I-131 hyperthyroid tx in Northeast?

Miss Kitty needs I-131 treatment, and we are looking at centers in Concord and Rochester, NH, Cornell in NY, and Boston Angell. I'm looking for feedback on any of the above, including what total costs were, and how long the required quarantine period was.

Boston Angell is the shortest travel-time for us (from Albany) and they claim 3-day discharge.
Not sure of their costs yet, and they are closed until Monday.

Miss K says thanks in advance.

 

Is Hypurrcat within driving distance for you? Dr Mark Peterson is the pioneer in radioiodine treatment for hyper-t cats. Their Frequently Asked Questions page has info on length of stay and cost.

 

Re Mark Peterson---he is a board certified endocrinologist and was my Quirk's diabetes vet. He's one of the good ones.

 

ok, how cool is Hypurrcat?? they let you watch your kitty via a live web cam!!

 

I looked at Hypurrcat, but there are two major negatives, in my opinion.

1. At $1750, it appears to be the most expensive center in the US.
In comparison, the Imaging Center in Rochester, NH, is under $900 http://www.myhreequine.com/Iodine131Therapy.htm

2. New York has the longest legal quarantine period of any state, roughly 3x as long as Massachusetts, for example.

So, at this point, Hypurrcat is out.

 

Regarding cost, you have to look closely at to what the the treatment facility does. For example Hyperrcat does:
Laboratory testing before and after treatment (thyroid, kidney, and liver profiles), as indicated.
but the other only one only discuss that they measure radioactivity only.

 

I'm in NJ and had Maui treated at the closest place to me - which is Garden State Veterinary in Tinton Falls.

She was quarantined for 72 hours (no visitation allowed) and the cost was approx $3000. this was in 2006 and I don't recall what all that included.

 

$3000 seems high. At about that time I had my Spot treated for $1300 at RadioCat in Va. Dropped of Monday morning and picked up Thursday morning.

 

No experience with I-131 treatment but I highly recommend Angell Animal Medical Center :thumbup Great hospital and vets. Here's the info page for I-131 treatment: http://www.mspca.org/vet-services/angel ... ogram.html

Angell is open 24/7. You can call the main number and speak to a liason for more info. There are IM vets on staff during weekends but I'm not sure if any of them work specifically with the I-131 program. You may have to wait until tomorrow to speak with a vet who is familiar with the program. If you would like the name of an awesome IM vet at Angell, please send me a PM.

 

The Angell Animal Medical Center is good since:
What makes Angell's I-131 Program Unique?
-We are the only thyroid treatment program that scans cats first. Some hyperthyroid cats don't need to be treated because they do not have thyroid tumors, despite the T4 level being elevated. The scan identifies these cats and negates the need for treatment with I-131.
-Our program has a vet on the premises 24 hours a day.
-We are the only facility that handles cats with major medical issues that could complicate I-131 treatment of hyperthyroidism.
-Our license permits release after three days but we also provide boarding for clients who do not want the responsibility of the radiation issues and handling concerns at home.

The RadioCat I went too also had 24 hour vet coverage since they shared space with an ER. The facility was also a referral center that covered many vet disciplines.

 

Dr Petersen took care of my late Binky at another faclity down the street from the Bedford Hills, NY location for his hyperthyroid problem with the I-131. Back then around 2002-2005, don't remember when and it cost me around $1300.

I personally know where the current Hypurrcat location is. It has been there for several years after moving from the previous location which is now Molly's vet practice. Hypurrcat location is right off the Saw Mill Parkway. Very convenient.

He was very thorough and very personable.

He told me that every cat is different. Some cats can get rid of radiation levels rather quickly and are let home quickly whereas other cats, they have to stay a bit longer. They measure the radiation levels and once the levels comes down to an acceptable levels, that is when the cat is released to the owner.

I did see Binky via the webcam daily which was very reassuring.

 

The feedback and suggestions are appreciated.

Miss Kitty is almost 12 years old, has a T4 value of 5.5, and no symptoms of hyperthyroid with the exception of a very minor weight loss (within her "normal" weight fluctuations, though).

