T4-Post Pill Test Results -- Normal For Greyhound?

[Guest colander_girl]

Hello!

 

I am hoping there are some experts out there in reading test results. My vet left us a message saying our boy's recent T4-post pill test came back really low and she wants to do more bloodwork to see if he is not responding to levothyroxine (he takes .8 mg twice a day). The test shows his result as 1.8 and normal as 3 - 5. However, do those normal ranges apply to greyhounds or all dogs in general?

 

I know greyhound thyroid levels are about half those of other dogs, so I was just wondering if Antech test results show the normal range for a greyhound, or the normal range for dogs in general.

 

Here is what it looks like, if this helps:

 

 

Thanks in advance for any advice!

[RaineysMom]

I went and looked back through my old posts to find out if I ever posted Rainey's results -- she was truly hypothyroid and I even sent the results to Dr. Couto at OSU and he told me "Looks like you are the proud owner of the fourth hypothyroid Greyhound I have ever seen."

 

the TSH value has to be high and the T4 low in order to be truly low thyroid. Do you have his TSH results? Also, I think you want to have a "free T4" test done, not just the regular one? According to Dr. Couto, even though a dog is very low on TT4, TT3, FT4 and FT3, if the dog were truly low thryoid, you would see a spike in the TSH. Meaning, there would be more Thryoid Stimulating Hormone in the dogs blood because the body would be telling the thryoid it doesn't have enough hormone, so its trying to create more. The TSH would be elevated beyond normal levels or reference ranges.

 

 

 

these were Rainey's results (I don't know why it's posting so weirdly, sorry):

 

 

Accession No. Doctor Owner Pet Name Received

CHBC47823220 DR.N JONES RAINEY 11/24/2010

 

Species Breed Sex Pet Age Reported

Canine Greyhound SF 10Y 11/30/2010 07:36 AM

 

Test Requested Results Reference Range Units

T3 (RIA)

T3 (RIA) 95 45-150 ng/dL

T4

T4 0.3 (LOW) 1.0-4.0 µg/dL

The Total T4 result is less than 1.0 mcg/dl. A Free-T4 by equilibrium

dialysis may be helpful in supporting the diagnosis of hypothyroidism

in patients demonstrating clinical signs compatible with

hypothyroidism.Please use test code 7589 for this additional testing.

Free T4 (Equilibrium Dialysis)

Free T4 Equilibrium Dialysis 4.1 (LOW) 8-40 pmol/L

Free T3

Free T3 3.3 1.7-5.3 pg/mL

T3 Autoantibodies

T3AA 0.9 Less Than 2.0

T4 Autoantibodies

T4 AA 1.1 Less Than 2.0

TSH

TSH 1.16 (HIGH) 0 - 0.60 ng/mL

Edited July 9, 2012 by RaineysMom

[KF_in_Georgia]

I'm sure more people will chime in with info, but I think it would help if you could tell us--

• How much time between when he took his pill and when the blood was drawn?
  
• How close to mealtime was the pill and the blood-draw?
  

If I remember correctly, both of those things matter.

 

How's your boy's coat? And does he have any particular symptoms that have you or the vet worried? (Symptoms besides his test results, that is.)

 

(Is this your dog with aggression issues? If so, you can skip that last question...)

Edited July 9, 2012 by KF_in_Georgia

[greysmom]

Is this number lower or higher than his most recent past test?

 

Was he taking thyroid supplementation when this test was drawn?

 

Just in my own experience, my boy's T4 was .2 (yes, point two) which is considerably lower than your boy's reading, and his TSH was in a normal range. But any supplementation caused him to be hyPERthyroid. So that number, even though incredibly low by any standards (regular dog or greyhound) was "normal" for him.

 

While he was still on thyroid he exhibited classic hyPERthroid symptoms - no ability to concentrate, couldn't hold any weight and was contantly skinny, very hyperactive, body temp was always on the high end of normal, seemed a bit "spooky" or anxious in certain situations.

 

When we discontinued supplementation all those symptoms disappeared. He was able to concentrate and actually remember basic commands. I was finally able to keep him at a healthy weight. He was able to be calm and settle himself down . He had impulse control. His average body temp dropped by about 2 degrees. He became my calm rock in new situations. And he grew some of his hair back on his thighs.

 

If your vet has suggested supplementation only on the basis of his blood work and/or hair loss, I would seriously consider discontinuing it. Particularly if there was no measurable positive effect in other aspects of his demeanor and behavior.

[IndyandHollyluv]

Hi there. I adopted a senior female in April (she will be 13 in September). Very shy, spooky, skittish.

