My Cat Has Hyperthyroid.. Maybe? + Questions About I-131

[Sylvashia]

My 14yr old boy Pepper has been getting increasingly vocal/restless for a couple years. Anytime I took him to a vet they said he seemed great and didn't recommend any blood work or anything. (Now I feel dumb for not thinking hey maybe I shouldn't just trust a physical exam with nothing else). So on recommendation from this forum I got his blood work done.

My vet said his thyroid level was a 4.1 when the normal is 1-4. She also said something in his liver was elevated and the combination of the two results is what makes her think its hyperthyroid, along with his increased vocalizing.

Now I guess my concern is that it didn't sound 100% and he doesn't show much in other symptoms but she still has him starting Methimaloze. He acts hungry a lot but he is a slow eater. Usually leaving and returning to his dinner several times over the night, unlike the other cats that scarf it down immediately. He seems to drink normal, his coat is very nice, he lost weight but only a couple pounds over the past 2ish years (and I did change him to a healthier diet and stopped free feeding as much food as before in that time). He does vomit quite frequently which all vets have just been like "hm weird idk seems fine tho. heres some hairball stuff even tho he doesnt have hairballs". So I'm just scared hes possibly on this medication but may not even need it.

She told me about the 2 treatments, meds or I131, but she kept saying I131 was usually a good option for younger cats. So I told her I would try pills. Now doing my own research I see a lot of negative experience with the pill and only good experience with the I131. I also see people with older cats do get I131 quite often while she made it sound very rare.

I'm just not sure what to do now, he took his first pill this morning (hes currently just on 2.5mg once a day) and the vet wants me to come back in a month just for blood work. It worries me that he had no other test though to definitively say yes he does have this instead of 'it looks like he has this'.

I was also wondering if anyone had more info about the post I131 care. If in a month she say his levels are still up and wants him on more meds I think I would rather get him the cure option because it sounds like pill cats don't live very long. But hearing about my cat being radioactive for weeks also sounds kind of scary and complicated. I have another young cat around, will it effect her if he gets that treatment? What kind of rules do you actually have to follow post I131? How long have your cats lived past the treatment? Does anyone have a positive experience on Methimazole? I plan on researching more myself, but I really like hearing personal experiences too.

 

[FeebysOwner]

Hi. I do not have any direct experience with this, but I know I have read a lot of posts on this site from members who do. Sometimes, it just takes a while for members to get time to log on and read through posts - so just be patient while you wait to hear from them.

In the meantime, maybe this article (below) will help tell you some of the things you are wondering about. I don't know why the title shows up to be something other than about hyperthyroidism, but trust me when you click on the link below the contents are not what the title says!

Old English Sheepdog | Appearance & Grooming

 

[LTS3]

Here's info on I 131 treatment and post-procedure cautions:

Centers for the Treatment of Feline Hyperthyroidism
I-131 Therapy • MSPCA-Angell
https://www.mspca.org/wp-content/uploads/2015/08/i-131-handout-for-clients-1-2-14.pdf
Iodine-131 Therapy for Feline Hyperthyroidism
Feline Hyperthyroidism

I-131 treatment is considered the best treatment followed by methimazole and then diet (Hills Y/D). Methimazole can be compounded for easier giving. Any compounding pharmacy can do this. Wedgewood Pharmacy is a popular one and has these options available: Methimazole Medication & Information for Animals, Wedgewood Pet RX, Wedgewood Pet RX

 

[kittyluv387]

Antonio65 has some personal experience with this. Hoping he can give you some first hand input.

I have looked into hyperthyroidism since it's so common and one day my cats will get old and might get this. Please get a scintigraphy first. This will determine how much radioactive iodine he needs. This is important so that he doesn't get too much and end up with hypothyroidism. And yes you should definitely opt for this over the pills. The pills are NOT a cure and if left untreated it is fatal. The disease will continue to progress slower, but will still progress. It sounds like you caught it early which is fantastic. If you let it go on for too long on the pill the disease will do permanent damage to his organs. From my understanding your cat will have to be boarded for some days while he receives the treatment. Once he gets home you're supposed to limit physical contact for a little longer. If any of my cats get this disease I will immediately be putting them on this treatment. But remember to get the scintigraphy for accurate dosage first.

 

[Antonio65]

Yes, I did have an experience with this disease, my cat was treated with the pills for 10 months before I could get access to the radio iodine treatment.

My cat had an apathetic hyperthyroidism, with no apparent symptoms.

It is true, the cat can be slightly radioactive for a short period of time after the treatment, but the level of radioactivity should be low enough to allow the kitty to live along with its humans without much hassle. It might be a different matter if other pets are in the house, but I am sure that the facility that will perform the treatment will also give you the best advice about this issue.
I was told to keep my cat away from me for a couple of weeks after the treatment, but I disregarded this tip.

kittyluv387 has already given you all the info you need, including the scintigraphy to be done beforehand.

What I would like to suggest you is to have your Pepper tested again with a full blood panel (liver and kidney levels are important) and both T4 and fT4 thyroid levels tested, remember, both levels, this is very important. This is useful to understand if Pepper is really hyperthyroid.
If he is, I would also suggest you to lower the dosage of methimazole from 2.5 to 1.25 mg.
That medicine can give irreversible damages to liver and kidneys, even worse than the disease itself. It is way better to start with a low dosage and than increase it, than the other way round.

My cat was 16 yo and had a slight kidney disease when she was treated, so the young age isn't the first thing to be taken into consideration. Even because a young cat is rarely affected by the hyperthyroidism.

 

[fionasmom]

I had a cat, elderly when dxed with hyperthyroidism, on the pills for three years. She was dxed at 13 or so and lived to almost 17. She was a little hard to pill but took them with either certain foods or a pill gun. I can understand anyone who opts for the I 131 and maybe I would do it now for current cats. At the time the vet presented it as an option that is rarely used or needed. Having said that, I would run every test, geriatric blood panel, thyroid etc so that you have the big picture and then you can make a decision. I am not trying to spend your money, but it does sound like your vet might have glossed over some points or just based it on what she has "seen" frequently in her practice.

 

[Sylvashia]

An update on Pepper.

I gave him his first 3 day of pills and it was a nightmare. I've pilled other cats that have struggled but he has been the hardest. Spit flails, spits it out, he had his jaw locked at one point. My hands are cut and he's traumatized after. He wont come near me for a while. He wouldn't eat it in food.

So I called his vet to see what we can do. I told her I was interested in the I-131 treatment, so she told me we could stop pills and in a month go back and do a more extensive blood test to make sure he is in fact HT.

 

[Antonio65]

Keep in mind that if pilling is hard and stressful for both of you, you can use eargel, much easier to dose and with less side effects than pills.

 

[Sylvashia]

Keep in mind that if pilling is hard and stressful for both of you, you can use eargel, much easier to dose and with less side effects than pills.

Thank you. I'll keep that in mind in case he has to go back onto the medicine.