Radioiodine pre-treatment testing protocol?

david68

TCS Member
Thread starter
Adult Cat
Joined
Oct 15, 2014
Messages
204
Purraise
153
I'd decided to go ahead with radioiodine treatment for my 15 year-old cat, Liza, and the only local facility around here says she needs to have her thyroid levels checked after being off methimazole for 14 days to determine dosage. I cleared doing this thoroughly with her regular vet. She's now been off methimazole for 10 days, and her condition has started to decline sharply. She's hiding. She's barely eating, and she obviously feels bad. She has gone from 8.7 to 8.2 pounds. I do have an appointment with my regular vet first thing tomorrow morning (soonest I could get after the 4th), but I was looking around at other pre-treatment protocols. Cornell's site said that a cat would have to be off methimazole for 7-10 days, not 14. I did speak to my vet today, and she said to call the radioiodine program to ask if 14 days was absolutely necessary. But the radioiodine treatment hospital was still closed for the 4th today, so I couldn't reach them.

I'm just wondering what kind of pre-treatment testing protocol others have been required to perform. I feel horrible that I'm making her feel so bad.
 
  • Thread Starter Thread Starter
  • #3

david68

TCS Member
Thread starter
Adult Cat
Joined
Oct 15, 2014
Messages
204
Purraise
153
Call your vet back.
And say what? I told my vet every detail in this post, and I have an appointment at 7:45am tomorrow morning.

I did get her to eat a decent amount tonight. It took pan-fried Alaska salmon. I'm going to make sure she keeps it down, then feed her some more small meals of it.
 

neely

May the purr be with you
Veteran
Joined
Dec 22, 2005
Messages
19,853
Purraise
48,341
I'm just wondering what kind of pre-treatment testing protocol others have been required to perform. I feel horrible that I'm making her feel so bad.
I'm so sorry Liza is having difficulty since being off Methimazole. 🤗 Our boy was off it for 14 days before receiving the I-131 injection. He also had a complete blood panel including T-4, urine analysis and two chest x-ray views. Everything had to be reviewed and cleared by the radiologist.
 

CoffeyCats

TCS Member
Kitten
Joined
May 20, 2021
Messages
14
Purraise
30
Cole had to be off methimazole for 10 days before his pretreatment labs. His t4 tripled but otherwise no real changes. Slightly agitated and some stinky farts otherwise status quo.
 

Attachments

  • Thread Starter Thread Starter
  • #6

david68

TCS Member
Thread starter
Adult Cat
Joined
Oct 15, 2014
Messages
204
Purraise
153
Update: My cat Liza has bounced back from her health crash going off methimazole. She gets it transdermally, and I've split the dose up to give it to her every six hours every day to make sure blood levels stay consistent. I have alarms programmed into my phone to remind me. She's regained 0.5 of the 0.7 pounds she lost. (She only weighs 8.7 normally.) I gave her fluids a couple of times, and I'm feeding her Nutri-Cal in addition to her food.

The i131 clinic did accept her test (T4 was 19!), so she is scheduled for treatment. They warned me she might have to stay there for more than 5 days due to the dose level necessary.

One takeaway from all this is that if you are going to do radioiodine treatment for hyperthyroidism, do it SOONER rather than later. My vet didn't make clear to me when we started treating her with methimazole that as the condition slowly worsened, taking her off medication for pre-treatment testing (which I didn't know would be necessary) would get more dangerous. I now wish I had done this two years ago instead of waiting until it became difficult to control it with medication.
 

fionasmom

Moderator
Staff Member
Moderator
Joined
Jun 21, 2014
Messages
13,460
Purraise
17,746
Location
Los Angeles
Thank you for the update. Having been told about the i131 treatment previously would have helped; when Fiona as diagnosed years ago, the treatment was not widely used and I was not informed about it either. Please let us know how Liza does.
 

neely

May the purr be with you
Veteran
Joined
Dec 22, 2005
Messages
19,853
Purraise
48,341
The i131 clinic did accept her test (T4 was 19!), so she is scheduled for treatment. They warned me she might have to stay there for more than 5 days due to the dose level necessary. One takeaway from all this is that if you are going to do radioiodine treatment for hyperthyroidism, do it SOONER rather than later.
The important thing is that you have her scheduled for the I-131 treatment now. I never thought I'd make it through the 5-day wait for our guy, Carleton, to come home but looking back it went quickly. Although not quite as long as you waited we also used the transdermal Methimazole and our vet was the one who convinced us not to procrastinate. He had bloodwork done two weeks ago at his senior exam and I'm happy to say his T-4 was 2.5.

Thanks for the update and best of luck to Liza. :crossfingers:
 
Last edited:
  • Thread Starter Thread Starter
  • #9

david68

TCS Member
Thread starter
Adult Cat
Joined
Oct 15, 2014
Messages
204
Purraise
153
I never thought I'd make it through the 5-day wait for our guy, Carleton, to come home but looking back it went quickly.
I think the longest we've been separated in 15 years was when she got out through a broken window screen and disappeared for 48 hours. I'm definitely going to leave her there with a t-shirt I've worn, but not washed. I know they'll have to throw it away, but that's OK.
 

neely

May the purr be with you
Veteran
Joined
Dec 22, 2005
Messages
19,853
Purraise
48,341
I think the longest we've been separated in 15 years was when she got out through a broken window screen and disappeared for 48 hours. I'm definitely going to leave her there with a t-shirt I've worn, but not washed. I know they'll have to throw it away, but that's OK.
Believe me, I understand what you're going through and can completely relate. My husband and I are so attached to Carleton that we talked about him constantly in the five days he was at the specialty hospital. :lovecat2: One thing that helped immensely was the staff who were his surrogate companions, checked on him regularly, called with numerous updates and told us to call as often as we pleased. I hope this helps and you have the same experience for Liza.
 
  • Thread Starter Thread Starter
  • #11

david68

TCS Member
Thread starter
Adult Cat
Joined
Oct 15, 2014
Messages
204
Purraise
153
Update on Liza: Liza is now on her 9th day in isolation at the facility where they do the radioiodine treatment. They are waiting for her iodine-131 levels to come down enough to release her. She had to get a high dose because her T4 levels were so high. At least it's just a flat fee for the procedure.

Just for anyone reading this, if radioiodine treatment is an option for you, DON'T WAIT LIKE I DID. Do it ASAP. The longer you wait, the more stressful it will be for you and your cat. I'm kind of angry with my local vet that they didn't explain that clearly to me.
 

neely

May the purr be with you
Veteran
Joined
Dec 22, 2005
Messages
19,853
Purraise
48,341
Just for anyone reading this, if radioiodine treatment is an option for you, DON'T WAIT LIKE I DID. Do it ASAP. The longer you wait, the more stressful it will be for you and your cat. I'm kind of angry with my local vet that they didn't explain that clearly to me.
We waited too but only nine months. Fortunately our cat's T-4 levels are under control thanks to the I-131. You can't look back but hopefully Liza will get through the procedure and have the same results. I don't know if your vet is a feline only specialist but if not you may want to consider consulting with one. Thanks for the update and please continue to keep us posted.
 
Top