Cooper’s Hyperthyroidism Story – Treatment

 

Last week I shared with you Cooper’s Hyperthyroidism Story – Diagnosis. As I had mentioned, hyperthyroidism is a serious disease for cats, but there are treatment options and even a cure. This week I will go over each treatment option. I will provide the basics of what each treatment entails along with the pros and cons of each. Finally, I will share the choice we made for Cooper.

Before I go any further, I want to emphasize that I am not a veterinary healthcare professional. Your pet’s health should always be directed to your pet’s veterinarian. The health and care of Cooper and the choices made are always thoroughly discussed with Cooper’s doctor.

Treatments for Hyperthyroidism:

There are three treatment options for cats with hyperthyroidism. Medication, surgery and radioactive iodine treatment. Depending on the health and condition of your cat(s), your veterinarian will go over the options that are specifically best for your cat(s). One way or another, treatment is a must and a management plan should be set in place quickly.

Below are the three treatment options along with their advantages and disadvantages. I obtained the chart below from peteducation.com which provides a basic layout of the advantages and disadvantages of each treatment option. The first treatment mentioned, Methimazole, is the most common form of medication given to cats with hyperthyroidism.

 

Comparison of Treatments for Hyperthyroidism in Cats
Treatment	Advantages	Disadvantages
Methimazole	Medication readily available Inexpensive in short-term No anesthesia or surgery No hospitalization or special facilities required Treatment is reversible, if needed Development of hypothyroidism very rare Preferred in cats with kidney failure or other serious disease Used prior to radiation or surgery to stabilize cat	Not a cure; the adenoma will continue to grow Lifelong therapy necessary Medication may need to be given more than once daily May be difficult to give medication Medication occasionally has side effects some cats cannot tolerate Periodic blood work required
Surgery	Cures the condition unless all of the abnormal tissue is not removed Approximately the same cost as several years of methimazole Short hospitalization No need for daily medication	Requires anesthesia Cat must be a good surgical candidate Post-operative complications can occur to parathyroid gland or nerves in the area Could rarely cause hypothyroidism Not possible if thyroid tissue is located within the chest May need to be repeated
Radioactive Iodine Treatment	No anesthesia, sedation, or surgery All abnormal tissue is treated No need for daily medication Does not destroy healthy tissue or other organs Normal thyroid function returns within a month Preferred if malignancy present, or thyroid tissue located within the chest	Availability limited Most expensive alternative: over $1,000 Specialized facility required Hospitalization and quarantine required Treating other diseases during initial days following treatment is not possible In rare cases may need to be repeated Could rarely cause hypothyroidism

 

Cooper’s Story:

The day Cooper’s doctor called me with the diagnosis of hyperthyroidism, the three treatment options were discussed in detail. Fortunately, Cooper qualified for all three. However, surgery was not recommended to be the top choice. Surgery would require sedation and post-operative recovery. So, we scratched surgery off of the list.  We were left with the option of medication for life or radioactive iodine treatment. Ultimately, we chose radioactive iodine treatment for Cooper

Why Did We Choose Radioactive Iodine Treatment Over Lifelong Medication?

When I was first told that radioactive iodine therapy was an option for treating hyperthyroidism in cats, I was not familiar with it at all. Cooper’s doctor answered all of my 100 questions, and the process made more sense as the right choice for Cooper. I was happy to learn that radioactive iodine treatment has been a method of successful treatment for cats for years long before Cooper was even born. Radioactive iodine therapy is successful around 95% of the time to cure the disease and destroy the thyroid tumors. There have been no proven harmful side effects that come with radioactive iodine treatment. The only precautions we were faced with was Cooper had a slight risk of developing hypothyroidism, and an additional round of radioactive iodine may be required, if the first dose did not work completely. However, these risks were small. If we chose to keep Cooper on medication, the medication would not cure the disease, and the thyroid tumors could continue to grow, making treatment more difficult. With those factors in mind, the decision  was easy. We wanted to cure Cooper of hyperthyroidism.

