Goldie's Nights Are Getting Better! Holding Off On The Anipryl

[Guest Energy11]

If she had only two small incidents, I'd wean her off ALL her current meds, wait at least 10 days, and then reassess. That's a heavy medication load and could be causing her ongoing symptoms all by itself.

 

Best luck.

 

Ya know.... I was thinking the SAME thing! Both vets, my current one, and my former vet/employer, and friend, say no.

[robinw]

I don't understand...how did you come to the conclusion that she has a brain tumour? What does your vet think?

[Batmom]

If she had only two small incidents, I'd wean her off ALL her current meds, wait at least 10 days, and then reassess. That's a heavy medication load and could be causing her ongoing symptoms all by itself.

 

Best luck.

 

Ya know.... I was thinking the SAME thing! Both vets, my current one, and my former vet/employer, and friend, say no.

 

I'd ask what their reasoning is. You usually don't put a dog on pheno for two small possible seizure incidents, which could equally have been stroke incidents. Pheno, pred, and valium can all make a dog odd and restless given just individually, let alone all three together.

[Guest Energy11]

They are basing it on the fact, approx six months prior to her two small and one pretty substantial focals (*I was there with her in the Evets), Goldie was "acting like a puppy," ... running thru the house, and, she WAS barking, whining, pacing and starting to show aggression at night, but, just not as bad as now. Based on all the above, Drs. Beau, Karen, AND Couto, are calling it a "brain lesion."

 

I have pet insurance, and could get an MRI, BUT, Goldie HATES the vets and does not do well with sedation, therefore, I don't want to put her through it. And, I wouldn't treat this any differently if I had a definite diagnosis of brain tumor. So, I guess, I take it day by day, and follow the quality of Goldie's life. Last night, she was normal. Today, she is out with the others in the big pen (*snow gone), enjoying herself.

 

Like when my husband was dying of cancer, and under my and Hospice's care ... I took it day by day, in order to keep my sanity.

 

Dr. Couto's answer, when Goldie had her Evet incident. *He states "the AE (adverse effects) is not likely to be the Phenobarb.

 

" Sorry to hear, Dee; sounds like a structural brain lesion (mass or stroke). Is she on aspirin? Unlikely to be AE of the PB. Hope this helps,..."

 

 

Edited December 31, 2010 by Energy11

[RobinM]

I am sorry. Wish there was something I could say or do....

 

 

[robinw]

[greyhead]

If she had only two small incidents, I'd wean her off ALL her current meds, wait at least 10 days, and then reassess. That's a heavy medication load and could be causing her ongoing symptoms all by itself.

 

Best luck.

Those thyroid results are just about unreadable. Can you copy and translate them, Batmom, if you know where the spaces are supposed to be? I can't tell where a value ends and a range starts! But I know you swear by MSU, so maybe you understand this. And in the antibody section, the important words seem to have been replaced by the kind of gobbledy-gook that happens when one computer's email program isn't compatible with the other's. But I wouldn't expect you to sort that out!

 

I'm sorry, Dee. Take it easy.

[Guest Energy11]

. ...

If she had only two small incidents, I'd wean her off ALL her current meds, wait at least 10 days, and then reassess. That's a heavy medication load and could be causing her ongoing symptoms all by itself.

 

Best luck.

Those thyroid results are just about unreadable. Can you copy and translate them, Batmom, if you know where the spaces are supposed to be? I can't tell where a value ends and a range starts! But I know you swear by MSU, so maybe you understand this. And in the antibody section, the important words seem to have been replaced by the kind of gobbledy-gook that happens when one computer's email program isn't compatible with the other's. But I wouldn't expect you to sort that out!

 

I'm sorry, Dee. Take it easy.