We have decided to have her re-tested at a place with better lab equipment (first test was at local vet office, repeat test will be at Cornell vet college). Depending on what Cornell advises tomorrow, I'm thinking a "free T4" test is appropriate (the "free" doesn't refer to the cost!). My impression is that a T4 value of 5.5 is significant in a cat that old, but I have also read that typical vet office T4 tests are pretty unreliable. We will have the blood drawn locally, then mail the sample to Cornell. Yeah, maybe I'm in denial, but I want a second opinion, especially with the lack of typical symptoms.

I'll keep you folks posted.

-Karl

 

Very few vets have in-house capability to do a T4 test. There is an Idexx snap test for T4
http://www.idexx.com/view/xhtml/en_us/e ... b=Benefits
but is requires a special reader.

My vet says the gold standard for thyroid testing is Michigan State University. Here is the test I would do:
http://animalhealth.msu.edu/Bin/Catalog ... id&Id=2171

 

Will most local vets be able to centrifuge a blood sample, in order to send it off to a professional lab?

 

All the vets that I know can draw blood and centrifuge a blood sample.

 

Hi Karl,
My cat has HyperT and did not have the "usual" symptoms either. Only the weight loss and a slightly above normal water consumption. So it's good you are reading all you can about Hyperthyroidism, remember most of them say the cat has "some, all, or none of the symptoms" - OK?

You are right in wanting a fT4. I also learned in my research that one T4 result should not be the definitive diagnosis.
No, you're not in denial - but a very good Dad, wanting to make sure - GOOD JOB!
I also had it done. and my vet sent it out.

Yes, please keep us posted. Good luck!

 

Miss Kitty is going to have free-T4 (dialysis method) testing done, then, if the hyperT is confirmed, will be going either to Rochester, NH or Angell-Boston for I-131.

The Rochester imaging center has a Technetium thyroid pre-scan as about a $450 option, whereas it is mandatory at Angell-Boston. The two centers are priced fairly similarly, assuming the pre-scan is wanted. The place in NH is significantly cheaper than Boston if the pre-scan is not requested (about $650 cheaper).

Details to follow as they become available.

 

Angell-Boston informed me that they cannot get the technetium-99m necessary to perform the thyroid scan, due to world-wide shortage and prioritization to human patients.

Cornell still has access to it. Blood was drawn locally two hours ago for a free-T4 via dialysis...results by Tuesday...then, probable admission to Cornell.

They are sort of promising a 6-day quarantine...

 

maybe the 131 treatment was about 1300 - 1500 - and the 3000 I wrote, was the total cost I paid for all the visits Maui had prior to treatment, and I just lumped it together. I'd have to see if I can find the invoices.

 

How is it going - results back?

 

The free T4 via equilibrium dialysis test method (apparently the "gold standard') came back yesterday with a value of 56 nmol/L. Normal limits vary by who you talk to, but are typically between 10-50, so she's roughly 10% above high-normal.

Both the lab and the Vet feel that Miss Kitty has the very earliest stage of hyper-T and the timing for treatment is discretionary, but should be done within six months. My intention had been to drive Miss K to Cornell this week, but I was just released from the hospital yesterday with a back problem that won't let me drive the necessary 700 miles (350 miles round-trip, twice).

I'm hoping to be ready to travel within two weeks, even if it means having to do an overnight in Ithaca to avoid the whole trip in one day.

 

If the high scale on the test is 50 , and she is at 56 - yes, she is in the begining stages. The original 5.5 was only slightly raised - that's good, so she should be getting a very little dose of radiation. Which I suppose, would mean a shorter quarantine.
Please keep us updated.

 

Miss K is being admitted Monday, 4/5, at Cornell.
She is going to hate me.

 

My Gett went in January. Gett and his brother and sister were born in my home, I adopted their mom already pregnant.

I thought Gett would never forgive me, he had never been away from our home before, but he did great. He was fine when he got home.

Even better, his face has filled out, he looks healthier than he has in ages, he actually looks younger. I have a feeling your kitty wont hate you either

 

Oh, now don't add that thought to your worries, please?
I think Sweety hates me every time I put her in the carrier and take her to the vet - but she gets over it.
It's for her own good - remember that.
Keep us updated - I'm sure she'll be fine - we're all rooting for you!

