Civie has hyper-t

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allie and newkitty

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Our tortie went to the vet today and was diagnosed with hyper-t. Her T4 was 10.0. She has lost nearly 3 pounds in a year but during that time we have taken away all her access to dry food and she gets fancy feast only now, so we expected her to lose weight. Her heart rate was over 200. :( The vet said we can do 1) meds, 2) surgery (but she does not have a palpable mass), and 3) radioactive iodine treatment (closest place is 3 hours away, cost is $$$$).

She was given Tapazole and heart meds to get started, going back in 2 weeks. Right now I think the best course is going to be the radioactive therapy, despite the cost and the 1-2 weeks away, because it sounds curative. I did not see any risks associated with it in the information they gave us, whereas there were some listed with surgery and the pills may not work for her. The cost is prohibitive but if it can cure her we will come up with it somehow.

Anyone have any experience with this, advice or recommendations?
 
I have had two kitties treated with the I131. The first one, many years ago, was at the place from Monday to Saturday. The other one from Monday to Thursday. It was well worth the cost. After two weeks on the Tapazole make sure that kidney function is checked since hyperT can mask kidney degradation. Like all treatment, there is guarantee of no problems. One in a while the I131 treatment is not successful and rarely the kitty has to be on a thyroid since too much of the thyroid was killed.
 
My civie had Hyper T around this time last year. We tried the meds but quickly realized that one of us wasn't going to survive a twice a day pilling.

He had the I131 last year the day before Christmas Eve. He is doing great.

There are always exceptions. One member here ended up with her kitty going Hypo T afterwards and now has to take meds for that. She went to the same vet we did.

When it works it is a cure.
 
How old is she? If you anticipate another 5 years or so with her (we hope more!) ... or she resists pilling with a vengance, I-131 becomes very cost-effective (where cost includes your medical bills!).

If she is an older kitty (say, over 15), you may ask them to deliberately undershoot on the I-131 and leave her a little high, to offset any renal compromise.

If she is nearing 20, I would not spend the money on I-131. She has to be away from home for a chunk of the time post treatment because she is radioactive and that is very stressful.

And by the way - her litter either must be flushable, or held for a couple months until it is no longer radioactive ... or you trigger the radiation alarms in the garbage dumps!!! Apparantly water treatment doesn't have them (at least not in Columbus, OH).
 
i had a civie that was hyperT and on the tapazole for about 2 years. she did just fine on the tap. i have no problem pilling kitties and she was very cooperative about it so we went for the pills and they were working fine so we never really looked into the radiation thing.

i too had one at the vet today, actually one with an appt and another was not right this morning so she went too but that's another story.....anyhow, the boy i took today turns out to be hypertensive and we're waiting on lab results to come back on kidneys, thyroid, etc.... vet said not to be surprised if he comes back as hyperT since his thyroid felt larger than normal to her on exam. given that he is 15 years old, the brother to the one i lost last year to cancer and another sibling lost to cancer too about 7 years ago, i'll go with tapazole with him too given what i know about this litter of kitties in all honesty.

surgery, to be blunt, is a waste of money as it can come back and you can be right back to square one.

if one of my younger kitties was diagnosed with it, i might look into radiation
 
Thanks so much, all of you!! I appreciate all of the advice and input. She is 13.5 years young. The vet already mentioned we need to recheck her kidneys (though her values were perfect today, quite a bit better than Newkitty's). I will let you all know what happens. If she is a candidate for the radiation thing (she has to have some xrays and stuff first, I think) we will probably go with that. I am a master piller and she is a very good cat (when not at the vet, where the TORTIETUDE comes out!!) but I would prefer to wipe it out if possible.

Can anyone tell me how much you paid for the procedure, if you do not mind to share?

Thanks so much!
Allie
 
About 15 years ago I had a little black and white female cat trated with radioactive iodine. It worked beautifully and she died 2 years ago at 21 (kidneys). I seem to recall that she was away about a week and the cost was an even thousand. I couldn't bear the thought of pills and continual testing to be sure that the dose was correct. I am in BC, so not sure if the costs vary widely by province or state.
 