 

Anyway, took her in for blood work to check re-kidney values (she was started on kidney diet prior to adoption). All blood work looked pretty good -- except vet said her T4 was extremely low. So taking her in tomorrow for a blood draw (there wasn't enough from the original draw) and will send to Michigan State University (MSU) for a complete thyroid panel, which I was always told was the "gold standard" for thyroid panels.

 

I have had three hounds who were truly low thyroid; one that was not. And all of my hounds exhibited different symptoms, manifestations of low thyroid function. A long story, but my first hound suffered horrible skin / allergy issues for several years. Two vets insisted his thyroid was within normal limits. I finally insisted on a third test and the results were borderline. I said let's start him on thyroid meds as nothing else was working. Within months all his skin and allergy issues cleared. Behavioral issues, bowel movement problems -- everything seemed to resolve.

 

I know people love to debate this issue - but you know your pup better than anyone - and what is "normal" for one dog may not be "normal" for yours. A clinical range are simply that - a range or guideline. As my vet says, you have to treat the patient not just the numbers.

 

Good luck to you!

Edited July 9, 2012 by IndyandHollyluv

[tbhounds]

I also have a TRUE hypothyroid hound-actually I made her that way. She had a thyroidcarcinoma which lead to the excision of her left thyroid gland. I did run a MSU panel way prior to her developing the tumor and it was considered normal gh values.

After the thyroid gland was removed her thyroid values went to T4>0.4 and the cTSH was 4.75!

Fast forward a few months after her latest results 5 hours post 0.6mgs supplementation (she's 65#'s) her was T4 0.5 and cTSH 0.07. Waiting to here from Dr Couto to see if he's happy with the results (her surgery and care was and is under OSU and Dr Couto)--- I think he'll be happy with her levels.

GH's are not supposed to have other breed "normal" thyroid values and so many vets try to push them into those ranges IMO.

[Batmom]

Doesn't answer your question with precision but gives some background for you: http://animalhealth.msu.edu/Sections/Endocrinology/Monitoring.php#02

 

How long after the medication was taken matters.

 

Whether the dog is having any symptoms also matters. When you medicate, you want to give only enough to get the TSH into normal range (usually) and to eliminate symptoms. As tbhounds notes, there's no reason to push a dog's T4 higher if any symptoms have resolved with the amount of medication you're giving.

 

If you don't know whether the dog really was hypothyroid before starting meds, you need to have the dog off meds for 6 weeks, then retest with a full thyroid panel. Testing now, while the dog is on meds, tells you only whether the meds are being absorbed appropriately.

[krissy]

Just re-iterating that you be sure you have a truly hypothyroid greyhound before medicating. I've never run a T4 on Summit because he's never had any clinical signs. I ran bloodwork on him last week and my clinic includes a T4 as part of their most comprehensive blood panel. His result came back "<3.8" which was really really low. So I sneakily showed it to everyone at work (at my clinic) and asked them what was wrong with my dog, knowing full well myself that there was nothing wrong with him.

[Guest colander_girl]

I'm sure more people will chime in with info, but I think it would help if you could tell us--

• How much time between when he took his pill and when the blood was drawn?
  
• How close to mealtime was the pill and the blood-draw?
  

If I remember correctly, both of those things matter.

 

How's your boy's coat? And does he have any particular symptoms that have you or the vet worried? (Symptoms besides his test results, that is.)

 

(Is this your dog with aggression issues? If so, you can skip that last question...)

 

It was almost exactly 4 hours, to the minute between when he took the pill and when his blood was drawn.

 

He took the pill with his breakfast at 6 am, and had blood drawn at 10 am.

 

His coat seems healthy, though he does shed a LOT -- like about 10 times more than our girl.

 

This is our boy with aggression, and I do feel bad saying that since he's only actually shown severe aggression in 3 short incidents over the past couple of years. Most of the time he's not aggressive at all. But it was after his first attack that the vet tested him.

 

Looking through his receipts:

 

March 6 2010: ANTECH SA120 CHEM27/CBC/T4

March 7 2010: Put on .7 mg Levothyroxine (twice a day)

March 29 2010: THYROXINE(T4)/CHOLESTEROL VS2

 

Then every 6 months he's had the ANTECH T497 T4-POST PILL. His medication was raised just this past March to .8 mg.

 

Unfortunately I have none of his test results other than the most recent one, but I think I'm going to ask for a copy of all of them.

[Guest colander_girl]

I went and looked back through my old posts to find out if I ever posted Rainey's results -- she was truly hypothyroid and I even sent the results to Dr. Couto at OSU and he told me "Looks like you are the proud owner of the fourth hypothyroid Greyhound I have ever seen."

