Radio iodine treatment - nervous cat

[MidwinterMary]

Hi everyone

First post here, hoping that someone will have experience of radio iodine treatment for cats (especially in the UK). My sweet, sassy girl is booked in to have the treatment at the Wetherby Hyperthyroid Cat Centre next week, and - no exaggeration, we're worried almost witless! She can't tolerate the medication treatment though, so there's no other sensible option.

My main concern is that, although she's bossy and quite dominant at home, she's been an indoor cat all her life and tends to be nervous and withdrawn in unfamiliar places: I don't think this is something we've done to her - when we first brought her home, she hid under a bed for the first 3 or 4 days, while her sister was marching about the house exploring straight away! On her first outing, she crept onto my chest and slept for an hour before going back under ... kitten days

Fast forward, and she's a young 14 years old so we feel like we have to swallow our terror and make the 5 hour journey to Wetherby (they're the centre that currently has the shortest stay. Potentially). But, on past experience, she could literally be too paralysed with fear to eat, drink or use the litter tray. Hopefully that won't happen ... neither cat is a fan of Feliway, but the vet at HCC has suggested Gabapentin, which sounds like quite heavy medication.

If anyone has any recent, or not so recent experience with this Centre, or nervous cats having this treatment generally, I'd love to hear.

C

 

[neely]

First, welcome to TCS! Second, although I'm not in the UK we recently went through with the I-131 radioactive iodine treatment in the states for our 12 year old cat. We started treating him with Methimazole in the transdermal gel form which I rubbed into his ears. However, since the vet and radiologist determined he was an excellent candidate for the I-131 we saved up and eventually scheduled it. Another important note to mention is that the facility we chose for the I-131 does Scintigraphy prior to injecting the radioactive iodine which is very importnant so you may want to ask about this procedure if it has not already been mentioned. There are other members who have also gone this route and there are many threads about it if you would like to do a search on the site. I will list a few threads at the end of my post.

I can tell you that we were worried sick about our guy, Carleton, just like you. He had to stay at the facility for five days but the staff was wonderful and very caring. They kept me updated on everything from his appetite, litter habits to mood. They also reassured me to call whenever I wanted. I knew it would seem like weeks that he was there but told myself once it was over I would look back and be thankful since the treatment has a 96-98% success rate. I'm sure the staff at Wetherby has explained the follow up when your girl comes home. It is important to adhere to their instructions both for you and your cat. Our boy goes in for his six month T-4 test this week per protocol and I'm crossing all my fingers his levels remain in the normal range.

Here are some thread about Hyperthyroidism and the I-131 treatment that I thought might be helpful for you. If you have any other questions please do not hesitate to ask, that's what we're her for. BTW, what's your sassy girl's name? Best of luck!

My cat's hyperthyroidism is successfully treated with a low-iodine diet.
Please share your Methimazole experience..
Hyperthyroid cat,methimazole and I131 treatment

 

[WMM201]

To chime in with what neely said, my cat had the radioiodine treatment too, and she did very well in the hospital. The vet there called daily with updates and I also was told to call if I have any concerns. I did a lot of reading on this site and others before getting the treatments for my cat (same reason as you, she wouldn't tolerate the ear gel), and I never saw anyone say that their cat refused to eat or eliminate or traumatic stress reactions while in the facility. Of course the cats were thrilled to come home (while following safety guidelines--PLEASE FOLLOW) but the hospitalization wasn't an issue that I saw from people whose cats actually went through the process. I hope this gives some reassurance, and good luck with your cat!!

 

[MidwinterMary]

First, welcome to TCS! Second, although I'm not in the UK we recently went through with the I-131 radioactive iodine treatment in the states for our 12 year old cat. We started treating him with Methimazole in the transdermal gel form which I rubbed into his ears. However, since the vet and radiologist determined he was an excellent candidate for the I-131 we saved up and eventually scheduled it. Another important note to mention is that the facility we chose for the I-131 does Scintigraphy prior to injecting the radioactive iodine which is very importnant so you may want to ask about this procedure if it has not already been mentioned. There are other members who have also gone this route and there are many threads about it if you would like to do a search on the site. I will list a few threads at the end of my post.

I can tell you that we were worried sick about our guy, Carleton, just like you. He had to stay at the facility for five days but the staff was wonderful and very caring. They kept me updated on everything from his appetite, litter habits to mood. They also reassured me to call whenever I wanted. I knew it would seem like weeks that he was there but told myself once it was over I would look back and be thankful since the treatment has a 96-98% success rate. I'm sure the staff at Wetherby has explained the follow up when your girl comes home. It is important to adhere to their instructions both for you and your cat. Our boy goes in for his six month T-4 test this week per protocol and I'm crossing all my fingers his levels remain in the normal range.

Here are some thread about Hyperthyroidism and the I-131 treatment that I thought might be helpful for you. If you have any other questions please do not hesitate to ask, that's what we're her for. BTW, what's your sassy girl's name? Best of luck!