 

 

THYROID PANEL #5

 

 

 

Test

 

Result

 

Reference Range

 

Low

 

Normal

 

High

 

 

T4

 

7

 

15 - 67 nmol/L

 

LOW

 

 

T3

 

0.7

 

1.0 - 2.5 nmol/L

 

LOW

 

 

FREE T4 (EQUIL DIALYSIS)

 

3

 

6 - 42 pmol/L

 

LOW

 

 

FREE T3

 

QNS

 

4.5 - 12.0 pmol/L

 

 

T4 AUTO-AB

 

QNS

 

0 - 20 %

 

 

T3 AUTO-AB

 

QNS

 

0 - 10 %

 

 

K9 TSH

 

15

 

0 - 37 MU/L

 

 

THYROGLOBULIN AUTOANTIBODY ^{35% POSITIVEA modification of the canine thyroglobulin autoantibody (TgAA) ELISAhas been implemented. The result of a sample will now be calculated asthe percentage of a standardized positive control that was used in thepast. Cutoff values for a positive (35%), negative (<20%) andinconclusive (20-30%) result have been defined for this new procedure.THERE IS EXCELLENT EVIDENCE TO INDICATE THAT REFERENCE VALUES FORTHYROID HORMONES ESPECIALLY T4 SHOULD BE EXTENDED LOWER THAN THOSELISTED HERE FOR THIS BREED OF DOG. THERE IS NOT THE ELEVATION OFTHYROID STIMULATION HORMONE THAT IS EXPECTED WITH PRIMARYHYPOTHYROIDISM. THE NEGATIVE AUTOANTIBODY RESULTS FUTHER DECREASE THELIKELIHOOD OF LYMPHOCYTIC THYROIDITIS IN THE THYROID GLANDS OF THISDOG. THIS PROFILE DOES NOT OFFER SUPPORT FOR A DIFFERENTIAL DIAGNOSISOF HYPOTHYROIDISM. THE SAMPLE VOLUME WAS NOT SUFFICIENT TO PERFORM ACOMPLETE PROFILE BUT IT IS UNLIKELY THAT THE ADDITIONAL RESULTS WOULDHAVE ALTERED THE DIAGNOSTIC MESSAGE.Referral test performed at Michigan State University."1}

 

4

 

%

 

 

Comments:

 

 

 

 

1.

 

TGAA REFERENCE RANGE:

<20% NEGATIVE

20-35% INCONCLUSIVE

>35% POSITIVE

A modification of the canine thyroglobulin autoantibody (TgAA) ELISA

has been implemented. The result of a sample will now be calculated as

the percentage of a standardized positive control that was used in the

past. Cutoff values for a positive (>35%), negative (<20%) and

inconclusive (20-30%) result have been defined for this new procedure.

THERE IS EXCELLENT EVIDENCE TO INDICATE THAT REFERENCE VALUES FOR

THYROID HORMONES ESPECIALLY T4 SHOULD BE EXTENDED LOWER THAN THOSE

LISTED HERE FOR THIS BREED OF DOG. THERE IS NOT THE ELEVATION OF

THYROID STIMULATION HORMONE THAT IS EXPECTED WITH PRIMARY

HYPOTHYROIDISM. THE NEGATIVE AUTOANTIBODY RESULTS FUTHER DECREASE THE

LIKELIHOOD OF LYMPHOCYTIC THYROIDITIS IN THE THYROID GLANDS OF THIS

DOG. THIS PROFILE DOES NOT OFFER SUPPORT FOR A DIFFERENTIAL DIAGNOSIS

OF HYPOTHYROIDISM. THE SAMPLE VOLUME WAS NOT SUFFICIENT TO PERFORM A

COMPLETE PROFILE BUT IT IS UNLIKELY THAT THE ADDITIONAL RESULTS WOULD

HAVE ALTERED THE DIAGNOSTIC MESSAGE.

Referral test performed at Michigan oftlineState University.

 

 

 

How's this???!!! Took it out of AOL and copied it in Word Perfect ... DEE

[greyhead]

That's amazingly sweet of you, Dee. I surely didn't want to put you to any trouble. Now I'll refill my coffee and read your handiwork.

[Guest Energy11]

That's amazingly sweet of you, Dee. I surely didn't want to put you to any trouble. Now I'll refill my coffee and read your handiwork.

 

NO trouble! I appreciate you looking at it! Enjoy your coffee :-))

[greyhead]

As you may know, Dee, I hate the whole greyhounds-don't-need-thyroid-hormones approach to test interpretation that rules thanks to MSU. I just have to ask how a dog is supposed to function without enough T4, fT4, T3 and fT3. Just saying. By any definition that makes any sense at all, Goldie is hypothyroid. Her thyroid gland isn't producing enough hormones even for a greyhound!

