Limping Due To Hypothyroidism?

[Guest mrs]

Anyone seen or heard of a dog who was limping due to hypothyroidism?

 

Smitty has been limping since December. After testing, physical therapy, and thousands of dollars later, he's still limping. He does have tears in his supraspinatus tendons as well as some arthritis. He started to improve after some physical therapy but then starting limping again. Further physical therapy didn't help.

 

Anyway, about a year ago my regular vet said Smitty's thyroid was low. I know that's normal for greyhounds so I dismissed it as I didn't see any other symptoms. I have noticed some thinning of the hair on his tail and the area where he was shaved for ultrasounds is growing back very, very slowly. (my cat recently had a surgery and her hair is growing back quickly). Anyway, I ran across an article linking limping with thyroid. I can't figure out how to put a link here but if you google "Can hypothyroidism cause limping in dogs" a result pops up "Neuromuscular manifestations of hypothyroidism in dogs". I just found this interesting.

 

I want to talk to my vet and maybe do a more thorough thyroid panel. Just wondering if anyone has dealt with this.

[Batmom]

Limping on one specific leg, or generalized unsteadiness / not moving well? The former is most likely a result of his tendon problems / arthritis. The latter *can* occur due to hypothyroidism but a lot of other things are more likely.

 

Hair growth in short-coated sighthounds (greyhounds, whippets) can be slow "just because."

 

Has he had x-rays? Lyme disease test? Check for corns?

[greyhead]

Yes, hypothyroidism can cause all kinds of things, including musculoskeletal pain/weakness. And it's such an easy fix, so it really pains me to know that people just blow right by a low thyroid finding and will test for everything else in the world without even trying to learn if their greyhound is one of the greyhounds who is truly hypothyroid. Please, do the panel, and don't be persuaded that *no* detectable thyroid hormone is okay for a greyhound.

[Batmom]

No detectable thyroid hormone is fine for a greyhound -- especially if you're talking about a TT4 or T4 test rather than the more accurate fT4ed.

[seeh2o]

Yes, hypothyroidism can cause all kinds of things, including musculoskeletal pain/weakness. And it's such an easy fix, so it really pains me to know that people just blow right by a low thyroid finding and will test for everything else in the world without even trying to learn if their greyhound is one of the greyhounds who is truly hypothyroid. Please, do the panel, and don't be persuaded that *no* detectable thyroid hormone is okay for a greyhound.

I agree 100% with this. My boy had symptoms of being hypothyroid that were a bit out of the norm, his thyroid numbers were low, but not not detectable. If I'd chosen not to treat him based on that he would have gone blind. I'd have a full panel run to see where he's at, it's a good place to start.

[Guest mrs]

Thousands of dollars spent so far, so yes he's had multiple x-rays, ultrasounds, etc. After 6 weeks of physical therapy he was doing so much better but then relapsed and started limping again. More physical therapy made no difference. They redid the ultrasound to check the tears and they didn't change, so the orthopedist didn't think it was due to that. The next step was an MRI but I'm not going to do that. I'm actually pretty fed up with the specialist and all the testing. Right now he's on tramadol, gabapentin, and Deramaxx. When the tramadol and gabapentin was added in I noticed some improvement. Still limping but less painful. Tried adding Rimadyl first with no change at all. Did a wash out period and am trying Deramaxx now.

 

The hair not growing on his shoulders is what made me think back to that thyroid test. Now I wish I had done the full thyroid panel back then, but due to everything I read about greyhounds and thyroid I decided against it. Then I started researching thyroid and limping and saw there could be a link. I'll call my vet on Tuesday and discuss it all. Right now we have him limited in his activity. Yesterday he got through the area of our fenced in yard we've been limiting him to and he took off doing zoomies around the rest of the yard. He was the happiest I've seen him in six months! There was absolutely no increase in his limping after that or today. I'm ready to let the boy live and be happy.

 

Anyway thanks for all your replies. I know this might be a stab in the dark but I will do a full thyroid panel and start him on supplement if needed.

Edited June 29, 2014 by mrs

[Batmom]

You have to do all the tests and consider a dog's symptoms.

Many people (and some vets, annoyingly enough) want to base decisions on a T4 alone, often in the absence of symptoms or without exploring more likely causes for the symptoms that the dog has. That is where folks (and dogs) get into trouble.

