Belle is home from radioactive iodine treatment! :)

[Susan and the girls]

Well, I got to bring Belle home yesterday afternoon. She is below the "allowed level" of radioactivity (per the Vet school & what they called "state guidelines") but she still has to be isolated (i.e., kept away from the other cats & my children) for two weeks. I have to wear gloves when changing litter or when I might come into contact with any bodily fluids. (Belle is a kisser - on my hand - when I pet her, so I try to wear gloves when I pet her a lot, too.)

She meowed the WHOLE way home. It was not her 'chirpy' meow, either. It was either fussing at me asking why I hadn't gotten her sooner, or telling me all she'd gone through there.... LOL

She looks so pitiful! I guess living without her for a week made her weight loss seem even more pronounced when I got her out of the carrier. She looks so "pekid" -- skinny and weak.

She didn't eat much of her food overnight, just a few nibbles. She did drink some water, though. She's been home roughly 20 hours and has only produced one BM that was about 2" long and urine which made a "golf-ball" sized clump in the clumping litter. Traci -- is that enough? She is a social eater, so I pop in every hour or so to talk to her & she eats one or two nibbles. She just doesn't look like she feels great. And, what's worse, her usually VERY white paws & legs & chest are "dirty" looking -- like she has been walking through dusty dirt. I know that she was kept isolated there at the Vet school because of the treatment, but it bothers me to know that she came home so dirty looking. I mean, was her cage THAT dirty? It makes me wonder about the quality of her care, really. It's a teaching hospital, not my dear vet's office, and they have students do the majority of the care. By nature of her treatment, she could not be handled, and the amount of time they spent in the room with her had to be minimized, but REALLY.... did she HAVE to come home looking THIS unkempt? I may have to question them about that....

If anyone else has had a cat have the radioactive iodine treatment, would you respond & let me know how your cat acted when you got him/her home? I just wonder if this is the "norm" for a cat who has been caged for a week with this treatment.

Thanks!

[Traci]

Susan, it isn't unusual for them to go through an "adjustment" period directly after being released from the clinic.

There should be no side effects from the treatment, and a decreased appetite at first might be noted, this could also be due to a bit of stress upon returning home (admustment). Sometimes cats have a little bit of a sore throat but you should be able to determine that by a raspy voice.

As for the BM and urine amount, don't worry about that right now, with each passing day, her output should return to more normal. Likewise, as she adjusts to being home, each day she should consume more food and water.

As for the unkempt coat condition, my guess is that the staff are not allowed to thoroughly bathe the cat due to emission of radioiodine, increasing their risk. But, by all means, call the clinic and ask if this was their reasoning. Also ask how her appetite was while there, her elimination habits, her overall demeanor, what food she was eating and if she was weighed both prior to and at time of release and ask them for those weights. DO express your concern if you feel Belle is weak, there should be no reason she should be weak, so discuss that with them immediately.

Did they give you an instruction sheet? Does such a sheet explain they will follow up with you or your primary vet? Does the instruction sheet recommend you follow up with your primary vet within 2 weeks?

[Susan and the girls]

Hey Traci!
I was SO hoping you'd reply!

Yes, they gave what I'd call a VERY thorough "discharge" sheet, explaining how to do everything. And believe me, I asked a LOT of questions to make sure I was clear!

The summary says that "she ate reasonably well and urinated within normal limits." She ate more when they were there in the room with her. That's just her style.

I didn't ask if they'd weighed her. All I know is what she weighed upon admission (10.7 lbs). I had asked the student who was last with her if he could (please) check her heartrate, and he tried, but couldn't get a good count because she was purring so loudly. (It was the first time he'd been able to get her OUT of the cage the whole week.) My vet had never ascertained an accelerated heart rate in her office. Belle is always very comfortable with her, so I questioned the Vet school vets (repeatedly) if they thought she might be anxious, and THAT might be why her heart was racing, but they were "sure" it was the hyperthyrodism. (Bedside manner is definitely lacking at times in a teaching hospital. I sorta got the feeling they thought I was a totally uneducated owner.) Her heartrate was 280, but her bloodpressure was 120 mmHg. They actually said "a grade 2 out of 6 sternal heart murmur was ausculted, but no arrhythmias, crackles or wheezes were heard."

