Feline Radioactive Thyroid i-131 Treatment

 I-131 is available at VCA Raleigh Hills Animal Hospital! We would like to work with you and your clients, on a referral basis, to treat your hyperthyroid patients. Our facility has been operational since March 2014! We offer radioiodine therapy with a standard 4 day stay and also offer extended post-treatment boarding for up to 7 additional days (including weekends).

Our goal is to provide a customized treatment plan suited to the needs of the patient, their owners, and the referring veterinarian.

Do you have a cat that comes to mind that might benefit?  

For cats with no other clinical, concurrent disease, we request the following prior to treatment. 

Within the last 60 days:

  • Physical examination
  • Bloodwork including renal values, CBC and T4 (free T4 if indicated)
  • Urinalysis including USG
  • 3 view thorax/2 view abdomen radiographs with radiology consult are strongly recommended, but not required, for complete pre-treatment screening

For a newly diagnosed patient, we recommend:

  • Methimazole or y/d trial for 4 weeks to attain a euthyroid state
  • Bloodwork at 4 weeks post start of medication/diet trial (renal values, CBC, T4)
  • USG while euthryoid

If you suspect cardiac disease based on a murmur, tachycardia >240, an arrhythmia (gallop), or dyspnea, we recommend the following before referral:

  • Consultation with a cardiologist
  • Echocardiogram 

If you suspect GI disease based on anorexia, vomiting, diarrhea, continued weight loss during the methimazole/Y/D trial period despite thyroid control, we recommend the following before referral:

  • Consultation with an internist
  • Abdominal ultrasound with a radiologist

 

Referral Process

Please send a completed referral form and pertinent medical records including lab work and radiograph reports by fax or e-mail. We will need to meet with each client and patient prior to treatment to examine the pet and discuss treatment options. This initial consultation is a time for us to answer an owner's questions and help them make informed choices in regards to treatment. No additional exam fee will be charged if I-131 treatment is performed.

General Program Information

Patients are admitted for treatment Mondays between 9:00am and 12pm. Patients must be eating and drinking adequately on their own. We are not able to provide parenteral fluids or assisted feeding during their stay, as it could expose the treatment team to increased amounts of radiation. We are able to administer oral or transdermal medications on a twice daily basis, but injectable medications are not able to be given. Patients will be discharged to their family or into extended stay boarding on the Thursday following injection between 3pm and 6:30pm.

Methimazole Information

Hyperthyroid patients can have occult progressive renal disease due to the increased glomerular filtration rate. Once the patient receives the irreversible I-131 injection, the glomerular filtration rate will decrease within approximately 2 weeks resulting in a potential increase to BUN and creatinine blood chemistries and a drop in the urine specific gravity. It was previously noted that normal BUN and creatinine with a urine specific gravity above 1.035 prior to treatment were good indicators that patients would have stable renal values after treatment. However, recent reports show that these "normal values" are not good predictors for development of renal disease post I-131 if a patient is not euthyroid. A pre-treatment methimazole or Y/D trial is strongly recommended for any patient undergoing radioactive iodine for this reason – both to gradually decrease GFR and reduce risk of acute kidney injury, as well as to best assess renal function before I-131 treatment. Please note a methimazole trial or Y/D diet screening does not guarantee a patient will not develop renal disease.

We understand some patients will not take medications or eat specific diets, and some cats can't tolerate the methimazole. If clients have been properly educated, and agree to sign a consent form in which they acknowledge the risk of development of renal disease post treatment, we consider proceeding with treatment on a case-by-case basis.

Questions?

If you have any questions about our service, have a case to discuss or would like to see our facility, please contact us at 503-292-9227 or [email protected].

We look forward to working with you!

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