Soloxine Dilemma

[Guest ariaadagio]

I adopted my first greyhound (my first dog, too!) on Thursday from a local greyhound rescue. Unfortunately, because I'm so unexperienced, I feel a little out of my depth on some things. When I recieved the dog, I was given a bottle of soloxine and instructions on how much to give. The rescue told me I would need to get a vet appointment ASAP since she's due for a heartworm pill on the first of the month.

 

I went to my vet yesterday. For background, I've taken my cats to this vet for four years, now, and have always been pleased. I called beforehand to ask if they had any experience with greyhounds, and they said they work with several of the local greyhound rescues, which placated me, and I went ahead and made an appointment with my vet instead of the greyhound rescue's recommended vet. Anyway, my vet told me that most greyhounds don't actually need to be on soloxine and that hypothyroidism is overdiagnosed. He said that the bloodtest (T4) that had been run on my dog when the rescue got her was practically useless in determining hypothyroidism in greys. He suggested that I gradually wean her off the soloxine and see how she does, and he said if I really wanted to test her thyroid, once she's been off the soloxine for a month or two, to get a free T4 test done, which is more helpful for a diagnosis. He showed me what symptoms to look for, and specifically how to determine if my greyhound was getting overweight.

 

Well, when I got home, I talked to my adoption coordinator about the vet appointment because she wanted to know how it had gone. I told her about my vet's recommendations for the soloxine, and she told me, albeit more politely, that my doctor was essentially a quack when it comes to greyhounds, that he has no idea what he's doing, that the T4 test they run is perfectly sufficient, and that if I were to take the dog off soloxine, I wouldn't be operating in the dog's best interest. She went on to tell me they've been doing this for 30 years and had helped thousands of greyhounds, and that my vet couldn't possibly have as much experience as theirs does. All my attempts at trying to rationally discuss the issue, such as asking about the risks of weaning the dog off the medication vs leaving her on it if she doesn't need it, were curbstomped by the "we know what we're doing, and you don't" attitude, and I felt like dirt when I got off the phone.

 

Well, I've now googled the issue extensively, and I've poked around on these forums, and I really feel like my vet is in the right on this one. It seems like the predominant and current thought is that greyhound thyroid levels are naturally lower, and that in order to determine a truly hypothyroid greyhound, one must see clinical symptoms, and get more comprehensive bloodwork than a T4 test. I'd like to entreaty those of you with more experience, though, for your opinions. Who am I to believe; my rescue and their vet, who no doubt does have lots of greyhound experience, or my vet? I'd really appreciate some insight on this issue.

[JAJ2010]

It's one of those things where you have very passionate people on either side of the issue. Sunshine is on Soloxine, because it works to help balance her spooky self out. She is borderline low with her numbers but still normal for a greyhound.

 

Rainy was just recently put on Soloxine. She has a pretty normal T4 and we spend over a year and a half cycling through numerous anxiety medications to help with her increased sound phobia and anxiety in the car. Soloxine worked almost immediately. The vet was amazed and flabbergasted!

 

Many people say both my dogs should not be on the medication and will list all these horrible risks, etc. It works for *MY* dogs and it is what is best for them.

 

In my opinion, I would wait 6 months to a year before weaning your dog off the Soloxine. That way they are established in your home and you will have a better feel on behavioral changes that may arise. But if you decide to do differently, that okay! It's whatever works best for you and your dog.

Edited May 29, 2013 by JAJ2010

[Batmom]

Your vet is correct. The adoption person is way, way, way off base. Not only in his/her medical assessment but for making you feel bad about asking very reasonable questions.

 

You want a free T4, by equilibrium dialysis method if at all possible, and a TSH. The dog needs to be off meds for 6 weeks for those to be meaningful tests.

 

I wouldn't wait 6 months to wean her off. I'd do it now.

[racindog]

When I moved my vet changed from one that had Goldie on soloxine to a board certified vet that told me the exact same thing your vet told you. He even gave me a protocol for weaning him off of it. I did and guess what- he was right. Goldie did not need it at all. I could only hope that I didn't do him any harm having given it to him for so long by listening to the first vet. That was before I learned to take what any vet told me 'under advisement' and research it before acting on it.

