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Hyperthyroid Persian Cat

Jora

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Hi Everyone,
My Persian Baby Boy (12 years) was diagnosed with Hyperthyroidism back in Dec. Based on Vet's recommendation, we started him on a low dose of Methimazol (0.15), and after a month and a half, it increased his liver values (normal before, more than doubled after the medication). The Vet said to stop it immediately, and try the Radioiodine route.
Hubby suggested we try the wholistic route first since our boy is so sensitive. We took him him to a $$ wholistic Vet, who is 45 minutes away from our home. After spending a lot of money, and many herbal/wholistic supplements later, we got the results back from his blood work, and not only his thyroid levels have not improved, but both his thyroid and liver levels are elevated. We are beside ourselves and not sure what to do. Wanted to reach out to this community to see if anyone has had a similar experience, what route they chose, and if it was to reach out to this community to see if anyone has had a similar experience, what route they chose, and if it was effective.
We also read up on Radioiodine Therapy, and I'm more than frightened. Although I've read many positive posts, I read a couple that were very negative. One indicated that if the dose is not 100% accurate - it can cause Hypothyroid or Kidney issues. AND that it can be deadly. I'm really beside myself and not sure what to do. I want my baby to be healthy and happy, and with me for the next several years. He is my life, and I can't bare to be without him.
Thank you in advance for any info. you can provide. BTW: We reside in Northern CA. if that helps with suggestions.
 

silkenpaw

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It’s true that the dose of I131 (radioactive iodine) is not an exact quantity, it’s an estimate based on the degree of hyperthyroidism. There are rare cases where the cat has to be re-treated.

It’s also true that the cat may become hypothyroid after I131 but that is easily treated with thyroid hormone, which does not have any of the side effects of methimazole.

I’ve never heard of a deadly reaction to I131. What exactly was the reaction you read about and how common is it?

If I had a delicate cat, my first choice would be I131, as it’s the most physiological treatment for hypothyroidism. The cat may have to stay at the facility overnight, depending on local regulations, and you are supposed to do something special with the litter (I can’t remember what). Then you are advised to keep the cat isolated from other animals for a period of time.

My Surfeit also had his liver enzymes go up after methimazole and we had to stop it for a while before his I131 treatment. He did great. The greatest problem was how lonely he was in his isolation room, so we let him out of there early after consulting with some radio-physicist friends. I’ve never heard of a human being hospitalized or isolated after I131 treatment and their dose is much larger.
 
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Jora

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Silkenpaw - Thank you for responding. I'm sitting here crying because I feel I have no recourse for my Love Bug. He has always been one of the sweetest love bug, and that is why having him be in this state is hurting me more.

There was an individual on this site who spoke about this treatment. He/She indicated that although this treatment can be effective, that it's imperative to get the kidney levels checked prior to the procedure with Medication Trial, so that the T-4 levels come down and then test for kidney. He/She indicated that if the kidney is not well, then it can be fatal to the cat.

I was so happy to hear about all the positives this procedure has, until I read a couple of very scary posts, and now I feel hopeless.
 

molly92

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Hi, so sorry you're having difficulties.

The risk of hypothyroidism is possible with radioiodine, but not common, and even then, it is very treatable, and much more manageable than hyperthyroidism.

The kidney concern is real but a bit misleading. Cats do not develop kidney disease from radioiodine treatment, but rather, if they had kidney disease before, it is only observable after the treatment because hyperthyroidism "masks" the signs. Hyperthyroidism makes everything go fast. Heart rate goes fast, calories are used fast, and urine is pumped through the kidneys fast (which is why kidneys don't seem like they're failing at first). And as the overactive thyroid grows, which it always does, everything goes faster and faster and spirals out of control. This puts a huge strain on every system in the body, burning through energy and losing weight to try to keep up. Kidney disease, on the other hand, is a single system failure. Yes, it can be debilitating, but it is not always a death sentence. It can be managed for many years sometimes, although admittedly it is unpredictable. That said, if a cat "develops" kidney disease after radioiodine treatment, the cat certainly had the kidney damage before, it just wasn't noticeable. And hyperthyroidism will destroy the body faster than failing kidneys will.

