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This is a "What would you do situation". I need advice :)

Rgeurts
May 30th, 2011, 04:46 PM
Ok, as most of you know, Nookie has more disorders/issues than any dog/puppy should ever have to deal with. This is concerning his Thyroid. Some of you will remember a couple of weeks ago they were thinking he had ME (megaesophogus), which turns out he didn't :thumbs up
We decided to have his t4 levels tested since it had been a little over a month and we were noticing that he was starting to have issues again and had another seizure. Our regular vet called a few days ago and said they got the results back and that he didn't even look remotely close to a dog on thyroid supplementation :confused:
She said a dog on hormone replacement will typically be in the 40-50 range (high normal) and low normal would be 13, but Nookie is at 9.7. :eek:
So... she said she has a feeling this is why he is having more frenquent seizures and all the other issues he's been having. She is also now convinced (after observing him) that the tail chasing/aggression are focal seizures. He has been chasing his tail several times a day for the last couple of weeks as well as having little fits of "aggression". We are to the point now when he starts, we will get down on the floor and put our arms around him and just hug/love him and talk to him. He will squirm, wiggle, try to bite and growl. It lasts only a few minutes, then he's fine and back to his happy, puppy little self, like nothing ever happened :shrug:. We have found that when we do this, it doesn't lead in to a grand mal as it sometimes does after chasing his tail. It definitely isn't rough play or behavioral. When he gets like that, there is nothing we can do to make him stop/focus, not even food. If he is just acting out, he will always stop and look at you (and drool lol) when you mention food or treat. So our vet believes he's now having several focal seizures daily. Our vet said she would like us to contact Dr. Marsden and have him up the dose asap.

I emailed Dr. Marsden as he is in the states (and has been for a few weeks). He emailed me back saying he thinks it's an error and does not want us to increase the dose at all as if it's too high it can also cause severe problems. So he reccomended we do another thyroid panel and send it to hemopet, which we have done (another $1000 vet tab week :().

This is the dilema:

Do we wait for the thyroid panel and do nothing for our precious boy as Dr. Marsden says, or do we do as our other vet said and increase it? The last thyroid panel we had took about 3 weeks. Nookie is having some serious issues. The tail biting/aggression is one. He will also do nothing but whine/pace/howl for the first few hours in the morning, then again in the evening until it's time for bed (hubby noticed it seems to get worse after he eats?). He's constantly panting and hot, he has started doing some really odd things like jumping on the windows/doors and howling like he's trying to escape. We take him outside, then he just wants to come right back in. And he has found his "howl", which is sometimes VERY cute, and others, like 5 am, is not so cute. The howl doesn't bother me, but the frequency and occassion sometimes do. He was sound asleep the other night when he started whimpering, then all of a sudden he lifted his little head, nose to the ceiling and let out the longest, most haunting howl I have ever heard from a dog :eek::eek:
Hubby heard it all the way downstairs in the computer room (I was standing next to him when he did it)! He came running up and Nookie seemed fine. I don't know if he was just dreaming, or if he was hurting/uncomfortable, but it broke both our hearts because it was just SO mournful. So any advice? Should we wait it out, or would that be harmful if he truly is that low? Or do we up it and risk the last test actually being an error and taking his levels too high which could result in heart problems? I'm SO confused :(

Thanks in advance to anyone who responds :)

Robyn

Winston
May 30th, 2011, 06:32 PM
Oh Robyn what a situation!! I guess if we talk it through maybe you will be able to make a decision you can feel good about.

First off they could have made a mistake on the panel. It would be a costly mistake to you to the tune of $1100. Or what if there was a problem with the panel for some unknown reason. A second one will confirm for sure if it comes out the same. Having said that maybe just maybe it will have a different result?

Would the different result affect Nookie over all ? I mean the increase in the meds? Could it possibly wait for the 2nd result? or would it be better for Nookie to have the increase and then change it again?

Could they put an absolute RUSH on the panel so that there is a 1 day turnaround? and then at the very least you could put it off until you confirm?

Your in a tough one. As if you dont have enough to deal with.

I guess if you have talked to Dr.Marsden last then perhaps you could go back to your regular vet with his suggestion and see what they think. Maybe they will agree? you never know?

