Hyperthyroid cat, 12 yrs old

[GlomOfNit]

As suspected, the blood tests we had done last week show our nice middle-aged neutered tom has hyperthyroidism. The vet was very optimistic about this (it's the easiest chronic disease to treat, etc) and has given us various pathways. The two she's pushing are 1) surgery and 2) nuking him (radioactive iodine treatment).

We're not sure which way to go. Surgery carries a risk of damage to the parathyroid gland which would bugger up his calcium levels apparently, and they only remove one gland at a time so it might need repeating. She quoted £550-600 for that. Radioactive iodine treatment is much more expensive, but only has to be done once and after he's waited out the half-life of radioactivity can come home from his lead-lined bunker and things should be normal. She quoted about £2200 for that option. Said it was the 'gold standard'. (he is uninsured, yes I know, this will never ever happen again with any subsequent cats!)

We're tending towards surgery but I'm a bit concerned about his age, though aside from his thyroid he's apparently healthy. He would also need to go on meds to stabilise him before the surgery, and probably yet more blood tests (he does not give blood readily!).

Has anyone had to dither between these two options for this condition? How did it go?

Our cat is currently having radioactive iodine treatment (thankfully insured) and we were strongly advised against surgery although I don’t recall why and were basically offered medication or iodine. Apparently it will be difficult to get iodine after July so if you want to go that route now is the time.

Our cat is a roamer and we weren’t sure we’d get medication down him every day so we went the iodine route.

Had medication. It been suggested? I think you can get a gel that you rub in their ear.

I was offered surgery for my cat but settled for Vidalta tablets which he is doing very well on. Prescription is £25 from vet then 100 tablets bought online costing £52. Cat has 2 tablets a day so they don't last long.

Our cat is on thyronorm liquid medication twice daily. Was not offered surgery, we were told its not generally done now. We were suggested the radiation treatment too, its tempting but as puss not insured its on the back burner for now. She is doing well on medication though.

We picked radioactive iodine therapy but we were insured. It was great as she didn’t respond well to meds and surgery felt a bit of a risk. I will mention that her thyroid issue came back towards the end of her life but this is almost unheard of after radioactive treatment. Always wanted to be special! If we had our time again I’d still do the iodine therapy, it was incredibly straightforward and non traumatic for us and her (she stayed in the centre three weeks and that was that).

Our cat was on thyronorm liquid meds for the last 3 years of his life (passed away at 18 yrs old this weekend - unrelated to thyroid).
It's super simple to use. Just add to food. The staff prepared a special little saucer of pate with the thyronorm mixed in every morning for our Overlord, which made him feel even more Divine than before his diagnosis, if that were possible 🙄
Had bi- monthly bloods to get the dosage stable initially, then 6 months bloods to check how he was doing, just like his aged human man servant.

Sounds a bit drastic. My cat just has a medicine. Why put him through that?

We did the tablets as we did not think our highly sociable and rather anxious cat would cope with being isolated for the radio iodine.

It was very easy, squished a bit of Webbox cat stick around the tablet each morning, cat came running and gobbled them up.

Made a dramatic difference to the cat's quality of life, we were very ashamed to realise she had been ill for years before we noticed.

100% radioactive iodine. Less invasive, one injection then they just chill in the Cattery for a couple of days then home.

no cutting required and more effective, it’s a progressive condition so meds at this stage are less ideal as will need higher and higher doses, better to cure if possible. Also if you add the costs of meds and bloods to monitor it often works out cheaper for iodine if more than a year/two years treatment required (which hopefully at 12 he definitely would need!).

We did Vidlata. She lived until 17, possibly older, as she was an adult when we got her and we were never sure her age. I didn't have enough upfront for radiation but I easily paid that over time with the pills and subsequent vet visits and bloods every few months, especially when her levels got wonky. If I could do it over I'd have done radiation without a doubt.

Friend of mine did the nuking option with her quite elderly kitty as the least invasive option. Cat has gone on for several years since quite happily.

I agree that irradiating your cat sounds 'drastic' but this is in fact the gold standard treatment and recommended by vets pretty much everywhere, so ...