 

As to relying on TSH, here's the thread I started a few weeks ago. There are reasons why TSH alone is not a reliable indicator of thyroid status. If you wade into the article I cited there, you'll see why: http://forum.greytalk.com/index.php/topic/265751-hypothyroidism/

And MSU is relying for its interpretation on only two things that I can see, TSH and antibodies.

As to antibodies, one can have hypothyroidism without have autoimmune hypothyroidism (Hashimoto's in humans). So I wouldn't rely on the antibody finding either.

 

Sweetie, given Goldie's age and the state she's in, I'm not giving advice here. I'm just so sorry that things have come to this.

 

Much love to you and Goldie,

Mary

 

 

[Batmom]

By any definition that makes any sense at all, Goldie is hypothyroid. Her thyroid gland isn't producing enough hormones even for a greyhound!

 

 

Don't see how you can say that. Greyhounds can be perfectly normal and have an fT4 of zero. This dog actually has a measurable fT4, which is in a very common range for healthy greyhounds, and a midrange TSH, which again is what we expect in a healthy dog. There is no indication of thyroid autoantibodies. Basically, there is no indication at all that the dog has any type of thyroid pathology. I don't know why anyone would think that she does.

 

Note that it is nearly impossible to judge thyroid function if the dog is taking phenobarbitol.

 

It is also very difficult to judge thyroid function when the dog is already ill with something else.

 

With the number of medications this dog is taking, adding another with no good evidence that it is needed -- and significant evidence that it is not -- would be extremely poor practice.

Edited December 31, 2010 by Batmom

[Guest Energy11]

As you may know, Dee, I hate the whole greyhounds-don't-need-thyroid-hormones approach to test interpretation that rules thanks to MSU. I just have to ask how a dog is supposed to function without enough T4, fT4, T3 and fT3. Just saying. By any definition that makes any sense at all, Goldie is hypothyroid. Her thyroid gland isn't producing enough hormones even for a greyhound!

 

As to relying on TSH, here's the thread I started a few weeks ago. There are reasons why TSH alone is not a reliable indicator of thyroid status. If you wade into the article I cited there, you'll see why: http://forum.greytal...hypothyroidism/

And MSU is relying for its interpretation on only two things that I can see, TSH and antibodies.

As to antibodies, one can have hypothyroidism without have autoimmune hypothyroidism (Hashimoto's in humans). So I wouldn't rely on the antibody finding either.

 

Sweetie, given Goldie's age and the state she's in, I'm not giving advice here. I'm just so sorry that things have come to this.

 

Much love to you and Goldie,

Mary

 

Hey Mary!

 

My Dd has Hashimotos Disease, so I know a bit about it, too. I DID forward these results to Dr. Jean Dodds, and Dr. Couto (*who is away for a few more weeks, ... so we shall see). My former vet/employer and friend, Dr. B, said HE WOULD start her on 0.8 mg daily, .... ?

Edited December 31, 2010 by Energy11

[Batmom]

On what basis would you start this dog on thyroid meds? I would find a new vet.

[Guest Energy11]

On what basis would you start this dog on thyroid meds? I would find a new vet.

 

 

I am not going to start her on anything. This was just something a very trusted former vet/employer, and still friend, mentioned. He lives in Florida. My vet here said no, and ... so, UNLESS Dr. Jean Dodds, and/or Dr. Couto says to start on thyroid meds, I am not going to. We will just take it day by day with this girl. :-) I do appreciate your input.

[greyhead]

By any definition that makes any sense at all, Goldie is hypothyroid. Her thyroid gland isn't producing enough hormones even for a greyhound!

 

 

Don't see how you can say that. Greyhounds can be perfectly normal and have an fT4 of zero. This dog actually has a measurable fT4, which is in a very common range for healthy greyhounds, and a midrange TSH, which again is what we expect in a healthy dog. There is no indication of thyroid autoantibodies. Basically, there is no indication at all that the dog has any type of thyroid pathology. I don't know why anyone would think that she does.

 

Note that it is nearly impossible to judge thyroid function if the dog is taking phenobarbitol.

 

It is also very difficult to judge thyroid function when the dog is already ill with something else.

 

With the number of medications this dog is taking, adding another with no good evidence that it is needed -- and significant evidence that it is not -- would be extremely poor practice.

The only way low fT4 can be a healthy state, if we want to call it that, is when there is enough fT3 to get the job done. Which in this case there is not.