T4 -- the "quick and dirty" test that often shows up on blood chemistry panels -- has only very limited value in assessing thyroid function. If it's within normal range, it tells you that the thyroid is functioning normally. If it's below normal range, well, that doesn't mean the thyroid isn't functioning normally. The T4 value can vary from hour to hour and day to day; it can be at the high end of normal in the morning and zero in the afternoon, all in the course of a normal dog's day. So you can't diagnose thyroid disease or inadequacy from that particular test; rather, it would tell you whether to pursue further thyroid testing or to look for some other cause of the symptoms the dog is having. This is usually straightforward in other breeds but harder in greyhounds since normal greyhounds frequently have traits that are associated with hypothyroidism in other breeds (bald body parts, cold intolerance, sleeping a lot ....).

To diagnose thyroid disease, you need to run a full thyroid panel including, at a minimum, fT4ed (free T4 by equilibrium dialysis), TSH (thyroid stimulating hormone), and some auto-antibody tests. The first two are used together to assess thyroid function; the auto-antibody tests are used to help gauge the accuracy of the other tests. Some good information about testing is here: http://animalhealth.msu.edu/Sections/Endocrinology/Thyroid_Canine.php

[Guest mrs]

Yes, I'm going to ask for the whole thyroid panel to be done. I'll check out the link. Thanks!

[JJNg]

Please, do the panel, and don't be persuaded that *no* detectable thyroid hormone is okay for a greyhound.

 

No detectable thyroid hormone *can be* ok for a greyhound. But the finding of a low T4 value shouldn't be dismissed just because the dog is a greyhound. In a dog showing some symptoms, it should be investigated further with a full panel. If Smitty wasn't showing any symptoms at the time of the low T4 result last year, there was nothing wrong with the decision not to do further testing at that point.

[greyhead]

You have been through a lot, and I just want you to know that I can feel your fatigue and your tremendous caring for your dog! (We haven't been sleeping well around our house for quite a while due to our GH's health, so....) I really hope things improve.

[greyhead]

No detectable thyroid hormone is fine for a greyhound -- especially if you're talking about a TT4 or T4 test rather than the more accurate fT4ed.

 

Must have missed the humor in this, cuz I don't get it.

 

Whether no detectable thyroid is okay for a greyhound depends, I'd say, on whether they are also symptomatic in some way, or do you disagree with that? I'll never forget Energy11's Goldie and her no-detectable-hormones. And as long as I do remember that, I'll keep popping up with a yeah-but.

[Batmom]

TT4 and T4 can be zero. That doesn't mean the dog produces no thyroid hormone. It means only that those are poor tests to use for diagnosis. TT4/T4 can be used for *screening* -- if it's low AND the dog has likely symptoms, proceed to further testing. If it's not low, look for something else (or nothing, if the dog has no symptoms).

[Guest Gemma]

Hypothyroidism can cause muscle weakness/limping, as others have said. Starting this passed January, Peyton started falling suddenly and had a marked increased in hind end weakness. He does have a bad leg and back pain as a result of a poorly fixed leg break, as well as a diagnosis of arthritis in most of his joints. I assumed that the hind end weakness was a progression of his pain and muscle troubles so we went to the vet for a full work up. Turns out, his thyroid test came back low so we did a full panel and he was very much hypothyroid. Within a week of being on Soloxine, we saw a dramatic improvement. He still has some weakness (and does fall on occasion) but the progression has slowed dramatically and he is much more bouncy. At nearly 12 (next month!) and with his old injury, I am very pleased with his progress. I never would have thought hypothyroidism could have caused his symptoms as he showed NO other signs of it. I'm very glad that I asked around and found a grey-savvy vet when we moved here.

[tbhounds]

Hypothyroidism can cause muscle weakness/limping, as others have said. Starting this passed January, Peyton started falling suddenly and had a marked increased in hind end weakness. He does have a bad leg and back pain as a result of a poorly fixed leg break, as well as a diagnosis of arthritis in most of his joints. I assumed that the hind end weakness was a progression of his pain and muscle troubles so we went to the vet for a full work up. Turns out, his thyroid test came back low so we did a full panel and he was very much hypothyroid. Within a week of being on Soloxine, we saw a dramatic improvement. He still has some weakness (and does fall on occasion) but the progression has slowed dramatically and he is much more bouncy. At nearly 12 (next month!) and with his old injury, I am very pleased with his progress. I never would have thought hypothyroidism could have caused his symptoms as he showed NO other signs of it. I'm very glad that I asked around and found a grey-savvy vet when we moved here.

