facility, your regular veterinarian will receive a letter summarizing the treatment given to your cat at our Hypurrcat center, as well as specifying specific monitoring recommendations for your cat. The referring veterinarian is welcome to contact the specialists at Hypurrcat if they have any questions or concerns, as needed. The vast majority of cats require minimal aftercare. In most cases, your veterinarian should monitor the thyroid function 3 months after radioiodine therapy and then monitor thyroid function on a yearly basis as a part of their ongoing health care plan for your cat. | ||
| What is the recovery time for my cat to return to normal? | ||
| You may see changes in your cat's behavior within a few weeks, but some cats require 2 or 3 months for all clinical signs to disappear. As the cat's metabolism returns to normal, body functions slow down. The formerly hyperactive cat becomes calmer. Along with a slower heartbeat and respiration, changes may include weight gain, better grooming, less vomiting, reduced appetite, fewer visits to the litter box, and more sleeping. Some cats gain one or more pounds in the first month, whereas other cats put lost weight back on more slowly. | ||
| Does the radioiodine treatment always work to cure hyperthyroidism? What is the success rate? | ||
| Our studies have shown that a single dose of radioiodine is effective in curing hyperthyroidism in 95% to 98% of cats treated. Even cats that are not completely cured after one treatment, however, show some lowering in their circulating thyroid hormone concentration and improve clinically. If hyperthyroidism persists for longer than 3 months after treatment, retreatment with radioiodine is generally recommended to cure the disorder. Virtually all cats that remain hyperthyroid after the first treatment are cured by the second treatment. | ||
| How often should my cat be monitored after treatment with radioiodine? | ||
| At our Hypurrcat facility, we will repeat your cat's thyroid profile and kidney/liver profile on the day of release. Depending on the results of these tests, we will recommend that you recheck with your regular veterinarian in 1 to 3 months (and then on a yearly basis) to assure that your cat has continued to respond appropriately to the treatment. In most hyperthyroid cats treated with radioiodine at Hypurrcat, the serum thyroid hormone concentrations will already be normal on the day of discharge from our facility. In approximately 20% of cats treated with radioiodine, however, it takes 1 to 3 months for the serum thyroid hormone concentration to normalize after the radioiodine has been administered. If hyperthyroidism persists after the 3-month period, retreatment with radioiodine should be considered. Once thyroid function in your cat has normalized, additional thyroid rechecks should be scheduled once a year in order to monitor your cat's thyroid function. | ||
| Can the hyperthyroidism ever recur? | ||
| Yes, although it is very uncommon (less than 5% of cats treated). In addition, such recurrences usually develop 3 years or longer after the hyperthyroidism was first treated. Therefore, such relapses may indicate the development of a new thyroid tumor causing hyperthyroidism, rather than relapse from the first tumor that was treated with radioiodine. | ||
| What is the long-term prognosis for my cat after radioiodine treatment? | ||
| The long-term prognosis for hyperthyroid cats treated with radioiodine is very good to excellent. Many owners are hesitant to have their cat treated with radioiodine because of their cat's older age. But remember, middle- to old age is not a disease. The outcome following radiation therapy is generally excellent, and almost all cats return to a normal state of health and live a completely normal life afterward. | ||
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Preparing your cat for treatment |
Cost of Radioiodine Treatment for Cats | |
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"Long term, radioiodine is far less expensive, more successful, and the least risky of any of the treatment options" |
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| Is radioiodine therapy expensive? | ||
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The cost of any treatment for feline hyperthyroidism is significant. The fee for radioiodine therapy is generally $1700-$1800, but it may be more if the hyperthyroidism is severe or if additional tests need to be performed at our facility to ensure that your cat is a good candidate for radioiodine treatment. A one-time admission fee covers the total cost of the treatment, so there are no hidden charges. This fee covers the following:
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This compares reasonably with most fees for surgical treatment of cats with hyperthyroidism. The cost of daily medication would average over $500 per year plus the cost of follow-up examinations and repeat blood tests. |
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Preparing your cat for treatment |
Why Choose Hypurrcat over Other Radioiodine Facilities? | |
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As you may know, other facilities offer radioiodine treatment for cats with hyperthyroidism. Some of these facilities offer slightly less expensive fees than we do at Hypurrcat. Why should you take your cat to Hypurrcat for this treatment instead of one of the other treatment facilities? We believe that there are a number of reasons that treatment at Hypurrcat is the best option, both for you and your cat.
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