# Radioactive Iodine Experience and Quarantine Times



## keeferkat (Feb 11, 2007)

One of our cats died recently from the ravage effects of Hyperthroidism. He was 16.5 years old. He had already lost ~ 3 lbs when we discovered it last September. His T4 count was 17.8. The Vet recommended Methimazole 5 Mg twice a day in pill form.

Keefer was very difficult to pill, but we did it for ~ 10-14 days. He then became very lethargic. Took him back and he was put on a lower dose (2.5 Mg). And we went with the Methimazole compounded into a Gel applied to the inner ear this time, which was much easier. He seemed to still have some side effects and never seemed to gain much weight. But all in all he seemed to be doing better.

In December he went back for a check and his Platelet count was low. Coupled with the side effects we decided to go the Radioactive Iodine route. 

When he was first diagnosed we ruled out surgery because of his age and everything I read (Internet) about the Radioactive Iodine treatment was that he would have to be quarantined for ~ two weeks. At his age the stress would of been a lot for him. So we decided on the Methimazole.

I was very surprised when I finally did inquire at the two places near us that did the Radioactive Iodine treatment that the quarantine time was only 2 days. Keefer got his shot and was back in less that two days actually. In at 11:00 AM on a Tuesday and I picked him up on Thursday at 8:00 AM. The time period has changed recently for many of these places that do the Radioactive Iodine.

Unfortunately Keefer was given an inadequate dose of Radioactive Iodine and he died 25 days later. We were told we would see some change for the good in about a month. When the Hyperthyroidism behavior returned I called and was told to give it more time. Keefer ran out of time and Keefer fell into the 6% that they said would need a second shot.

My reason for this post is to make people aware that the quarantine time for the Radioactive Iodine may be less than what is generally believed. If we had known that his stay would of been only two days we probably would have opted for it first. 

We were told that 90% of the Radioactive Iodine is gone from the cat in two days. The remainder is gone in about the next two months or so. You would actually have to ingest the cats waste for it to be harmful to you. Some places realize that the stress of being away from home for so long is not good for older cats. And if you follow their instructions you have nothing to worry about.

I was in the hospital myself recently and had some xrays done and was told that I received much more radiation from that than I would from being around Keefer.

So the quarantine time may vary from facility to facility or even state by state. So don't assume that this treatment choice requires a long stay away from home and puts you and your family at risk when the cat goes home. 

Even though it didn't work for Keefer, I would do it again as some cats tolerate the Methimazole better than others. The only thing I'd do different is instead of listening to the Technician about giving it more time I would of brought him to the Vet sooner.

The Emergency Hospital Vet where we brought Keefer the day he died said we should of seen a change for the better in two weeks and we should of not have seen the Hyperthyroid behavior returning, if the Radioactive Iodine shot had destroyed the tumor. 

Hind-sight being 20-20 we would of done some things differently. And for anyone considering having this done, make sure you do your homework as best you can. I would of been more diligent as to how they determine the dose level. There is something I believe is called a TC 99 Isotope Scan that determines the size of the tumor. I'm not sure this was done to Keefer as his dose level did not work.

The success rate for Radioactive Iodine is in the 90+ % range. The only reasons it may not work is an inadequate dose given or some other medication interfering and possibly a cancerous tumor (less that 1% they say) which requires a dose ~ 10 times the amount . 

Hopefully Keefers experience can help someone else considering this option.


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## Nell (Apr 7, 2005)

Thank you so much for sharing that information. I an probably going to have the radioiodine treatment done with Trixie sometime soon (just have to save up some money first).
She has had hyperthyroidism for 2 years and is pretty easy to pill, but lately we're having some trouble regulating her medication.

The information I got from the Madison Vet school is that cats at their facility must go in for a bunch of preliminary tests first. Then they get the shot and usually stay for about a week or until the amount of radioactivity is at a safe enough level.

Did your cat have to have a bunch of tests beforehand? How much did it end up costing you?


