Arlie's Thyroid Panel Results

[Rickiesmom]

My vet received the following from Dr. Dodds lab for Arlie:

 

T4 - 6.9 nmol / L (low normal is 15)

 

T42step - 4 pmol / L (normal is between 8 and 32)

 

T3 - 1.65 nmol / L (normail is between 0.9 and 2.1)

 

TSH is 0.17 ng / ML (normal is 0 to 0.6)

 

Apparently in people TSH is the gold standard for measuring hypothyroidism (in which case the value would be high) however, my vet says the accuracy in dogs is about 35%. The interpretation is that she is hypothyroid but I would like to ask those of you who are familiar with normal values to comment. In parallel I am going to look through some of the reference material that has been posted in this forum recently.

Edited July 21, 2007 by Rickiesmom

[Burpdog]

You can email Ohio State. It is my understanding that TSH in dogs is not very reliable and I've seen comments like "disappointing" as to it's reliability.

 

Looks like she's a bit dificient

[ahicks51]

If Dr. Dodds at Hemopet says Arlie is hypothyroid, I'd believe it. The meds aren't expensive; give Soloxine a whirl, and see if there's any change in activity, attitude, etc.

 

Some vets prescribe whatever synthetic thyroid they have on hand; others are explicit about Soloxine. I seem to recall Dr. Stack being quite specific with respect to using Soloxine. YMMV.

[Guest dmona]

Rickiesmom, if the vet says to give soloxine, I have a prescription that I had filled for my cocker spaniel that we had to put down. I will be glad to mail it to you. You get let me know by email dmona4@verizon.net. I have no use for it and would love for someone to be able to use it. It is 0.3 mg.

Edited June 14, 2007 by dmona

[Guest hllb]

dmona - my mini-schnauzer takes .3 mg thyrozine right now. If soloxine is equivalent, I would love to take it! I can't PM yet on the forum so you can email me at hlaclair@gmail.com

 

Holly

[Rickiesmom]

Rickiesmom, if the vet says to give soloxine, I have a prescription that I had filled for my cocker spaniel that we had to put down. I will be glad to mail it to you. You get let me know by email dmona4@verizon.net. I have no use for it and would love for someone to be able to use it. It is 0.3 mg.

I am very sorry about youd cocker spaniel.

 

Thank you for the offer of the soloxine, I really appreciate it. Perhaps someone else will be able to use it, unfortunately as I live in Canada I don't think it is permitted to send prescription drugs across the border privately. (I tried to PM you but could not as you don't have quite enough posts yet (requires 50).)

[Guest dmona]

dmona - my mini-schnauzer takes .3 mg thyrozine right now. If soloxine is equivalent, I would love to take it! I can't PM yet on the forum so you can email me at hlaclair@gmail.com

 

Holly

 

 

What does PM mean? Hope that's not a dumb question. Holly, I emailed you.

[Guest dmona]

Rickiesmom, if the vet says to give soloxine, I have a prescription that I had filled for my cocker spaniel that we had to put down. I will be glad to mail it to you. You get let me know by email dmona4@verizon.net. I have no use for it and would love for someone to be able to use it. It is 0.3 mg.

I am very sorry about youd cocker spaniel.

 

Thank you for the offer of the soloxine, I really appreciate it. Perhaps someone else will be able to use it, unfortunately as I live in Canada I don't think it is permitted to send prescription drugs across the border privately. (I tried to PM you but could not as you don't have quite enough posts yet (requires 50).)

 

I didn't even think about the mailing of meds to Canada. That's all I need is to end up in jail for trying to do something nice. Hope you get a diagnosis for your pupper. Also, thanks for the condolences.

[Burpdog]

Am I not reading right or did they not do the equilibrium dialysis? What did Dr. Dodds say?

[Guest taylorsmom]

Just what I was going to ask--what did Dr. Dodds say in her interpretive report? I would go by what she said, she has lots of experience with greyhounds. I get Taylor's thyroid testing done by her lab, and have her on what she recommends. I also want to put a plug in for Soloxine as opposed to the generics-- first I had Taylor on the levothyroxine and saw a big difference when I had her switched to Soloxine because of Suzanne Stack's recommendation. I think the free T4 is an important value too, but I don't think I see it here?

[Rickiesmom]

I didn't actually see the report - spoke with my vet over the phone and he said the interpretation was hypothyroid but I don't know if there was any additional information. No one mentioned equilibrium dialysis so I'll ask about that too. My vet won't be back in the office til Monday, so I will try to find out more then. Thank you for the input and questions

[2hounds]

I don't have any advice to offer, but wanted to ask if you could give Arlie a big hug and kiss for me.

[NeylasMom]

The results look normal to me, but I guess the important question is what symptoms of hypothyroidism does Arlie have?

