Bernie's Anxiety/weight Loss/thyroid Saga

[Laurenbiz]

Hello! News about Bernie.

 

BACKGROUND: Adopted in 2010. Had SA, gave him 25mg Clomipramine (from a consumer pharmacy) and it worked like a charm. Weaned him off successfully. Went on for a few years SA-free and medication-free.

 

DEC 2014: BACK ON MEDS: Put him on Clomipramine anticipating some issues with moving. Ordered 40mg from a compounding pharmacy since the consumer pharmacy price shot up to $600. The new compounding pharmacy Clomipramine has never seemed to have any effect.

 

JAN 12: CRAZY SA RETURNS: Sudden severe SA that has never really gone away since. Pee/poop inside, tear down blinds, tear up and move the couch, dig up carpet. Vet added 1.5 mg as needed Xanax along with the Clomipramine.

-Also has been occasionally limping since Jan 12.

-Has been super tired and lost 8 lbs since Jan 12. (We assumed he's just using up all his energy during the day panicking.)

 

Jan 22: VET VISIT #1: Contacted previous vet in previous town; he recommended bloodwork. DH took Bernie to the first available appt. but saw the other vet in the practice. Justin said the appt. was a waste of time, the vet didn't take blood and told him, "well, you could increase this, you could increase that."

 

Feb 4: VET VISIT #2: Took Bernie to a new vet near our new town. She took blood, mentioned potential thyroid issues, and wants to "switch to a non-compounded medication" and called in an RX to my Target pharmacy for Prozac. (Sidenote: the whole compounding pharmacy thing seems like a joke to me!) Bernie has a tendon or ligament strain in his arm, probably from so much carpet-digging. (This is causing the limping since his initial outburst Jan. 12.)

 

Feb 5: BLOODWORK RESULTS: Vet called me this afternoon to discuss bloodwork. Everything was normal except thyroid. She also emailed me his exam document that talks about the bloodwork. It reads:

(1) His liver values are normal. This is important as he is on medications that need to be processed by his liver. His other chemistry values are normal, as well.

(2) Due to the change in behavior from the clomipramine to the compounded version; we are changing to Prozac (fluoxetine) instead. To begin - we will wean the Clomipramine to every other day. While he is being weaned, you can begin giving Prozac - 2 tablets in the morning (or 1 tablet am and 1 tablet pm) on the days he has no Clomipramine. After a week of weaning, you can continue with the same dose of Prozac or go to the labeled dose of 2 tablets in the morning and 1 tablet at night. Give for 4 weeks, if no improvement, we can increase to 2 am and 2 pm.

(3) He may be hypothyroid as seen by a low T4 (0.3) and a low, normal heart rate (80) (Greyhounds generally are at 120-140 in the clinic). His thinness may be due to maldigestion, stress or chronic pacing and activity when you are away. The full thyroid panel should be checked to assess if this is a true metabolic concern (that can add to his anxious behavior). There is a chance that it is low due to stress or other illness. The good news is that his bloodwork doesn't indicate other types of illnesses.

 

We talked on the phone about the bloodwork/antidepressants/thyroid for about 15 minutes. I figured copying/pasting her actual notes about the thyroid made sense here. I admit I'm not very well-versed on thyroid function.

 

What do you think???

Edited February 6, 2015 by Laurenbiz

[PrairieProf]

Oh shoot Lauren, I am so sorry sweet Bernie and you and Justin are going through this. Not a medical expert but yes to thyroid panel. Low T4 is meaningless in a greyhound. Beth's was 0.4 and she's fine.

 

Glad the limping is nothing terrifying.

[seeh2o]

Wow. I know there are others more knowledgeable, but you can't tell what's going on with his thyroid based on a T4 count alone. He needs a full thyroid panel.

[Batmom]

Yeah, as seeh2o notes, you want a full panel, with fT4ed (free T4 by equilibrium dialysis) and TSH (thyroid stimulating hormone). Clomipramine in particular can lower T4 values, so you want the equilibrium dialysis measure (less influenced by other medications than other test methods).

[NeylasMom]

I would do the full panel with MSU to be safe. It's probably not what's causing the issue, but would suck if it were and you missed it.

 

I hope the Prozac solves the problem for you. It sounds like you've done everything right, including starting him back on the meds in preparation for the move. This must be so frustrating for you. There is a solution though - it's just a matter of figuring it out!

[Guest normaandburrell]

It sounds like the vet is really taking this seriously and trying to find a solution. Sorry for both you and the hound that you are going through this.

[SarahsBlackPack]

if your are going to do a full panel with MSU make sure that you ask for a interpation along with it. We had a senior hound develop canine dementia. And after talking with our vet we started him on Fluoxtine and it worked well for him!

[Fruitycake]

(Does anyone else want to give the first vet a "Gibbs' slap"? Grrr.)

 

Definitely a full thyroid panel. Expensive but worth it to be sure something is actually going on, or to verify that actually the thyroid is fine and it's something else.

 

I also posted in your T&B post about maybe trying to dim the view through the patio doors by sticking some of the window tint sheets to them. I don't know if he's doing damage other than near the doors that he can see out of, but if there is an aspect of getting frantic at something he's seeing maybe it could help. Some people swear by the "calming cap" for dog reactivity, which works on the same principle, so maybe there is a small chance that it might help. It cannot hurt, other than your pocketbook - which is already suffering!

 

I am sorry that you (humans) and he are going through this.

[Guest Scouts_mom]

I just want to add that I am glad you are changing drugs. I've been on antidepressants for years and every few years I need to change what I am on because it stops working on my body. Something like that may be going on with your boy.