 

the TSH value has to be high and the T4 low in order to be truly low thyroid. Do you have his TSH results? Also, I think you want to have a "free T4" test done, not just the regular one? According to Dr. Couto, even though a dog is very low on TT4, TT3, FT4 and FT3, if the dog were truly low thryoid, you would see a spike in the TSH. Meaning, there would be more Thryoid Stimulating Hormone in the dogs blood because the body would be telling the thryoid it doesn't have enough hormone, so its trying to create more. The TSH would be elevated beyond normal levels or reference ranges.

 

 

This is the kind of thing I wish I had! I have a feeling he's never had a full panel. I need to talk to his vet when she gets back tomorrow. Thanks!

[Guest colander_girl]

Is this number lower or higher than his most recent past test?

 

Was he taking thyroid supplementation when this test was drawn?

 

Just in my own experience, my boy's T4 was .2 (yes, point two) which is considerably lower than your boy's reading, and his TSH was in a normal range. But any supplementation caused him to be hyPERthyroid. So that number, even though incredibly low by any standards (regular dog or greyhound) was "normal" for him.

 

While he was still on thyroid he exhibited classic hyPERthroid symptoms - no ability to concentrate, couldn't hold any weight and was contantly skinny, very hyperactive, body temp was always on the high end of normal, seemed a bit "spooky" or anxious in certain situations.

 

When we discontinued supplementation all those symptoms disappeared. He was able to concentrate and actually remember basic commands. I was finally able to keep him at a healthy weight. He was able to be calm and settle himself down . He had impulse control. His average body temp dropped by about 2 degrees. He became my calm rock in new situations. And he grew some of his hair back on his thighs.

 

If your vet has suggested supplementation only on the basis of his blood work and/or hair loss, I would seriously consider discontinuing it. Particularly if there was no measurable positive effect in other aspects of his demeanor and behavior.

 

Unfortunately I don't know what his previous numbers were but I will find out. I just know when he was tested in March they were low so the vet raised his levothyroxine to .8 mg. He wasn't tested again after that until last week.

 

My boy definitely doesn't seem hyperthyroid... he's never been really skinny, definitely not hyperactive, he's good at concentrating and obeying commands. He had a little bald thigh syndrome when we first got him, but his fur quickly filled in. That being said, he has very few hypothyroid symptoms -- mainly excessive shedding, and he does get a few pimples or pustules in various locations on his body (and apparently aggression--but only in rare circumstances). I have noticed he seems to be in a better mood when he's on medication (there have been a couple of times when he's been off for a few days while we were waiting for his refill to arrive in the mail).

 

That's great that you were able to discontinue your boy's medication, it sounds like it made a drastic difference!

[Guest colander_girl]

Hi there. I adopted a senior female in April (she will be 13 in September). Very shy, spooky, skittish.

 

Anyway, took her in for blood work to check re-kidney values (she was started on kidney diet prior to adoption). All blood work looked pretty good -- except vet said her T4 was extremely low. So taking her in tomorrow for a blood draw (there wasn't enough from the original draw) and will send to Michigan State University (MSU) for a complete thyroid panel, which I was always told was the "gold standard" for thyroid panels.

 

I have had three hounds who were truly low thyroid; one that was not. And all of my hounds exhibited different symptoms, manifestations of low thyroid function. A long story, but my first hound suffered horrible skin / allergy issues for several years. Two vets insisted his thyroid was within normal limits. I finally insisted on a third test and the results were borderline. I said let's start him on thyroid meds as nothing else was working. Within months all his skin and allergy issues cleared. Behavioral issues, bowel movement problems -- everything seemed to resolve.

 

I know people love to debate this issue - but you know your pup better than anyone - and what is "normal" for one dog may not be "normal" for yours. A clinical range are simply that - a range or guideline. As my vet says, you have to treat the patient not just the numbers.

 

Good luck to you!

 

Thanks and good luck to you too! I do recognize a difference in my boy's mood on thyroid medication (for the better). My mom's greyhound also tested low and was put on thyroid meds. She really didn't have any problems before other than obsessive licking (she'd lick her underarms raw) and the levothyroxine made no difference so my mom stopped them.

[Guest colander_girl]

I also have a TRUE hypothyroid hound-actually I made her that way. She had a thyroidcarcinoma which lead to the excision of her left thyroid gland. I did run a MSU panel way prior to her developing the tumor and it was considered normal gh values.

After the thyroid gland was removed her thyroid values went to T4>0.4 and the cTSH was 4.75!

