Hypothyroidism

Swarupmay Majumdar Pet Ferry,A mixed Terrier lasaapaso..10 yrs age,intact male18kg! Presenting signs, itch,laziness,PUPD and Polyphagia, wait gain,laziness.....Pe: Scaling,Hyperpigmentation,hair loss, and greasyness ....Thyroid profile done at Mumbai lab: T3-57.98ng/dl.T4 1.3ng/dl,TSH 0.09Ng/dl. Trial therapy :: Has been on Eltroxine tablets 1-0-2 orally + fipronil Spot on . 45 days later, he is putting on more weight, more lazy indoors , skin is fine, new hair , tail remains same yet but he looks btttr.What next

19 July at 19:21 · Comment · · Flag

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    Jess Vergis y have u given fipronil spot on?wat abt present T3 status?any complications reported?

    19 July at 19:39 ·
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    Swarupmay Majumdar I wantede to control Fleas as well as I found a few but systomatically there was more about Hypothyroids where as the lab reports suggests its not! My dilemma as the Thyroid result has come in Do I really need Elthroxin, if so how long? will this cause unnecessary complications??etc...Can u suggest me something and the dose for Elthroxin also

    19 July at 19:53 ·
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    Swarupmay Majumdar T3 staus is as of 1.7.10, recied 3 days back

    19 July at 19:54 ·
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    Rajshankar Tony Sarma

    I don't know the reference ranges for your T3/T4/TSH; however the common complication with interpreting these is euthyroid sick syndrome - I've had dogs with, say, ringworm turn up and give low T4 readings. If there was any doubt about the dog's thyroid status, what you could do is treat for one thing only initially - treat the fleas, then when the dog seems all fine, repeat the thyroid screen. If the results from the lab do not seem hypothyroid, I'd not treat for thyroid.
    
    Guess I'd want to review the initial thyroid screen and be convinced that the dog was truly hypothyroid, and that the T4 status was causing skin signs - which, given presence of fleas, may or may not be the case. If a true hypothyroid, then therapy is usually life-long; monitoring is usually by post-pill T4 (4-6 hours usually, talk to the lab!)
    
    Confounder. Just a thought - PUPD and weight gain and alopecic dermatosis. Cushingoid???

    20 July at 03:13 · · 2 people
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    Ajay Kesarwani supplementation with eltroxine improves skin and hair even in euthyroid dogs so that part of improvement shud be ignored.I too agree with Dr Raj.Meanwhile go for CBC and blood sugar.

    20 July at 09:27 ·
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    Swarupmay Majumdar

    Cushings! can be ! but he has a very thick fatty coat. and I dont find any signs like visible blood vessales on skin.
    The biggest problem in thyroid testing in India is, only one lab in mumbai does the canine specific thyroid testing. so post pill not a possible wish!
    
    My questions at this point is whether to continue with the eltroxins? will there be side effects of such therapy?
    
    @Ajay: I have Blood sugars and CBC results done twice before the elthroxine supplementations and they are normal.

    20 July at 10:36 ·
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    Jess Vergis

    eventhough the levels are breed dependent, the normal levels are as:
    fT4 is 3.53+/- 0.34ng/dL; T4 RIA is 2.3 +/ - 0.8 mcg/dl and T3 is 107+/ - 18 ng/ dL.Also we should bear in mind that fT4 is more specific as far as diagnosis is concerned.
    check for any concurrent infections like CHF,renal/hepatic failure.if so make ur dose to 25% of the standard dose.
    
    standard dose being 22mcg/kg bid for adults and reduce to od if response noted..in pups,it is 33mcg/kg and the dose should be monitored by T4 levels every 4 weeks...

    20 July at 19:41 · · 1 person
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    Sp Singh you can --on the basis of your clinical signs

    21 July at 16:41 · · 1 person
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    Premal Darji chck for cushings also

    21 July at 17:52 ·
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    Rajshankar Tony Sarma

    Hmm. If T4 and T3 and TSH were all normal (don't have ref ranges, but am presuming from tone of debate) then I don't think you can justify treatment - other diseases can cause similar signs, so they must be ruled out before we jump to treatment. Presumptive treatment can be ok *IF* everything else is ruled out first, but I don't think that is the case here yet. Supplementation may cause hyperthyroidism, which is also undesirable.
    
    Also, this is a debate for the endocrinologists - we see a lot of animals who have been put on thyroid supplementation on the basis of dubious T4 results (especially T4). These usually get referred when it becomes obvious that something else is going on; frequently they were in fact "euthyroid sick syndrome" rather than genuine hypothyroid. Hypothyroidism is "the great impersonator" - so while we must always be suspicious of it, it does not need to look like its "classic" textbook description!
    
    And in particular (on a tangential point) - there are a lot of owners who seem to think it must be hypothyroidism rather than "hyper-paratha/naan/curry-ism" that is the problem with their dog's weight... ;o)

    21 July at 22:59 · · 1 person