My Sophia has hyper-t and we rub the gel in her ear. She was doing fine in Aug but right now has lost l lbs since then and is not eating. We took her to the vet today.

IShe is 15 1/2. If she had been younger I would have had that 1131 but dh thought she was too old for it and it was much too costly... I would have done it anyhow.. but Sophia is his cat... and he made the decision,

I have heard nothing but good news.... and she will be cured....
 
Just a caution - it is possible to overshoot w/ the I-131 and have a cat which is HYPOthyroid afterwards. Thyroid pills are cheap though.

In Columbus, OH circa 2008, the treatment was $1500-ish.
 
allie and newkitty said:
If the hyper-t has caused heart damage already, is there anything that can be done?

Supportive treatment for the heart damage.
 
If any of my cats end up HT, they will get I-131 - no matter the shape of their kidneys. I will deal with whatever renal issues come up...IF anything came up post-I-131. I had a conversation with the vet who was the pioneer for I-131 treatment back in the early 80's and he feels the same way.

I really dislike tapazole and will not use it for any of my cats.
 
can you explain why, dr lisa? harry is currently on methimazole for hyperT and is doing well but i'm considering the radiation (not til things are more secure at home, tho). he's done very well on the methimazole.

unfortunately i've read of a number of kitties turning hypoT after the radiation so i'd wondered if it was worth it. guess the methimazole can be tough on the heart after a while or is that just any inadequately controlled hyperT? i think that's what i heard...
 
My civie had I-131 treatment in January of this year. He couldn't tolerate Tapazole. The total cost was $792

They kept him Mon-Thurs.

He does have problems with his kidneys now, but I knew that was a risk before undergoing the treatment. He also ended up hypo-T, and now takes thyroxine twice a day. BUT, the pill is tasteless and is easily given in a Pill Pocket.

I'm glad I did the I-131
 
Thanks everyone!! I appreciate all of your experiences and input and the cost info. I was thinking it was going to be closer to $3k so while it is still expensive it is not as prohibitive as I thought.

One question...from what I have read, the iodine therapy does not cause kidney damage, correct? What happens is their kidneys may already be compromised by age or whatever, but the increased blood flow caused by the thyroid/heart is helping the kidneys to function better, thereby masking the kidney issues. Then the iodine comes along, whups the thyroid into shape and voila...kidney function declines? Have I got that right (though quite dumbed-down, I know) or am I misunderstanding?
 
Lisa dvm said:
If any of my cats end up HT, they will get I-131 - no matter the shape of their kidneys. I will deal with whatever renal issues come up...IF anything came up post-I-131. I had a conversation with the vet who was the pioneer for I-131 treatment back in the early 80's and he feels the same way.

I really dislike tapazole and will not use it for any of my cats.


I'm having an extremely hard time coping with the fact that my civvie is now in renal failure after I131 treatment this year. I feel that I caused him to be suffering with this now.

He's lost 2 pounds since I131 treatment. I give him fluids and do my best to feed him Friskies Special Diet, but he really wants what the other cats eat. Since I must feed Lilly Grace (severe CH) on her own and often help her, I can't babysit my civvie when he's eating and he does trade with Sam sometimes.
 
allie and newkitty said:
Thanks everyone!! I appreciate all of your experiences and input and the cost info. I was thinking it was going to be closer to $3k so while it is still expensive it is not as prohibitive as I thought.

One question...from what I have read, the iodine therapy does not cause kidney damage, correct? What happens is their kidneys may already be compromised by age or whatever, but the increased blood flow caused by the thyroid/heart is helping the kidneys to function better, thereby masking the kidney issues. Then the iodine comes along, whups the thyroid into shape and voila...kidney function declines? Have I got that right (though quite dumbed-down, I know) or am I misunderstanding?

