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Old January 19th, 2017, 11:09 PM
Shazanne Shazanne is offline
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Thyroid Test Results Advice

My dog has been having some pretty bad skin issues (including patchy alopecia on her ears and blackened like skin under her fur) coupled with shaky back legs and generally aging much faster that I think she should be. She is 12 + years but the past year has shown a decline overall in her I had her skin biopsied and the results showed a bacterial skin infection and suggested that she be checked for hypothyroidism, which I had done immediately. She was last tested for thyroid function in July of last year and, while she was on the low side, she was within 'normal' range. However, part of her results returned today showing her T3 at 0.83 (normal should be 0.90 - 2.10) and her T4 at 23.5 (normal should be 13.0 - 53.0) Her TSH is at 0.19 (normal should be 0 - 0.60) I am awaiting her Free T4 before vet will discuss diagnosis. The figures I have suggest to me that her thyroid function is low - can anyone give their opinion based on their knowledge? Has anyone else's dog had similar readings and what was the outcome?
Thanks you in advance for any advice - I am so worried about her but, at the same time, I am hoping for a definitive diagnosis that we can begin to treat and help her with.
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Old January 20th, 2017, 12:10 AM
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hazelrunpack hazelrunpack is offline
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Ooops....I answered in your other thread. But I'll answer here, too.

We've seen similar numbers as our dogs were developing hypothyroidism. All three with the condition were put on thyroid replacement (Palatech) and did well. Shedding and skin condition improved greatly on the meds.

As problems go, low thyroid would be a blessing considering all the things your dog could have! It's easily treated...and the treatment would be the test, too, since successful treatment should lead to better skin and hair condition. I hope you get some answers soon! I know how worried you've been about Millie!
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Old January 20th, 2017, 05:09 PM
Shazanne Shazanne is offline
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Thank you so much hazelrunpack (Love the Pack's Head Servant line!!!)
Yes, I am hoping it turns out to be a definite diagnosis for Millie and that her vet sees the 'low normal' result for her TSH (down from .36 to .19 since last July) in addition to the Low T3 as sufficient for a diagnosis. Her T4 has come back at 23.5 (normal is 13.0 - 53.0) and her Free T4 is not back yet.
God knows I don't want to see my little fur-girl on life-long medication, but more so I don't want to see her without a diagnosis and continuing to have symptoms.
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Old January 24th, 2017, 04:50 PM
Shazanne Shazanne is offline
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Just got Millie's Free T4 (by Equilibrium Dialysis) results back and they read 20.6 - normal range is between 9.0 and 47.4.
So, it's on the low side or normal but still within normal range and her vet is pretty certain that she does not have hypothyroidism.
So now I am back to the drawing board with her. Her skin is better in places on the antibiotics but unchanged in most places. She still wants to lick and scratch so is still wearing the Elizabethan collar. Sutures come out tomorrow after her skin biopsies so I honestly cannot subject her to wearing a collar any longer.
I don't know which way to turn now and the vet seems baffled, which is even more discouraging. I am feeling pretty helpless at the moment.
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Old January 27th, 2017, 12:47 PM
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Aarrgghhhhh! I hate unanswered questions and inconclusive results when they involve our babies...

Are you anywhere near a Veterinary College? They often have small animal teaching hospitals associated with them. They can be a bit pricey, but we've always found them worth a visit for difficult diagnoses. They see so many special/unusual cases, far more than the general vet practitioner does, that they often can pinpoint causes that nonspecialists are baffled by. Maybe that would be an option for you and Millie?
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Old January 28th, 2017, 05:57 AM
MaxaLisa MaxaLisa is offline
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It's pretty clear with the low T3 that something is going on with the thyroid. The question is what, or if it's something else affecting the thyroid. It needs to be pointed out that the TSH is an inaccurate measure in up to 30% of dogs - I don't even know why they run it since it can be normally in a number of hypo cases. I've had three hypo dogs now and all three had normal TSH. There's an old Antech newsletter from 2011 I think that most clearly states this, it's a pdf and my phone wouldn't give me the url. The problem in older dogs is that they may be at the end point of an autoimmune thyroid issue and enough tissue is destroyed so that the antibodies don't show up.