[hikinghounds]

Mine have always had low thyroid levels, like greyhounds normally do, but they show no actual symptoms of hypothyroid. If they were another type of dog they would probably be medicated, but my vet knows greyhounds are low and therefore doesn't reccomend medication. I think the key thing is whether the dog is showing actual signs of hypothyroid. If you start reducing and she shows signs then she would probably need it, I'm guessing. I do know there is a test that is more accurate for diagnosing true hypothyroid, my cat had it, and I would think it's a good idea to have that done if you can. Sorry you have to worry about this. It sounds like she is healthy overall though and you are giving her the best care. She is a very lucky girl to be with you.

[KF_in_Georgia]

Welcome to the thyroid debate. Let me tell you that you may get the same range of opinions on here.

 

That said--how old is your dog and do you know how long she has been on soloxine?

 

Your vet is quite right that greyhounds as a breed often are over-diagnosed as hypothyroid. And your vet is right about the T4--even greyhound authorities agree on both those things. And unless your adoption coordinator is a vet, she needs to back off and do a little research into modern discussions of hypothyroidism rather than sticking with what they've been doing for the last 30 years. (Actually, even if she *is* a vet...) But as Jessica shows above, sometimes the numbers aren't what you have to go with. If your girl has been on soloxine for a long time, I might be more reluctant to wean her off, and Jessica's suggestion to wait until your girl is more established in your home is a good one--unless your girl was put on the soloxine only recently. (And if it was the rescue's vet that started the meds, it might be very recent.)

 

My old boy started on soloxine when he was about 3 or 4. We started it on the basis of a T4 (only) and a sudden and complete hair loss on parts of his body (throat and thighs--not butt). We might have been wrong to start it, but his hair grew back, his T4 numbers looked better, and he's been on the soloxine for about 10 years, so I'm not going to rock that boat. My vet isn't impressed with Michigan State's thyroid testing: his patients have used it half a dozen times and have gotten back nothing more definitive than "maybe" from the experts. (Sometimes, even with a free T4, you just don't get clear results.) My vet relied on a T4 (as an indicator), knowledge of the dog in question, and a carefully monitored short-term use of soloxine to see if the situation improved. I'm not certain I'd be so quick to put a new dog on soloxine these days--but I don't think my vet would be so quick to prescribe it, either. (ETA: A few years ago, we cut Sam's soloxine dose back substantially, and his hair thinned alarmingly almost right away. He's not taking quite as much as he took in his younger days, but I'm pretty sure that taking him off completely would be a bad move for him.)

 

So--your adoption coordinator is absolutely wrong about the reliablity of a T4 for diagnosing. Your vet is right about the T4-vs-freeT4 issue and about greyhounds being overdiagnosed as hypothyroid. The question is which one is right about your new girl? It's possible that the vet who put your girl on soloxine did more than rely on just the T4; there might have been other symptoms that influenced the decision. If I had a dog that was only recently put on soloxine, I'd be tempted to wean her off, but I'd then be worried about any behaviorial issues that might arise in a new dog--and wondering whether the soloxine prevented issues, caused issues, masked issues, etc. I don't think weaning her off and retesting would be harmful for her; it just might be confusing when you're trying to figure out behavioral and/or medical issues.

Edited May 29, 2013 by KF_in_Georgia

[greysmom]

There are usually two sides to every issue, but my hesitation comes when someone refuses to even acknowledge the other side exists, and uses your inexperience as a way to make you feel bad.

 

In this case, I tend to side with your new vet. Many greyhound experts now agree that most greyhound blood levels are just different than "normal" dogs, and that hypothyroidism is over-diagnosed.

 

One of our first greyhounds came to us on thyroid. He had the characteristic bald thighs, but no other symptoms other than a marginal blood level. He was returned from hsi first adoption because he was completely hyper and out of control. We loved him anyway, and, after a year or so, began to wonder if he really needed the supplementation. He couldn't concentrate. I had trouble keeping any reasonable weight on him. He was always running "hot" - his normal body temp was a couple degrees above normal. After much research and discussion with our vet, we weaned him off the soloxine. He calmed right down, was able to hold his weight, his temp dropped, he was able to actually do some behavior training and remember it. When we retested him after 6 months his thyroid level was .2 - this is low, even for a greyhound, but it was normal for him, and we did not put him back on it again.