Robyn whatever you decide just know that your doing whatever is best for Nookie and thats all that matters. Your boys are always in my prayers and not far from my thoughts. :angel2:

Cindy

Rgeurts
May 30th, 2011, 06:47 PM
Thank you Cindy :) :grouphug:

I did call our regular vet and told her what Dr. Marsden had said. For the very first time, through all of this, she said she "absolutely disagrees with Steve" (they went through school together and are good friends), her exact words lol. She said if we do increase it and he doesn't need it, then yes, we could see some heart issues and other nasty things. It would basically make him hyperthyroid instead of hypothyroid.Which, to be honest, the symptoms he has already fit with hyper, not hypo. He has a ravenous appetite, drinks a TON of water, is extremely restless and hyper, seems to have anxiety, intolerate of heat, rapid/heavy breathing etc. I did ask her if this was urgent that it be increased, or if we were ok to wait. She said it could definitely cause him more frequent and severe seizures if it's that low. She thinks the daily focal seizures will stop once we increase his dose, and I think she's right because those symptoms/aggression did subside a few weeks after starting the thyro-tabs initially. So, she wants us to increase by 25% immediately and monitor his heart rate, which scares the crap out of me :eek:

As for the rush on the panel, the blood has to be shipped to California, so if it gets held up at the border, it could delay it. I am going to call Dr. Marsdens clinic tomorrow and see if they can please contact Hemopet to definitely put a rush on it once they receive the sample. :)

hazelrunpack
May 30th, 2011, 08:08 PM
You might want to also PM Dr Lee, Robyn, and see what he suggests.

How much thyroid replacement is he taking now? A 25% increase may not be that big if he's at a low dose for his weight. We have a 43-pounder and a 62-pounder on the same .8mg/day dose and the smaller dog's levels are about the same as the larger dog's. Dogs seem to have a pretty easy time of clearing excess thyroid hormone from the bloodstream.

I hope Dr Marsden's clinic can get a rush on the panel. :fingerscr

Rgeurts
May 31st, 2011, 10:42 AM
You might want to also PM Dr Lee, Robyn, and see what he suggests.

How much thyroid replacement is he taking now? A 25% increase may not be that big if he's at a low dose for his weight. We have a 43-pounder and a 62-pounder on the same .8mg/day dose and the smaller dog's levels are about the same as the larger dog's. Dogs seem to have a pretty easy time of clearing excess thyroid hormone from the bloodstream.

I hope Dr Marsden's clinic can get a rush on the panel. :fingerscr

Thank you Hazel :)
I will PM Dr. Lee. Nookie started on .6 and about a month and a half ago they increased it to .7 as he was borderline low. So even with the increase, if the latest test was correct, he's dropped a lot more. You're dogs are about half his weight and on a higher dose, so I'm hoping that's all it is! I read somewhere that the typical dose was .1 per 10lb's of weight, but also that all dogs are different and you have to play with the dose. I'm hoping it's a matter of just needing to increase his dose and not that his body just isn't absorbing it as the vet say may be what's happening. She really didn't explain it very well, so I can't imagine what would cause him to not absorb it? I'm going to PM Dr. Lee and see if he can look at the thread :)
I don't want to hold off if it could be harmful, but I don't want to increase it if he doesn't need it. I just don't know which is the lesser evil here :shrug:

hazelrunpack
May 31st, 2011, 10:47 AM
I'm hoping Dr Lee can help you out with the metabolic part--how it's absorbed and what happens to the excess if it's not. :o I asked him some questions about thyroid replacement a while back and he was very helpful.

As I understand it, once a dog is on thyroid meds, they like to see the levels up in the upper 1/4 of normal range...or at least Dr Dodds recommends that level. :shrug:

chico2
May 31st, 2011, 05:12 PM
Awww Robyn,I really,really feel for you,hubby and the puppers and:pray:you'll have a solution:pray:

Rgeurts
May 31st, 2011, 05:49 PM
Thanks guys :) :grouphug:
I spoke with our regular vet again today. She said I need to just increase it and monitor his heart rate, though she's pretty convinced he's "ultra-low" and any complications due to excess amounts won't be an issue. If it were just the blood test results, I may be a little leary, but with all the weird things he's been doing and all the possible focal siezures daily, I know deep down that she's right. I am going to increase his dose by 25% tonight :)

Hazel, that's who we sent the panel to, Dr. Dodds. Last time it took about 3 weeks, but they said they should be able to get it rushed a bit, so here's hoping :fingerscr
And yes, our vet said the same. They like to see them in the "high" normal range, so I'm really hoping that it will be just a matter of increasing the dose :pray:

Goldfields
June 1st, 2011, 06:48 AM
Robyn, my 24lb sheltie(approx. guess) gets .4mg/day dose.
I attended a Seminar for thyroid sufferers and the Professor gving the lecture told us that we should not go by the book regarding how much to take, but by the dose rate that makes us feel the best - I am hypothyroid like Nookie. LOL. So, one Doctor wants me on 2 1/2 tablets, the other says two, but the higher dose suits me the most so the second Dr has just become resigned to my decision. No ill effects that we have noticed.

Rgeurts
June 1st, 2011, 08:47 AM
Thank you Goldfields!!! So Nookie, comparatively speaking, is on just under half the dose your pup is (going by weight). I have upped his dose by 25%, but I expect that when the results are back, they will have me up it even more. I don't think the test was wrong at all, he just is having way too many issues.

Thanks again :grouphug:

Robyn