•Frequently Asked Questions: Regarding Radio Iodine Treatment
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•Before the treatment
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•Q: Does my cat need to be fasted on the morning of treatment?
•A: No
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Q: What do I need to do at home before the treatment?
A: Please avoid feeding fish to your cat in the two weeks prior to the treatment as it would reduce the effectiveness of the treatment.
•Q: Will the cat lose its fur?
•A: No. There are no effects from the radiation on the rest of the body as it is a very low dose to start with, which is then concentrated by the body in a very small area (the thyroid gland). The majority of the radiation only travels a few mm through tissue so there is a very local effect. There is no radiation sickness: no fur falls out, they don’t get bone marrow suppression or gut damage. And they don’t glow in the dark!! A small patch of fur is shaved to allow the injection to be given safely.
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•Q: Can my cat be fed it’s normal diet when they are in the clinic for treatment?
•A: We feed a high quality commercial diet but owners are welcome to bring any special diet requirements their cat has.
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•Q: Can we see the cages they will be kept in?
•A: No. We are not allowed to let members of the public into the iodine isolation room by law. The cages are large enough to allow normal movement and there is space for a dirt tray, feed and water bowls.
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•Q: Do the cats’ vaccinations have to be up to date when they come in?
•A: We do not have strict policies regarding vaccinations for radio iodine cats. We would prefer for the cat to have it’s cat flu vaccinations up to date but sometimes in these older cats they have elapsed. It is at the owner’s own risk to admit a cat without it’s vaccinations but the risk is not that high as they are kept separate from each other and most of the others are vaccinated.
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•After the treatment
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•Q: My cat is really affectionate at home, what do we do?
•A: We would recommend minimising contact (i.e. closing bedroom doors and keeping cats off laps) and if this is not possible we recommend boarding them with us for the extra 2 weeks. The risk is from saliva, urine and faeces, therefore some of the material will be throughout your cat’s coat.
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•Q: How are other cats/pets at home affected by the treated cat when it returns?
•A: The same rules that apply to people apply to other pets. Minimising contact is the key. Therefore if the cat doesn’t interact much with the other pets, the risk should be as good as eliminated. However if the cat grooms or is groomed by other pets or they spend time in close contact we would recommend boarding the cat longer with us.
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•Q: My cat uses the veggie garden as a toilet, when is it safe to eat the vegies?
•A: Ideally the veggie patch should be made inaccessible to your cat. If this or keeping the cat inside is not an option, nothing from the garden should be consumed for 3 months.
•Q: How do we know if the treatment has worked?
•A: 4 weeks after the treatment day is the soonest we are going to get an accurate idea about how well the treatment has worked. Therefore we can’t test the thyroid hormone before the cats go home after 1-3 weeks here. We recommend going back to your regular vets at/just after 4 weeks and getting the thyroid hormone levels checked with a blood test . Symptoms of the thyroid disease start to diminish quickly so there will be improvements over the first 1-3 weeks.
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•Q: The thyroid hormone is still high after the treatment, what do we do?
•A: We recommend testing the thyroid hormone again at monthly intervals as in some cases it continues to decline for some time. If - after 3 months from the initial treatment - the thyroid hormone is still not normal we can make a booking for a re-treatment. It is our policy to have at least 3 months between treatments. Approximately 5% of cats require a re-treatment and we offer this for free.
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•Q: When does the offer of a free retreatment expire?
•A: 12 months after the initial treatment. Full conditions of guarantee available on our website.
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•Q: The thyroid hormone is low, what do we do?
•A: There are three scenarios:
•The cat is hypothyroid temporarily – some cases return to normal within a few weeks to a few months. We recommend monitoring the thyroid hormone monthly.
•The cat is permanently hypothyroid but does not show any signs. Some cats tolerate low thyroid hormone levels well and despite being hypothyroid permanently they do not require medication.
•The cat is permanently hypothyroid and requires thyroid hormone supplementation. Although this is an undesirable outcome to the treatment, the disease is less severe overall (esp. re heart and weight loss) than hyperthyroidism and is easier to control (less frequent medication). It is also a very rare occurrence - ~2% of cats.
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•Q: The kidney blood tests results are abnormal, what is the next step?
•A: This depends on the situation:
•If the cat was not on neomercazole, it may be worthwhile putting the cat on neomercazole for several weeks to normalise the thyroid hormone and while the thyroid hormone is normal check the renal parameters and USG again. There is a potential that normalising the thyroid hormone can make pre-existing kidney disease worse (can stop tablets immediately) but it is also possible that hyperthyroidism can elevate urea/creatinine, which will therefore be normal once thyroid hormone is normal also.
•If the thyroid hormone was normal when the renal function bloods and USG were taken, it may mean that there is pre-existing kidney disease. Radio iodine treatment can potentially make a pre-existing kidney condition worse by reducing blood flow to those kidneys (elevated blood flow due to the high blood pressure from hyperthyroidism) However, radio iodine treatment can also prevent further damage to the kidneys by reducing a high blood pressure back to normal. Giving palliative care with a reduced dose of neomercozole is often the best option.