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## nanook (Jun 12, 2005)

I'm so sorry to hear about Keefer.
Thank you for posting about the Radioactive Iodine therapy. When my cat was diagnosed with hyperthiroidism I looked into it as well and decided against it for the same reasons you did. Fortunately, he did well on the meds. They did want to keep him for 10 days here and that was the deciding factor. Had it only been 2 days I would have certainly considered it. It's good to know that that is possibility if I'm ever faced with it again.
I'm sorry Keefer had to go through so much but you did all you could and I'm sure he knew how much you loved him


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## CataholicsAnonymous (Dec 4, 2006)

That was so kind of you to post that information for everybody. 

Maybe 5-6 years ago, Andrew had the iodine treatment. The cost then was around $800. The only preliminary tests I remember were x-rays and blood tests. He stayed there for no more than 3-4 days. I had this whole list of things not to do, but I ignored them. He slept on or beside me from the day he got home. 

I can't believe how hard that was to post. I lost him on Dec 20, 2004, and I haven't been able to say his name since. I think this was the first time I even typed it, and it still hurts so bad. He was my soul mate.


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## keeferkat (Feb 11, 2007)

Nell said:


> Thank you so much for sharing that information. I an probably going to have the radioiodine treatment done with Trixie sometime soon (just have to save up some money first).
> She has had hyperthyroidism for 2 years and is pretty easy to pill, but lately we're having some trouble regulating her medication.
> 
> The information I got from the Madison Vet school is that cats at their facility must go in for a bunch of preliminary tests first. Then they get the shot and usually stay for about a week or until the amount of radioactivity is at a safe enough level.
> ...


I had to fax Keefer's blood test (as long as it's done within one month of the shot) to the facility that did the Radioactive Iodine treatment. I also had to have a stomach / chest xray done a few days before (which I brought with me the day of the shot). Keefer also had an Ultra-Sound that day done by the Vet who gave him the shot. Then I answered some questions they had about his history and left. I asked several questions myself and wish I'd asked more.

I believe some facilities over-do the quarantine time. The Vet who did Keefer's treatment actually had Graves disease himself and had the Radioactive Iodine shot (said he received a 12 dose). He explained that he went to work directly after and nobody was at risk from radioactivity from him. Like I said you'd have to ingest the cats waste to put you at risk. But I suppose some people could have children that could ingest the waste, so some places error on the safe side.

I think some may still require a longer stay due to state requirements or maybe even to justify the high cost (who knows?). Keefers was ~ $1200.00 total and it was done at Florida Veterinary Specialists in Tampa Fl. 

Do your homework and ask as many questions that you may have. The Vet said he usually gives a dose of between 3.5 and 4.5 (what measurement they use I don't know). Keefer received a 4 dose. I asked about how they determine the size of the tumor and he gave some answer (that to my mind) didn't have an exact science to it. But there is a way that they can determine the tumor size. Keefers regular Vet told me the dose was fixed like a Flu vaccine in which a 200 lb man and a 100 lb woman would receive the same dose. So there is a lot of mis-information among Vets as well.

I am not an expert, but I believe if the Radioactive Iodine is taken up by the tumor, it will be destroyed between 3 and 6 days (I could be wrong on this though). The thyroid hormones should start to regulate and a lot of cats see improvement in the first two weeks. I was told a month and most say you should see a change by then. 

Keefer had a heart murmur ever since he was a kitten that some Vets heard and others didn't. He seemed more concerned with Keefers heart mumur that his Hyperthyroidism. Keefer had a normal heart rate when he died and his little heart was the last thing to go. 

Keefer did have a high MA number (Microalbuminuria) and other numbers showed development of renal failure. Hyperthyroidism can mask renal failure because of the increased blood flow. So we may have traded one problem for another had the shot worked. But I would of accepted that.

His brother was diagnosed 10 months ago with this and is doing fine. Keefers Urine Specific Gravity test number was 1.020 which was a little lower that they like. But this number can change as to how much water they have drank.