Addison's and cushing's should be ruled out.
There is a disease process which I think would have shown up earlier, called alopecia X, or used to be called that, which is hormonal and can cause particular types of skin issues. I don,t know if it causes itchiness.

I had a GSD that always ran low T3 and all I kept coming up with was non-thyroidal illness. T4 values were low normal. Ultimately we just did a trial run of thyroid meds, and although his T3 was always low normal after that, he responded really well to the meds and grew an undercoat that we didn't realize wasn't there. It was amazing the difference. Most vet's won't do that without the low t4 though. But treat the dog, not the tests. The dog was hypothyroid, the tests initially didn't point to that except for the low t3.
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Old January 28th, 2017, 12:59 PM
Shazanne Shazanne is offline
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You have been incredibly helpful MaxLisa and you have summed up most of my thoughts throughout this process with Millie. (I also replied to you in one of my other threads)

I thoroughly agree with the concept of treating the dog, not the tests. Cushing's has been ruled out definitively. Testing for Addison's has never been suggested. But my instinct continues to point to hypothyroidism and it has from the very beginning.

My vet is fluctuating between a trial on thyroid medication or not - on the basis that her own thyroid will stop producing the hormone and she will require the thyroid medication for life. However, and perhaps you can confirm this, taking the medication with her current results cannot do any harm according to my research. Plus, at 12 + years old (she's a rescued dog so unsure of her exact age) I feel that if her quality of life can be enhanced and the medication will not harm her in any way, it is worth trying.

I will discuss it with my vet again. With regards to Alopecia X, I have read about it in passing but it has never been mentioned as a possibility by her vet. She is not itchy, except for regular aggressive licking/biting at her vulva area, which has been checked for any obvious problems but nothing was detected.
Thank you for taking the time to respond.
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Old February 4th, 2017, 05:36 PM
MaxaLisa MaxaLisa is offline
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Quote:
Originally Posted by Shazanne View Post
My vet is fluctuating between a trial on thyroid medication or not - on the basis that her own thyroid will stop producing the hormone and she will require the thyroid medication for life. However, and perhaps you can confirm this, taking the medication with her current results cannot do any harm according to my research. Plus, at 12 + years old (she's a rescued dog so unsure of her exact age) I feel that if her quality of life can be enhanced and the medication will not harm her in any way, it is worth trying. .
I personally feel that a trial wouldn't do harm because of the low end levels. There are worse things for a 12+ year old dog than to be on lifelong thyroid meds IF you notice that they are getting better. You will know within 6 weeks (maybe sooner). If they don't feel better, you can also gradually wean off the hormone and get completely off it IF there was no positive response. IMO.

I wouldn't expect a vet to be experienced with Alopecia X, and maybe just a few dermatologists, because I don't think it's that common. From what I read (and worth perhaps further research), the treatment is melatonin and flaxseed. You could give melatonin at night and fresh ground flax mixed with something liquid with meals. I give the flax as a regular part of the diet. For my girl here I tried the evening melatonin and it didn't seem to be the right fit so I didn't continue, but I might try again now that she is better in other ways (peeling the layers of the onion, so to speak!). But melatonin, if starting with small dosages is pretty safe as a trial. It can help so many different things.
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Old February 13th, 2017, 10:06 AM
rhynes rhynes is offline
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Thyroid trial won't do any harm and any vet worth their salt should be willing to put a dog with questionable results on a trial. just be aware of what the symptoms of hyperthyroidism are - and stop if symptoms show.

My ex's minpin was neutered early, around 4 or 5 months I believe. Essentially, he didn't go through puberty properly, ended up bigger and after 3 years of chasing vets - he was finally put on a trial of synthroid. Western vets only looked at the T4, claimed the thyroid was fine - T3 and others didn't line up. There is a secondary hypothyroid condition - basically the thyroid is producing, but the pituitary or hypothalamus are malfunctioning.
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