Hyperthyroid Diagnosis

[FeebysOwner]

I don't want to answer for FeebysOwner FeebysOwner and I'm sure she will give you her reason(s) for not choosing the I-131 treatment.

It was plain ignorance and the reluctance to put her through the isolation. Pure and simple.

 

[rubysmama]

LOVED LOVED LOVED this video. Going to try the treat sandwich!! So inventive. (And her kitty was hissy.)

Hope it works for you.

 

[Antonio65]

I have been reading on Reddit and radio-iodine treatment sites and did NOT catch that I HAD to give her medicine first. That is such bad news. This will add days of stress trying to trap her and get her into my small holding cage for further testing at her regular vet after the meds start. (I read that the I131 places need the cat to be OFF meds and Y/D food for weeks before a consultation and testing with them can begin.)

Your cat will have to be treated with methimazole for several weeks before being evaluated for the I-131 injection.
Your vet will give you the directions for administering the methimazole. Too many vets tend to use an "aggressive" method with 2.5 mg twice daily, while more conservative methods advise on 1.25 mg twice daily.
Five to six weeks later you will have to re-test your cat's thyroid levels. If the dosage was correct, the levels will be within the lab range, if they're not, the dosage had to be adjusted to new levels, then again five to six weeks later you'll re-test your cat.
Of course, kidney, liver and other levels will be tested to qualify your cat as a good candidate.
Before being treated with I-131 at a facility, you will be asked to discontinue the methimazole for a week.

I just ordered a large cat condo off Chewy. I am going to need a place for Kay to live 24/7 to access her to medicate and take to the vet; and she will not be happy. She cried for 24 hrs. in the small holding cage before her vet appt. Thursday. I have condo neighbors that must have heard it. Appreciate your insight. Thank you.

As I wrote above, because it will take months before your cat might be deemed as a good candidate for radio-iodine, I doubt you will be able to keep your Kay into that cat condo. It's not a matter of days, it's a matter of months. Are you sure you want to have your Kay live in an enclosed space for such a long time?

 

[cocoanlace]

I don't want to answer for FeebysOwner and I'm sure she will give you her reason(s) for not choosing the I-131 treatment.

Even though our cat had a successful outcome the I-131 is not a "one size fits all" treatment. That is, there are numerous reasons besides expense why people don't choose this method. Just to name a few: their cat has a pre-existing condition that would cause a contraindication, their cat is too old in some cases or after having the series of tests one month prior to receiving I-131 they are not a good candidate for it, etc.

You're wise to do your homework and read about I-131 but there are some other more professional and knowledgeable sites than Reddit which you mentioned. I thought you might be interested in these:
Hyperthyroidism in Cats
Penn Vet | Feline Hyperthyroidism

Thanks! I had read that some cats are not great candidates but based on Kay's recent wellness checkup which included everything except a fecal, I am thinking she'd do OK. I did read an article on the Cornell University of Medicine website, but it had old info. (I go to Reddit when I want more personal experiences from cat owners. Plus, it came up first in my search.)

 

[cocoanlace]

[QUOTE="Antonio65, post: 5806673, member: 118356
Are you sure you want to have your Kay live in an enclosed space for such a long time?
[/QUOTE]
Thanks for explaining how the initial process works. My mind is beginning to grasp it all. Yes, I do want to use the condo initially to make certain that Kay gets her required doses. If it turns out that I can make a "treat sandwich" with the Felimazole that she will readily eat without vomiting it up, she will not need to be confined daily. I am 76 with bad knees. She runs upstairs to the loft to hide. I cannot chase her twice a day. She can be fractious and will try to bite me. (Her sister Rochana bit and scratched me in 2022 when I was trying to trim nails that were growing into one foot pad. I got 8 stitches at ER that day.) I am making the confinement decision to save her life. Compromises must be made.

 

[cocoanlace]

QUESTION: Wanted to get started on drugs ASAP to get Kay stabilized. Vet's office said they need to arrange for compounding the medication and then it gets mailed to me. Never heard of such a thing. I have had transdermal Gabapentin compounded at a pharmacy before on my own, but I really expected the vet's office to have Felimazole on hand for dispersing like other common treatments. BTW, lady on phone said their patients are on Methimazole; she was not aware of a difference or aware of the term "Felimazole." I stressed I needed the one for cats. ??

 

[cocoanlace]

It was plain ignorance and the reluctance to put her through the isolation. Pure and simple.

