Kits Made for Radioactive Iodine Treated Cats with Hyperthyroidism – An Interview with Scott Oesterlin
I am a part of the Cat’s Writer’s Association and recently I rec’d an email from CWA that was a pitch about a product that interested me because of my own personal history with hyperthyroidism and the debate of whether or not to do radioactive iodine to eradicate my thyroid.
Hyperthyroidism #1 Endocrine disorder in cats and over 30% of cats will get the disease in their lifetime. This can happen because a cat can get a non cancerous growth on their thyroid. The thyroid reacts to the tumor by overproducing the thyroid hormone making the kitty thirsty, hungry all the time and losing weight. To treat hyperthyroidism in cats, you can surgically remove the thyroid (rare), treat the kitty with anti-thryoid drugs or have your cat be administered radioactive iodine. These three options are the same for humans as they are for cats.
The radioactive iodine (RAI) treatment is becoming more and more common for hyperthyroidism in cats. This normally, one time treatment, has proven to have close to a 100% success rate while being painless to the cat (this is up for debate in my opinion because of what I read about humans that went through this procedure).
One of the negatives with RAI is the radioactivity in your body or in your cat’s body post treatment – and not only bringing you home but also your cat home following the RAI. Federal regulations mandate that the cat be isolated at the treatment facility for several days to several weeks before being released back to it’s family (ironically there are not federal regulations for humans and the United States is the only country in the WORLD that allows patients to go home after receiving RAI). This isolation period varies widely from facility to facility and sometimes is based on the dosage administered to the cat. The premise is that the cat will be minimally radioactive when released.
While the amount of radiation emanating from the cat is minimal at the the time of release, the underlying concern is that the kitty is still excreting radioactive iodine in its urine, feces, saliva and even perspiration for an extended period of time at home. For this reason owners are instructed to use “flushable” kitty litter and not to let the cat outside the home for a minimum period of typically two weeks.
Many owners become concerned about exposure to this excreted radioactive iodine, especially when there are children in the home. Radioactive iodine is well known to be very volatile, meaning that it easily converts to a gas and can spread and even be inhaled. Radioactive iodine can be especially problematic for children, as their developing thyroid readily absorbs any iodine they come in contact with. This can lead to thyroid cell damage, death or mutation. Long term risks may include induced hypothyroidism or worse. (When I was considering RAI for my own hyperthryoidism they told me that I couldn’t be around my cat for several days because the radiation in me would kill his thyroid).
The Nuclear Regulatory Commission has a policy in effect called ALARA, which means “as low as reasonably achievable” and states that all reasonable means should be taken to minimize exposure to radiation.
Laboratory Technologies Inc. has developed a small inexpensive kit, called the Bind-It Feline Care Kit, that safely and effectively traps radioactive iodine and removes it, so that it cannot volatilize or cause contamination beyond the litter box. The Bind-It kit contains a spray and hand soap, both of which are designed to bind and remove radioactive iodine. This kit is based upon a product of that has been used for radioactive iodine cleanup for many years in Laboratories and Nuclear Medicine Departments. It is completely safe for pets and owners and very convenient to use. Using a Bind-It kit is a simple, inexpensive, and highly effective way to safeguard the family and friends from the harmful effects of radioactive iodine contamination.
I reached out to the original writer of the post and was transferred to Scott of the same company – I wanted to learn more about this product that they were selling and why it was important to be sold. Below is my interview with Scott:
Q. What are the treatment options for a kitty with hyperthyroidism?
A. Hyperthyroidism is the leading endocrine disorder in cats. There are three typical treatment options:
- Thyroid surgery. This can be expensive, and as you can imagine based on the small size and location, very delicate. Damage to vocal cords has been reported. As with any surgery, there is a period of healing afterward, and quite a bit of discomfort for the patient.
- Thyroid medications. If this route is taken, it is a lifelong commitment. Once the proper dosage is determined, pills must be administered 1-3 times every day for the rest of the cat’s life. Medication can only suppress the symptoms, it is not a cure. Often the dosage will need to be changed and adjusted numerous times. Periodic blood tests will need to be maintained.
- Radioactive iodine. This is the newest and for some people, controversial treatment. It’s not cheap, but it is usually less expensive than medication over the lifetime of the patient, and comparable to surgery (certainly less if secondary surgery is needed). Radioactive iodine treatment has up to a 97% first time cure rate, and it is said to be painless to the patient. Radioactive iodine treatment is widely considered to be the most effective and least traumatic method.
Q. What is the harm in keeping them on ATDs (anti-thyroid drugs)?
A. Probably the constant monitoring, rechecking and administration of the pills. Thyroid medications are not curative, they merely seek to control and suppress the hormone levels and symptoms. There may be some concern about long term liver and/or kidney damage from the medications. Surgery and radioiodine treatments are curative by contrast.
Q. What do you guys do?
A. LTI is primarily an instrument manufacturer. For 30 years we’ve been designing and making instruments for counting radioactive samples in clinical laboratories, hospital nuclear medicine departments and other areas. We have developed a series of products for radioactive decontamination in those facilities as well. Whereas other radioactive decontaminants can be very harsh, emitting strong odors (think rotten eggs) and even clouding the leaded glass used in nuclear medicine departments, our Bind-It products are pleasant scented and gentle – they are safe for almost any surface.
