I can’t even trim Steve’s nails, so the thought of giving her pills twice a day made me anxious
Steve and Justin. Photo courtesy of Justin Warren.
Steve is the only feline in my home and I am the only human. She’s a female domestic shorthair, her name a bad inside joke between me and my ex-wife. Steve doesn’t have a gender identity and she rarely responds to her name anyway. I’m her favorite furniture and she likes nothing better than for me to pick her up and carry her around. We’re very close. I often say that we have it bad for each other.
I’m a good veterinary client. I miss the occasional dose of parasite prevention, but Steve gets in for every annual wellness exam and I get all of the blood work done every time. She also goes in every six weeks for nail trims. As close as we are, we’ll never be THAT close. I’ve worked for the Veterinary Information Network for more than 17 years, and I was married to a veterinarian for about ten. I take this stuff seriously.
Steve’s last wellness visit took place in November 2019 and her blood work showed high normal thyroid values for the third time in a row, this time high enough for her vet to diagnose hyperthyroidism and prescribe methimazole. As I mentioned, I can’t even trim Steve’s nails, so the thought of giving her pills twice a day made me anxious. But not knowing what else to do, I picked up the meds and some Pill Pockets.
In an embarrassing, ham-handed attempt at administering the pill, I managed to get it down Steve’s throat just before she escaped my grasp. She promptly ran under the bed, where she stayed, overnight, and where I found her the next day after I returned home from work. Normally she comes running when she hears my key in the door. I thought about other ways I might be able to get the medication into her, but I had nothing. Steve doesn’t enjoy ingesting anything but her own kibble and water. She eschews all forms of treats. This whole medication thing was clearly not going to work out.
The next day, I instant-messaged my co-worker and close friend Tony Johnson, an ER veterinarian, to whine about my situation. His immediate response was “Nuke her thyroid.”
“Huh?” I typed back.
Tony sent me a link to an agency that coordinates radioactive iodine (I-131) treatments for cats all over the U.S. I read the summary of how a cat’s hyperthyroidism can be cured with one injection of I-131, skimmed the parts about the three days in the hospital to allow for radiation levels to drop, the necessary flushable litter, and the need to distance oneself from the cat for two weeks following the treatment while she eliminates the remaining radiation. This part in particular sounded difficult – as I mentioned, Steve and I are very close. She is the most affectionate cat I’ve ever encountered and for 12 years I’ve made few attempts to limit my contact with her, so the idea of that seemed impossible to me, but that would have to be a problem for later. I jotted down a short list of questions. The biggest one to get out of the way was the one I asked Tony: “How much does this run?” Tony quoted to me what felt like a hefty sum – the sort of money that I’m fortunate to be able to make happen, but still a lot to come up with all at once. I would have to think.
By the next morning I had decided to start the process. I had done the math and determined that if Steve lived another five years, the costs of meds and the extra blood work involved in monitoring her condition would be easily twice the cost of the I-131 treatment over time. And I knew that the cost to my relationship with Steve would grow far higher than that even if I could figure out a way to get her pills twice a day.
After some phone tag, I spoke with the coordinator who took down all of Steve’s pertinent info, and walked me through the procedure and the aftercare. I had read all of this before, but I understood that it’s an essential part of the process. At the end, we made an appointment for Steve to receive the treatment in late January. In the meantime, I would need to arrange more bloodwork and a series of radiographs.
During the following weeks I made the appropriate arrangements and waited. While waiting I had weird daydreams about Steve, under the influence of I-131, turning into a gargantuan angry monster, possibly accidently injuring me severely in her efforts to get snuggles. I watched too much television and read too many comic books as a child. I still do.
A week before the procedure, called to confirm the appointment. Yes, we will absolutely be there at the appointed time. Steve’s zoomies had increased in intensity and her appetite continued to grow. She was clearly not comfortable. I cannot speak for her, but I was ready for some relief.
I got up early on the day, ate a hasty breakfast, blocked all of Steve’s hiding spots, and brought in the carrier. Upon seeing it, Steve did her best to hide in a corner, but I trapped her easily. She croaked plaintively through the heavy traffic (she doesn’t have a proper meow, rather a grunty little croak that I can’t get enough of at home when things are well), for two hours on our way to Oakland. I was a bit early. I had the bag with the non-returnable (radiation don’tcha know) item from home (an old t-shirt I had slept in the night before) in hopes that the scent would comfort Steve during her time in the cubby watching bird videos. Also in the bag was a clean towel for the ride home and a container of Steve’s food (as I mentioned, the only thing she’ll eat).
The I-131 tech came out, went over the aftercare instructions again, took payment for the treatment, and took Steve away. On the drive home, I found myself wishing that I had asked for a moment with Steve outside the carrier where I could hold her and share some nose nuzzles (our favorite), but there were others waiting to check their own cats in and it would have been rude to delay them. My job requires a fair amount of travel, so it’s not as if I don’t spend three days (and longer) away from Steve routinely, but then I know she’s comfortable in her own space and can get daily pets and snuggles from her loving caregiver. I knew Steve would be in great hands with the I-131 tech, but one can’t really snuggle a radioactive cat. And seriously, Steve requires many pets and snuggles. I continued to struggle with the idea of her confined to a cubby watching bird videos.
The tech called daily to let me know that Steve was eating well, eliminating normally, and “meowing for attention.” This caused me to daydream more, picturing a scenario where Steve had gotten mixed up with another cat. That she had experienced some previously unheard-of complication, awful and bloody no doubt, and that some other poor people were informed of her death and were now mourning their cat who was now eating well, eliminating normally, “meowing for attention,” and being called Steve. My cat simply does not meow. I did my best to dismiss this madness and look forward to retrieving Steve at the end of the quarantine time.
I arranged a vacation day and drove back to Oakland to retrieve Steve. Normally I let her ride up front with me, airbag off, strapped in by the seatbelt and the seat moved up to wedge the carrier against the dash. This time, mindful of radiation concerns, I secured her in the back seat for the two-hour drive home, during which she croaked plaintively the entire way.
Limiting contact with Steve was a challenge. I shut her up in my spare bedroom at night, closed my own bedroom door, and cranked up the ocean waves app on my tablet so I couldn’t hear her banging against the door and croaking. It was hard at first, but grew easier over time. My partner and I had arranged a five-day vacation out of town while an informed caregiver was charged with caring for Steve and limiting pets and snuggles. I didn’t hate missing almost half of that.
Steve’s frequent zoomies calmed down significantly, her appetite diminished, and she got back to a healthy weight.
As of this writing, I just had her in for her second post-treatment blood draw. Her thyroid levels are now in the normal range and her kidney values are good for a cat her age. Hyperthyroidism, I learned through this process, can mask kidney disease.
Steve has a brain slightly larger than a large walnut in its shell, which I suppose precludes her from being glad that I put her through this ordeal, but she’s healthy now. I can be glad for both of us.
VIN News Service commentaries are opinion pieces presenting insights, personal experiences and/or perspectives on topical issues by members of the veterinary community. To submit a commentary for consideration, email firstname.lastname@example.org.