I totally get that. It is overwhelming. I recall a friend doing this and how she needed to keep her cat isolated from her other cats, wear gloves, etc. and it sounded daunting. (We are no longer pals so I could not ask her about her experiences.)

 

[FeebysOwner]

I suppose some vets only carry methimazole in their office, but Felimazole is not a med that needs to be compounded. Chewy.com carries it as is, of course after they receive a prescription from your vet, which can be done online and fairly fast. .Compounding is done with most any med when the dosage needs to be different than what the standard pills come in or to mask the taste of a med. I am not sure what to tell you other than to try to get more specifics on why the vet says it has to be compounded, and what they mean by that. Do you know what dosage the vet is recommending?

 

[cocoanlace]

I suppose some vets only carry methimazole in their office, but Felimazole is not a med that needs to be compounded. Chewy.com carries it as is, of course after they receive a prescription from your vet, which can be done online and fairly fast. .Compounding is done with most any med when the dosage needs to be different than what the standard pills come in or to mask the taste of a med. I am not sure what to tell you other than to try to get more specifics on why the vet says it has to be compounded, and what they mean by that. Do you know what dosage the vet is recommending?

Hi, thanks. Just got off the phone with a Chewy.com pharmacist. Says Felimazole is the brand name and Meth is the generic they use for whatever reason (cost?). Said the ingredients are the SAME. Said Felimazole comes in 2.5 and the Meth comes in 5mg. So sounds like I will be asking for 2.5 initially. Pharmacist said, "compounding is how we get different strengths of the drug should we not carry the mg the vet prescribes." Added I could get compounded flavored liquid or even compounded flavored chews for cats. No, I do not know what mg the vet will prescribe until she calls back, but I will push for the lowest dose to start with for a 15 year old, 7.3 pound cat with a T4 of just 5.2. Make sense?

 

[FeebysOwner]

Makes total sense to me!! Felimazole is a coated, rounded pill, so it can make it a tad bit harder to crush, but I do it for Feeby. Since she is on a lower dose (1.875mg AM/1.25mg PM), there is no way I could deal with methimazole.

 

[cocoanlace]

UPDATE: Kay's vet office has not called back. In the meantime, I decided to get the facts from the horse's mouth (the I131 hospital in Tustin, CA which is way south of me).
1. I do not need to stabilize Kay with ANY treatment at all (food, drugs, etc.) before I131.
2. The director, Dr. Michael Broome, consults with me with Kay in his office and does a Scintigraphy to confirm hyperthyroidism diagnosis and needed dose.
3. I pay $400 now to order the isotope used for the scan ahead of time. After payment, I can make the appointment.
4. Current cost for the entire shebang is currently $2475 with 4 night minimum stay (longer stay is $125 more each night).
5. A satellite office slightly closer to me exists where I can drop off Kay before and after. (They would meet me there-no extra cost.)
I do hope this information is valuable to others as it certainly differs from what I have "learned" over the past 72 hours.
Hugs to All!!
(So no real need for that deluxe condo that arrives today. )

 

[FeebysOwner]

Very interesting! I have never heard of most of what you were told, but then again, every vet can be different, so who knows. If I were you, though, I'd call around to other locations and see what they say, just for some points of reference. You can also take a look at this site for their opinion. The vet behind this sits is considered well respected and a very reliable source.
Animal Endocrine Clinic | Where science and compassion cure

 

[cocoanlace]

Very interesting! I have never heard of most of what you were told, but then again, every vet can be different, so who knows. If I were you, though, I'd call around to other locations and see what they say, just for some points of reference. You can also take a look at this site for their opinion. The vet behind this sits is considered well respected and a very reliable source.
Animal Endocrine Clinic | Where science and compassion cure

I have decided not to overthink this. Dr. Broome has great reviews. My vet Dr. Clark mentioned, last Thursday, that this is where he would refer me to. I booked the appt in the satellite office, closer to me, for next Wednesday at 10:00. Already paid the $400 and filled out the health/history questionnaire. Kay's medical records have been requested. If for some reason, Kay does not have HT or has cancer, etc. I am only out the $400 cost for the scan (and I think that scan is ultimately a necessary part of her diagnosis going forward anyway...to SEE what is in there causing the blood-tinged vomit so often). I'm good. Thanks again.

 

[fionasmom]

The plot thickens. Here is Dr. Michael Broome who appears to have been as associate of Dr. Peterson and was on his staff.

Dr. Michael R. Broome | Animal Endocrine Clinic

 

[cocoanlace]

The plot thickens. Here is Dr. Michael Broome who appears to have been as associate of Dr. Peterson and was on his staff.