And the kidney disease is only a maybe, whereas hyperthyroidism is for sure. My then 16 year old cat went through this a year ago. Her kidney numbers were borderline enough that we were concerned that kidney disease would become prominent after radioiodine treatment, but for me it was an easy choice. Now, she's completely cured of hyperthyroidism, and we keep watching for signs of CKD and nothing has changed. She still appears to be healthy and doesn't have CKD symptoms. We're very cautious with medications and vaccines, and she eats all wet food, but so far so good. Meanwhile she obviously feels so much better now that her thyroid's in check. She didn't go into the hypothyroid range, even though I think the hospital way overdosed her (she's only 5 pounds and her thyroid was not large enough to be palpable). If you do it, which I think you should, try your best to make sure the clinic does scintigraphy based dosing, and that will ensure the risk of incorrect dosing to be very negligible.

Radioiodine is very safe because only one thing in the body absorbs iodine, and that's the thyroid. Nothing else is affected, and the diseased thyroid tumor is so intense that it sucks up all the radioiodine, leaving nothing for the healthy thyroid, which is why it's so often successful even with a high dosage. It's an amazing technique, and it delivers a complete cure, which is so rare in veterinary medicine. I really recommend it. To be blunt, hyperthyroidism will only get worse and if untreated, cats will die from it. So you don't have a lot of options, but you do not need to be so scared of this one.
 

silkenpaw

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Did the scary posts come from veterinarians? I doubt it. They probably came from people with no credentials. Who are you going to believe? Who knows what else was going on with their cats when they got the I131? Who knows whether their cats even got I131 or whether they are just relating second- or third-hand experience? Why would you believe them rather than trusting your vet?

Please discuss it with your vet or with the vet who will be giving the I131. They have the most experience and education and they don’t want anything bad to happen to your cat. Why would they recommend a procedure they don’t have confidence in? If you don’t trust your vet, it’s time to find another one, whose judgement you do trust.

No honest person is going to tell you that any medication or procedure is without complications. But nothing in life is without complications and the risk of untreated hyperthyroidism is much, much greater than the minute risk of the treatment.

Yes, it’s ideal to have any kidney insufficiency under control before you treat with I131, but that is done while the cat is being treated with tapazole and you no longer have that option, since he didn’t do well on tapazole. Sometimes you have to make the best of a less-than-ideal situation.

Your cat is lucky to have such a caring human, so please don’t let your fear of complications compromise his treatment.
 
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Jora

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Molly and Silken - Thank you both for your responses.
The first Vet recommended the Radioiodine treatment in April, AFTER she had prescribed the Methimazol, and it didn't agree with our love bug - increasing his liver values.
She said that our kitty is really sensitive to medication, and that since the very low dose she'd prescribed (0.15 ml Twice a day, after a meal), was still too much, that we should seek the other alternative.
Hubby and I were scared to death of taking him for Radioiodine treatment, because he is such a sensitive love bug...so Hubby did some research and suggested we go down the holistic route. Which, as indicated in my initial post, only masked the disease (less vomiting, less agitated, etc.), but had actually increased his levels by a LOT.
We just found this out late yesterday.
The info. I got about the scary stuff was actually on this site (on the hyperthyroidism thread, there was a link of another persons story about this).
I apologize if I miscommunicated in my previous thread. The individual had indicated that the kidney levels have to be monitored and ensured to make sure that they are OK, as if they are not, then the Radioiodine treatment can be deadly.
I just made a call into RadioCat (we are located in Northern California) to talk to them.
I'm really scared and thinking we should have just done this back in April, in lieu of waiting to go down the holistic route (what if we wasted valuable time).
I'm beside myself, and want to do whatever we can to help our baby. We are a one income household, but I rather pay credit card interest than risk my baby's life.
 
