Taggart’s I-131 Treatment & Radioactive Kitty Update
Now that Taggart’s hyperthyroid treatment is a few weeks behind us, I can finally write about it and give you all an update. She was the whole reason we came to NYC after all, and although we managed to squeeze in quite a few outings in the Big Apple, pretty much all of our sightseeing was timed around her and the radioactive pee watch that came after.
For those who just want the short summary the treatment went smoothly, she appears to have recovered well, but we won’t know for sure if she’s cured until her next blood tests. For those of you interested in the gory details below is an update of how everything went and how we’ve handled the tricky after-treatment & radioactive watch period. And of course for those not interested at all, just feel free to skip the whole post. Here goes:
Being Mobile For Health Care Can (Sometimes) Be An Advantage
I did a lot of research before we settled on a treatment spot for Taggart. Part of it was my general OCD’ness (I research everything half to death), but part of it was also because we were ABLE to do so. The clinic that I chose is one of the top 2 in the country and traveling to NYC, although not part of our original plans (or budget) was do-able. It was a choice, and being able to make that choice is something I’m deeply thankful for.
Unexpected health issues (whether it be for your paws or for you) are always going to occur at some time or another, and they can be super tough to deal with on the road. You don’t have a trusted network of vets/docs or hospitals that you know, you don’t have a fixed place to stay (for treatment or recuperation) and whatever travel plans you made for that month (or even the year) will likely ALL have to change on a dime. That’s part of the uncertainty you accept when you go fulltime RVing.
On the other hand being mobile means you can go almost wherever you want. And as long as your issue isn’t an emergency or super time-critical, that can be an advantage too.
In Taggart’s case we thankfully had some time to think. We put her on the hyperT meds for several months to see how her kidneys would react (I covered this in my last post on this). This also gave us some breathing room to deal with Polly’s torn ACL (which was way more time critical). Once we were done w/ doggie and got a clean bill of health on the cat we were able to go ahead and book the I-131 clinic. In this case our nomadic flexibility worked out.
Choosing Hypurrcat (Animal Endocrine) Clinic
Hypurrcat is widely known in the feline hyperT community. The Doc in charge (Dr. Peterson) has done years of research into this particular disease and published many excellent documents both online and in the vet community. In fact if you lookup research on hyperT his name is very likely one of the first authors you’ll see on most of the papers, and if you’re wanting to learn about the disease his website is one of the best resources out there. They also have an active Facebook page where you can see all the cats going thro’ treatment at the clinic.
Hypurrcat has two I-131 treatment locations near NYC, one inside the city itself and one an hour north at Bedford Hills. However stay limits & costs are quite different at each. Due to local city ordinances the NYC location requires a 5-day stay (and is more expensive as a result), whereas the Bedford Hills clinic only requires a 3-day stay. He only accepts cats once a month at each clinic and is generally booked out 1-2 months ahead of each open date.
For accommodations, both clinics provide a very nice 2-level “condo” for kitty which is equipped with a hiding spot, separate litter area and a live web cam (you can watch kitty online!). Plus they provide kitty entertainment including a flat-screen TV that plays relaxing nature videos and also a live gerbil habitat (right opposite the condos). It’s a pretty cushy set-up.
For Taggart we wanted the minimal possible time in isolation so we chose the Bedford Hills Clinic with admittance Oct 3rd. We had to stop her meds (Felimazole) 7 days before treatment, but otherwise there was no other prep needed.
Taggart’s Stay At The Clinic Went Smootly
The day I drove Taggart to the clinic I very nearly got into a serious car accident. The drive from Liberty Harbor RV Park to Bedford Hills is pretty crazy either taking you straight through downtown or across the Washington Bridge, both of which will enter into the maelstrom of NYC traffic. I was so stressed and anxious that I barely missed a hit from a crazy driver swerving in from another lane and was so shaky it took me around 1/2 hour to calm down once I got to the clinic.
But I needn’t have worried.
The clinic was awesome, really it was. Carol (the lady at the front desk) is warm and calming and does a fabulous job with all the overly-stressed kitty owners coming in. Dr. Peterson is very patient and thorough and takes time to describe everything in detail to all his patients. Plus you get a tour of the facility and a detailed run-down of everything that happens to kitty during his/her stay.
I left Taggart at the clinic at around 10AM. She got full blood tests and a thyroid scan an hour later which showed a moderately large tumor (1.9 by 1.5 cm) on her left thyroid node. She was injected with a very small amount of I-131 (1.85 mCi) and then put into her kitty condo for monitoring.