Dr. Michael R. Broome | Animal Endocrine Clinic

You scared me! I thought there would be some horrible story.

 

[fionasmom]

Actually, if I had found something awful, I would not have posted it that way. He sounds very qualified and I am taking the page that I found as an endorsement from Dr. Peterson.

Let us know how this all goes. Someday I might be making the drive to Tustin or their satellite office myself with some cat in the future who needs treatment.

 

[cocoanlace]

Another question about I131 aftercare. I have read the articles that the Tustin office sent me. I can't find anything that addresses my specific concern. Kay has been peeing on puppy pads/towels next to the litter boxes for 2 years. Tests have never shown a UTI, but she did get broad spectrum antibiotics "just in case" twice. New vet said last week it is most likely behavioral. So what do I do about the peed-on towels while she in quarantine after the treatment? I am thinking that if I don't place a comfort towel or small bed inside the recovery condo, she may just pee on the floor, making it more difficult to clean up. (She HAS peed on the kitchen floor in a corner several times so a towel is not a requirement for her.) Can I wash the "radioactive" towel in my laundry solo?
Thanks!
And while I am thinking about this, how do I protect myself in the car on the hour drive home with her in her carrier? Is a KN-95 mask sufficient??

 

[Antonio65]

I'm Italian and live in Italy. There are non radio-iodine facilities here, so when my cat had to be treated for HT, I had to take her abroad, and among many places available in the rest of Europe, I chose Belgium.
It was a 12 hours drive both ways.
On the way back, my cat was in the carrier on the passenger seat.
At home she would stay with me, next to me, on my lap. I totally disregarded the safety directions the facility gave to me when they discharged my cat four days later.
The only thing that I observed was to dispose of the litter in a dedicated bin away from home and that the waste wouldn't be collected for at least three months.
You could do just the same with the puppy pads, you put them away for a while before letting the waste collection take them away.

A KN-95 mask is for dust and droplets not for radiations which have the ability to travel and go through materials.

 

[fionasmom]

Safety Precautions Following I-131 Therapy – Centers for the Treatment of Feline Hyperthyroidism
https://www.mspca.org/wp-content/uploads/2015/08/i-131-handout-for-clients-1-2-14.pdf
Read pg 3/4 generally in this article

I don't know if these articles answer anything for you or not. Having said that, your questions are very logical and for the money you are paying and the fact that you are providing gold standard treatment for your cat, it seems that the facility in Tustin should be happy to discuss those with you for a few minutes.

I have never done this procedure, so am not speaking from experience. One article mentions that local trash companies scan for radioactive materials which have been disposed of, so the time limit that is given is very important. I assume that means for pee pads as well.

I have a older cat rescued from an alley who only uses pee pads. She never saw litter in her life, so you are not the only one who has a cat who does this.

 

[cocoanlace]

Update: Kay was admitted yesterday, June 12. I drove her to the satellite office in Los Angeles for a 10 a.m. appt. which was still a 1.5 hour drive through heavy traffic for me. I was asked to bring enough food for 7 days (originally, they said they had just about "every cat food" available so not to worry because it was included in the cost) but Monday, Renee called saying it would be impossible for them to assure there were no seafood/fish ingredients in their food (they are unable to read labels?) so I complied. Kay had her scintigraphy scan that same day, and Dr. Broome phoned me that evening (I believed to discuss her results, but I was mistaken). I asked when I could know/see the results of the scan. I am very interested in how many/how large the thyroid tumor(s) are as it directly relates to the dosage required and, consequently, the duration of her stay. He said that will be provided at the very end when a report is emailed to the regular vet and me. (I prepaid $400 for the scan tape; I expected info now.) I liked Dr. Broome. He is thorough and patient. And has aged since his online photo was taken. But so have I. All of my online photos (here, Google, FB, YouTube channel) are false advertising! Oh, and this morning's email said that the doctor decided my Kay would benefit from being in a larger enclosure/run so unfortunately, I will NOT be receiving a link to the icam so I can SEE her over the next several days. Boo! Watching your cat on the webcam is a special feature. She is a small cat. I think they do not have enough cameras. You can't tell but I am pouting. (Well perhaps you can.) One other thing we discussed here: Her peed-on towels can be laundered TWICE. Any paper pee pads need to be secured and stored 90 days so I will not be using them. Ditto paper towels used for pee cleanup. (Vomit cleanup can be trashed immediately.) Dr. Broome said that during my drive home with Kay, she can be in the back seat and I will be safe from exposure.