 

In contrast, we recently began one of our girls on thyroid to see if it would make a difference in her anxiety disorder. Her tested levels had come back at a borderline reading of .5 - which would not in and of itself cause me to consider supplementation in the absence of other symptoms (which she doesn't have). There has been no measurable decrease in her anxiety, so at this point we are on the fence about keeping her on it. We'll see what follow-up tests show in two weeks.

 

You might search for a thread here that lists the greyhound normal levels for different bloodwork tests. It's very handy to have on hand for reference. You also might send a copy to your adoption rep.

[Guest ariaadagio]

Thank you so much for the help, everyone. I really appreciate it! It's helpful to talk this out with people who have experience and see the various POVs.

 

Weaver is 6 and a half, and she's been on the soloxine since the rescue got her in July 2012, so almost a year. The rescue gave me a copy of all her lab results, and the only thyroid test that was run was the T4. I'm not sure if she had any physical indicators or symptoms of hypothyroidism, but from what I've gathered, my rescue medicates any dog that tests borderline or lower on the T4. They even told me up front before I'd picked a dog that most greys they rescue are on soloxine. The lowest value for normal on their T4 test was listed as 1.0, and Weaver was at .4 She currently has a bald belly and some bald patches on her legs, even with the soloxine.

Edited May 29, 2013 by ariaadagio

[Guest DeniseL]

Thank you so much for the help, everyone. I really appreciate it! It's helpful to talk this out with people who have experience and see the various POVs.

 

Weaver is 6 and a half, and she's been on the soloxine since the rescue got her in July 2012, so almost a year. The rescue gave me a copy of all her lab results, and the only thyroid test that was run was the T4. I'm not sure if she had any physical indicators or symptoms of hypothyroidism, but from what I've gathered, my rescue medicates any dog that tests borderline or lower on the T4. They even told me up front before I'd picked a dog that most greys they rescue are on soloxine. The lowest value for normal on their T4 test was listed as 1.0, and Weaver was at .4 She currently has a bald belly and some bald patches on her legs, even with the soloxine.

I really don't know much about the thyroid question, but I do know that I adopted both my greyhounds last year and both of them tested below 1.0. Neither have ever been put on soloxine for it...my group explained that they only use it if they test very low and they are spooky or have some other significant symptoms...

 

Good luck with Weaver and welcome to the wonderful world of greyhounds!!

[tbhounds]

Your vet is correct. The adoption person is way, way, way off base. Not only in his/her medical assessment but for making you feel bad about asking very reasonable questions.

 

You want a free T4, by equilibrium dialysis method if at all possible, and a TSH. The dog needs to be off meds for 6 weeks for those to be meaningful tests.

 

I wouldn't wait 6 months to wean her off. I'd do it now.

This-but, I would definetly run the TSH :-)

[hikinghounds]

Both my boys thyroid levels are about 0.4 too.

[a_daerr]

The only real way to KNOW if she is hypothyroid is to wean her off the soloxine and re-test. That's probably what I'd do, unless you can get your hands on her previous vet records to establish a baseline. I'm also a big proponent of getting an OSU consult. They are greyhound experts and can tell you with certainty whether or not the dog should be medicated.

[tbhounds]

Perhaps this will help--page 2

http://www.greyhoundadoptionofoh.org/Library/2010-greyhound-medical-packet.pdf

[JJNg]

And here's another good reference regarding hypothyroidism in greyhounds, from Dr. Couto's program at Ohio State, which most consider one of the leading authorities in greyhound medicine.

http://www.vet.ohio-state.edu/assets/pdf/hospital/bloodBank/wellness/newsletters/2010/ghwpNewsletterWinter2010.pdf

[GeorgeofNE]

Your vet is correct. The adoption person is way, way, way off base. Not only in his/her medical assessment but for making you feel bad about asking very reasonable questions.

 

You want a free T4, by equilibrium dialysis method if at all possible, and a TSH. The dog needs to be off meds for 6 weeks for those to be meaningful tests.

 

I wouldn't wait 6 months to wean her off. I'd do it now.

Agree.