While she was at the clinic I was able to check-in with her all day (on the kitty cam), plus I was able to call-in pretty much anytime I wanted if I was anxious and had questions (I think I called 3 times in the first day, and the clinic was superbly gracious and patient with me each and every time). Hypurrcat also called me every AM to give me a detailed update on how Taggart was doing including her activity levels, behavior, food intake, bowel movements and pretty much anything else a kitty owner would even remotely stress about. Their attention to detail was amazing.
I picked her up 3 days later and got her full discharge papers including her scan results (which had already been e-mailed to me) and test forms for the follow-up blood tests (see below). Apart from the bill (cough, cough), it was painless overall.
Radioactive Kitty Watch In The RV
The hardest part of I-131 treatment, apart from the time kitty has to spend away from you at the clinic, is handling the radioactive discharge when he/she gets home. Kitty herself is mostly fine (especially with the small doses** they give at this particular clinic), but you are supposed to limit how much she lies ontop of you (at least for the first week) and her pee/poop is “hot” for some time. For 2 weeks after treatment you must scoop and clean the box regularly, and then either flush the soiled litter down the toilet (if you live in a regular house where you can do that kind of thing) or store it somewhere safe for 3 months before you throw it away.
In the RV there’s not too much we could do to limit physical contact (we’ve done our best, but we just don’t have that much room), but we have been super fastidious about the litter-box. We scoop everytime she goes, wash our hands thoroughly and store each scoop in an empty litter container outside the rig (underneath the RV). Since we have TWO cats and we don’t always catch who did what we’ve simply been storing ALL the soiled litter (from both cats) in the same place. As we travel we will keep the container(s) in one of our bins until they are ready to be thrown away.
The other (kinda crazy) thing we’ve been doing is timing our outings around kitty pee. As soon as Taggart goes we know we have a few hours of free time before we have to be home on watch again. It’s a very (overly) conservative approach and it’s been a tad limiting (we actually had to cancel seeing some friends in NYC with the line “sorry, kitty hasn’t pee’d yet” -> whoever thought we’d use that excuse?!), but thankfully she is fairly regular so it’s not been too bad. The things we do for our pets, eh?
**Geek Stuff: For the geek types out there I-131 has a half-life of 8.02 days, so it decays fairly fast. The first days after treatment are the most critical which is why clinics keep the cats isolated for that time. When cats come home levels are typically low enough that they are emitting negligible body radiation, but they do continue to eliminate through pee/poo. Obviously the bigger the dose of I-131 given, the more radioactive your cat will be afterwards, and one of the advantages of Hypurrcat is that they use VERY small, targeting dosing (typically 1.3-2 mCi) compared to most clinics (typically 4 mCi). It’s one of the many reasons I chose them. I actually wish I had had the foresight to buy a Geiger Counter before we did the treatment (you can get them on Amazon, of course!) since it would have been interesting to test Taggart’s radioactivity after the treatment. Oh well!
What’s Next? Is She Cured?
So, basically we don’t know yet. After almost 2 weeks home she already looks MUCH better. She’s started to put on weight, she’s more relaxed (less “hyper”), she stopped sneezing (a side-effect of the hyperT and the meds) and she honestly looks really, really good. We’ve also had zero side effects from the treatment except for around 3 hours of meowing when she first got home from the clinic (she was seriously telling us off) followed by a solid 24-hour sleep (she was VERY tired). Other than that no eating issues, no lethargy…she just looks and acts like a normal cat!
But we won’t know for sure if she’s cured until the next blood tests.
Serum thyroid hormone (T4) typically normalize within 4 weeks of treatment in ~85% of cats and in ~95% of cats by 3 months. So we have to test kitty at 1, 3, 6 and 12-months to see how her thyroid is doing. At Hypurrcat these tests are actually covered in the $$ you pay up-front for the treatment and can be completed anywhere in the country (you just need to find a vet to draw the blood and send it in). The hope is that the I-131 has completely killed the tumor and any remaining healthy thyroid has kicked in and normalized her levels. We’ll know more when we take her for her first test in NC at the end of this month. Paws crossed!
That wraps up our kitty update. If you’ve got any questions or thoughts about hyperT or I-131 feel free to comment below. In the next post we’ll be back to our regular RV travels -> there’s a Podcast, a ferry trip, some old friends and wild horses involved 🙂