10/27/23 - Kaz - RE: Diabetes and radioactive iodine therapy or surgery for Thyroid

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Claire and Kaz

Claire and Kaz

Member Since 2022
@Suzanne & Darcy
@Bron and Sheba (GA)
@FrostD

Hoping that someone on this site may have opted to go with iodine therapy or surgery to treat their cats thyroid condition. Kaz is 16 years old and it appears that he is now getting hyperthyroidism.
It appears from research that the medications interfere with insulin.
The surgery is expensive and Kaz is on the older side so I wanted to see if anyone else had done this and what the outcome was. Just seems that Diabetes and Thyroid issues don't mix well and I want to help him if I can but don't want him with unnecessary risk at his age.


"....Hyperthyroidism is associated with insulin resistance. However, hyperthyroidism also reduces BMI, which may increase insulin sensitivity...."

Thanks
 
I don't remember the names, but I know there have been several cats here with hyperthyroid and diabetes. If you can't afford the surgery, go with the medication. As long as you're testing enough, you'll be able to adjust the insulin (either up or down) to keep Kaz safe.

Hopefully some of the members who have dealt with both will be online and able to answer more of your concerns.
 
Chris & China (GA) said:
I don't remember the names, but I know there have been several cats here with hyperthyroid and diabetes. If you can't afford the surgery, go with the medication. As long as you're testing enough, you'll be able to adjust the insulin (either up or down) to keep Kaz safe.

Hopefully some of the members who have dealt with both will be online and able to answer more of your concerns.
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Thanks Chris - hoping for the surgery have just requested more info from Angel so see what I get.
 
Melissa, who you originally tagged above, hasn’t been on for a little while I think, but Mr. Kitty had been diagnosed with hyperT, I don’t recall what route she ended up taking. @Sue and Luci is another member, also not as active, but sometimes comes around. She provided input to Melissa in this post. She tried the methimazole in the beginning with Luci and ended up doing the iodine treatment, which I believe worked out well.

https://www.felinediabetes.com/FDMB/threads/3-25-mr-kitty-hypert-dx.261173/#post-2929970
 
Christie & Maverick said:
Melissa, who you originally tagged above, hasn’t been on for a little while I think, but Mr. Kitty had been diagnosed with hyperT, I don’t recall what route she ended up taking. @Sue and Luci is another member, also not as active, but sometimes comes around. She provided input to Melissa in this post. She tried the methimazole in the beginning with Luci and ended up doing the iodine treatment, which I believe worked out well.

https://www.felinediabetes.com/FDMB/threads/3-25-mr-kitty-hypert-dx.261173/#post-2929970
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Thanks Christie. The news just continues to get worse for Kaz. He beat cancer then became diabetic and now Thyroid and just had another call from the vet that another lab came back showing he has early onset kidney disease and probably should not have the iodine surgery because this.
Poor sod can't catch a break. I will follow the link and read the other post thanks for sending it over.
 
One of my diabetics developed Hyperthyroidism at age 12, four years after being diagnosed with diabetes. We started with oral tapazole and he became very ill with nausea, vomiting and inappetance. Then we tried the transdermal form which wasn't any better and just added severe facial itching and swelling to his misery. It really is a nasty, toxic drug that can have some pretty bad side effects and these reactions are not uncommon. I don't recall the medication having any effect on his insulin dose. Radioiodine treatment cured him and he lived to be 19.

Radioiodine is given as a single injection, no anesthesia required. Though there is a surgical procedure to remove the thyroid gland, it's tricky and must be done by a skilled surgeon and is no longer recommended.

You mention Angell ... are you in Mass.? If so, we ended up going to CAVES in Concord NH. They couldn't test blood sugar because he was radioactive but did give insulin. I liked that they are a 24 hour emergency hospital and had cameras so I could check on him anytime. He was there for 3 days.

My only regret is that I wasted months worrying about possible kidney issues while he was so miserable. The veterinarian who administered the i131 wasn't concerned about doing a trial on oral meds. As long as the kidneys are in relatively good shape, he recommended going ahead with i131 because both Hyper-T and the drugs used to treat it are so hard on other organs, particularly the heart and kidneys, and is fatal if not treated. If another cat were to develop it, I'd go straight to i131.
 