Cost:

Radioactive iodine treatment has an expensive upfront cost, but it does not require continuous costs. The cost can fluctuate from facility to facility, but expect to pay over $1,000. However, if we had opted to give Cooper medication for life, we would be spending more money in the long run due to the cost of medication and the necessary and frequent lab work to make sure the dosage of medication is keeping the thyroids at a healthy level along with monitoring other blood levels. In comparison, radioactive iodine treatment was more cost-effective than the cost of lifelong medication.

Preparing for Radioactive Iodine Treatment:

Getting Cooper or any cat prepared for radioactive iodine treatment does not happen overnight. Cooper’s thyroid levels needed to be stabilized, so he was put on medication immediately. Medication is standard to treat cats preparing for radioactive iodine treatment. Cooper is not an easy kitty to administer pills. Fortunately, the medication could be compounded into a cream which was rubbed on the inside of his ear (not down the ear, but rubbed on the inside of the ear on the area with no hair). During that time, we had to find a treatment facility nearby. These treatment facilities specialize in radioactive iodine treatment, and they have a limited amount of space. So, there was a waiting period. During that waiting period, Cooper’s thyroid levels were regularly checked by the vet. We even had to increase dosage during this time because the thyroid levels were not coming down enough. The treatment facility gave Cooper’s doctor a list of what they required prior to Cooper’s appointment. All requirements were met and the tests showed Cooper was ready to receive radioactive iodine treatment.

The Radioactive Iodine Treatment Process:

Cooper’s appointment was on a Monday morning at Radiocat. The clinic was a two and half hour drive for us. He would stay at the facility for 5 days, so we would not get to see Cooper until Friday. That was the hardest part for me, but Cooper was going to get a roomy and comfortable place to be fed and treated very well during his stay. I, nor anyone, was allowed to stay or visit the cats that have received radioactive iodine during the 5 days. Only the doctors and staff were going to monitor Cooper and the other cats being treated. Once we arrived, we met with the technician that would be taking care of Cooper for the week. We provided all of the food Cooper would be eating for the week. We were also allowed to bring one item from home so Cooper could have a familiar smell with him. That item cannot be returned due to the exposure of radiation, and it is disposed of by the clinic according to proper regulations. Once we went over Cooper’s feeding schedule, the technician walked us through the procedure. Cooper would be receiving an injection of radioactive iodine that is measured specific to his body the morning we dropped him off. We would get a call from the technician advising that the injection was made and how Cooper was doing. We would also get daily phone calls from the technician letting us know how Cooper was doing. So, we left Cooper in the care of Radiocat for 5 days. I did receive daily phone calls from the technician. She provided us with the amount of food and water Cooper consumed that day. She gave me updates on Cooper’s temperament and activities each day. Any questions I had were answered. As hard as it was to leave Cooper, I could not have asked for better care and I knew Cooper was in great hands. Five days seemed like five weeks, but Friday finally arrived, and we drove two and half hours back to pick up Cooper. We were pleased to know that Cooper’s thyroid levels were normal and the radiation level was safe enough to release him to come home! We were ecstatic! Success!

After Radioactive Iodine Treatment:

Although Cooper’s treatment was successful, there are guidelines that we had to follow for 2 weeks once we got home. His litter had to be disposed of in a specific manner. Limited contact with Cooper was advised. The reason for the guidelines is due to the radiation that still remains with the cats for a short time after the treatment. We received all of these guidelines in writing, and they were a small sacrifice in the grand scheme of it all. Cooper was home and no longer had hyperthyroidism. Cooper’s doctor did monitor his thyroid levels to make sure they remained normal. Cooper’s thyroids were stable, and to this day he remains hyperthyroidism free!

Fortunately, Cooper’s hyperthyroidism diagnosis was caught in time and the treatment cured the disease. Next week, I will conclude Cooper’s hyperthyroidism story by sharing with you the experiences that others have discussed with me on their cat’s hyperthyroidism experience.

 

A Special Thanks to Riverview Animal Clinic and Radiocat (Marietta, GA).