My cat's hyperthyroidism is successfully treated with a low-iodine diet.
Please share your Methimazole experience..
Hyperthyroid cat,methimazole and I131 treatment

Hi Neely, thanks for that lovely reply. I think there's no way around the worry and this really is the only solution for Chessie, our girl. We're all set with accommodation for her when she comes home, so that's less of a worry than how she might cope, or what might happen, while she's in hospital.

In the UK, I believe scintigraphy is usually only used prior to surgery, to locate ectopic thyroid tissue. Since the radio iodine should it all, vets here don't normally offer that for cats undergoing I-131 treatment - or at least, that wasn't mentioned by any of the centres I called. As Chess needs treatment without delay, we've gone with the centre that came up with an appointment first - not my first choice, but they are only one in the UK that potentially discharges them in under 10 days.

 

[MidwinterMary]

To chime in with what neely said, my cat had the radioiodine treatment too, and she did very well in the hospital. The vet there called daily with updates and I also was told to call if I have any concerns. I did a lot of reading on this site and others before getting the treatments for my cat (same reason as you, she wouldn't tolerate the ear gel), and I never saw anyone say that their cat refused to eat or eliminate or traumatic stress reactions while in the facility. Of course the cats were thrilled to come home (while following safety guidelines--PLEASE FOLLOW) but the hospitalization wasn't an issue that I saw from people whose cats actually went through the process. I hope this gives some reassurance, and good luck with your cat!!

Thanks M I HOPE she'll be OK but going on past experience of her personality and how she's been on the occasionally day hospitalisation at our own vet, I suspect she might just freeze in a corner. Hopefully there's something they can do if that happens - even though they are at pains to say they can't intervene after the treatment, due to risk of exposure to staff.

 

[WMM201]

Thanks M I HOPE she'll be OK but going on past experience of her personality and how she's been on the occasionally day hospitalisation at our own vet, I suspect she might just freeze in a corner. Hopefully there's something they can do if that happens - even though they are at pains to say they can't intervene after the treatment, due to risk of exposure to staff.

M MidwinterMary I hope so, too. Let me tell you a "secret". When I picked my cat up from the hospital, the special radiology technician told me about how my cat allowed and enjoyed petting, even though many cats don't let people pet them. So, at least in that one facility and that one technician, the zero intervention rule has a little leeway for comfort. All places and handlers are different, though. But all the best to your girl, who will be very brave I am sure.

 

[MidwinterMary]

M MidwinterMary I hope so, too. Let me tell you a "secret". When I picked my cat up from the hospital, the special radiology technician told me about how my cat allowed and enjoyed petting, even though many cats don't let people pet them. So, at least in that one facility and that one technician, the zero intervention rule has a little leeway for comfort. All places and handlers are different, though. But all the best to your girl, who will be very brave I am sure.

That's hugely comforting and I had begun to suspect as much, from talking to various staff at the centres. One vet told me (in the context of giving medication) that while they need to be seen to comply with regulations and can't tell clients anything that would lead to them being less than careful once back home, they do "bend the rules" a bit. Good if they can, because I think touch is going to be one of the best ways of getting through to this little one, if she's scared. Meanwhile, pinning everything on the promise of a quick"home" date!

 

[neely]

In the UK, I believe scintigraphy is usually only used prior to surgery, to locate ectopic thyroid tissue. Since the radio iodine should it all, vets here don't normally offer that for cats undergoing I-131 treatment - or at least, that wasn't mentioned by any of the centres I called.

Yes, it sounds like the Scintigraphy is handled differently in the UK than here. The reason they do it here is to determine the exact amount of radioactive iodine to inject since they don't give all cats the same amount. They also use Scintigraphy to determine if there is more than one tumor on the thyroid as well as the size of the tumor and if the cat would need to have the thyroid removed instead.

We were assigned a specific vet tech when our cat was admitted and she was responsible for Carleton's care. She called regularly with updates and from what she told us it fit his personality so we knew she was conscientious and doted on him. I'm sure they will do the same for Chessie and although she doesn't understand she will be thankful you helped her to feel better. How soon is she scheduled for the I-131 treatment? Best of luck and please let us know how it goes.

 

[MidwinterMary]

Yes, it sounds like the Scintigraphy is handled differently in the UK than here. The reason they do it here is to determine the exact amount of radioactive iodine to inject since they don't give all cats the same amount. They also use Scintigraphy to determine if there is more than one tumor on the thyroid as well as the size of the tumor and if the cat would need to have the thyroid removed instead.

We were assigned a specific vet tech when our cat was admitted and she was responsible for Carleton's care. She called regularly with updates and from what she told us it fit his personality so we knew she was conscientious and doted on him. I'm sure they will do the same for Chessie and although she doesn't understand she will be thankful you helped her to feel better. How soon is she scheduled for the I-131 treatment? Best of luck and please let us know how it goes.