Deborah & Muffy(GA) & Wendall said:
One of my diabetics developed Hyperthyroidism at age 12, four years after being diagnosed with diabetes. We started with oral tapazole and he became very ill with nausea, vomiting and inappetance. Then we tried the transdermal form which wasn't any better and just added severe facial itching and swelling to his misery. It really is a nasty, toxic drug that can have some pretty bad side effects and these reactions are not uncommon. I don't recall the medication having any effect on his insulin dose. Radioiodine treatment cured him and he lived to be 19.

Radioiodine is given as a single injection, no anesthesia required. Though there is a surgical procedure to remove the thyroid gland, it's tricky and must be done by a skilled surgeon and is no longer recommended.

You mention Angell ... are you in Mass.? If so, we ended up going to CAVES in Concord NH. They couldn't test blood sugar because he was radioactive but did give insulin. I liked that they are a 24 hour emergency hospital and had cameras so I could check on him anytime. He was there for 3 days.

My only regret is that I wasted months worrying about possible kidney issues while he was so miserable. The veterinarian who administered the i131 wasn't concerned about doing a trial on oral meds. As long as the kidneys are in relatively good shape, he recommended going ahead with i131 because both Hyper-T and the drugs used to treat it are so hard on other organs, particularly the heart and kidneys, and is fatal if not treated. If another cat were to develop it, I'd go straight to i131.
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Thanks Deborah
Yes I am in MA with a Dr Brum who is great I really like him. He at the end of the day will do what ever I want. I am actually going to try Pet Wellbeing first as Kaz had fantastic results with this during the cancer episode. I am then going to retest in 3-4 weeks and have a consult with the people that administer the iodine treatment/surgery and find out if there is a chance that he may be a good candidate. I have already decided to treat him if he is allowed as its a permanent fix and he doesn't need more sickness piled on top of what he already has.
Just want to confirm that its not going to kill him. Dr Brum is worried about the kidney issue prior to that he was all for me having the treatment with a week in the hospital.
Guess going to have to play the waiting game for a month to see.
 
Sienne and Gabby (GA) said:
FWIW, my sister was in Boston and Dr. Brum was her vet. One of the members here highly recommended him. Angell has a great reputation and my sister thought very highly of Dr. Brum.
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Dr Brum is fantastic I show him the spreadsheet every time I go in and he says he's in total awe of what we all do on the forum to monitor our cats and jokingly asks if I would meet with most of his other diabetic owners who do not do this.
 
Claire and Kaz said:
Thanks Deborah
Yes I am in MA with a Dr Brum who is great I really like him. He at the end of the day will do what ever I want. I am actually going to try Pet Wellbeing first as Kaz had fantastic results with this during the cancer episode. I am then going to retest in 3-4 weeks and have a consult with the people that administer the iodine treatment/surgery and find out if there is a chance that he may be a good candidate. I have already decided to treat him if he is allowed as its a permanent fix and he doesn't need more sickness piled on top of what he already has.
Just want to confirm that its not going to kill him. Dr Brum is worried about the kidney issue prior to that he was all for me having the treatment with a week in the hospital.
Guess going to have to play the waiting game for a month to see.
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Hi @Claire and Kaz it's good to see you on the board again. Sorry about the diagnosis, hopefully the stuff you get from pet wellbeing will work for you like it did with the cancer. I need to see if they have anything for UTIs since Panzer struggles with those.
 
Chrispooky12 said:
Hi @Claire and Kaz it's good to see you on the board again. Sorry about the diagnosis, hopefully the stuff you get from pet wellbeing will work for you like it did with the cancer. I need to see if they have anything for UTIs since Panzer struggles with those.
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Still working through the issues of my friend that I told you about but this came up and Kaz needs to get the best help and advice possible so needed the help of all the experts over here that have saved Kaz's life numerous times already.
New thing now is that the vet has told me that I need to change his insulin as needed probably more regularly. He had suggested weekly blood tests with him but hen based on the spreadsheets that we all keep he says I am more of an expert than him and can regulate myself but that it should be done till the thyroid issue is adddresseed. Bit scary as the iodine treatment if allowed can't happen till after my UK trip as I would not feel safe doing it in December as I fly Dec 14th. Nobody regulates as well as I do for Kaz so bit uneasy about this but I have to keep fingers crossed and hope for the best.
 
