Advice Needed- Thryoid Levels Rechecked

[Guest FreddyGirl]

Freddy had a full thyroid blood panel done in 12/06 and was placed on Soloxine. See results:

 

Range

T4 0.4 (low) 1.0-4.0

Free T4 (Equilibrium Dialysis) 3 (low) 8-40

TSH Level 0.13 0.00-0.60

 

She has been taking 0.6mg of Soloxine 2x/day and currently weighs 62 pounds.

 

We just did a T4 on 11/11 as a 6 month check up. Her results were:

T4 0.2(low) 1.0-4.0

 

The vet asked me if I saw clinical signs, hair loss, lethargy etc. I indicated no, as her initial signs were that of significant hair loss. Th vet did not increase the soloxine level.

 

Does this sound right? My other greyhound recently tested <0.2 and the same vet upped her Soloxine by 0.1 2x/day.

 

Nancy

[Guest Energy11]

I run all of Curfew's thyroid numbers past Dr. Couto. He says a lot of greys are unnecessarily put on thyroid supplements.

 

Was a Free T4 ever done? I'd email Dr. Couto and get his opinion. Good Luck!

 

couto.1@osu.edu

[greyhead]

Free T4 (Equilibrium Dialysis) 3 (low) 8-40

 

Yup, FT4 done and looks pretty persuasive.

 

I don't hold with those who demand evidence of symptoms with numbers like this. An under-functioning thyroid is a miserable thing, not all symptoms are visible, and our dogs can't tell us about the non-visible ones (e.g., joint/muscle aches, reflux, etc.)

[Guest FreddyGirl]

 

Free T4 (Equilibrium Dialysis) 3 (low) 8-40

 

Yup, FT4 done and looks pretty persuasive.

 

Persuasie that the Soloxine should be increased?

 

[Guest Energy11]

Yes, those T4 numbers are pretty persuasive. Sorry I missed that in my first post. I have a stupid migraine tonight :-(

[Guest FreddyGirl]

That's what I thought, too. And, I'm not a veterinarian:)

[RobinM]

Marybeth will do what you want, ask her what the lowest increase could be to see some results. Look at the results of Molly when she dropped again and you raised the dosage. Molly is back!

 

Chloe has beenn .5mg 2x a day for 3 years with no increase...yet. I hope she remains ok on this dose.

[Guest FreddyGirl]

I agree, Robin. I'll be calling her, is she in tomorrow?

[RobinM]

Yes, 2-6 nomrally, but maybe different hours this week due to holiday? I know she is in though.

 

 

[tbhounds]

Personally, I don't think supplementation is necessary. A true hypothyroid dog's TSH would be sky high. Anytime you supplement with Soloxine they will feel better but, that doesn't necessarily mean that the supplementation is indicated. I would hold off on the Soloxine. You could ask Dr Dodds for her opinion--she's always so helpful.

Edited November 24, 2009 by tbhounds

[BauersMom]

Personally, I don't think supplementation is necessary. A true hypothyroid dog's TSH would be sky high. Anytime you supplement with Soloxine they will feel better but, that doesn't necessarily mean that the supplementation is indicated. I would hold off on the Soloxine. You could ask Dr Dodds for her opinion--she's always so helpful.

 

I agree. The TSH is more indicative than the T4, which is almost always low.

 

If the dog is not symptomatic and the TSH isn't showing a problem, I don't think there's a real benefit to putting them on meds.

[sweetdogs]

I don't hold with those who demand evidence of symptoms with numbers like this. An under-functioning thyroid is a miserable thing, not all symptoms are visible, and our dogs can't tell us about the non-visible ones (e.g., joint/muscle aches, reflux, etc.)

Boy howdy, ain't that the truth.

 

Since Freddy's T4 is now .2, I would think about increasing the soloxine.

[BauersMom]

Also - it seems really, really odd that a dog on soloxine would have a lower T4 than before they were supplemented.

[seeh2o]

You may want to email the information to Jean Dodds, she usually gets back to people within 24 hours. Her email address is:

hemopet@hotmail.com

[RobinM]

You may want to email the information to Jean Dodds, she usually gets back to people within 24 hours. Her email address is:

hemopet@hotmail.com

 

 

Nancy- I would definitely emal Dr. Dodds and give all infor re: history before and after meds too,

[brandimom]

I am not trying to hijack this thread. I have my vet send the lab work to Dr. Dodd's in regards to thyroid testing but she does not do the TSH whereas Dr. Cuoto and his staff do the TSH. Why do you think they have different opinions? I just found out they had different opinions when I sent the results from Dr. Dodds to OSU for another opinion and they asked for the TSH report. Any one else encounter this?