Yes, the hyper T masks the kidney disease. dr. Lisa being a vet can probably sweet talk a I-131 facility do it without tapazole/methimazole but there were no facilities here that would do it without putting the cat on a course of it to see what happens to the kidneys when the hyper T is controlled. For that matter, my vet wouldnt either. The exception might be a cat that cant tolerate the drug. We have a shelter kitty right now who goes into liver failure when she gets tapazole and we are going to get her the I-131 now. I believe that you will know right away if the kidneys are going, because they crash. Conor already had sl. elevated kidney numbers, but on tapazole they didnt get any worse, and they still felt he was a good candidate. oh, he was 13 then and had also just been dxed with pancreatitits.

Conor got radiated in September of 08, the initial consult was 164, blood panel and xrays at reg vet within 10 days prior to that appt.. actual cost of the I-131 was 1300. But..over the life of the cat you do have all the blood panels to make sure the thyroid dosing is correct. In Conors case, he was needing increasing amount of tapazole, so I think that means the tumor was getting bigger. He is slightly hypo T now.. and I dont think its possible to "ease up" on the amount of I-131..its either going to happen or not (the hypoT) I made sure I went to a facility that did technitium scan prior to injecting the rad Iodine. This scan can give them a better idea of how much rad iodine to use, and can rule out malignant tumor of the thyroid ( they would have to use more rad iodine then) and can tell where the actual tumor is to aid in placement of the rad iodine shot. Even with the technitium scan, he went slightly hypo T..but I do not regret that.

Xrays at your vet are to determine what kind of heart damage, if any, the hyper T did so they can medicate or not do it. The facility I went to will not do it if the heart is bad enough-not sure if thats common feeling at rad iodine places.

I had to switch to clumping feline pine, and had to be very careful flushing it in this old building. But in a studio there was no way I was going to save it for a month or so.

These links were very helpful, the gulf coast link is a little more current.
http://www.gcvs.com/page3/page66/page66.html
http://www.marvistavet.com/html/thyroid.html
 
I fully realize that I am in the minority regarding my quick comments above. I am so pressed for time these days and just can't type much. But quickly....

I do note on VIN that a couple of other colleagues treated their own cats (normal kidney values pre-I-131) with i-131 with no tapazole trial so I am not the only one who goes down this road. Just differing opinions....

Of course, for a client's cat, we discuss all options and tapazole trials are discussed and weighed out with each case.

HT wreaks havoc on the body as does a chemical like tapazole. Tapazole, in the long run, is more expensive than I-131 (if the patient is monitored correctly) and is not easy on the body. There is also a recently study showing a much longer lifespan for cats that got I-131 vs tapazole.

I am just not keen on dumping a drug into a cat's body when there is (in my opinion) a better option. And quickly...I would not use a 'one-size-fits-all' dosing facility. I would only treat with I-131 after a scan has been done.
 
tuckers mom said:
I'm having an extremely hard time coping with the fact that my civvie is now in renal failure after I131 treatment this year. I feel that I caused him to be suffering with this now.

Hi Jennifer,

I am really sorry to hear about your experience above. It makes me sad to see anyone regret a decision that was obviously made with love.

What you describe above is not all that common - not to the degree that you describe.

I did note on VIN (on a thread that was VERY pro-I-131 calling it the "gold standard") that a side discussion was going on regarding giving cats that ended up in CKD thyroid supplementation. Interesting thought but we have to also keep in mind that cats die from HT also. Having your body revving at 150 mph due to HT is NOT a good thing so I am still of the mind to get the body SLOWED DOWN...and then deal with any kidney issues afterward.

The way that I see it...cats can either end up with an unmasked CKD or their hearts/bodies can burn out from HT....I just having a hard time signing up for the thought that we need to use tapazole to keep their motors revving in order to keep up GFR (blood through the kidney) given the negative toxicity issues with tapazole and the negative aspects of keeping a cat's metabolism revving.
 
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