Years ago my diabetic Lightning developed hyperthyroidism. His hyperthyroidism was treated w/oral methimazole. He did OK and because of his not too good health he was not really a candidate for the radioactive iodine treatment. I would not go w/surgery since it is too risky and a lot of time does not work, the can can die, stay hyperthyroid or become hypertyroidisn and require meds. Last year I had two cats treated with radioactive iodine, one was a diabetic in remission. For one I tried the orial med but after a month he would not eat. Then went to transdermal and that worked fine. For the diabetic in remission he would not tolerate daily pilling. The transdermal worked fine but I did not want to deal with daily transdermal application and the periodic blood test so I opted for the radioactive iodine treatment. Those were the third and fourth I had so treated. The time the cat was away has dramatically decreased. The first one was dropped off Monday afternoon and picked up Saturday morning. The last two were dropped off Tuesday@ about noon and picked up Thursday afternoon. Some cagts do not eat well right after treatment so if you go w/radioactive treatment make sure you give good instructions on what to do if the cat does not eat well. In any event I wouild give a reduced dose if they he fully eats.
 
Larry and Kitties said:
Years ago my diabetic Lightning developed hyperthyroidism. His hyperthyroidism was treated w/oral methimazole. He did OK and because of his not too good health he was not really a candidate for the radioactive iodine treatment. I would not go w/surgery since it is too risky and a lot of time does not work, the can can die, stay hyperthyroid or become hypertyroidisn and require meds. Last year I had two cats treated with radioactive iodine, one was a diabetic in remission. For one I tried the orial med but after a month he would not eat. Then went to transdermal and that worked fine. For the diabetic in remission he would not tolerate daily pilling. The transdermal worked fine but I did not want to deal with daily transdermal application and the periodic blood test so I opted for the radioactive iodine treatment. Those were the third and fourth I had so treated. The time the cat was away has dramatically decreased. The first one was dropped off Monday afternoon and picked up Saturday morning. The last two were dropped off Tuesday@ about noon and picked up Thursday afternoon. Some cagts do not eat well right after treatment so if you go w/radioactive treatment make sure you give good instructions on what to do if the cat does not eat well. In any event I wouild give a reduced dose if they he fully eats.
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Thanks Larry

Based on responses I can see that surgery is not a good option so I will be pushing for the injection. Kaz is not a good pill taker and after all the research really don't like the meds to treat this either and appears to interact with the diabetic numbers.
I have had a lot of luck with Pet Wellbeing. Helped his cancer and its stopped the other cat going onto kidney medication. Vet was surprised as he wanted to start Sam on new meds but the blood readings show he's just boarder line so no meds.
So today we received the thyroid drops and Kaz had his first dose tonight. Three weeks he will be rechecked and hopefully this will allow him to be a candidate for the permanent fix.
 
We had a cat develop hyperthyroidism, and tested borderline diabetic at the same time. Hyperthyroid disease ramps up their entire metabolism, so kidneys, liver, almost anything can look bad when it actually isn't (once the thyroid is controlled) and it can mask some other things. It's like driving a car with one foot pushing the accelerator to the floor, and controlling the car with shifting and really hard braking. Hyperthyroid disease is pretty much always caused by a tumor in the thyroid. Most are benign tumors, but they will continue to grow, needing higher doses of the medicine. Sometimes the tumor turns malignant, and thyroid levels get really really high much quicker.
We used the transdermal creme medication in our cat's ear. But his levels kept rising, and eventually got so high it was pretty sure his tumor was going malignant. So we did the radioactive iodine treatment. Because his levels were so high, they gave him a BIG dose. Result was that he ended up HYPOthyroid, with levels too low. However, this is really not a problem. A simple small pill of thyroid hormone takes care of that. Check his blood every 6 months or year to make sure he's stable (he has been). Once the radioactive iodine kills the thyroid tumor, it's usually cured and after several months the thyroid levels stabilize, as our cat's did. Hubby can shove the tiny pill down his throat, I'm no good at that but I can hide it in a cat treat and he eats it without even noticing. Wish we had done the radioactive I-131 much sooner than we did. Lamborghini was 12 when diagnosed, we did the iodine treatment at 14-1/2, he's now 17.
(and we had switched him to very low-carb canned food, no exceptions, at the start and luckily held off the diabetes. Kidney and liver values came back to normal once the hyperthyroid was being controlled.)
 
