Hyperthyroidism in 14 year old cat. Vet has ideas.

[MyFriendsCat]

Hi all, I'm posting on behalf of my friend (hence the username) whose 14 year old cat has been diagnosed with hyperthyroidism.
He's suggested a radical treatment to them which involves the cat going to Yorkshire for at least two weeks where she will have some form of radiation treatment. The vet seems to think this will give her a good quality of life if they can get it under control or even cured.
They obviously want what is best for her and are having conversations over what to do. The cat isn't insured but they will do whatever is best for her regardless.
Has anyone been through this?
She's not a doddery old cat and leapt onto the counter the other day when I was round. She's still continent and eating and drinking well.
I've said (and they know) that two weeks away at that age is a lot of upheaval.
Any information would be very helpful.

I'm not an expect but, first of all, if my vet prescribed very expensive radical treatment, I'd get a second opinion, are they near any vet schools? If not, just another vet.

I'm not entirely sure but I've looked this up and I think both my cats had this, one starting age 17 (died age 19) and one age 15 and still going strong and they both had thyronorm which regulated their thyroid back to normal levels and cost about £30 per month.

My elderly cat made it two more years and the younger one has been on the meds a year and seems well.

Obviously I'm not a vet, I just came on to say, I've paid a lot of vet bills and I've sought second opinions from our local vet school twice and it's been hugely helpful both times.

2 weeks? I sent my cat for radioactive iodine treatment at 18 and she was only away for one week and when she came home she was fantastic. She had another two very good years eventually dying of "old age" at 20. She's been extremely ill and the meds gave her chronic diarrhoea and didn't control her condition.
I think you'll find it's commonplace now it isn't a new treatment.
I'd do it every single time.

All they do is inject a radioactive substance into the back of the neck, no worse than the annual vaccinations but they have to keep them in for a week minimum until they have excreted most of the radiation and their blood tests are normal.
It's a bit of a hotel holiday for the cat.
Mine was only lightly sedated for the procedure.
It can give them many more years of good life.

Thank you. A second opinion is not a bad idea.
Obviously when you've never had dealings with it it sounds a bit extreme. I'm glad it gave your cat a few good years.
They know there's no guarantees so it's just weighing it all up.

Can I ask if they both went to the place in Yorkshire or are there a few places that do it? X

it sounds a bit extreme to me - tbh, if the vet school had recommended it, we'd have gone for it as I'd have done a lot of things to hold onto my old cat for longer but for £40 or so to see another vet, if the treatment outlay is very significant it makes sense.

There are several places near me that go that treatment. From what I understand. It does offer a total cure.

My 12 year old cat had hyperthyroidism and I discussed the treatments with my vet. Radiation therapy was mentioned but I wanted the least disruptive option for her, she was a very nervous cat with low tolerance for vet visits.

She had medication to reduce her levels for about 3 weeks, then had surgery which wasn't expensive (I think was about £300 from memory, but this was a few years ago). She needed no further treatment and was absolutely fine for the next four years, she died at 16 so she had a good innings.

My cat had hyperthyroidism aged 18 and was given medication. She then developed hypothyroidism due to the medication and had an epileptic fit, which was awful. She was never the same afterwards. So I would definitely get the radiation therapy, no faffing about trying to get a cat to swallow a pill, which also means they will need regular blood tests to ensure they don't develop hypothyroidism.

Nothing radical about radioactive iodine treatment it has been the gold standard for at least 15 years. It is totally curative in around 98% of cases.
Having priced up all the options they are all very similar, but radioactive iodine the cost is all up front.

There’s a diet available which is iodine free which can put them into remission. It’s not cheap though and they have to eat that and nothing else at all.
There are also daily tablets or liquid.
There’s also the option of surgery but it’s not without risk.
It’s probably more cost effective and far less stressful for the cat to have the radioactive iodine treatment.

If it’s left untreated they can go into heart failure due to the continued increase in metabolic rate.

We did Thyronorm and special food. But had to stop the food as he refused to eat it. But DCat was pretty elderly and we were just really trying to keep him comfortable for his last year. At 14 you might get another 4 to 6 years so more radical/expensive treatment is probably worth it.

Thank you I'm passing this all on.

It's not that new and radical (I.e. it's not an experimental untested treatment). I worked at a vet school hospital almost 10 years ago, & it was being offered then, but the stay was much longer (around 6 weeks, I think).

My cat is insured & I'd do it in a heartbeat - so much better than daily pills & regular blood tests to check it is being controlled (uncontrolled hyperthyroidism can cause other health issues). However I understand the reticence when it is a big upfront cost.

Thyroidectomy is another possibility, but in a significant minority of cats it reoccurs, so it's not as successful as radiation.

Radioactive iodine has been used for 75 years for humans with thyrotoxicosis, OP! It is certainly a well established treatment, and very effective. It also is a one off procedure, so no faffing about with tablets or injections forever. If your cat still has a reasonable life expectancy, it is well worth doing.