[Batmom]

Personally, I don't think supplementation is necessary. A true hypothyroid dog's TSH would be sky high.

 

Ditto. Pretty well documented that fT4 in greyhounds can be below measurable levels and entirely normal. I wouldn't consider hair loss in a greyhound to be a symptom of hypothyroidism.

 

 

 

I am not trying to hijack this thread. I have my vet send the lab work to Dr. Dodd's in regards to thyroid testing but she does not do the TSH whereas Dr. Cuoto and his staff do the TSH. Why do you think they have different opinions? I just found out they had different opinions when I sent the results from Dr. Dodds to OSU for another opinion and they asked for the TSH report. Any one else encounter this?

 

I would send the labwork to MSU. On a premium panel, they do the fT4 by equilibrium dialysis, TSH, and several other measures that most labs don't do and that are needed for the least equivocal analysis, particularly in a greyhound. Add maybe $5? (used to be $2) and they'll include their endocrinologist's written interpretation.

[Batmom]

Some useful thyroid info:

 

http://www.animalhealth.msu.edu/Sections/E...roid_Canine.php

http://www.animalhealth.msu.edu/Sections/E.../Monitoring.php

[Burpdog]

am not trying to hijack this thread. I have my vet send the lab work to Dr. Dodd's in regards to thyroid testing but she does not do the TSH whereas Dr. Cuoto and his staff do the TSH. Why do you think they have different opinions? I just found out they had different opinions when I sent the results from Dr. Dodds to OSU for another opinion and they asked for the TSH report. Any one else encounter this?

 

Because TSH is not as accurate in dogs as humans.

 

I wouldn't consider hair loss in a greyhound to be a symptom of hypothyroidism.

 

Yes it is On some

 

I would send the labwork to MSU. On a premium panel, they do the fT4 by equilibrium dialysis, TSH, and several other measures that most labs don't do and that are needed for the least equivocal analysis, particularly in a greyhound.

 

The OP indicates the FT4 was does by equiplimbrium dialysis.

 

Question: are they on brand name soloxine? or generic?

[Batmom]

I would send the labwork to MSU. On a premium panel, they do the fT4 by equilibrium dialysis, TSH, and several other measures that most labs don't do and that are needed for the least equivocal analysis, particularly in a greyhound.

 

The OP indicates the FT4 was does by equiplimbrium dialysis.

 

TSH in dogs is pretty reliable these days. Is it 100%? Nope. Few tests are. I think MSU pegs it at 85%.

 

I was responding to a different question, about why some sources might have different interpretations. Even fT4ed can be affected by nonthyroidal illness and plain old environmental stress, which is why fT4 alone should not be considered diagnostic. Note also that these tests can be affected by any other medication given to the dog, including very likely some of the herbals that people give but don't consider drugs.

 

Hairloss *can* be a symptom of hypothyroidism, but if that's the only symptom in a greyhound, I wouldn't attribute it to hypothyroidism without significant backup data. Greyhounds blow their coats when changing environments, some blow their coats seasonally, some have very sparse coats ......

 

The problem with supplementing a dog with inconclusive symptoms is first, it does make a dog seem "brighter" in behavior, which may cause the owner to stop looking for underlying conditions such as infection, tick disease, heart disease, etc. Second, if the dog is not hypothyroid, supplementing can cause serious problems if the dog has certain other conditions. Really best to be sure and consult the experts.

[brandimom]

Personally, I don't think supplementation is necessary. A true hypothyroid dog's TSH would be sky high.

 

Ditto. Pretty well documented that fT4 in greyhounds can be below measurable levels and entirely normal. I wouldn't consider hair loss in a greyhound to be a symptom of hypothyroidism.

 

 

 

I am not trying to hijack this thread. I have my vet send the lab work to Dr. Dodd's in regards to thyroid testing but she does not do the TSH whereas Dr. Cuoto and his staff do the TSH. Why do you think they have different opinions? I just found out they had different opinions when I sent the results from Dr. Dodds to OSU for another opinion and they asked for the TSH report. Any one else encounter this?