Gracie85 said:
We had a cat develop hyperthyroidism, and tested borderline diabetic at the same time. Hyperthyroid disease ramps up their entire metabolism, so kidneys, liver, almost anything can look bad when it actually isn't (once the thyroid is controlled) and it can mask some other things. It's like driving a car with one foot pushing the accelerator to the floor, and controlling the car with shifting and really hard braking. Hyperthyroid disease is pretty much always caused by a tumor in the thyroid. Most are benign tumors, but they will continue to grow, needing higher doses of the medicine. Sometimes the tumor turns malignant, and thyroid levels get really really high much quicker.
We used the transdermal creme medication in our cat's ear. But his levels kept rising, and eventually got so high it was pretty sure his tumor was going malignant. So we did the radioactive iodine treatment. Because his levels were so high, they gave him a BIG dose. Result was that he ended up HYPOthyroid, with levels too low. However, this is really not a problem. A simple small pill of thyroid hormone takes care of that. Check his blood every 6 months or year to make sure he's stable (he has been). Once the radioactive iodine kills the thyroid tumor, it's usually cured and after several months the thyroid levels stabilize, as our cat's did. Hubby can shove the tiny pill down his throat, I'm no good at that but I can hide it in a cat treat and he eats it without even noticing. Wish we had done the radioactive I-131 much sooner than we did. Lamborghini was 12 when diagnosed, we did the iodine treatment at 14-1/2, he's now 17.
(and we had switched him to very low-carb canned food, no exceptions, at the start and luckily held off the diabetes. Kidney and liver values came back to normal once the hyperthyroid was being controlled.)
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Thanks Gracie the info is helpful with making decisions. Poor Kaz doesn't need anything else to go wrong. Praying for the expensive iodine shot and that it works and then we go back to just dealing with the diabetes. He needs to catch a break.
 
My sisters cat Libby has both treatments last year. In her case the iodine therapy did not work. For the surgery they removed one of her thyroid glands because is was very enlarged. When they did the biopsy they discovered it was cancerous and that is why the iodine therapy did not work for her. However after the surgery she recovered quickly. She doesn't have diabetes but was 12 when she had both treatments
 
Lisa and Witn (GA) said:
My sisters cat Libby has both treatments last year. In her case the iodine therapy did not work. For the surgery they removed one of her thyroid glands because is was very enlarged. When they did the biopsy they discovered it was cancerous and that is why the iodine therapy did not work for her. However after the surgery she recovered quickly. She doesn't have diabetes but was 12 when she had both treatments
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Hi Lisa

Can you please tell me was the surgery a success in the fact that the cat is first and most important happy and healthy and secondly did it cure the thyroid so that no medication is now necessary.
I keep hearing people say to stay away from the surgery but I know that the thyroid gland in his neck is large and this cat has had cancer before so now I'm a bit worried about that as well.
 
Hi I just wanted to let you know Babu was diagnosed with hyperthiroidsm about a year ago, the thyroid issues have not impacted his blood glucose numbers so far but he's been on remission, he had kidney issues long before the thyroid problems which probably had something to do with this problem, he's being treated with oral metimazole quite frankly because there is no other option where we live.

Dosing the metimazole has been quite a challenge, because I've found that I have to be changing the dose up and dawn and since the only way to know how he's doing is with blood tests done by the vet is hard to be adjusting the dose

Having gone through thiroid problems in my family and after trying to get Babu's thyroid regulated, I would say I think the best option is the iodine inyection, treating someone with oral metimazole for very long periods is not really recomended even for humans because of the side effects, and surgery has to be made by a very specialized surgeon ( also not an option here) and is complicated. He may need to take thyroid hormone after the treatment but that's ok people can take that one all their lives
 
Claire and Kaz said:
Hi Lisa

Can you please tell me was the surgery a success in the fact that the cat is first and most important happy and healthy and secondly did it cure the thyroid so that no medication is now necessary.
I keep hearing people say to stay away from the surgery but I know that the thyroid gland in his neck is large and this cat has had cancer before so now I'm a bit worried about that as well.
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Yes the surgery was a success. Once the cancerous one was removed the remaining one began working normally. Libby has been off all thyroid meds for over a year and regained her weight.
 
My Ginger is not diabetic, but she went hyperthyroid 7 years ago when she was 12.
She is really hard to pill, so we chose the i131 injection. She received a small dose of radioiodine and still went hypothyroid. She gets a tiny pill that is tasteless and dissolves easily in water. I put some water in her breakfast bowl, add the pill which dissolves instantly and add her food, and she eats it no problem.
 
