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Ongoing Thyroid Saga



 
 
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  #1  
Old October 19th 06, 01:53 AM posted to rec.pets.dogs.health
Suja
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Posts: 873
Default Ongoing Thyroid Saga


A while back, I posted about Pan's T4 coming back low. We redid the test,
and checked a couple of additional things - the T4, free T4 came back low,
TSH was borderline normal. On that basis, we started her on her Thyroid
supplements. We had the re-test a couple of days ago, and the test results
came back clear as mud. T4 - 4.2 (on a scale where 1-4 is normal range),
Free T4 -14 (where normal is 12 - 39?), TSH normal, at 1. We had an
endocrinologist consult, and she's of the opinion that Pan's thyroid is
fine, and this is caused by 'something else'. Of course, finding that
something else appears to be more art than science, as there are many, many,
many things that could cause suppressed Thyroid results.

First candidate was Lyme, but her Lyme results showed no active infection.
It could be kidneys (maybe liver too, I don't remember now), but her test
results on the geriatric panel were in normal ranges. It could be the
pancreas, gall bladder...pretty much anything except that damn thyroid, I
guess. Endocrinologist wants urinalysis, retest of the thyroid function,
X-rays and follow-through with ultrasound if anything looks even the least
bit abnormal. I'm thinking that this is a wild goose chase on a dog who is
the picture of health.

For now, we're stopping the thyroid supplements. I haven't noticed any
changes in her, and the test results don't seem to support a thyroid problem
anyway. We will do a urinalysis to see if there is a UTI (that shows NO
symptoms) or protein loss or something weird. A month later, we'll do a 6
panel thyroid, and this time I'm having it sent to MSU. Beyond that, I'm
just not willing to sedate her to X-ray her whole body to see what if
anything might be wrong. Any other suggestions?

I'll say this. This totally sucks. It seems like something might be wrong,
but we have no indication of what that might be. With nothing to go on, I'm
not going to subject her to procedures that seem completely unnecessary, yet
it feels like I'm not doing enough (and I know I'll beat myself up if
something pops up at a later date, and it turns out that it could've been
caught earlier if I'd done this).

Anyway, a looong post to ask if anyone has suggestions for how to collect
urine from a girl dog without freaking her out. Vet suggested clean
gladware (or something similar); I'm supposed to do first catch (to see if
she's concentrating her urine properly), and get it to them in 3 hours.

Suja

P.S. In case anyone might have missed it, that buglady really knows her
stuff.


  #2  
Old October 19th 06, 02:57 AM posted to rec.pets.dogs.health
Melinda Shore
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Posts: 7,732
Default Ongoing Thyroid Saga

In article [email protected],
Suja wrote:
Anyway, a looong post to ask if anyone has suggestions for how to collect
urine from a girl dog without freaking her out.


I usually use some sort of disposable kitchen container
(large and shallow) and wait until she squats then quickly
stick it in underneath her. I've never had a dog object or
freak out.

My vet has a gizmo made out of the sawed-off bottom from a
bleach jug with a long handle made from a bent wire hanger.
It's pretty handy.
--
Melinda Shore - Software longa, hardware brevis -

There are 2,012 earmarks in the research section alone
of the GOP's latest defense bill.
  #4  
Old October 19th 06, 03:37 PM posted to rec.pets.dogs.health
buglady
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Posts: 863
Default Ongoing Thyroid Saga

"Suja" wrote in message
news:[email protected]
A while back, I posted about Pan's T4 coming back low. We redid the test,
and checked a couple of additional things - the T4, free T4 came back low,
TSH was borderline normal.

.........no T3?

We had an
endocrinologist consult, and she's of the opinion that Pan's thyroid is
fine, and this is caused by 'something else'.