I knew they wouldn't be able to bathe her. (She would NOT have liked that anyway.) I kept asking if they could just brush her some, and the students always said they had to limit their contact. I know that compared to the average person in the non-medical field, they have a MUCH higher exposure to things that are dangerous in large quantities (like radiation), so I tried to reassure myself that it wasn't neglect, but "self-preservation" for the persons treating her. They explained repeatedly that the radiation exposure (to me or anyone) comes mainly from her bodily fluids and feces, and that being in the same room with her (at this lower level) is "safe."I just really expected they'd "hang out" more with her than they did when she got to a lower level. After all, they "suited up" completely when they went into her room.... But I actually had to drive all the way around to the back "loading dock" to pick her up from the "isolation" area because they couldn't bring her through the hospital and expose other animals....

Maybe she's not more lethargic or "weakly" than she was before admission. Maybe she's the same as she was, and I'm just paranoid. Maybe she's just resting.... She doesn't act "weak," per se, but she's content to sit on her little cushion, and her food isn't disappearing like it was before. (I had originally told them she wasn't eating or drinking more than usual, but after she'd been gone a couple of days I realized that she HAD been. The food bowl(s) were staying full, and I wasn't having to refill the water bowl nearly as much.

I am to follow up with bloodwork in three weeks. We're going to check her kidneys very well, too. (The Vet school vets, with their lovely bedside manner, said - very matter of fact - that she could likely go into renal failure following the treatment. I discused that at length with my regular vet and she wasn't so worried about that, since Belle's kidney values have been good since 2005. I'm just praying very hard about that!) Maybe I'm subconsciously looking for symptoms and Belle's lower energy level is making me nervous. (In the last 4-5 years, Belle has never been the bundle of energy! Why am I expecting that now, after she's just had a major treatment???)

When I walk into the bathroom where she's staying, she hops right up off her cushion to meet me - meowing the whole time, or she sits up & meows at me in greeting. I just want to make sure she's putting out enough urine. What would I be seeing if her kidneys were in trouble? Less output? More output? Less odor? I am trusting God that her kidneys are going to be fine, but I can't help worrying! After all, I'm only human!!!

[Susan and the girls]

Oh - wanted to add this, too: The accelerated heart rate was found when I admitted her to the Vet school. They actually gave her a beta-blocker shortly after she was admitted (just before the I131 shot) so that her heart wouldn't be racing when the radioactive iodine hit her thyroid. They tried to give her another one each day, but she wouldn't "eat" it in the snacks they hid it in. That's why I asked the student (who was last with her, and who checked me out) to check her heart rate before I brought her home. He couldn't get a rate. I'm very tempted to take her to my vet just to see if they can take a listen.....

[Traci]

You can "try" to weigh her if you have a bathroom scale at home. Just weigh yourself, then pick Belle up and hold her and weigh yourself while holding her and calculate the difference. Try doing this twice a day for accuracy, at least for two days for a more accurate number.

Stressed cats at any clinic won't eat as much as they normally do at home, not much one can do to change that, except change the environment, and not easy to do with this type of clinic. Most radioiodine clinics try to enhance the environment with a comfy room, soft music or cat videos etc, but it will not help the cat when people come to tend them all dressed up in hazard material suits! So, it is possible she has lost a small amount of weight due to stress and not eating as much as normal. As long as weight loss is not severe, she will soon compensate for this and start eating more regularly when she is less stressed (which can also be a good sign the thyroid is back to normal function).

Whatever amount going in is the only amount that's going to come out. So, if she's not eating or drinking too much right now, she isn't going to produce much output either way. Give this a couple more days, and accomodate her if you can by offering to sit with her more times during the day to encourage her to eat. Are you feeding her canned or dry? Perhaps canned might encourage her more right now.

Renal patients usually tend to drink more, and urinate more than usual. Urine is sometimes very concentrated or very dilute, depending on the individual cat, whether infection is present, and based on water intake and the kidney's ability to filter. Don't worry about this at this point, keep your scheduled appointment, and check bloodwork then.

Your own vet will be better able to listen to Belle's heart and lung sounds, since it sounds like Belle is more comfortable with your vet's clinic and because the exam room isn't as restricted as the radioiodine clinic. Plus, make sure your vet takes 3-5 blood pressure readings at the same appointment to get the most accurate reading.