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Jora

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Silken - I forgot to add, that I hate to admit that unfortunately I do not trust any of the vets.
We have taken our baby to two different ones, just this year, and another one last year. Although they all seem very loving and caring, it seems that ultimately they just are more concerned about $$$ they can get out of a vulnerable pet parent.
i.e. the Dr., who prescribed the Methimazol, exam fee was $95.00.
They charged us $180 JUST for the exam, and then told us that it's $95.00 per 30 minutes, and since we were in there for 40 minutes, they had to charge us that amount.
1. We were never told fee was based on time
2. No other patients have ever been told about this time based fee (I know many of their clients, most of which said that their visit was close to an hour and they only paid the one fixed fee).
3. The reason the visit was 40 minutes is because the Dr. was in late (but counted from the time the appointment was to start), and she spent many minutes petting our love bug.

This is just ONE example of why we have trust issues with Vets. :( :(
 

silkenpaw

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I can understand how you have issues with vets. I fired a vet who did that to me.

It’s very important to find a vet you like and trust and who’s willing to spend time to address your concerns without charging you by the minute. My vet sometimes runs late but I never mind it because I know that when my turn comes, he will spend all the time he needs with me and my animals.

You can’t possibly know everything about various diseases that might affect your cat. You need the help of a veterinarian to keep him healthy. So need to find a vet you trust to do the best for your cat.
 

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Holistic stuff is often great to help the body help itself as optimally as it can. But, it really should be used to augment conventional medicine, not in place of it, because of situations like hyperthyroidism where more direct intervention is needed. That said, please try not to beat yourself up about not picking the "right" option sooner! I don't think there's a single pet owner who doesn't wish they could get several do-overs when it comes to their animal's health, because we're all constantly learning as we go.

Also, from what cases I've heard about/been told by vets, hyperthyroid symptoms disappear after treatment in pretty much all cured patients, so I don't think it's likely that your kitty is going to have that much irreparable damage. That'd be a good question for the vet.

Dealing with vets you don't trust is frustrating, but you can manage it and get the best treatment. They DO have expertise that you need, even if you have to sometimes ask the right questions and insist on something that goes against their recommendation occasionally (which you should only do if you've thoroughly researched the topic!)

For radioiodine treatment, especially because you don't know how large the tumor is at this point, I strongly recommend finding out if the clinic using scintigraphy-based dosing methods. Radiocat's website doesn't mention that in their treatment plan, so that makes me wary, but ask if they can do it for you. Be persistent and get a response from the actual vet if it seems like the front desk person doesn't know what you're talking about. If you get resistance, arm yourself with information from Dr. Mark Peterson: Hypurrcat | Animal Endocrine Clinic. He's pretty much the leading expert on this in the country, and he has info on how to do the dosing if the clinic doesn't know.

Some clinics don't look into this stuff because their stats are already pretty good because radioiodine is so low risk, but his methods go further to minimize risks and increase chances of success even further.

If they won't budge on the scintigraphy, consider looking somewhere else. I did a quick search, and they are not cheap, but it looks like UC Davis does the scintigraphy: Hyperthyroidism in Cats | School of Veterinary Medicine. There's one in Oregon that doesn't do scintigraphy, but does try to tailor the dose with other methods. Not the most accurate method, but way more accurate than not tailoring at all, and they are cheaper: Feline Thyroid Clinic - FAQ. This Las Vegas hospital does not include a lot of details, but you could call and ask: Feline Radioactive Thyroid (I-131) Treatment
 

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I have been treated with radioactive iodine. No visible side effects over 35 years post treatment. My thyroid is normal. My doctor warned me at the time, to not to fly for three days post treatment because the residual radioactivity would be detected by airport security devices. He offered me a letter verifying my treatment if I had to fly.
 