.........I think that's what they call euthyroid sick, though in people
having both a low T3 and T4 and not being hypothyroid usually means they're
critically ill and in the hospital.
http://www.postgradmed.com/issues/19...99/camacho.htm

......I Googled euthyroid sick vet and came up with some interesting stuff.
Perhaps a sonogram of the thyroid may be in order:
J Vet Intern Med. 2005 Jul-Aug;19(4):491-8.
Thyroid sonography as an effective tool to discriminate between
euthyroid sick and hypothyroid dogs.
Reese S, Breyer U, Deeg C, Kraft W, Kaspers B.
Institute of Veterinary Anatomy, University of Munich, D-80539 Munich,
Germany.
The diagnosis of canine hypothyroidism and its differentiation from
euthyroid sick syndrome still is a major diagnostic challenge. In this
study, ultrasonography was shown to be an effective tool for the
investigation of thyroid gland diseases. Healthy control dogs (n = 87), dogs
with euthyroid sick syndrome (n = 26), thyroglobulin autoantibody-positive
(TgAA-positive, n = 30) hypothyroid dogs, and TgAA-negative (n = 23)
hypothyroid dogs were examined by thyroid ultrasonography. Maximal cross
sectional area (MCSA), thyroid volume, and echogenicity were measured.
Statistical analysis identified highly significant (P .001) differences
between euthyroid and hypothyroid dogs both in thyroid volume and in MCSA,
whereas no significant differences in thyroid size were detected between
healthy euthyroid dogs and dogs with euthyroid sick syndrome. In euthyroid
and euthyroid sick dogs, parenchymal echotexture was homogeneous and
hyperechoic, whereas relative thyroid echogenicity of both TgAA-positive and
TgAA-negative hypothyroid dogs was significantly lower (P .001). When
using arbitrarily chosen cutoff values for relative thyroid volume, MCSA,
and echogenicity, thyroid volume especially was found to have highly
specific predictive value for canine hypothyroidism. In summary, the data
reveal that thyroid sonography is an effective ancillary diagnostic tool to
differentiate between canine hypothyroidism and euthyroid sick syndrome.
PMID: 16095165

.......this is a study of canine osteoarthritis and thyroid, but still the
discussion is interesting, not to mention the list of refs at the end:
http://www.pubmedcentral.nih.gov/art...i?artid=340149

First candidate was Lyme, but her Lyme results showed no active infection.

..........did you test for any other tick diseases? And are they even on the
radar in your area? And a further thought - Pan may be reacting to an
exposure to some sort of infectious disease and possibly in a few months
everything will read normal. Dogs do get exposed to stuff like Lyme all the
time, react, develop antibodies and never get the disease itself. It just
may be that you had a blood test done at a *critical* time so to speak.

I'm thinking that this is a wild goose chase on a dog who is
the picture of health.

.......really, absolutely no symptoms of anything? The only *problem* is the
test results? :-) I'm wondering about the adrenal glands though as
apparently high corticosteroids can depress thyroid function - this would
mean Cushings. And if I was going to X-ray anything, it would probably be
the head (pituitary).

...........and did they take a really good listen to Pan's heart?
http://www.ncbi.nlm.nih.gov/entrez/q...trieve&dopt=Ab
stractPlus&list_uids=11420766&query_hl=4&itool=pub med_docsum

.........I guess this is a partial explanation of why *other illnesses* can
affect the thyroid:
http://www.ncbi.nlm.nih.gov/entrez/q...trieve&dopt=Ab
stractPlus&list_uids=2285599&query_hl=4&itool=pubm ed_docsum

We will do a urinalysis to see if there is a UTI (that shows NO
symptoms) or protein loss or something weird.

.............yeah, that's a good idea as kidney function can't be completely
covered w/o urinalysis.

A month later, we'll do a 6
panel thyroid, and this time I'm having it sent to MSU.

.......good plan.

With nothing to go on, I'm not going to subject her to procedures that seem

completely unnecessary, yet
it feels like I'm not doing enough (and I know I'll beat myself up if

something pops up at a later date, and it turns out that it could've been
caught earlier if I'd done this).

........well I really don't know what you can do at this point. Number #1 is
to get 6 panel thyroid. If it's not hypoT, then I'd do other endocrine
tests, perhaps test for all tick diseases. Still nothing, I'd wait a few
months and repeat all blood tests. And that's about all you can do, unless
you want to drain your bank account and get every test known to dog done.

suggestions for how to collect
urine from a girl dog without freaking her out. Vet suggested clean
gladware (or something similar); I'm supposed to do first catch (to see if
she's concentrating her urine properly), and get it to them in 3 hours.