Some of it MAY be your projection of how you visualized Belle's health state prior to treatment and then now. Even a two-day stay at any vet hospital can leave a cat with a different appearance to the owner and we are even more keen as they are released. Sometimes it is simple handling of the cat which gets the fur coat all dissheveled and the cat is stressed and doesn't groom. Sometimes it is because poking and prodding leave shaven marks, cage confinement prevents grooming, litter in litterbox is dusty and gets on fur in confined space etc etc. But, weight loss is concerning when there has been a significant loss in a very short period of time.

Do not bathe Belle yourself. If her fur seems "dirty", simply take a slightly dampened bathroom washcloth and run it over her fur. If it is slightly damp, this will encourage her to groom herself. Otherwise, don't do anything, when cats get home from the hospital, they tend to start grooming on their own, at the very least, to rid the hospital scents off of them. When she feels less stressed and more relaxed, she will probably start grooming herself.

If, by Monday, and you still feel Belle doesn't seem to be feeling 100%, call your primary vet and see if he would like to see her to be on the safe side. Otherwise, keep a close eye on her but I think you'll find she may just need to have a couple days to readjust to being home.

[Susan and the girls]

Thanks Traci!
I think I'll try the damp washcloth with her. Until I read your post, I hadn't even considered that their litter was a different type than what I use. I believe they told me they used a "biodegradable" type. That probably explains her "dusty" look.
I'll try weighing her here, too. I have a digital scale, so at least I'll get a "number" instead of a wiggling pointer I'd have to guesstimate with...
Earlier today, I cut up two thin slices of packaged meat and she enjoyed that. They said they fed her the ScienceDiet there, but she also ate some canned food. My cats usually try to "cover up" wet food!

Thank you again for replying! I'll keep you posted.

[Traci]

I think they recommend litters like Sweatscoop, etc, pellet and sawdust crap, LOL. But, because small amounts could be flushed down the toilet I guess. And yes, those types of litter will leave residue, and in a confined space, probably unavoidable to get on fur and paws.

[Susan and the girls]

Yes, they told me that if I used a "flushable" litter, it was safe to flush (in a municipal system), but since I have a septic tank, I can't. The resident actually said that she'd tried flushing the "flushable" kind once and had a pretty bad clog in her toilet that made a horrible mess....

It's 11:30 pm and Belle has eaten a *little* more. She has urinated another 'golf ball' sized clump, too. She's SOOOOO talkative when I go in, and she's so happy when I just sit & talk to her. I really have to watch out because she loves to rub her mouth on me as I pet her. (Not supposed to get saliva on me!) She just gazes at me with her big golden eyes, too, as she makes biscuits and purrs. I wonder what she's thinking. It's like she's in love with me or something!!

I tried offering her some wet food (some Science diet stuff I bought a while back) and she wasn't interested. After I'd been in the room with her a few minutes, I kinda ignored her and she went over to her bowl & ate a few crunchies. I figure if she's at least eating SOME, it's progress!!

[Traci]

The canned was just a suggestion, but if she won't eat it, don't worry about it, she will probably start eating more of her normal dry food.

[Susan and the girls]

Well, she's eating a *little* bit more. I've taken her the sliced sandwich meat (diced up) several times, but her food is finally starting to slowly disappear. (I put about 3/4 c when she came home Friday late afternoon, and two days later about 1/8 of a cup of it is left. That just seems like a starvation diet, so I'm making sure she gets a little extra "snacks" and ham.)

Is the ham safe to give her occasionally? How about a scrambled egg? I gave her two small (1 inch cubes) of chicken from the stir fry last night, and she loved that. She may like some cheese, too. I just want to get calories in her!

I've scooped a total of four (maybe five?) clumps of urine out. The first two were about golf-ball sized, and the next ones were a little larger.

She is meowing and purring, kneading the floor, and seems much happier today. I took my hair dryer to "her" bathroom this morning to dry my hair (she LOVES to paw at me when I dry my hair) and she *really* seemed to like that. I just have to watch out because she's such a kisser. She got up on her haunches and tried to kiss me several times.

Oh - this morning, when I went to check on her, as I walked up the stairs I could see that the bathroom door was OPEN!!!!!! The other cats were happily resting in our bedroom downstairs, so I don't think they were even aware. I walked in (panicked!), and there sat (my very obedient) Belle, just as if the door was closed. All I can figure is that I didn't close it all the way and the "suction" of the heat coming on pushed it open. She greeted me with her "MEOW!!" and sat up on her cushion.

She's such a doll. She's starting to clean up the dusty spots on her white fur, and I really think she's feeling better.

Traci - does this all sound pretty normal still?