I thought Goldie was taken off pheno before this test. I understand about the being ill (though I don't recall what else Goldie is sick with) and taking lots of meds, which is why I said I wasn't offering advice.

 

But I'm beyond unhappy about the way greyhound thyroid is handled. And I'm still waiting for somebody to produce an actual study that I can read that provides more than the conclusions, something that shows the number of subjects, their demographic status, and what criteria were used to determine that they were "healthy." For example, Burpdog recently posted that she doesn't trust the pool of supposedly healthy dogs that was used for norming TBD's, I think it was, and she suspects some unhealthy dogs were unwittingly included. Because dogs can't talk, we can ask them all the questions we could ask humans to determine if they really are healthy or if they have non-visible symptoms of illness. That's my problem with this stuff, but I am emphatically not giving advice about Goldie for the reasons I already mentioned. I trust Dee will do what she thinks best, and that's fine with me.

 

ETA: I now remember that Burpdog was discussing platelet levels when discussing greyhound norms.

Edited December 31, 2010 by greyhead

[Guest Energy11]

I am a firm believer in QUALITY of life over quantity. Being a paramedic on the ambulance, ER, AND, especially, the ICU (*God, I hated it there), I can truly say, I believe in QUALITY over quantity of life. I also watched a husband die of cancer, and I was his caregiver, with help and support of Hospice. I believe in the concept of Hospice, and therefore, practice it for my dogs, as well.

 

For NOW, Goldie seems happy. She is a bit "out of it," and wobbly, but still runs after the others when they poop! :-)) She is a major poop lover! UGH!!! :-( ...

 

I am sure I will know when it is "time," ... and, when it is, the vet will come here.

 

I love her with all my heart, and, so, ... there will be no needless prolonging of life or suffering here. I don't believe in it.

 

I am blessed to have each and everyone of you here for us, and I VALUE your opinions, input and thoughts!

 

Love you! Dee

Edited December 31, 2010 by Energy11

[Batmom]

The only way low fT4 can be a healthy state, if we want to call it that, is when there is enough fT3 to get the job done. Which in this case there is not..

 

T3 is even more sensitive than T4 to nonthyroidal illness. If you've got a decent T4 and T3AA is OK, the low T3 is generally meaningless.

[greyhead]

The only way low fT4 can be a healthy state, if we want to call it that, is when there is enough fT3 to get the job done. Which in this case there is not..

 

T3 is even more sensitive than T4 to nonthyroidal illness. If you've got a decent T4 and T3AA is OK, the low T3 is generally meaningless.

What do you mean when you say "sensitive", please? Do you mean nonthyroid illness causes reduction in actual T3 and/or fT3, or do you mean that nonthyroid illness makes the measurement of those things unreliable?

 

ETA: I have to go out to run errands before the stores close, so please don't think I'm ignoring you if I'm absent for a bit.

Edited December 31, 2010 by greyhead

[Batmom]

Nonthyroidal illness reduces T3.

[Batmom]

Sorry for cluttering you up with extraneous stuff, Dee. Really hope your girl makes some improvements and you can figure out what's troubling her.

[Guest Energy11]

Sorry for cluttering you up with extraneous stuff, Dee. Really hope your girl makes some improvements and you can figure out what's troubling her.

 

You two aren't "cluttering..." you are giving valid opinions and medical info. I am happy to read it!

 

Bottom line, ... there were no "Chritmas Miracles" for my Goldie, but she isn't ready to check you yet!

[duncan41]

Praying for quiet nights and days filled with fun with Goldie! We all know that you would walk on hot coals for your brood, Dee, so all we can do at this point is to send our love, support and prayers. I will be interested to learn of Dr. Couto's input. :grouphug

 

 

[seeh2o]

Dee, I sure wish I could offer something more tangible than long-distance support. I hope that you hear back from Dodds and Couto in short order.

[Guest Energy11]

I might not learn anymore than I already know from Drs Dodds and Couto, but I value second, third and fourth opinions!

 

Dh and I will have a talk about our girl tonight or tomorrow. I am also fighting a "flu thing," ... head and body aches, so that doesn't help, either. :-( Having been a cop and paramedic, OBVIOUSLY, WE would NEVER go out on NY Eve, and of course, I don't leave my dogs.

 

To those of you going out, PLEASE BE CAREFUL! It is "amateur night!"