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Jora

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Silken - Yes, you are correct. We would never try to diagnose our baby ourselves. We have always taken our pets (past and present) to the vet if we felt it was necessary, but always hated doing so. Used to be that veterinarians went into the business because of their love for animals. Now, in CA anyway, seems like they are in it solely for the $$. Unfortunate but true. We have gone to the most recommended ones, and they are all the same. Unfortunately. Our baby has been to three vets in the past 2 years, and they have all been about the $$$.

Graceful - I read your and Felix's story last night. I was very very tired, but read almost every post you had on there. It gave me 'some' hope, in the midst of my tears of hopelessness last night. Right after yours, I read a very scary one (wish I hadn't) about how this guy had to search to find a place that actually did the R.I. therapy correctly. Needless to say I woke up this morning very very depressed!

Molly - Thank you. Thank you. I LOVE YOU. Thank you for looking up the different places.
My husband and I spoke to the 'coordinator' (a very very cold and mean lady, but unfortunately the only first point of contact) at Radiocat earlier today. Based on the info. I had read (on this site), I asked her about their dosing method, and specifically brought up scintigraphy-based dosing. She said that although some placed do it, they based their dosing on blood tests, and chest x-rays. I didn't want to push her on this, because she was REALLY short and mean in demeanor, and since she has the capability of pushing our date further out (right now is set for October, with call back if there is any cancellation), so I had to try really hard not to tell her how inappropriate her 'tone' is.
We locked in a date with her ONLY because this was the first place we contacted, and I need to do more research and don't want to go further and further down the appointment list.
Davis is out, because I'd read that when you schedule the procedure at any school, then you have the students who are performing the Radioiodine therapy, and I don't want to risk that. As well, it is over 2 hours from where we live and our love bug has trouble breathing properly in car rides.
We live in Santa Clara (Northern CA), and there is one other place in Santa Cruz, CA. However, they haven't returned my message, and when I had my sister - who lives there - stop by today to ask...the front desk people weren't even aware they do this procedure.
Do you know how I can find out if there is another place close to us where does that particular dosing testing you (and others) recommend?
As well, thank you for telling me to not beat myself down...but I do it everyday. I keep thinking that it was my wrong choices that has brought him to this point (wrong foods, wrong timing, not making the move quicker, etc.), and I'm afraid to make anymore mistakes. I honestly envy people who care nothing about their pets, and treat them like a temporary amusement in their life.

Archy, I wasn't aware that humans go through the same Radioactive iodine therapy as cats do, until I read up on it last night. Glad to hear that you are 35 years free and going strong. :)
 

molly92

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My husband and I spoke to the 'coordinator' (a very very cold and mean lady, but unfortunately the only first point of contact) at Radiocat earlier today. Based on the info. I had read (on this site), I asked her about their dosing method, and specifically brought up scintigraphy-based dosing. She said that although some placed do it, they based their dosing on blood tests, and chest x-rays. I didn't want to push her on this, because she was REALLY short and mean in demeanor, and since she has the capability of pushing our date further out (right now is set for October, with call back if there is any cancellation), so I had to try really hard not to tell her how inappropriate her 'tone' is.
We locked in a date with her ONLY because this was the first place we contacted, and I need to do more research and don't want to go further and further down the appointment list.
Oh dear, that is bringing back flashbacks to my experience! So difficult to get someone to answer my questions unfortunately! (Hopefully you won't call a week ahead and find that no one actually booked your appointment when they said they did which is what happened to me...)

I did go to a university hospital (I'll name names, it was Michigan State and I was not enthused!), and honestly, having a student perform the procedure was the least of my worries, because it's something that would be pretty difficult to screw up, and if they did, the biggest mistake they could make would be something like slipping and injecting themselves with radioactive iodine. It's just an injection, not a super specialized skill like surgery. Way more risky for the humans than the cat! And I found the new student (his first day on this rotation) was much more willing to listen to me than his resident supervisor who'd done this a million times and was dismissive...until I pulled out a stack of journal articles and starting citing studies that she hadn't read. (I'm sure she hates me but it was worth it.) (Oh, if anyone wants any papers that are behind a paywall by the way, let me know because I have access to most journals through my job!)