It's interesting, isn't it, how things are done differently? Chess had her pre-treatment tests today (blood tests, blood pressure and a urine sample), and I asked the vet about scintigraphy, in the context of radio iodine. His response was that, here, aside from being used to reveal ectopic tissue prior to surgery, it's mainly used to help identify the small minority of cats who might have a malignant thyroid growth, and so wouldn't benefit from treatment - or at least, not at the normal doses used for benign tumors. I think another major reason is that it's not available outside of a handful of veterinary colleges, so the dose is more often calculated on weight and thyroid hormone levels.

In an ideal world, I'd have every possible test done, but as she can't tolerate the medication and has been quite poorly, we've opted for the centre that could help her soonest. They are the biggest centre in the UK - despite that, I do feel that their approach seems quite basic in some ways, compared to some other places. But their view seems to be that, if the cat needs treatment for hyperthyroidism, the condition is dangerous and almost regardless of what other tests might discover, there aren't too many findings that would change the potential benefits of treating the thyroid problem.

So, her admission appointment is next Wednesday. This is great because there are currently long wait lists for the treatment at UK centres and they pushed her up the queue because she's not on medication. It doesn't help my anxiety that she came home traumatised by her day-long hospitalisation today, and hadn't eaten, drunk or used the litter tray while there. According to the staff - who are lovely with her - she'd spent the whole day hiding under her blanket. I'm still wondering how this will play out over 5 or more days, but I guess she won't be the first nervous cat they've treated, so hopefully they'll have some ideas.

I'm expecting the centre to update me at least daily - or I will be calling them! They've been very understanding so far, and she can take her own bed, a toy or two, her own food dishes and is even being allowed her familiar cat litter as a special concession. Obviously none of this can come home afterwards, but that's fine ...

 

[WMM201]

I am glad Chess can have her treatment sooner rather than later. Hopefully they can use her blood tests to provide a good dosage range for her T4 level, even if scintigraphy isn't offered. It's nice that Chess can have some home comforts with her, too. I bet that will make a difference vs today, plus she will have time to settle in. (By the way, I left my cat a soft sleeping pad fully expecting it to be thrown out, and it came right back with her in her carrier! I tossed it out myself after we got home!) What's important is that the staff treated her nicely, which it sounds like they did. I hope Chess will cheer up soon after today's ordeal. At least now that they have done all the poking and prodding, it will just be a simple dosing next week and then off to her hotel room. Please keep us posted and fingers crossed for an uneventful treatment and stay!

 

[neely]

So, her admission appointment is next Wednesday.

Wishing you the best of luck on Chessie's upcoming I-131 treatment. I hope she does well and will rest comfortably when she gets home. Fingers and paws crossed for you. Please keep us updated.

 

[MidwinterMary]

Wishing you the best of luck on Chessie's upcoming I-131 treatment. I hope she does well and will rest comfortably when she gets home. Fingers and paws crossed for you. Please keep us updated.

THANK YOU! Yes, we will let you know how it goes

 

[Antonio65]

My cat had an I-131 treatment in August 2017, in Belgium, not the UK.
I'm from Italy and there are no facilities of this kind over here, so the only option for us is to trave abroad. The UK was one of my first choices, but then I found out that Belgium had a much less expensive option and, moreover, they didn't need a referral, which my vets didn't want to do.

My cats was very nervous, she didn't trust anyone but me (and sometimes she wouldn't trust me either), and I was so afraid she would have been very much stressed out during the five days she had to stay at the center. I left a whole 24-pack of wet food with her when I took her in, with the recommendation to give her two cans a day.
Well, she stayed there 5 days, but she didn't eat her lunch on the first day, and she didn't eat on the second day, but they only returned 11 cans to me. So I thought she was very hungry during her stay, though I thought it was unusual for her to be hungry when she was out of home. As a matter of fact, she lost a pound of weight.

The trip to the Belgium facility was 12 hours long, we stopped along the way for a night, and we stayed in another hotel the night prior her hospitalization. Well, I can tell you that she only used the litter twice Saturday to Monday, she didn't want to eat, drink or sleep, no matter how I tried to make her feeling safe.

Anyway, I was happy she was successful treated at the facility, and this success was worth the "little sacrifice" for her to stay among strange people.

 

[Antonio65]

make the 5 hour journey to Wetherby (they're the centre that currently has the shortest stay. Potentially).

I checked the HT cats centre's website, and among the several pages, there's one about "how to prevent HT" and it says
-Avoid bottled or demineralised water.
They advise in favor of filtered tap water.

I only give my cats bottled water, which is what many cat owners do over here, and we all use the same brand, which seems to be the best for infants and so it should be for cats.
I wonder why tap water should be better than bottled water.

The water I use is bottled at the spring, at nearly 2,000 (6,500 ft) of altitude, so I think it's potentially free of pollutants. The label reads:

I don't know how a good tap water could be better than this one.