Fast forward a few months after her latest results 5 hours post 0.6mgs supplementation (she's 65#'s) her was T4 0.5 and cTSH 0.07. Waiting to here from Dr Couto to see if he's happy with the results (her surgery and care was and is under OSU and Dr Couto)--- I think he'll be happy with her levels.

GH's are not supposed to have other breed "normal" thyroid values and so many vets try to push them into those ranges IMO.

 

That's what I'm afraid of. I'm just not sure what the scale or reference is for the test results. According to my internetting, normal greyhound T4's range from .7 to 3.6 which would put my dog right in the middle with 1.8. Of course, that is 1.8 while on levothyroxine. But unless I'm mistaken, that wouldn't be considered low, despite the test saying normal is 3-5 (which I assume is for non-greyhounds).

 

Good luck with your girl!

[Guest colander_girl]

Doesn't answer your question with precision but gives some background for you: http://animalhealth....nitoring.php#02

 

How long after the medication was taken matters.

 

Whether the dog is having any symptoms also matters. When you medicate, you want to give only enough to get the TSH into normal range (usually) and to eliminate symptoms. As tbhounds notes, there's no reason to push a dog's T4 higher if any symptoms have resolved with the amount of medication you're giving.

 

If you don't know whether the dog really was hypothyroid before starting meds, you need to have the dog off meds for 6 weeks, then retest with a full thyroid panel. Testing now, while the dog is on meds, tells you only whether the meds are being absorbed appropriately.

 

Thanks for the info! I have a feeling this is what he needs (to be off meds 6 weeks and retest). Apart from flipping out and attacking on rare occasions, he has no other symptoms (other than shedding--which we've just assumed was "normal" for him).

[NeylasMom]

Call your vet and ask them to fax you any blood work test results (at any time since you've had him), particularly any thyroid values and then post them all here with dates. You don't need your vet to tell you this - just call the front desk and tell them you want his records faxed (or emailed if they have that ability).

 

I strongly suspect that your vet based the dx only on a T4 and that you may be unnecessarily medicating your dog. If the results they fax over support that, I would take him off of the meds (I believe you have to wean him off), then do a full panel with MSU in 6 weeks.

[Guest LindsaySF]

Call your vet and ask them to fax you any blood work test results (at any time since you've had him), particularly any thyroid values and then post them all here with dates. You don't need your vet to tell you this - just call the front desk and tell them you want his records faxed (or emailed if they have that ability).

 

I strongly suspect that your vet based the dx only on a T4 and that you may be unnecessarily medicating your dog. If the results they fax over support that, I would take him off of the meds (I believe you have to wean him off), then do a full panel with MSU in 6 weeks.

Agreed.

[Guest colander_girl]

Bloodwork results have been requested and are being faxed to my husband's work, so I will get them posted hopefully tomorrow morning!

 

For those following my other topic about my dog's aggression -- we will not be returning him to the adoption group this Saturday after all. We want to get his thyroid issue (if he HAS a thyroid issue) figured out first. So I'm happy. I wasn't looking forward to Saturday.

[krissn333]

Agree with Jen and Lindsay above.

 

I also wonder if the aggression might be related to an issue with his pituitary gland - and getting a good TSH reading might help you figure that out.

[Guest colander_girl]

Ok, as I suspected -- I could find no full panel. I did get literally ALL of his medical records though.

 

So, here is the history of his T4 testing (level, low and high references):

 

MAR 19 10 - ANTECH CA SUPERCHEM/CBC/T4

T4 0.3 1 4

(Prescribed .7mg levothyroxine, 2x day)

 

MAR 29 10 - IDEXX - CANINE T4

T4 3.7 1 4.7

 

APR 11 11 - ANTECH T495 T4

T4 1.4 1 4

 

APR 14 12 - ANTECH T497 T4 POST PILL

T4-POST PILL 2.2 3 5

(Levothyroxine increased to .8mg after this test)

 

JUL 3 12 - ANTECH T497 T4 POST PILL

T4-POST PILL 1.8 3 5

 

Other interesting things to note:

BABESIA CANIS-POSITIVE INTERPRETATION: 1:160

Cryptorchid

CREAT: 2.2 (however his BUN and BUN/CREAT Ratio were in the normal range)

All other weirdness in his bloodwork appears to be attributed to his greyhoundiness.

 

I have all of his medical records, except I can't find anything that says he was treated for a high Babesia titer. Would it be called something weird and maybe I just don't recognize it?

[NeylasMom]

I am still in favor of weaning him off of the thyroid meds and getting a full panel in 6 weeks. .3, while low, without any other symptoms or blood results to back it up would not be sufficient for me to supplement in a greyhound.

