Advice Needed- Thryoid Levels Rechecked

[Guest FreddyGirl]

Many thanks. Happy Thanksgiving to all:)

[tbhounds]

Had a thought--are you sure you didn't miss read the latest t4 results? Is the latest reading 0.2 or 2.0??

[seeh2o]

Carl had balding thighs and chest, it was thin all the way up to his back and his skin was sort of like an old person's. Beyond that he had no other classic symptoms. Because he was hypothyroid he had developed something unusual - corneal rings - which were misdiagnosed repeatedly. In November last year the new vet discovered he was hypothyroid and put him on another thyroid medication in November, I saw no change in his fur in 6 weeks. Asked that he be switched to Soloxine. A year later he has some regrowth, his fur, what he has of it, is shiny, soft and smooth like patent leather and his skin is very soft, but he is still a very bald boy - he has a naked chest and patches of hair on his thighs. His corneal rings have cleared up for the most part, but it comes and goes. The ophthalmologist said it would always be with him, but now that he is being treated it is much better.

 

Good luck.

[greyhead]

Carl had balding thighs and chest, it was thin all the way up to his back and his skin was sort of like an old person's. Beyond that he had no other classic symptoms. Because he was hypothyroid he had developed something unusual - corneal rings - which were misdiagnosed repeatedly.

There's a good example of the miserable non-visible symptoms I keep bellyachin' about. Thanks for sharing.

 

A question: How come Soloxine is better than the other thyroid meds? I'm wondering whether to put my dogs back on it. They do okay on the other meds but I wonder if they could do better. (I don't mean to hijack or anything but this seems like a good place to ask.)

[seeh2o]

There's a good example of the miserable non-visible symptoms I keep bellyachin' about. Thanks for sharing.

You're welcome, that's why I always add his unusual symptoms in thyroid threads. If I'd listened to others here on GT (balding is not enough to call for a thyroid check) I'm afraid Carl would be blind or close to it by now. I'm also glad I changed vets and she was willing to explore the possibilities. If it feels wrong, get it checked out...trust your gut!

 

A question: How come Soloxine is better than the other thyroid meds? I'm wondering whether to put my dogs back on it. They do okay on the other meds but I wonder if they could do better. (I don't mean to hijack or anything but this seems like a good place to ask.)

 

That's a great question, one I've wondered about myself. My vet had never heard of anyone asking specifically for Soloxine, but was happy to oblige. There was more fur regrowth and his eyes got a lot better after I switched him to Soloxine.

Edited November 26, 2009 by ckruzan

[BauersMom]

 

Here's my point from an earlier thread about the same thing. The important thing is to find the RIGHT diagnosis... not settle for the quick and easy "T4 is low"... Knowing what I know now, I really do think that maybe if we had actually looked for the real reason for his symptoms, I would have found out that he had a deadly cancer and handled things differently. The soloxine grew back his hair and made him not so lethargic... but if I had to do it all over again, I would not have settled on the thyroid diagnosis without exhausting other diagnoses and certainly would not have stopped at seeing a "low T4" only number.

 

Just my experience.

 

 

I know we discussed things earlier in PMs but don't completely rule out hypothyroidism yet. The bloodwork for me was also normal for a Greyhound but it doesn't mean that he couldn't be hypothyroid. Not every dog with hypothyroidism has an elevated TSH. One of the biggest things that I see as a difference between your hound and so many others that I read about on GT that are diagnosed is that your hound actually has signs that could be attributable to hypothyroidism. The derm vet should have been able to give you a pretty good opinion on if that was likely or not.

 

 

I AGREE. I would not rule out hypothyroid and would keep him on the meds to see how he does. If it the meds work, IT DOESN'T MATTER WHAT THE NUMBERS SAY!!!!!

 

Well, it DOES matter what the numbers say, to a point.

 

I could give any healthy dog a supplement of soloxine and probably see improvement in hair growth, stamina... because that's what the drug does. But why give a dog not hypothyroid something it doesn't need?

