Treatment failure in hyperthyroid cats after radioiodine (I‐131) injection

Abstract Background There is limited published information on the outcome for cats where total thyroxine concentration (TT4) remains elevated after treatment with radioactive iodine (RAI). Objective To determine the frequency of, and predictors for, subsequent treatment failure in cats for which TT4...

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Main Authors: Deirdre Mullowney, Yu‐Mei Chang, Barbara Glanemann, Harriet M. Syme
Format: Article
Language:English
Published: Wiley 2021-07-01
Series:Journal of Veterinary Internal Medicine
Subjects:
Online Access:https://doi.org/10.1111/jvim.16161
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author Deirdre Mullowney
Yu‐Mei Chang
Barbara Glanemann
Harriet M. Syme
author_facet Deirdre Mullowney
Yu‐Mei Chang
Barbara Glanemann
Harriet M. Syme
author_sort Deirdre Mullowney
collection DOAJ
description Abstract Background There is limited published information on the outcome for cats where total thyroxine concentration (TT4) remains elevated after treatment with radioactive iodine (RAI). Objective To determine the frequency of, and predictors for, subsequent treatment failure in cats for which TT4 remains elevated at hospital discharge, and to report clinical outcomes for cats requiring repeat treatment. Animals One hundred twenty‐one cats with TT4 ≥40 nmol/L after treatment with RAI (out of an original, treated study sample of 959 cats). Methods Retrospective study. Data regarding signalment, weight, TT4 concentration (before RAI treatment, at discharge, and percentage change), day of sampling, and I‐131 dose were acquired. Logistic regression was performed to evaluate predictors of treatment failure. Results In the 87 cats for which classification was possible, 35 (40%) became euthyroid without further treatment. All TT4 variables and weight normalized RAI dose were independently predictive of subsequent treatment failure. In multivariate analysis, TT4 concentration at discharge (P < .001) and weight normalized RAI dose (P = .04) remained in the final model. All 28 cats with TT4 concentration ≥150 nmol/L at discharge ultimately failed treatment, compared with 13/40 (32.5%) and 11/19 (57.9%) cats with TT4 concentrations of 40‐100 nmol/L and 100‐150 nmol/L, respectively. Of the 52 cats that failed treatment, 14 were subsequently managed medically, 12 underwent thyroidectomy (4 with carcinoma), 14 had repeat RAI treatment which was successful in 12/14 (86%) cats, and 13 had no further treatment. Conclusions and Clinical Importance Cats with TT4 >150 nmol/L at discharge after RAI might be candidates for immediate repeat treatment.
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spelling doaj.art-b7fe36ef5f7e46ecabd6c0594c8e88382022-12-21T22:46:09ZengWileyJournal of Veterinary Internal Medicine0891-66401939-16762021-07-013541688169610.1111/jvim.16161Treatment failure in hyperthyroid cats after radioiodine (I‐131) injectionDeirdre Mullowney0Yu‐Mei Chang1Barbara Glanemann2Harriet M. Syme3Department of Veterinary Clinical Sciences Royal Veterinary College, University of London Hertfordshire AL9 7TA United KingdomResearch Support Office The Royal Veterinary College London United KingdomDepartment of Veterinary Clinical Sciences Royal Veterinary College, University of London Hertfordshire AL9 7TA United KingdomDepartment of Veterinary Clinical Sciences Royal Veterinary College, University of London Hertfordshire AL9 7TA United KingdomAbstract Background There is limited published information on the outcome for cats where total thyroxine concentration (TT4) remains elevated after treatment with radioactive iodine (RAI). Objective To determine the frequency of, and predictors for, subsequent treatment failure in cats for which TT4 remains elevated at hospital discharge, and to report clinical outcomes for cats requiring repeat treatment. Animals One hundred twenty‐one cats with TT4 ≥40 nmol/L after treatment with RAI (out of an original, treated study sample of 959 cats). Methods Retrospective study. Data regarding signalment, weight, TT4 concentration (before RAI treatment, at discharge, and percentage change), day of sampling, and I‐131 dose were acquired. Logistic regression was performed to evaluate predictors of treatment failure. Results In the 87 cats for which classification was possible, 35 (40%) became euthyroid without further treatment. All TT4 variables and weight normalized RAI dose were independently predictive of subsequent treatment failure. In multivariate analysis, TT4 concentration at discharge (P < .001) and weight normalized RAI dose (P = .04) remained in the final model. All 28 cats with TT4 concentration ≥150 nmol/L at discharge ultimately failed treatment, compared with 13/40 (32.5%) and 11/19 (57.9%) cats with TT4 concentrations of 40‐100 nmol/L and 100‐150 nmol/L, respectively. Of the 52 cats that failed treatment, 14 were subsequently managed medically, 12 underwent thyroidectomy (4 with carcinoma), 14 had repeat RAI treatment which was successful in 12/14 (86%) cats, and 13 had no further treatment. Conclusions and Clinical Importance Cats with TT4 >150 nmol/L at discharge after RAI might be candidates for immediate repeat treatment.https://doi.org/10.1111/jvim.16161euthyroidfelinepersistent hyperthyroidismthyroid gland
spellingShingle Deirdre Mullowney
Yu‐Mei Chang
Barbara Glanemann
Harriet M. Syme
Treatment failure in hyperthyroid cats after radioiodine (I‐131) injection
Journal of Veterinary Internal Medicine
euthyroid
feline
persistent hyperthyroidism
thyroid gland
title Treatment failure in hyperthyroid cats after radioiodine (I‐131) injection
title_full Treatment failure in hyperthyroid cats after radioiodine (I‐131) injection
title_fullStr Treatment failure in hyperthyroid cats after radioiodine (I‐131) injection
title_full_unstemmed Treatment failure in hyperthyroid cats after radioiodine (I‐131) injection
title_short Treatment failure in hyperthyroid cats after radioiodine (I‐131) injection
title_sort treatment failure in hyperthyroid cats after radioiodine i 131 injection
topic euthyroid
feline
persistent hyperthyroidism
thyroid gland
url https://doi.org/10.1111/jvim.16161
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