I just starting looking at places on this list: List of Facilities - Mar Vista Animal Medical Center. Not sure how well maintained it is, so it's worth asking around for others. Maybe make a separate post asking for recommendations for Northern California. I didn't realize you can't make a long drive, that will be limiting unfortunately (poor kitty!).

X-rays were all that MSU wanted too. I didn't get my scintigraphy scan at the end of the day, although I think I could have pushed harder, and I think I would have chosen somewhere else if I were to do it again. But it did work out just fine in the end, and like I said, the success rate is very good even when they don't do the individualized dosing because of the nature of the procedure. So give it a try, and at some point you may need to make concessions because circumstances aren't ideal, but do make sure the vet knows you're worried about dosage because it has been so long and you don't want to end up with a hypothyroid kitty and you also don't want to have to do this again. They should be able to work with you at least somewhat or explain why they're not concerned. If you're stuck with Radiocat, I would call again at some point and request someone call you back when they have time because you have some concerns about the procedure that you want to address before you arrive. Don't try to get a straight answer out of reception, just ask them to relay your message. At least, that's how I think I should have done it when I was getting that kind of resistance.

Good luck! Sorry I may be projecting a bit reliving my own experience and wishing I could do things differently, be more assertive, etc, so take my advice with a grain of salt. You're doing great!
 
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Jora

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Hi Molly,
Unfortunately I've been down with one of my worst migraines for the past two days (brought on because of all my worries and concerns over my love bug), and just getting a bit better - enough be get on this site.

Thank you for your information/suggestions/every thing you said. You are not projecting at all. I'm SO INCREDIBLY grateful that you are giving me all the info.
I really appreciate you giving me details of your experience.

I think had I been you, going to a University, and having the student being on his first day of rotation, would have been enough for me to have a heart attack. Although you are right that the new student resident is most likely more focused and attentive than a long time supervisor, I think I'd still be very frightened for them to perform the procedure - regardless of how basic it may have been. :)
The lady said she is calling us back with more questions, after getting our baby's records from the two different Dr.'s, and then sending us all the necessary info. I'm giving her until end of Monday. If I don't hear back, I will call her first thing on Tuesday.

There is another place, located 45 minutes from our house, located in Santa Cruz CA. They apparently also do the Radioiodine treatment. I did leave them a message on Thursday, and someone called back yesterday with a message to call them with my email address so they can send me detailed information. Unfortunately I was in my migraine comma, and haven't been able to give them a call back.

What stack of journals are you referring to? Are they the ones from that Dr. (I forget his name) who has done extensive studies on this matter?
I'm curious, where you able to actually go in on the day of the procedure? I ask only because you knew who would be performing it, and all the other details.
I'm even more worried now, because during my 'migraine fog' I logged on my emails long enough to read the holistic Dr.'s response to my concerns about our baby's lab work.
The previous Dr. had prescribed Methimazol for our baby because of him being hyperthyroid. Although the dosage was very small, not only it had not corrected this hyperthyroid, but it also raised his liver values.
After the Dr. suggested we stop Methimazol, we took him to the holistic Dr. and after about 2-3 months of holistic medicine, did another round of blood work, and our baby's thyroid and liver values are even higher. When I got really upset and sent a very stern email to the holistic Dr. about this issues, she responded yesterday saying that our love bug's liver values should have come down after we stopped giving him the Methimazol that the first Dr. had prescribed, and the fact that it has gone up higher, might mean that our baby has a liver disease. She did say that it could also be due to his hyperthyroidism. Regardless, that email was enough to SHOOT my migraine levels to skyrocket, and I became bend bound shortly after.

Thank you again for all your responses. I'm truly grateful for anything I can get here.
 
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