 

Dr. Guillermo Couto, who few can argue is THE Greyhound expert, says that he has almost NEVER encountered a Greyhound who truly has a thyroid problem, and that it is the most over-diagnosed condition in Greyhounds.

 

And FYI, Batmom is one of the most knowledgeable folks on this board...

 

Thank you so much for the help, everyone. I really appreciate it! It's helpful to talk this out with people who have experience and see the various POVs.

 

Weaver is 6 and a half, and she's been on the soloxine since the rescue got her in July 2012, so almost a year. The rescue gave me a copy of all her lab results, and the only thyroid test that was run was the T4. I'm not sure if she had any physical indicators or symptoms of hypothyroidism, but from what I've gathered, my rescue medicates any dog that tests borderline or lower on the T4. They even told me up front before I'd picked a dog that most greys they rescue are on soloxine. The lowest value for normal on their T4 test was listed as 1.0, and Weaver was at .4 She currently has a bald belly and some bald patches on her legs, even with the soloxine.

 

This is ridiculous!

 

Just flat out ignorant. I imagine they mean well--but they need to educate themselves.

[a_daerr]

They even told me up front before I'd picked a dog that most greys they rescue are on soloxine.

 

This is really scary.

If this were my dog, I'd wean her off the soloxine then do a full thyroid panel (T4, T3, free T4, and TGAA).

[PrairieProf]

My hound had 0.4 for T4 and we did the full panel through MSU and she is absolutely normal. What's going on in your adoption group is just insane and scary.

Edited May 30, 2013 by PrairieProf

[Tallgreydogmom]

My vote is your vet is correct. I have had greyhounds that had 0 thyroid level on there tests. They also had seizures. The thyroid medicine seemed to work in conjunction with their seizure medicine. No idea how but from working with the medicine over time, that's how it was. One of the girls became very lethargic. I upped her thyroid medicine half a pill AM and PM. She had more energy and was like a new girl.

 

We had thyroid level tests done when requested by the vet. Otherwise we went by what we saw. The greyhounds seemed happy and we were happy they were happy. You might say we experimented with the medicine a bit to see what was best for the greyhounds.

 

We also noticed a difference in how the hair filled in on the bare back ends.

[MaryJane]

This-but, I would definetly run the TSH :-)

 

 

I agree, wean the dog off slowly from the medicine and then recheck and see where the levels are.

 

The "no hair" on the stomach and butt is common for greyhounds. It may grow back but, then again, it may not. One of my dogs that had this condition when I adopted him is now so hairy he's like a polar bear.

 

Keeping a dog (or human) on thyroid medicine that they don't need will speed up the metabolism and as a result, can cause heart fibrillation/irregular beats among other issues -- it's like getting shots of adrenaline.

[Guest ariaadagio]

Thank you so much, everyone. I'm leaning strongly toward weaning her off the soloxine at this point and just seeing how things go. Please, pardon my ignornance, but how does one do a full thyroid blood panel through MSU? Is this something I'd ask my vet about?

[a_daerr]

how does one do a full thyroid blood panel through MSU? Is this something I'd ask my vet about?

 

Your vet will draw the blood and send it out to the lab. Then, after you get the results back, you can either fax or mail the report to MSU and/or OSU. I'm not sure about MSU, but OSU's website has instructions on how their consultation service works.

[greysmom]

The last time I checked - several years ago - MSU had paperwork and instructions on their website for sending in bloodwork. I'm sure your vet can help you figure this out.

[Guest ariaadagio]

Thanks so much! I'll look into that.

[Wonder]

Congrats on your new addition. We need pictures!

 

I too was told my girl needed to be on soloxine (which I don't believe now) and has been for the last few years. I'd take her off but she started having seizures a year ago and I don't want to do anything to mess with her at this point.

[Batmom]

Here is the submittal form: http://animalhealth.msu.edu/Submittal_Forms/AD.ADM.FORM.007.pdf

 

You want 20011, *Premium* Canine Thyroid Diagnostic Profile. Premium uses the equilibrium dialysis method, which is what you want. Also check the "Interpretation" box right above that.

 

And here is there canine thyroid FAQ section: http://animalhealth.msu.edu/Sections/Endocrinology/Thyroid_Canine.php