Hi!
I'm sorry about Kaz's recent diagnosis' . My diabetic cat, Chuckie, had the I-131 treatment when he was 16 and had diabetes, early kidney disease, an intermittent heart murmur, and gall stones. He did well with it. He stayed in the hospital for 4 days until his radioactivity was under a certain level. I received updates every morning and was allowed to bring in his diet with the understanding that whatever surplus of food I bring, it would not to come home with him.

One thing I wanted to mention with chuckie's situation is that his t4 was normal, but since he was displayed symptoms they checked the free t4 as were, which was too high from the lab to measure. Anyway, he was placed on methimazole temporarily just to get him on something. We had a bit of a waiting person until he could see the specialist. However, we had to take him off the methimazole one or two weeks before his consultation, so that they could take blood and see an accurate level, and there's properly dose the I-131. He had his first consult with the specialist and they were about to admit him that day to receive the radioiodine that day.
 
Veronica & Babu-chiri said:
Hi I just wanted to let you know Babu was diagnosed with hyperthiroidsm about a year ago, the thyroid issues have not impacted his blood glucose numbers so far but he's been on remission, he had kidney issues long before the thyroid problems which probably had something to do with this problem, he's being treated with oral metimazole quite frankly because there is no other option where we live.

Dosing the metimazole has been quite a challenge, because I've found that I have to be changing the dose up and dawn and since the only way to know how he's doing is with blood tests done by the vet is hard to be adjusting the dose

Having gone through thiroid problems in my family and after trying to get Babu's thyroid regulated, I would say I think the best option is the iodine inyection, treating someone with oral metimazole for very long periods is not really recomended even for humans because of the side effects, and surgery has to be made by a very specialized surgeon ( also not an option here) and is complicated. He may need to take thyroid hormone after the treatment but that's ok people can take that one all their lives
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Thanks for this more I read the more I hope for the injection.
 
Dyana said:
My Ginger is not diabetic, but she went hyperthyroid 7 years ago when she was 12.
She is really hard to pill, so we chose the i131 injection. She received a small dose of radioiodine and still went hypothyroid. She gets a tiny pill that is tasteless and dissolves easily in water. I put some water in her breakfast bowl, add the pill which dissolves instantly and add her food, and she eats it no problem.
Click to expand...

Whats the name of the pill as I'd like to write it down in case Kaz trends this way,
 
Johann_marcel said:
Hi!
I'm sorry about Kaz's recent diagnosis' . My diabetic cat, Chuckie, had the I-131 treatment when he was 16 and had diabetes, early kidney disease, an intermittent heart murmur, and gall stones. He did well with it. He stayed in the hospital for 4 days until his radioactivity was under a certain level. I received updates every morning and was allowed to bring in his diet with the understanding that whatever surplus of food I bring, it would not to come home with him.

One thing I wanted to mention with chuckie's situation is that his t4 was normal, but since he was displayed symptoms they checked the free t4 as were, which was too high from the lab to measure. Anyway, he was placed on methimazole temporarily just to get him on something. We had a bit of a waiting person until he could see the specialist. However, we had to take him off the methimazole one or two weeks before his consultation, so that they could take blood and see an accurate level, and there's properly dose the I-131. He had his first consult with the specialist and they were about to admit him that day to receive the radioiodine that day.
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Your fur baby sounds similar to Kaz he is also just 16 has diabetes early kidney disease and a slight heart murmur. No gall stone.
Good to hear so many success stories hopefully Kaz will be the next.
 
Yes, levothyroxine is cheap but get it from your regular pharmacy, not the vet's. The vet can send the prescription to any pharmacy for you. It's also cheap through the online pet pharmacies. Our vet was charging us something like $1 per pill, but pharmacies and online it's only 7 CENTS per pill for the dose our cat needs!
 
I know I'm late responding - but the i131 was a game changer for Luci. She was so thin prior to the procedure and her numbers were all out of whack. After the procedure which required one night of hospitalization and then careful handling of her liter, etc. after bringing her home (I had to flush it and wear thick rubber gloves ) which were then wrapped up as directed and disposed of in the trash. They provided a detailed list of instructions on care/handling after bringing her home. Since then she has gained weight and seems to feel better. She's still a diabetic and her numbers are nothing to write home about as far as her glucose goes, but we do ok with testing/dosing and are all doing very well here in our household. I hope by now you've gotten that under control. I never regreted the i131 for a minute!
 
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