Wondered if you would share the bloodwork results????

[Guest Gemma]

Wondered if you would share the bloodwork results????

 

NP! I think I found the right lab results. . .

 

T4: 0.4 ug/dL (ref range 1.0-4.0)

 

cTSH: 0.57 (ref range 0.05-0.42 ng/mL)

[tbhounds]

NP! I think I found the right lab results. . .

 

T4: 0.4 ug/dL (ref range 1.0-4.0)

 

cTSH: 0.57 (ref range 0.05-0.42 ng/mL)

Thanks. My girl became hypoT post a unilateral thyroidectomy--her T4 was 0.4 but her cTSH was just under 5.0 (same reference range) Do you remember what your hounds cholestrol #was?

[Guest Gemma]

Thanks. My girl became hypoT post a unilateral thyroidectomy--her T4 was 0.4 but her cTSH was just under 5.0 (same reference range) Do you remember what your hounds cholestrol #was?

 

Looking at the labs, I am assuming that 'CHOL' stands for cholesterol. His was 196mg/dL (ref range 131-345), listed as normal.

[tbhounds]

Looking at the labs, I am assuming that 'CHOL' stands for cholesterol. His was 196mg/dL (ref range 131-345), listed as normal.

Interesting-most hypoT dogs have a high cholesterol--I'll have to look back to see my girls number-I remember it was sky high.

Here's a pretty good link as to why... Find this stuff so cool :-)

https://ahdc.vet.cornell.edu/clinpath/modules/chem/cholest.htm

[JJNg]

As tbhounds noted, most (but not all) hypothyroid dogs have high cholesterol. The most recent case I diagnosed (not a greyhound, but a Jack Russell) had a cholesterol level that was low normal. But she had a very low T4 and fT4, and her cTSH was 4 times higher than the high end of normal.

[Guest Gemma]

Interesting-most hypoT dogs have a high cholesterol--I'll have to look back to see my girls number-I remember it was sky high.

Here's a pretty good link as to why... Find this stuff so cool :-)

https://ahdc.vet.cornell.edu/clinpath/modules/chem/cholest.htm

 

 

As tbhounds noted, most (but not all) hypothyroid dogs have high cholesterol. The most recent case I diagnosed (not a greyhound, but a Jack Russell) had a cholesterol level that was low normal. But she had a very low T4 and fT4, and her cTSH was 4 times higher than the high end of normal.

 

Ahh, that is interesting!

 

I realise it could just be a weird variance but I wonder if Peyton's diet kept his cholesterol low despite the hypothyroidism. He's had stomach issues for a few years so we have had to carefully control his diet/food intake and restrict what kind of things he can eat.

[Guest mrs]

UPDATE: Ok, so I have great updates. First, Smitty, who has been limping since 12/25/13, has gone through thousands of dollars of testing, physical therapy (which worked at first but in March he had a relapse and PT wasn't helping anymore), medications, etc., is 95% better! I have no idea why all of a sudden he's doing awesome. About a month ago, he got out of the little fenced in area within our fenced in yard that was his spot to keep him from running. Well, he ran around the yard and had a ball. I was worried he was going to have a major relapse, but ever since that time, he hasn't been limping. He's now off ALL medications and doing fantastic. I'm now allowing him free roam of the yard, and while he doesn't do zoomies quite like he used to when he was younger, he's so happy to be free! I can see it in his face and in his demeanor. I'm so glad I stopped seeing the orthopedist and took a breather from more and more testing. When they started talking surgery (I guess to explore the shoulder joint), I knew I didn't want to put him through all that.

 

I had a complete thyroid profile done on him and everything was normal...so that's more good news.

 

I have no idea what was going on with him or what caused the limping. I do have meds on hand in case he starts showing signs of limping again. I'm just so happy that my 10-1/2 year old boy is doing so well. Just had to share.

[Batmom]

Happy for your good news .

 

They can pull a muscle or strain a ligament etc. and those soft tissue injuries are 1. very difficult to detect and 2. sometimes awhile in healing.

[Remolacha]

great update!

[seeh2o]

Great news!