Q. So you have a kit to help prevent RAI contamination. How did this come about?
A. A couple of years ago, we were contacted by a lady whose husband was undergoing radioactive iodine treatment for thyroid cancer. She found Bind-It through a search, and contacted us about purchasing some to clean her home after her husband’s treatment. She had young children in the house and was very worried about contamination. Even though the products at the time were not labeled for consumer use, she purchased them and encouraged us to look into making patient oriented versions. We discussed this idea with other patients, as well as nuclear medicine technicians, and they all agreed that it was a good idea. Many of them worried about patients contaminating their homes and exposure to children, so they felt it was a good idea. That’s how the first consumer oriented Bind-It kits came about.
In a similar way, we kind of “fell into” the the cat treatment area. One of the major treatment centers which has many clinics across the country had a contamination issue at one of their centers. We rushed them some Bind-It products to help them decontaminate their facility. They were so impressed, that they purchased the products to keep at each of their clinics to have quick access. After some discussion with them about making kits for customers to help prevent home contamination, we developed a more compact version specifically for feline treatment. They are presently looking into the possibility of supplying the kits to all their customers as part of the treatment.
Q. What happens when I bring the cat home? What is the cat likely to contaminate? What do you have to keep your kitty away from?
A. When you bring your cat home you will most likely be instructed to keep the cat isolated in a bedroom or other area so it doesn’t have free roam of the house. Likewise, you will probably be told not to let your cat outside for 2 weeks or so.
The main source of contamination will be from the cat’s urine, so the litter box is the most prominent point of contamination. You will likely be told to use flush-able kitty litter and to dispose of it in the toilet. It is important to wash your hands and clean the toilet after flushing the litter. Your cat’s saliva is another strong source of contamination. Therefore, it’s fur is likely to be contaminated as it cleans itself.
Q. Why can’t I use regular cleaning products? Like bleach or bathroom cleaners?
A. Bleach in particular is well known to cause radioiodine to volatilize and become gaseous. Iodine does this naturally, but bleach hastens the effect. The same is true with many acidic cleaners like bathroom cleaners. Many people naturally think of using the strongest cleaner they can, which is why you would think of using bleach. It kills everything, right? While that’s true of bacteria, viruses, etc. it’s not the case with radioiodine. You can’t kill it, only remove it. Turning it into a gas where it can be inhaled isn’t the way. The scary thing is, whether it’s patients being treated in a hospital, or cat owners bringing their cats home, they are rarely warned not to use bleach. If you go to any major university’s website and find their radiation safety guidelines, you will find that they very strongly warn against using bleach in the event of a radioiodine spill. Why this isn’t told to patients or cat owners is a mystery to me.
Q. How much are your kits?
A. The feline kits are $54.95, and contain enough hand soap and spray cleaner for 2 weeks of cleanup at home.
Q. How much testing have you done with the kits? In other words, how do you know they work?
A. Bind-It products have been in use for over 20 years in medical institutions around the world. They are used in laboratories, nuclear medicine departments, to clean hospital isolation rooms, nuclear pharmacies and cyclotrons.
We receive a lot of feedback from customers telling us how well the product works. In fact, they even surprise us sometimes on the range of surfaces they are able to decontaminate. We had one example where a patient had vomited on the wall of a hospital room, and the radioiodine had gotten under the wallpaper. Nothing would remove the contamination until they tried Bind-It. The solution actually pulled the radioiodine from under the paper and they removed it with paper towels.
There is a paper on our website (www.I131safety.com) that was presented to the European Health Physics Society meeting last year. This paper outlined a study done by technicians at a prominent hospital in the U.K. showing the effectiveness of Bind-It. Likewise there is a letter also posted on the site from one of the technicians who performed the study telling about her experience with Bind-It products.
Q. Can you order it online? Or how do I get one?
A. Both the human kit and the feline kit are available to order online. Our websites for these products are: www.i131cat.com (feline) and www.i131safety.com (human). Bind-It kits are also available at: www.oldmaidcatlady.com, and are coming to several other online retailers soon. We are also working with several nuclear pharmacies to be possible distribution centers.
Q. Would you buy this if your cat has RAI done?
A. Well obviously, my answer is going to be a little biased – but yes I would buy this kit. Here is my reasoning:
My son is 20 years old, but I have younger nieces and nephews who come over often. Contamination that is not removed will persist for a long time. While I131 has a short 8 day half life, that doesn’t mean it will be gone in 16 days. It means that every 8 days the amount remaining is reduced by 1/2. Higher contamination areas not cleaned properly can still be radioactive after 3 months or more. Personally knowing how well Bind-It removes radioiodine and following the instructions in the kit, I would be comfortable with the procedure.
Now, with all that said, it is my opinion that I131 treatment for feline hyperthyroid disease is a very viable and safe option. Since the cat is isolated at the clinic, the amount of radioactive iodine remaining upon release is fairly small, but is still a concern. Following a little common sense, good hygiene and having some knowledge will make the procedure not just good for your cat, but safe for your whole family as well.
Category: Health Care