 

Just some added information, particularly why we are going to Cornell, rather than Angell Boston...

The choice was between those two centers, since Radiocat and Thyrocat centers don't do pre-scans, which we felt was important to determine I-131 dosing levels, and also to exclude the possibility of thyroid cancer, since Miss K is "borderline" hyper-T.

The pre-scans use Technitium-99 isotope, which has been in worldwide shortage for at least a year, with rationing going on, obviously with humans getting priority over cats (that would reverse if I was in control of this country...)

Angell Boston has been doing I-131 treatments for several months now, without the scan, due to lack of the Tech-99 nuclear product. Oddly, Cornell has a constant supply for small animal use, but can't get large quantities for equine use (horses, which need huge amounts due to body mass). Maybe it's an urban vs. rural thing, or political...I don't know or care.

Boston would have been first choice due to state law...2-day quarantine vs. 7-day in NY.
NYS allows human patients who have the exact same isotope administered (at probably 30X the dosage) to go home in one hour.

The situation will change as the Tech-99 shortage becomes history, possibly as early as August 2010 if/when the Chalk River reactor in Canada is functional. But, for any forum reader who wants a pre-scan before I-131 treatment, this means you will have very limited access for months, and will have to carefully shop for a provider.

 

Miss Kitty was admitted to Cornell yesterday morning, had xrays, thyroid T4 tests, urine analysis and culture, and ultrasound. With a 3.5 hour drive each way, and five hours spent at the clinic, I was glad to finally get home around 8PM.

This morning at 9AM, she gets her Technictium-99 scan, unfortunately with heavy sedation.
Once past that hurdle, it will just be a waiting game for test results to come in, then probably I-131 injection Wed. morning. They doc is hoping she will cool-down radioactively enough to allow for a legal discharge next Sunday afternoon, but that's iffy. Monday or Tuesday discharge (next week) is more likely.

The cat was pretty traumatized at first. She's never been in a car for so long, and she didn't like being poked and prodded for the tests. I was able to visit with her before the trip home, though, and she calmed down when I gave her her fleece and cardboard scratcher with all our scents from home on them. She also has all her favorite foods from home, too. It looks like nothing brought from home will be allowed to be taken back due to I-131 exposure.

BTW, Cornell University is basically a city unto itself. A lot of the students ride bicycles for shorter trips, but the shuttle buses are the general rule. Parking for cars is unobtanium. Even in downtown Ithaca, all parking is metered, 24/7. I was glad to get out of there. Even with a campus map and GPS, the campus is confusing.

 

My best to Miss Kitty for her treatments. And to you, having her away for so long. (((Karl)))

 

Going to be a long week for you, huh Karl?
Sending good thoughts - you're kitty is doing just fine, dreaming of being home again.
By the way, you picked a very good place that does the pre-scan for the dosing. I wouldn't have it done without one either.

 

Any updates on Miss Kitty's progress? Is she going to be released today?

 

Did everything go ak, Karl? Is Miss Kitty home safe and sound?

 

Sorry for the delay in posting. Two days before Miss Kitty's release from Cornell, I had a bad accident and fractured and dislocated both my shoulders. I have been hospitalized since.

My GF picked-up MK and everything went well. MK was so happy to see her and behaved well all the way home (3 hours), I'm told.

Total bill from Cornell was $1200 and change.

So, I'm still craving Miss Kitty, but I may be going home today.

 

I'm glad Miss Kitty is doing good. The $1200 is less than the $1300 I paid RadioCat about three years ago.

 

Sorry about the accident, I hope you get better fast and can home to Miss Kitty. Looking forward to updates, I assume she'll get a T4 recheck in about a month.

 

OUCH (((Karl))) Speedy healing vibes are on their way to you!!

 

Sorry to hear about your accident -
but you're home by now, and Miss Kitty too! - How is everyone?

 

Glad it went well the hard part is the isolation part treatmnpent is eassy its the waiting for kitty that's hard

Hope you feel better and get released soon.