[silverfish]

My vet received the following from Dr. Dodds lab for Arlie:

 

T4 - 6.9 nmol / L (low normal is 15)

 

T42step - 4 pmol / L (normal is between 8 and 32)

 

T3 - 1.65 nmol / L (normail is between 0.9 and 2.1)

 

TSH is 0.17 ng / ML (normal is 0 to 0.6)

 

Apparently in people TSH is the gold standard for measuring hypothyroidism (in which case the value would be high) however, my vet says the accuracy in dogs is about 35%. The interpretation is that she is hypothyroid but I would like to ask those of you who are familiar with normal values to comment. In parallel I am going to look through some of the reference material that has been posted in this forum recently.

 

On the basis that both T4s are way under 'low normal' and the results have been interpreted by someone who appears trustworthy on the subject, I'd go ahead and treat her.

 

Just as a FYI for those who may not realise: TSH is thyroid stimulating hormone. As the level of useful output from the thyroid falls, TSH will go up to try to stimulate the thyroid into producing more hormone. Hence a high TSH reading indicates low thyroid function.

 

It is a little odd that the T3 levels area the within the normal range though ... and the TSH appears normal too.

Edited June 15, 2007 by silverfish

[Batmom]

It is a little odd that the T3 levels area the within the normal range though ... and the TSH appears normal too.

 

That is exactly what you'll see if the dog has a low thyroid reading as a result of something other than primary hypothyroidism. Stress (of a new home, a move, an injury), infection, TBD, all kinds of things can cause low T4s altho fT4 (if used) is somewhat less affected.

 

If Arlie doesn't have significant symptoms that tend to be specific to hypothyroidism, I'd probably wait and retest in a couple months.

[Rickiesmom]

To me, total lay person, Arlie doesn't really have symptoms. She has a little baldness on her butt, but that may be unrelated, and really, it's not much. My vet said that hypothyroidism is insidious though, and one side effect can be to make the dog more prone to infections. Arlie has had a chronic problem with her vulva (there's a separate, older thread on that) and he is suggesting that this tendency toward infection might be contributing to that problem. She's not particularly lethargic, and certainly not by what I understand from this board to be by greyhound standards.

 

I called him to get the results I posted and wrote down what I heard on the phone. No one has commented on the T42 step test - maybe I misheard him and that isn't exactly the correct name - will ask about this along with other questions your collective feedback has suggested when I speak with him on Monday.

 

At this point I am of two minds about what to do. On the one hand, if Arlie goes on the Soloxine and her issues (bald spots, chronically irritated vulva) resolve, we have an answer. On the other, if she starts drinking a lot and peeing a lot, then maybe the drug is making her hyperthyroid and we stop it. It doesn't sound like it is harmful to give her, not to suggest in any way that I want to over-medicate her. On the contrary, that concern is exactly why I posted in the first place.

 

I certainly won't move forward with the meds until I receive more details (additional report comments, what about the equilibrium dialysis, etc.) and will let you know.

[feemandvm]

Several thoughts:

 

1. Many people here seem to like Dr. Dodd's group regarding thyroid testing. I prefer MSU (see below). For me, a Greyhound has to prove to me that it is hypothyroid to get supplemenation. In my experience with Dr. Dodd's lab... a dog needs to prove that is isn't hypothyroid to not get supplementation.

 

2. I only use Michigan State for thyroid panels. They also have endocrinologists on staff with extensive knowledge of Greyhound normals and are available for consultation. They also do T4, free T4, T3, free T3, TSH, T3/T4 autoantibody and one other test that is evading me. MSU is hte gold standard for thyroid testing IMHO.

 

3. Dogs can be hypothyroid and have a normal TSH so a TSH test is not perfect. : (

 

4. If my dog had no signs of hypothyroidism (and bald buns is not a clinical sign) then unless the bloodwork was CLASSIC (high TSH, very low T4/free T4) then I wouldn't supplement my own dog.

 

 

[Guest greytexplorer]

If Arlie doesn't have significant symptoms that tend to be specific to hypothyroidism, I'd probably wait and retest in a couple months.

 

 

Out of curiosity, what are some of the significant symptoms?

[feemandvm]

If Arlie doesn't have significant symptoms that tend to be specific to hypothyroidism, I'd probably wait and retest in a couple months.

 

 

Out of curiosity, what are some of the significant symptoms?

They can be VERY hard to diagnose in a Greyhound.

 

1. Lack of energy or lethargy. Most Greyhounds are pretty happy to just lay around the house, go run some sprints and lay around the house some more.

 

2. Hair loss. Bald buns does NOT count in this case. Patterned hairloss along the sides or top of the chest or abdomen.

 

3. Cold intolerance. Most Greyhounds are not fans of the cold.

 

4. Unexplained weight gain despite appropriate exercise and diet.

 

 

Those are just a few.

 

 

[ahicks51]

Several thoughts:

 

1. Many people here seem to like Dr. Dodd's group regarding thyroid testing. I prefer MSU (see below).

 

Doc, can you confirm that MSU is back to testing via dialysis? When we went to re-test one of our greys, we were going to submit to MSU again and there was some problem with them losing the license on the test they preferred. So, I sent it to Dr. Dodds instead.