......I use a pie plate, but it really depends on how annoyed your dog is
when you follow them around while they're trying to pee! I had one female
dog that viewed the whole thing with a high level of suspicion. What the
heck are you doing back there? I guess that's another good thing to
practice before you need it!

buglady
take out the dog before replying


  #5  
Old October 19th 06, 04:15 PM posted to rec.pets.dogs.health
buglady
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Posts: 863
Default Ongoing Thyroid Saga


"buglady" wrote in message
link.net...

.........few more!
http://www.dlab.colostate.edu/webdoc.../lablines7.pdf
http://archinte.ama-assn.org/cgi/con...ract/139/7/767
Cushings and HypoT:
http://www.lbah.com/canine/hypot4.htm

........and now it is late and HOT and my dogs hate me.

buglady
take out the dog before replying


  #6  
Old October 19th 06, 10:40 PM posted to rec.pets.dogs.health
Suja
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Posts: 873
Default Ongoing Thyroid Saga


"buglady" wrote in message:
........no T3?


No, hence the plan to send the next one out to MSU.

.........did you test for any other tick diseases? And are they even on

the
radar in your area?


Also negative for Ehrlichia. I have to see if anything else is found in the
region; after all, my friend's husband had Rocky Mountain Spotted Fever,
which is not at all common in this area.

And a further thought - Pan may be reacting to an
exposure to some sort of infectious disease and possibly in a few months
everything will read normal.


One can only hope.

......really, absolutely no symptoms of anything? The only *problem* is

the
test results? :-)


Pretty much. She had conjunctivitis a month or two back, and other than the
ongoing itchy shoulder problem I've described earlier (which also has the
vet stumped), nothing is wrong with her that I can tell.

I'm wondering about the adrenal glands though as
apparently high corticosteroids can depress thyroid function - this would
mean Cushings. And if I was going to X-ray anything, it would probably be
the head (pituitary).


I think that part of the problem is that there are no indications for where
exactly to look. Unless there is a really good reason, I am not going to
have a whole body scan of the dog.

..........and did they take a really good listen to Pan's heart?


Yes. It has always been fine. Both dogs have low-normal heart rate, which
the vet attributes to the amount of exercise they get.

............yeah, that's a good idea as kidney function can't be

completely
covered w/o urinalysis.


Yeah, and the vet said that there might be morphological changes in organs
that would be picked up by scans before they would show up on blood test
results.

.......well I really don't know what you can do at this point. Number #1

is
to get 6 panel thyroid. If it's not hypoT, then I'd do other endocrine
tests, perhaps test for all tick diseases. Still nothing, I'd wait a few
months and repeat all blood tests. And that's about all you can do,

unless
you want to drain your bank account and get every test known to dog done.


If we go the way the endocrinologist suggested, that's probably what would
happen. As it stands, we'll probably just stick with the urinalysis and
thyroid panel, and I'll talk to the vet about doing endocrine tests (I'm not
sure what if anything is covered in the geriatric panel) and a tick panel.

.....I use a pie plate, but it really depends on how annoyed your dog is
when you follow them around while they're trying to pee!


I'll find out tomorrow morning. I'll do my best to sterilize some
tupperware and see if we have any luck.

I guess that's another good thing to
practice before you need it!


Hindsight is 20-20! Wish I had practiced.

Suja


  #7  
Old October 20th 06, 12:08 AM posted to rec.pets.dogs.health
buglady
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Posts: 863
Default Ongoing Thyroid Saga


"Suja" wrote in message
news:[email protected]
Also negative for Ehrlichia. I have to see if anything else is found in

the
region; after all, my friend's husband had Rocky Mountain Spotted Fever,
which is not at all common in this area.


......really, absolutely no symptoms of anything? The only *problem* is

the test results? :-)

Pretty much. She had conjunctivitis a month or two back,

........in one eye? Was it itchy? I just read a site that said as a rule of
thumb conjunctivitiis is itchy. Lyme and toxoplasmosis can also cause
problems with the eye - they called it scleritis - reddening of the outer
sclera of the eye (white portion) and it usually occurs in only one eye.

and other than the
ongoing itchy shoulder problem I've described earlier (which also has the
vet stumped), nothing is wrong with her that I can tell.


