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Q: My cat has a thyroid tumor, which my vet offered to remove for $650. I haven't followed through with the surgery, partly because of the cat's age and because she otherwise seems to feel well. Her appetite is good and she's active, though very thin. What do you think about surgery? Is there a less expensive, nonsurgical option?

A: That's the odd thing about hyperthyroid disease in cats: They seem to be doing well in so many ways. In fact, it seems as if they've discovered the fountain of youth. They're also very hungry but remain thin.

Atlanta feline specialty veterinarian Drew Weigner explains that, in general, if the size of the tumor concerns your vet, a needle biopsy may rule out cancer. Generally, veterinarians prefer to deal with hyperthyroidism by either radioactive iodine or medication.

Radioactive iodine is considered a cure. This treatment effectively destroys the part of the thyroid gland causing the problem. However, cats undergoing this treatment are literally radioactive for a short time and must be separated from their families for several days. The cost is $800 to $1,200. According to the vet books, 10 percent of cats may require another treatment, but Weigner says he has personally never seen that needed.

Though medication is not considered a cure, it's an effective way to control the disease. The medicine is fairly inexpensive and relatively easy to administer (though not all cats would agree). Side effects are rare but potentially serious. (Problems are typically avoided by close monitoring for two months after medication is first prescribed.)

Ironically, curing hyperthyroid disease (with radioactive iodine treatment) may unmask underlying kidney failure. If your cat has underlying kidney disease, your vet may reject radioactive iodine in favor of medication. Also, radioactive iodine is not suggested for cats that just wouldn't do well separated from their families. Hyperthyroid disease almost always occurs in cats older than 10. For elderly cats, Weigner says he generally prefers medication. For younger cats, that's a lot of medication, and over time, the cost could easily add up to a figure well over that of radioactive iodine.

"It's really a case-by-case basis to determine what we do," he says.

Steve Dale welcomes questions/comments from readers. He will answer those of general interest in his column. Write to Steve at Tribune Media Services, 2225 Kenmore Ave., Suite 114, Buffalo, NY 14207. Send e-mail to