 

As far as the babesia goes, a titer of 1:160 is not considered positive enough to treat without symptoms present. Generally that's just considered an indicator that antibodies were present (dog was exposed to and fought off disease at some point). It's only when the result is 1:320 or greater that treatment is more strongly recommended although Protatek (who does the TBD titer panels) does recommend a recheck at 6 months for the titer level you reported. What you could consider doing if you want to fully explore medical options would be to get a PCR test done by NC State for Babesia. Go here and click on the links under contact information to get information on how to submit a sample and costs (PCR for Babesia will run you $50 plus expedited shipping and whatever vet would charge for blood draw and packing).

 

I would expect you'd see irregularities in the blood work (particularly signs that he is anemic although hematocrit typically runs high in greyhounds so a low normal value could be indicative of anemia in a greyhound and overlooked by a vet) if he's had an ongoing Babesia infection so to me it seems highly unlikely that he has it, but at the same time, you've got a dog with somewhat unusual behavioral issues so it might be worth running it or at least redoing the titer via IFA (NC State also does that).

 

ETA: I find that creatinine value a bit high even for a greyhound, but I think if his value hovered in that range consistently over time, I wouldn't worry about it.

Edited July 11, 2012 by NeylasMom

[tbhounds]

I would wean him off the supplementation. I don't think I would even bother to run a full panel unless your hound has clinical symptoms.

[greyhead]

Just catching up to this. I just read your aggression thread and replied there about our experience with that and hypothyroidism. I'd say aggression IS a clinical symptom, though not one frequently seen, so I'd have the panel done.

 

I'd take that Babesia finding seriously too. The vet on the Tick List, Dr. Beckett, says any positive finding is significant, and the size of the titer doesn't mean much because a high titer just means the body is mounting a big immune response while a lower titer may just mean that the body is incapable of the immune response it needs to be making. So the dog with the lower titer may be sicker than the one with a higher titer. Here again, symptoms are important to consider. Our Babesia dog has led a much better life (and one with lower creatinine values) since he was treated for it, and IIRC his titer was lower than your dog's.

 

Good luck with your commendable and considerable efforts to educate yourself about these things and to work with your dog's situation.

[tbhounds]

Mary, I know we always butt heads on this but, I have drilled many vets on the connection of hypoT and aggression-all the feedback I have been told is it's de-bunked-no comerction, I'm sure some vet somewhere will disagree with that but, isn't that the way medicine works?

I guess the only thing that would hurt by running a full panel is the OPs wallet.

[greyhead]

Tracy, you're the nicest head-butter I know!

 

The thing about de-bunking is this. If aggression happens rarely in hypo-t greyhounds or other dogs, which I don't doubt, then it won't attain "statistical significance" in any kind of study. But a symptom doesn't have to have statistical significance in order to have "clinical significance." All I know is that Spencer's aggression problem vanished with the use of Soloxine, and that he's not the only greyhound whose owner has observed this connection. So, yes, it does come down to the OP's wallet...but I keep making these points to beseech people to treat their dogs as individuals and not fail to explore the very real roads less traveled.

 

But it's also true that we've seen people spend enormous sums of money on lots of testing, some of it expensive radiography looking for brain tumors, without ever running a thyroid panel! And we know that panel is not that expensive, especially compared to an MRI, for instance. So as testing goes, thyroid panels are relatively cheap and easy to do, and the condition is relatively cheap and easy to treat.

Edited July 13, 2012 by greyhead

[Guest colander_girl]

Just catching up to this. I just read your aggression thread and replied there about our experience with that and hypothyroidism. I'd say aggression IS a clinical symptom, though not one frequently seen, so I'd have the panel done.

 

I'd take that Babesia finding seriously too. The vet on the Tick List, Dr. Beckett, says any positive finding is significant, and the size of the titer doesn't mean much because a high titer just means the body is mounting a big immune response while a lower titer may just mean that the body is incapable of the immune response it needs to be making. So the dog with the lower titer may be sicker than the one with a higher titer. Here again, symptoms are important to consider. Our Babesia dog has led a much better life (and one with lower creatinine values) since he was treated for it, and IIRC his titer was lower than your dog's.

 

Good luck with your commendable and considerable efforts to educate yourself about these things and to work with your dog's situation.

 

Thanks! That's good to know about Babesia. I will mention it to my vet when she returns my call. I would like to get the full panel just based on his initial .3 T4, so we'd know for sure if he has a thyroid problem or not. I'd hate to be blaming his aggression on his thyroid if it really wasn't that at all.