 

I would send the labwork to MSU. On a premium panel, they do the fT4 by equilibrium dialysis, TSH, and several other measures that most labs don't do and that are needed for the least equivocal analysis, particularly in a greyhound. Add maybe $5? (used to be $2) and they'll include their endocrinologist's written interpretation.

 

Great information. Thank you.

 

 

Personally, I don't think supplementation is necessary. A true hypothyroid dog's TSH would be sky high.

 

Ditto. Pretty well documented that fT4 in greyhounds can be below measurable levels and entirely normal. I wouldn't consider hair loss in a greyhound to be a symptom of hypothyroidism.

 

 

 

I am not trying to hijack this thread. I have my vet send the lab work to Dr. Dodd's in regards to thyroid testing but she does not do the TSH whereas Dr. Cuoto and his staff do the TSH. Why do you think they have different opinions? I just found out they had different opinions when I sent the results from Dr. Dodds to OSU for another opinion and they asked for the TSH report. Any one else encounter this?

 

I would send the labwork to MSU. On a premium panel, they do the fT4 by equilibrium dialysis, TSH, and several other measures that most labs don't do and that are needed for the least equivocal analysis, particularly in a greyhound. Add maybe $5? (used to be $2) and they'll include their endocrinologist's written interpretation.

 

Great information too! Thank you.

[Guest Greensleeves]

Freddy had a full thyroid blood panel done in 12/06 and was placed on Soloxine. See results:

 

Range

T4 0.4 (low) 1.0-4.0

Free T4 (Equilibrium Dialysis) 3 (low) 8-40

TSH Level 0.13 0.00-0.60

 

She has been taking 0.6mg of Soloxine 2x/day and currently weighs 62 pounds.

 

We just did a T4 on 11/11 as a 6 month check up. Her results were:

T4 0.2(low) 1.0-4.0

 

Ok, just to clarify: the original labwork was from three years ago? And her latest bloodwork shows a drop in her numbers? Do you have any interim results that show her numbers soon after she began treatment?

 

From what I recall of what my doctors told me, when I was diagnosed (granted, I am neither a dog nor a veterinarian), it's possible for the levels to shift and for dosages to need adjustment over time. Three years is a long time in the life of a dog. I would wonder if her own thyroid function has declined over time, calling for greater supplementation. Even patients who've had their thyroids removed don't always stay at the same levels/dosages throughout life.

 

I'm not arguing for or against a change in her meds; just offering a possible explanation for the change in numbers.

 

But the reason doctors and vets tend to err on the side of treating hypothyroidism when indicated is that 1.) It's serious and life-threatening (but easily treated, so we tend to forget this), and 2.) Fixing it will fix all the problems related to it; and once the symptoms that are caused by the hypothyroidism are taken care of, it's a lot easier to see the ones that *aren't.* Treating for hypothyroidism won't make the symptoms of a TBI or another autoimmune condition disappear.

 

Good luck! Hope you get to the bottom of this!

[Guest FreddyGirl]

Freddy lost ALL fur on her belly and rear haunches, after soloxine, it returned. I'm sending the info off to Cuoto and Dodds for their review.

[Guest Energy11]

Freddy lost ALL fur on her belly and rear haunches, after soloxine, it returned. I'm sending the info off to Cuoto and Dodds for their review.

 

Curfew was almost bald before starting the Soloxine. I thought he was just "blowing his coat ..." until his Free T4 and TSH came back. I did send the results to Dr. Couto, and he agreed on the Soloxine therapy, too. Now, his coat feels like rabbit fur, and he never sheds. He is happy like before. He is my "Old Curfew!"

 

I totally agree many many greys are misdiagnosed with hypothyriodism. Heck, I met a dentist here, whose non-GH savvy vet, had her on Soloxine, and she was three. Being a dentist, even HE questioned it, and finally got second and third opinions, and weaned her off.

[Batmom]

Review is a good idea! She may well need the thyroid meds, but it is worth noting that that type of hair loss is pretty common in greyhounds who don't have thyroid problems, and that thyroid meds tend to promote hair growth whether the dog needs them or not.

 

Also worth noting Dr. Stack feels that a supplemented greyhound shouldn't be supplemented up into the range of other breed dogs (see her article at greythealth.com ).

 

Hugs and best luck!