Thyroidectomy vs Radioactive Iodine?

[igotdemons]

My elderly girl was diagnosed as hyperthyroid in the Summer and since then has been put on both Thyronorm (sent her T4 levels so low they were in the minuses!) and Vidalta (became depressed, lethargic and stopped eating properly over being tableted everyday), without success. So at the moment she is unmedicated whilst I wait to discuss with my Vet what to do next.

The y/d thyroid care food is a no go because she likes being outside in the garden too much and I cannot guarantee it would be the only food she would eat. So that leaves either surgery or radioactive iodine treatment and I am torn over which one to pursue.

Obviously, I know the RI is the gold standard treatment in cases of hyperthyroid cats and this is what I am leaning towards. However, the main worry I have with this is the time she would be in isolation for, either in a treatment centre or at home. She has always been a cat that loves fuss and attention and I’m not sure she would cope with no physical contact. She has also been my shadow for the past 10 years and I don’t know how she would cope without being with me for such a long period of time.

I’m not too keen on the idea of a thyroidectomy because of the possible issues to do with the parathyroid and the fact that the average life expectancy of a cat after surgery is only 2 years compared to 5 years with RI. On the plus side, she would be home the same day (as long as there were no complications of course).

If your cat has had either of these treatments, could you please share your experiences to help me decide? I should add that I have insurance and they have accepted and paid my initial claim for this condition.

[Lonecatwithkitten]

I have cared for cats who have had both treatments.
Mean survival of thyroidectomy is lower than RI because RI excludes the majority of cats with other concurrent or pre-existing medical conditions.
Thyroidectomy can remove both thyroids, but a very small number of cats can have some ectopic thyroid tissue in the chest that can't surgically removed. Whilst parathyroid problems are a risk in the hands of an experienced surgeon they are not common and if they occur they are easily treated and resolve quickly.
Radioactive iodine is very, very effective, but comes at a significantly greater cost and many cats are not suitable candidates. Different centres have different isolation protocols so if you are considering it getting information from several is definitely worthwhile. When we last checked the RVC has the shortest isolation protocol. I have not heard of any centre offering home isolation due to the need to collect and dispose of all waste correctly and the potential risk to humans.
Even in some cats who go outside Y/d can be very successful they just must not eat anything else apart from the y/d. As most of these cats are elderly their hunting days are over and they just wish to lie in the sun outside.
There is also the transdermal gel which can suit some cats that the tablets and liquid do not as you apply it to the ear tips. It is a special order from a specialist compounder for your vet.

[chemenger]

My old cat had RI treatment ant the Edinburgh vet school. At the time they had the shortest isolation period, but that might have changed. To be fair my cat hated people so she didn’t really care about having no contact. It was a very easy procedure for her, and she was fine afterwards. We had to use flushable litter for a while and she couldn’t be in contact with small children or go outside.

[MitziK]

My Best Cat had a half thyroidectomy aged 7. The other side didn't play up until she was 14.


She went from a skinny little stress bag to a chilled, perfectly sleek madam almost as soon as she was brought home from the vet.


As she was 14 when the second half went skewy, she was managed by pills placed into pate and rolled into balls. She knew there were tablets in there, but decided it was worth taking the hit in exchange for lovely pate.

[TheGirlOnTheLanding]

LandingCat's mum had a thyroidectomy at around 7 (difficult to be more exact as she was a rescue) with no issues, and lasted several years after the procedure. At the time we chose that option because she was completely impossible to pill, we had another cat so special food was tricky, and we couldn't really afford RI but the op was a big success for her - as I recall she was in overnight for observation then home the following day and recovered as quickly as she had when she was spayed. She lived to a grand old age with no subsequent thyroid issues.

[LucieFurr]

My cat had radioactive iodine treatment. I was very concerned about the amount of time she needed to spend in isolation at the vet hospital, and also the fact that I had to limit my contact with her when she came home. However, I’m very pleased I had it done. She is now totally cured much happier and healthier.

The time she had to spend in isolation is now a dim and distant memory and she is a happy healthy cat. If I had another cat with hyperthyroidism I wouldn’t hesitate to go for radioactive iodine treatment. The vet hospital were excellent and phoned me up every day to let me know how she was getting on.

[CanYouHearThePeopleSing]

My lovely cat had a thyroidectomy aged about 12 and was perfectly fine afterwards. She recovered quickly and gained the weight she'd lost. She lived another 5 years and eventually died of a completely unrelated illness.

[igotdemons]

Thanks everyone for your responses! 😸

I’m still in two minds and am waiting for the Vet to call me. Ideally I would opt for Radioiodine but it’s a 4 hour drive to the nearest centre and I’m not sure if she would even cope with that, let alone the isolation period.

On the other hand, I worry about her having an operation and the effectiveness! I’m not even sure if she is a candidate for it as I don’t think they’ve been able to feel a goitre in her neck?! 🤔 Plus any tumours that maybe residing in her chest area...

I need to make a decision ASAP as she is untreated and driving me nuts at the moment with not being able to settle, the constant coming and going outside and me not being able to eat anything without being stared out! 😫

[LucieFurr]

I'm sure you've done this, but please do some research into the nearest centre for the radioiodine treatment. My vet referred me to a centre 200 miles away, but I found an excellent vet hospital 20 miles away who were fabulous. I'm in the Midlands

[ClownsandCowboys]

Two of our cats have had RI. Although they are isolated, the staff spend short amou ts of time with them every day, stroking, playing etc. One of our cats is the timidess cat ever, and weirdly she's actually come home more confident and less scaredy cat!

It has made such a difference. And the RI centre called us every day to update us.

[igotdemons]

Thanks @LucieFurr and @ClownsandCowboys.

I am still no further forward as my Vets practice are turning out to be more and more useless so I’m seeing a new one tomorrow and hoping that they’ll be much better. It shouldn’t be this hard should it?! Every time I seem to take my cat they just look at me as if I should have all the answers?! Last time she went they just did a blood test - didn’t even register with me until later that the Vet hadn’t even examined her! 🤦🏼‍♀️

[Lonecatwithkitten]

@igotdemons really they should be creating some treatment plan with you. The longer she is uncontrolled the greater the risk of end organ damage due to high blood pressure.

[igotdemons]

@Lonecatwithkitten Exactly! Took her to new Vets yesterday, seem much more switched on and knowledgeable thankfully. Took bloods and am waiting for them to call me with results.

One Vet at my last practise wanted to do a thyroidectomy as soon as she was diagnosed, whilst the other said she wouldn’t have been happy to do it ‘due to cat age and outcome’ - she then started talking about lymphoma?! Never been mentioned before or since so no idea where that came from! Saw a third Vet who contradicted second Vet telling me her kidneys were OK by saying they weren’t in his opinion! I just need consistency so I hope I get it at this practice... 🤞🏻