Middle Ear Infection Vs Hypothyroid Vs Something Worse?

[Guest NHgreys]

We brought Joy (almost 9) to the vet a week ago because she seemed a little out of sorts - whining (more than usual) and moody - we were worried she was having pain from something. The vet couldn't find anything very specific, just some mild dehydration and they gave her subcutaneous fluids. Then the next day she started showing left-sided facial paralysis and began shaking her head. We brought her back in the following day and the vet diagnoses a middle ear infection and also checked her thyroid, which has dropped to 0.6 -- either of these could potentially cause her symptoms. The vet started her on ear drop antibiotics (and eye ointment since she can't close it all the way). She wanted to hold off on treating the low thyroid until next week to see if her symptoms resolved in treating the ear infection. So far she has received 5 doses of the antibiotic drops with no improvement in her symptoms. And she seems to be having some problems with her coordination tonight; nothing drastic like falling over but some general clumsiness which isn't like her at all. We plan to call the vet tomorrow but thought I would post on here as well since GTers usually have the best suggestions! We're worried that it could even be something worse and hoping she gets better soon Thanks for listening.

[tbhounds]

Your hound is not hypothyroid--Dr Couto claims that would be a rather rare event in a hound. Could have a middle ear infection. Your vet may have to sedate to get skull films and a deep ear exam. Did they check her eye pressures??

Your pup may need an internal medicine Dr at this point.

[macoduck]

A Vestibular disorder maybe?

[Guest BiancasMom]

Sounds like something neurological. I've never heard of a middle ear infection causing facial paralysis, but have heard of balance issues. Could be some type of stroke? I'd try to get in to see a neurologist ASAP.

[Guest NHgreys]

Sounds like something neurological. I've never heard of a middle ear infection causing facial paralysis, but have heard of balance issues. Could be some type of stroke? I'd try to get in to see a neurologist ASAP.

 

From what I've looked up and in talking with our vet, the most common cause of facial paralysis is middle ear infection. Balance can be affected as it progresses to the inner ear. Stroke in dogs does not affect the face like it does in humans.

 

 

Your hound is not hypothyroid--Dr Couto claims that would be a rather rare event in a hound.

 

As far as the thyroid, I understand that greyhounds tend to have lower levels than other dogs; she had low levels before and our vet said that was typical. However, now that she has dropped lower is and exhibiting these symptoms, it may be time to treat it. Like I said, she's not responding to the tratment for an ear infection.

 

Just woke up (working nights) and still need to call the vet.....

[greyhead]

Your hound is not hypothyroid--Dr Couto claims that would be a rather rare event in a hound.

Seriously?! Hypothyroidism is not all *that* rare. It happens. On this point, I don't care what Dr. Couto purportedly claims.

 

Untreated hypothyroidism can lead to all kinds of things. It's irresponsible, IMO, to dissuade people from pursuing further testing.

[tbhounds]

Never mentioned not to test but, if the op does a full panel should be run including a ctsh. While hypothroidism is more common in older dogs and certain breeds like goldens I think you'll find it's rather uncommon to find a hound with a high ctsh value. Supplementing hounds that are not truly hypothyroid is dangerous and can present serious health risks.

The op's pup might be euthyroid -- most vets would not run a thryroid panel when a pet is ill- just my 2 cents.

[greyhead]

Surely you are aware that cths does not accurately reflect true hypothyroidism fully 15% of the time, per Michigan State. So to say that it's rare to find high ctsh is a specious argument if one is using it to support the idea that canine hypothyroidism itself is rare.

 

While one may not explicitly say someone else shouldn't test further, the statements that are made could lead the person to that conclusion. This happens way too often for my taste when questions of hypothyroid status arise in this forum. Sometimes I let it slide. Today I didn't, but I have no wish to single you out, tbhounds.

Edited December 8, 2010 by greyhead

[Batmom]

Hypothyroidism *is* rare in greyhounds per the peer-reviewed literature and research endocrinologists.

 

Since greyhound T4s can be zero -- that is, below the readable test values -- and still be normal, your best testing method is fT4ed + TSH + university endocrinologist's interpretation + thyroid-specific symptoms. There aren't many thyroid-specific symptoms in greyhounds -- they're already lazy and they don't grow hair well. Hence the value of certain tests.

 

You can start a dog on thyroid meds and discontinue years later if you find the dog isn't truly hypothyroid. It's a myth that once you start you have to keep them on the drug forever.

 

You really do want to do the appropriate tests whenever possible. As tbhounds pointed out, supplementing the thyroid when it isn't needed can cause just as serious of problems as not supplementing when it is needed. fT4ed (a specific form of T4 testing which very few labs do) is less likely to be affected by other illness than the other forms of T4 testing but as already pointed out, if the dog has another short-term ailment, it is best to clear that first, prior to testing.

 

Hope you can get to the bottom of your pup's troubles.

 

 

[greyhead]

It's tempting to ask for the definition of "rare" here. But it doesn't really matter. What matters is the definition of "normal."

 

In the arena of testing, of all kinds, "normal" means that the majority of beings tested have that result, whatever it is. It doesn't mean "good." It has bothered me for years that low thyroid numbers in greyhounds are defined as normal. For all I know, most greyhounds are hypothyroid!!! But it has been defined as normal for greyhounds because the majority's numbers fall within that range. Because the symptoms of hypothyroidism are not always easily observed, I also don't trust that these so-called normal dogs with numbers so small they can't even be observed are truly healthy. I care because I know *for sure* that untreated hypothyroidism results in a life lived somewhere between sub-optimal and miserable.

 

Not every expert in medicine has a truly sound education in statistics, about what they can and can't tell us. There's a reason Mark Twain alluded to the existence of three kinds of lies: "lies, damned lies, and statistics." He wasn't just being funny.

 

I mean no disrespect to anyone. I just feel compelled to push back against this idea greyhounds can be expected to be in perfect health in the absence of enough T4 to even measure.

 

 

 

[Guest NHgreys]

So, I finally got a hold of the vet in the afternoon. She is now leaning toward idiopathic vestibular disease, which can happen in any - usually older - dog (idiopathic meaning no known cause). She felt that the ear infection Joy has is too mild a case to cause all of these symptoms and that the imbalance issues would be more vestibular in nature. We're going to start her on meclizine tomorrow, which is available OTC for vertigo (used for motion sickness in people). We are both at work tonight and wanted to wait to start her on a new med while we're home with her during the day. For tonight, we blocked off all the stairs so that she'll stay on one level and not hurt herself falling on stairs or jumping off our bed. If no improvement by early next week, the vet may try Joy on prednisone to see if it helps. It could still possibly be thyroid-related but I guess she wants to rule out these other things first. If no improvements with anything, we can always get a CT scan of her head, we just would need to go out-of-state for it as it seems no vets in NH have CT scanners.

 

Thanks as always for your responses!

[tbhounds]

Fingers crossed that it's just vestibular disease!