Keefer basically starved to death / dehydration despite have a ravenous appetite and drinking a lot of water to the end. His dose wasn't high enough and the excessive thyroid hormones must of been raging throughout his little body and he couldn't absorb enough nutrition to survive. He acted pretty well up until the afternoon of the day he died. I was going to take him for his T4 count the following Monday. But I think he had lost too much weight to survive in the long run anyway.

Another thing is there is some controversy as to when to stop the Methimazole. Some Vets think it could hinder the effectiveness of the shot. The place I chose wanted it stopped 10 days before the shot. The other place said two days was fine. I had a medical problem myself so Keefers shot got push out another week. So he was off the Methimazole for 17 days before his shot. He lived another 25 so he was off the Methimazole for 42 days total which looking back probably cost him his life. 

It's ironic, but the Vet Tech at the Emergency Hospital we took Keefer the night he died had Graves desease and the Radioactive Iodine shot did not work for her either. She ended up having the operation.

Good Luck and go with your gut, not what you're told if you think there's a problem. I have a lot of guilt about the choices I made after (in my gut) I knew the shot probably didn't destroy the tumor. I could live with the fact if Keefer died from something like renal failure with can be treated but not cured. To have him die of hyperthyroidism, which is not only treatable but cureable is tough to accept.


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## keeferkat (Feb 11, 2007)

CataholicsAnonymous said:


> That was so kind of you to post that information for everybody.
> 
> Maybe 5-6 years ago, Andrew had the iodine treatment. The cost then was around $800. The only preliminary tests I remember were x-rays and blood tests. He stayed there for no more than 3-4 days. I had this whole list of things not to do, but I ignored them. He slept on or beside me from the day he got home.
> 
> I can't believe how hard that was to post. I lost him on Dec 20, 2004, and I haven't been able to say his name since. I think this was the first time I even typed it, and it still hurts so bad. He was my soul mate.


Thanks for the kind words. Believe me the tears are flowing as I type. My wife and I are a wreck. We've never felt so much sadness in our lives. Keefer was a very special cat to us. I'm hoping things get better, but I suspect it's going to take awhile as Keefer had a big impact on our lives. I think I'll always miss him. And Keefer slept with us his first night back home also (rather we slept with him, as he got most of the bed anyway).


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## keeferkat (Feb 11, 2007)

nanook said:


> I'm so sorry to hear about Keefer.
> Thank you for posting about the Radioactive Iodine therapy. When my cat was diagnosed with hyperthiroidism I looked into it as well and decided against it for the same reasons you did. Fortunately, he did well on the meds. They did want to keep him for 10 days here and that was the deciding factor. Had it only been 2 days I would have certainly considered it. It's good to know that that is possibility if I'm ever faced with it again.
> I'm sorry Keefer had to go through so much but you did all you could and I'm sure he knew how much you loved him


I'm glad things worked out for you. Keefer did go through a lot and it's a shame it ended as it did. We had such high hopes and then to have it come to an end so fast is hard to accept.


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## Kobster (Feb 1, 2007)

Puzzles went in for I-181 (Radioactive Iodine) treatment. She had to have a series of tests first. Bloodwork, urinealysis, a heart echocardiogram, and a kidney filtration test, which she failed, so she wasn't a candidate for the treatment

But, she could not tolerate Methimazole in pill form. It just tore her stomache to shreds, she wouldn't eat and she vomited several times a day.

We called around and finally found a compounding pharmacy that could compound the medication into a tuna flavored chew that we kept in the fridge and gave to her as a treat. She ate them like a pro and no more vomiting. She did well for close to three years on this treatment before she passed in December at the age of 20. 

So for all of you struggling with Tapazole Tablets, that aren't candidates for the I-181 treatment, you might see if there is a compounding pharmacy near by that can do this for you! It was inexpensive, about $30 for a months supply.


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