FELINE HYPERTHYROID TREATMENT

A Note From Dr. Coker ~

I am Dr. Coker and I am passionate about cats and cat care. Although I took a few detours to get here, a feline only practice was always that little voice pushing me on and I opened The Cat Doctor in 2007. My mission has always been to improve the health and welfare of cats by practicing good feline medicine standards of practice, education, and doing my best by them.

Feline hyperthyroidism has always been a thorn in my side as the only options I had to offer were pills or surgery. Pilling a cat is not something either of you look forward to, and surgery is well surgery with all the associated risks. I would offer referral to Dallas or Baton Rouge for radio-iodine treatment and was usually given the excuse, it’s too far or just plain inconvenient.

Another thorn, is methimazole which doesn’t cure the disease, but only ‘controls’ the signs. The tumor keeps stimulating the thyroid and as practitioners we see the kidney damage, heart problems and wasting away that occurs treated and un-treated. This disease is curable with radioactive iodine (I-131), but this protocol requires special boarding, specific training, equipment, and certifications.

I was tired of watching cats not do well on medication because they responded poorly to methimazole in any form or are impossible to treat daily. To alleviate the morbidity and frustration of this disease, hours of research, paperwork, radiation safety and training classes, and a remodel, The Cat Doctor received a Radio-active Materials License in 2016.

The Cat Doctor – Hyperthyroid Center is excited to invite you to refer your hyperthyroid patients to ‘cure’ this disease. This is the first Radio-Iodine Therapy Center in the area and makes treatment more accessible for many hyperthyroid patients in the Ark-La-Tex. We offer double wide condos for a comfortable stay with windows and bird TV. Accommodations for weekend admitting and discharge are available.

I hope this is the option you choose for your cat because it is the best option. Radio-Iodine is safe and effective with no physical side effects.

“NO MORE PILLS!”

See for yourself how Radio-iodine compares to Medication!

What to Expect with Radio-Iodine Therapy

Radioactive iodine (radioiodine or 1-131) has been used to treat hyperthyroidism in people for over 50 years. The first reported use of radioiodine in hyperthyroid cats was in 1980 (Peterson ME et al, Scientific Proceedings of the American College of Veterinary Internal Medicine, p 124, 1980). Radioiodine therapy is a safe and effective choice for treating hyperthyroidism in most cats. However, cats that have other serious disorders, such as renal failure (kidney disease) and/or advanced heart disease, are not good candidates for radioiodine therapy.

Treatment does not generally cause any adverse side effects from the radioiodine as the delivery of radiation is targeted to the overactive thyroid gland. The radioiodine treatment consists of an injection under the skin, usually on the day of admission to the unit. Since each cat's metabolism is slightly different, the length of stay may vary and is determined by the remaining radioactivity in your cat’s thyroid gland. State and City law requires that a cat remain hospitalized until the radioactivity has dropped to a very low level. This usually takes 1 to 3 days.

Once your cat has been treated, he or she need do nothing else but sleep, eat, and play while the radiation within the body dissipates to safe levels. During the hospitalization, your cat will stay in a comfortable Kitty condo equipped with a separate "bathroom" compartment and shelves for snoozing. Litter is changed regularly, and fresh food and water are always available. We like to "spoil" all our patients as much as safely permissible. During hospitalization, we provide favorite foods, diversions, and lots of "hands-on" care, brushing, and affection. Please be sure to let us know if your cat has any special feeding requirements so that we can make the stay as comfortable as possible.

We expect that over 95% of the hyperthyroid cats treated with radioiodine will become normal (euthyroid) within 1-3 months of therapy (Peterson ME, et al. Radioiodine treatment of 524 cats with hyperthyroidism. Journal of the American Veterinary Medical Association 207: 1422-1428, 1995). Less than 5% will become hypothyroid (too little hormone made) and may require oral thyroid hormone replacement therapy. Less than 5% of treated cats will remain somewhat hyperthyroid after their initial treatment dose. Cats with persistent hyperthyroidism can be re-treated 3-6 months after initial therapy.

What to know

• If your cat is receiving the oral anti-thyroid medication, Felimazole or Methimazole, these medications should be discontinued at least 5-7 days prior to therapy with radioiodine. 
• Hill’s Y/D diet should be discontinued at least 2 weeks prior.
• If other medications are being given, we will make every effort to administer those during your cat's hospitalization.
• There are no restrictions on food or water for treatment day. Your cat can eat and drink normally prior to admission. You may bring food, treats, and a few personal items to be given to your cat while in the therapy center. These cannot be returned because of radiation safety regulations. We reserve the right to limit the amount of material which can be left for a pet.
   
• You cannot visit your pet during therapy, nor can pets be removed from the ward until officially released. You cannot terminate therapy or arrange for early release once therapy has begun. Pets may not be boarded/hospitalized elsewhere until they meet the requirements for release.
   
• Your cat will be housed with us for 1-3 days. Louisiana mandates that your cat must be held for 5 days if there are any pregnant women or children under 12 in the household. Our condo units are spacious, comfortable, climate-controlled, and complete with videos for your cat to enjoy. Unfortunately, there is no visitation during your cat’s stay because of state and federal mandated safety regulations. You will receive an email or call daily with an update on how your cat is doing.
   
• When the level of Radioiodine being emitted from the pet is below the level the State and the Nuclear Regulatory Commission mandates and it is appropriate, the owner is contacted, and an appointment is made to discharge the pet. Arrangements can also be made for clients who wish to have their cat stay with us longer. This extra precaution attests to our commitment to assure the therapy is conducted in a manner that is most beneficial to the patient, safest for the owner, and reflects favorably on the referring veterinarian.
   
• After being released from therapy, your cat will still possess a very low level of radioactivity, which is voided primarily through urine and feces. You do not need to isolate your cat totally from people or pets, but you must follow certain safety precautions and collect the urine and feces for a specified time. Because of the natural decay of radioactivity and the continual loss of radioiodine through the urine and stool, your cat will have no detectable level of radioactivity a few weeks after discharge. When the patient is released from the facility, you will be given Radio-Iodine safety information and instructions on how to manage your cat's waste.
   
• This one-time treatment is sufficient to normalize thyroid function in 98% of cases. However, if in the rare case, that sequential thyroid function assessments indicate persistent hyperthyroidism or recurrence of the hyperactive state, then another course of I-131 may need to be scheduled if deemed appropriate.

The fee for radioactive iodine (I-131) therapy is $990.00. This includes consultation before and after treatment, the admission and discharge office calls, initial physical examination, radioactive iodine dose and administration, monitoring, and radioactive waste disposal during stay.

Payment is due upon admission to the I-131 Unit. We accept cash, personal checks, VISA, MasterCard, Discover, and American Express. For clients interested in payment plans, we do accept Care Credit. More information about this option is available at www.carecredit.com.

PATIENT REFERRAL FORM