 

It'd be nice to know if MSU is back to testing via their preferred technique. (I don't know because it turns out our grey's numbers were fine, so we don't have a need to re-test just right now.)

[feemandvm]

Several thoughts:

 

1. Many people here seem to like Dr. Dodd's group regarding thyroid testing. I prefer MSU (see below).

 

Doc, can you confirm that MSU is back to testing via dialysis? When we went to re-test one of our greys, we were going to submit to MSU again and there was some problem with them losing the license on the test they preferred. So, I sent it to Dr. Dodds instead.

 

It'd be nice to know if MSU is back to testing via their preferred technique. (I don't know because it turns out our grey's numbers were fine, so we don't have a need to re-test just right now.)

 

It wasn't that they lost their license... it was the company that provided one of their reagents was on backorder. It has been a bit of a mess there as it was out for a period... then back... then back out. I'd have to call to get the absolute latest.

 

As for Dr. Dodd's group... she and I just see things differently regarding thyroid levels so I just elect not to use her lab. Again, not saying I'm right and she is wrong as she is considered a "specialist"... but we are on different sides of the fence on thyroid levels.

 

 

[Rickiesmom]

My vet spoke with MSU and as of about one month ago, they are able to obtain the materials required to do the equilibrium dialysis test. This evening Arlie will go in to have a blood sample taken. My understanding is that it takes awhile for the results to return, but I will post when they become available. Thank you everyone who highlighted that test as key. Apparently the T4 2-step test is what is used when the equilibrium dialysis isn't available, but is not considered to be as definitive.

[Rickiesmom]

Here are Arlie's values from MSU:

 

These are the results: (L= LOW) (*= Interpretive Data)

 

TT4 level 2 L

TT3 level 1.0

Free T4 by dialysis 0 L

Ft3 level 2.1 L

T4 Autoantibody 1

T3 Autoantibody 2

Thyroid Stimulating Hormone 12

Thyroglobulin Autoantibody* 12 (<20% = negative)

 

These are the reference values:

 

TT4 (15-67)

TT3(1.0-2.5)

FT4 (8-26)

FT3(4.5-12.0)

T4 Autoantibody (0-20)

T3 " " (0-10)

Thyroid Stimulating Hormone (0-37)

Thyroglobulin Autoantibody (0-35)

 

My vet did not request a written interpretation - have asked him to follow-up, but she certainly does seem to be low!

Edited July 14, 2007 by Rickiesmom

[Batmom]

I would have your vet verify that they actually did the fT4 by dialysis. I've never seen one come back 0 before.

[feemandvm]

A free T4 of 0 would certainly be suggestive of hypothyroidism regardless of breed. HOWEVER, keep this in mind from a peer reviewed veterinary reference:

 

Thyroid Function Testing in Greyhounds

Sm Anim Clin Endocrinol 12[1]:4 Jan-Apr'02 Review Article 0 Refs

C.B. Chastain, DVM, MS, Dipl. ACVIM (Editor) & Dave Panciera, DVM, MS, Dipl. ACVIM (Assoc. Editor) Sm An Clin Endo

Gaughan KR, Bruyette DS.; Am J Vet Res 2001; 62:1130-1133

 

CLINICAL IMPACT: This study shows that serum T4 and fT4 concentrations in greyhounds are considerably lower than in non-greyhound dogs and clearly demonstrates the difficulty in diagnosing hypothyroidism in this breed. The lower limit of the reference range for T4 and fT4 concentrations in greyhounds is near the lower sensitivity of the assays. Therefore, it may be impossible to establish a diagnosis of hypothyroidism based solely on these hormones. Because the serum TSH concentration was similar to that of other breeds, an elevated cTSH combined with T4 and fT4 concentrations at the low end of the reference range combined with appropriate clinical signs is necessary to diagnose hypothyroidism in greyhounds. Dynamic testing using TSH or TRH stimulation testing may also be useful, but less practical. Testing when appropriate clinical signs are present is of particular importance in greyhounds. Caudal thigh alopecia, common in greyhounds, is not caused by hypothyroidism, and infertility is likely to be only infrequently caused by hypothyroidism in female dogs. Exogenous testosterone used to suppress the estrous cycle does not appear to alter basal serum concentrations of T4, fT4, or c-TSH, but responses to TSH or TRH stimulation may be increased by testosterone administration.

 

 

One of the keys of this paper was to show that a NORMAL Greyhound thyroid can be as low as some of the tests are even capable of detecting!!! Also, if there are NO clinical signs to monitor, how will you know if she is benefitting from treatment? In my opinion, if there are no clinical signs I wouldn't treat. I could make an argument that 0 could justify treatment but I wouldn't treat my own hound unless they also had an elevated TSH or clinical signs that fit with hypothyroidism.

 

Just my $0.02!