There are drawbacks to giving meds twice daily for the rest of their life. Like: it's not always tolerated, either by stomach or the cat! It can make it much harder to find someone to look after him if we go away. It's expensive in the longer run (he's only 12, vet says he should live well and another 5 years maybe, if he has this condition managed). Medication for thyroid requires blood tests to get levels right and they're costly too. Lastly, meds don't cure it, they manage it.

As far as I'm aware, he's not 'going to go through that' he has a single injection, he then has a stay away in cattery-like conditions. He's stayed in catteries most years for a couple of weeks, he's fine.

Surgery is something I'm hmming about because of the inherent risks of surgical intervention. But if you research (our vet said look at this site https://icatcare.org/advice/hyperthyroidism/ ) you will see that medical management tends to be the third favourite solution, all other things being equal (some cats might be too old or have other conditions that make an operation inadvisable, for instance).

That's really interesting. It does genuinely seem to be that simple! Shame it's so ££££ but he's 12, we absolutely hope he goes on for a good few more years in good health, vet thinks he should.

it's the upfront payment aspect, really. DH is tending to surgery for that reason...

It's interesting you said your cat only needed a couple of days incarcerated. I've read things online that say anything between one and three weeks!

thanks for all your (mostly) helpful posts, I'll sit DH down in front of this thread.

Our cat was diagnosed around 9 years old. He was put on a feline version of carbimazole, which he took for life. However he remained thin and with a huge appetite. We basically fed him whenever he was hungry. He did however have a tendency to beg from the neighbours, and we had to get him a collar saying Do Not Feed, Medical Condition. Before that, one of the neighbours actually took him to the vets asking if he was microchips, convinced he was a stray. Luckily the vet also lives down the road and was able to correct them! In a way I thought it was nice of the neighbours to be concerned, even if they had the wrong end of the stick.

As he got older, surgery was tentatively mentioned, but the consensus between us and the vet was thar his age and low weight meant the risk from the anaesthetic was high.

He lived till he was 18, so 9 years after the diagnosis. He was at one time quite poorly and another time he was bitten by ?another cat and the wound was infected but both times he pulled through. It's very common in cats.

I've got the opposite diagnosis (underactive thyroid) and am a fat cow as a result. I was at times jealous of him! (Only joking!!!)

Our 12 year old cat is on liquid thyronorm. She's very fussy but likes the taste. I put it in a treat. Her dose is about £50 every 3 months so much cheaper than any surgery or treatment and less traumatic. I wouldn't put your cat through that if they take medication well. Perhaps the vet can see £ signs. My vet mentioned it was an option but didn't push it. Said medication was fine.

What about meds? Ours never had any treatment except meds and they lived many years just fine ( longer than average) and they were a very elderly cat.

You could at least try the medication first. Are you insured?

My cat has special food. Got put on it at 9 and still good at 15. Only works for indoor cats though. I didn’t like the sound of the surgery at all.

Ours had the radio iodine treatment. He wasn't insured, either! He had it about 3 months after diagnosis, and we spent well over £300 in those three months having blood tests and buying a prescription cream to rub into his ear (and then doubling the dose, and doubling it again...). The radio iodine treatment was very straightforward. He was away for about a week, I think, although it was slightly complicated in that he came home just as the first lockdown started in 2020, so we may have taken him early on condition he was in isolation at home for a bit longer. I can't remember all the details, but the difference was amazing. It was well worth doing.

My 11 year old cat had the op some years ago as the meds didn't control it well enough. My vet specialises in thyroïdectomies and there were no problems at all. Small incision, quick healing and has not needed the other side doing. It was £700 I think including all the blood tests.

Considered having the radioactive treatment but decided against. Two weeks away plus further two weeks of isolation at home.

One of the cats I had used to have that. It worked very well indeed. She lived to be 18.

Jeez we can never get away from ‘being in it for the money’ 😡The vet will have to refer your cat to a specialised facility for radio-iodine and the cost will go to them, in compensation for building and staffing said facility. In most cases it’s one-and-done so your vet is actually turning away years and years of your cat being on prescription meds and needing regular blood tests. The cost benefit is about 2-3 years to break even compared to cost of meds so in a youngish cat that is used to being at a cattery if you can raise the upfront cost I would recommend. The length of incarceration is set locally by the radiation protection supervisor (amazing - not by the money grabbing vet!) and may depend on whether you have pregnant women or younger children at home.