 

Bauer was diagnosed hypothyroid, and ended up dying shortly after of hemangiosarcoma. His numbers weren't super low, but we saw what we thought were some 'symptoms' - lethargy, etc. I can't help but think now that the low thyroid was only a symptom of the cancer - and while the soloxine made him feel bettern on some counts, it did nothing for the ACTUAL problem. Had we really paid attention to his numbers, instead of finding something that worked for some symptoms, we might have dug a little deeper and found the real cause.

 

What I'm saying is that soloxine will cause certain results that will make people think it is "working". But that's NOT a real indication that the dog needs the medication in all cases. Which is why hypothyroidism is so difficult to diagnose and treat.

 

I'd say in Monty's case, given everything, there's a good chance he is hypothyroid, but it always helps to rule out any other possibility.

 

[Guest ishapespace]

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.

 

 

TSH is not always high. See this info on the MSU website: http://animalhealth.msu.edu/Sections/Endocrinology/Thyroid_Canine.php

 

This is from that link at MSU:

My patient has low thyroid hormone concentrations, but thyroid stimulating hormone is not elevated. What does this mean?

 

Depending on the clinical presentation, one of two main possibilities is likely.

 

1.The more common explanation is that T4 values often decline in animals with non-thyroidal illness and in animals receiving certain drug therapies (some glucocorticoids or anticonvulsants). Non-thyroidal illness may suppress TSH release from the pituitary via glucocorticoid-mediated inhibition or lower T4 concentrations by altering serum protein binding affinities.

2.The second possibility (if clinical evidence for hypothyroidism is strong and there is no illness or interfering medication identified) is that the animal truly has hypothyroidism but it is one of approximately 15% of cases in which TSH is not found to be elevated. If clinical signs are not suggestive of hypothyroidism, this picture could also be consistent with advancing age or normal breed differences (esp. sighthounds - see below). It is not clear why as many as 15% of hypothyroid dogs can have a normal TSH concentration, but suggested explanations include: rare cases of secondary hypothyroidism (where the pituitary gland is unable to secrete adequate TSH), the presence of TSH-suppressing concurrent significant non-thyroidal illness, and structural differences in the TSH molecule that interfere with its detection.

With this pattern of test results, a trial with T4 supplementation is suggested only if there is a strong clinical presentation consistent with hypothyroidism and if no non-thyroidal illness can be detected. An objective case review should be conducted after 6-8 weeks of therapy for evidence of clinical improvement. Thyroid supplementation can be discontinued if no improvement has occurred in that time, and the diagnosis reconsidered. A therapeutic monitoring sample taken during treatment should help confirm whether adequate amounts of thyroid medication were being absorbed. Even when there is clinical improvement, strictly speaking, therapy should be discontinued to see if the original clinical signs return in the absence of medication. Admittedly, this latter protocol is rarely followed in clinical practice.

 

While the administration of thyroid hormone to animals which do not have hypothyroidism is generally considered to have minimal risk, large scale studies in human medicine have shown detrimental effects of such treatment in patients that have decreases in serum thyroid hormone concentrations due to non thyroidal illness. (Brent GA and Hershman JM. Thyroxine therapy in patients with severe non-thyroidal illness and low serum thyroxine concentrations. J Clin Endocrinology and Metabolism. 1986, 63:1)

[TinyMityMo]

you have to make sure to draw the blood sample 6-8 hours after they take the meds to get a proper level.

[Guest FreddyGirl]

Had a thought--are you sure you didn't miss read the latest t4 results? Is the latest reading 0.2 or 2.0??

 

No, 0.2 was correct, however, according to Dr. Dodds, it was taken "during the trough" or something like that, inother words, Not within a 2 hour window. So, I went with her advice, actually for both Freddy and Molly, also hypothyroid. In consultation with my vet, wer reduced both girls to 0.4mg 2x/day and we return on Jan 23rd for the Ft3 and T4, or vice versa. Neither has lost any fur, however, Both are bulking up.

Edited January 4, 2010 by FreddyGirl