.........Oh yeah, forgot about the itchy shoulder. Interesting that all the
issues are sequestered in the head and neck. Wonder if that itchy shoulder
could be some kind of pinched nerve in the neck?

.....Oh well, I guess just wait and see. Good luck with the Tupperware!

buglady
take out the dog before replying


  #8  
Old October 20th 06, 01:04 AM posted to rec.pets.dogs.health
Suja
external usenet poster
 
Posts: 873
Default Ongoing Thyroid Saga


"buglady" wrote in message:

.......in one eye?


Both, one worse than the other. The vet chalked it up to allergies.

Was it itchy?


I don't think it was.

Lyme and toxoplasmosis can also cause
problems with the eye - they called it scleritis - reddening of the outer
sclera of the eye (white portion) and it usually occurs in only one eye.


That's an interesting thought. Both dogs get raw once in a while, and they
get pork necks as a part of it (possible source of Toxoplasma). This is
really interesting
http://www.veterinaria.org/revistas/...306/030612.pdf I'm going to
run this by the vet.

........Oh yeah, forgot about the itchy shoulder. Interesting that all

the
issues are sequestered in the head and neck. Wonder if that itchy

shoulder
could be some kind of pinched nerve in the neck?


The vet doesn't think there is any kind of neurological involvement. I am
going to do a little digging around with Lyme and toxo as possible suspects,
to see if any of this ties together.

....Oh well, I guess just wait and see. Good luck with the Tupperware!


Thanks! She's gonna think that I've lost my mind.

Suja


  #9  
Old October 20th 06, 05:34 PM posted to rec.pets.dogs.health
bethgsd
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Posts: 526
Default Ongoing Thyroid Saga


"Suja" wrote in message
news:[email protected]

"buglady" wrote in message:
........no T3?


No, hence the plan to send the next one out to MSU.


In the for what it is worth column, when I need thyriod tests done on my
animals I go straight to MSU.

.........did you test for any other tick diseases? And are they even on

the
radar in your area?


Also negative for Ehrlichia. I have to see if anything else is found in
the
region; after all, my friend's husband had Rocky Mountain Spotted Fever,
which is not at all common in this area.


Many years ago I lived in NoVa and a kid in my fifth grade class got very
ill. Almost died before RMSF was diagnosed. Also, back in the 1990s my
wire fox terrier had RMSF.


Good luck figuring out what is bothering your girl. Makes Star and his
garbage gut look like nothing. Unless you're the person that had no sleep
last night with Mr. Vomit and Diarrhea.

Beth


  #10  
Old October 20th 06, 09:42 PM posted to rec.pets.dogs.health
Suja
external usenet poster
 
Posts: 873
Default Ongoing Thyroid Saga


"bethgsd" wrote in message
news:[email protected]

In the for what it is worth column, when I need thyriod tests done on my
animals I go straight to MSU.


Lesson learned. They have longer turnaround than the local lab which is why
I agreed, but it won't happen again.

Many years ago I lived in NoVa and a kid in my fifth grade class got very
ill. Almost died before RMSF was diagnosed. Also, back in the 1990s my
wire fox terrier had RMSF.


That's odd and rarely mentioned. It's going to go on the list of suspicious
characters.

Good luck figuring out what is bothering your girl.


Not enough clues to figure this out. Not even Sherlock Holmes could do it
at this point. I've dropped off a urine sample this morning; we'll see what
turns up. I'm taking bets that it is either nothing or nothing that makes
any sense. Pan was a little puzzled that I had her pee in tupperware, but
that was about it.

Makes Star and his
garbage gut look like nothing. Unless you're the person that had no sleep
last night with Mr. Vomit and Diarrhea.


I know what that's like. I haven't had much sleep in the last couple of
days, mostly because of my overactive imagination. I don't know why it is
that the brain automatically goes only to worst case scenerios.

Suja


 




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