Originally Posted by
mauricenme
the t4 and both free t4s were way high now so he said to only give one pill a day in the morning. by now I'm started to research things on my own and everything i read says to divide the dose in half ,morning and night. I asked, mentioned that and he said I was misinformed and if it were his dog he would do one in the morning. so I followed what he said and after a couple weeks maurice symptoms didn't change and that nagging feeling I had to stop the meds wait a week and get a full thyroid panel and go the distance to the vet I trusted.
The half life of Thyroxine is no more than 12 hours so that’s why you give the med every twelve hours. If the results of the test were way high 4 to 6 hours after the morning dose, switching to one daily dosing is not really an appropriate way to reduce a dose. By the way what is way high? Can you post the number for us? A dog who is getting too much thyroxine will flip from hypo to hyperthyroidism and will start peeing buckets and drinking huge amount of water. These are classic symptoms of hyperthyroidism. Was Maurice drinking and peeing a lot after starting the thyroid meds?
I just wanted to add the alkp and the other values that were abnormal the first time which was CHOL, ALB, and MCHC but that also didn't happen. I now have 3 sets of the same bloodwork.
Unfortunately, you cannot pick and choose which blood enzymes to test. These are all part of a complete blood chemistry test. There is a cheaper mini blood chemistry but it only includes some liver enzymes and kidney values.
I demanded a ldds test because I read it was the most reliable for cushings. He said I was wasting my money. I said I don't care it's my money.
While the LDDS is probably the hallmark test used to diagnose cushing’s, it is also the most likely to yield a false positive result in the face of non adrenal illness or even severe stress. Since Maurice didn’t have the usual symptoms commonly associated with cushing’s he was not wrong in believing that it may not be cost effective to do an LDDS test. The goal of treatment is to remedy problematic symptoms which are usually a lot more problematic for the pet owner. A once housebroken dog who is soiling in the house and a dog constantly begging, whining and foraging for food can wear you down. If there are no symptoms, an experienced vet usually won’t recommend treatment, especially in a case like Maurice where there also no overt abnormal blood or urine values that are commonly seen in cushing’s. There have been some different trains of thought lately on starting early treatment in the absence of symptoms but I don’t think Maurice would qualify as a likely candidate.
I also asked that a bile acids test be done thinking about the plastic that may be in there someplace. But instead of a pre and post pandrial like i wanted i got a pre panpandrial random with a small d in front but the pre was normal but i do not know if the post was or not he didnt do the post.
Your vet probably didn’t feel it necessary to put Maurice through the entire bile acid test as his liver enzymes are not suggestive of liver disease. A cushing;s savvy vet knows that a good many dogs diagnosed with cushing’s will have increased pre and post prandial results and won’t recommend a bile acid test unless they suspect more than cushing’s is affecting liver function. If liver function was being impaired by something that is obstructing the bile duct, you would see more than a mild elevation in liver specific enzymes, ALT & GGT as well as elevated cholesterol. Maurice’s ALT, GGT and cholesterol are normal.
The ldds test came back friday and i had to call again to remind them to email the results to me even though they said they would. The results are cortisol pre dex 2.6 baseline with the range being 1.0-6.0 ug/dL, cortisol 4 hour post dex 1.9 no range listed but ug/L, cortisol 8 hour post dex 1.7 with an a in front.
Those LDDS test results are consistent with cushing’s but as I already mentioned, this test is prone to false positives so given that Maurice’s doesn’t really present as a cushingoid dog, both physically and clinically, I personally wouldn’t spend money on pursuing a cushing’s diagnosis at this point in time.
while I was waiting for the 4 hour blood draw I got a phone call from the vet who did the xray after maurice was hit. She said she showed the xray to the radiologist and he saw something in his left lung she wanted to make sure my vet knew.
Did you have the LDDS test done right after Maurice was hit by a car? If so, the stress alone could cause a false positive result.
so at the end of the day when I asked my vet if anyone called him about the xray and he said yes but he was busy he didn't take the call. I told him to call her back cause something was found. I found out he never called because I decided to take everything I had to this last vet cause she cared enough to take that 3rd xray that I didn't get charged for. I went in for a followup on the xray she took and a 2nd opinion on all my blood tests. Well she wanted to do another xray first to compare so I let her do that and it turned out that whatever it was was no longer there not only that but my explanation for his cough being from minor collapsed trachea was just blown out of the water his trachea looked normal in all those xrays and cushings is present because after she did the math.
At this point, the only thing I’d blow out of the water is a cushing’s diagnosis. One positive LDDS test for a dog with no symptoms and negligible abnormalities on bloodwork falls way short of supporting a cushing’s diagnosis. Setting the thyroid issue aside, I’m inclined to believe the Maurice does have a collapsing trachea. Panting, labored breathing and coughing are all very common symptoms associated with a collapsed trachea. It is almost impossible to tell the difference between a cough caused by a collapsing trachea and kennel cough. Both coughs sound like a honk. Coughing at rest isn’t unusual but it is easily triggered with excitement, eating, drinking, exercise and hot and humid weather. This could be why you observe Maurice coughing more on hot and humid days. One of my little dog had horrible coughing attacks when we had heavy smoke from brush fires in California so airborne irritants can trigger the cough as well. I have shared my life with and rescued many toy dogs over the years and I have dealt with many collapsing tracheas. Little dogs, especially toy breeds, are genetically predisposed and for what it’s worth, I never lost a baby due to collapsing trachea, however, it can be life threatening.. Symptoms of the condition can start at any age but in my experience, it’s more likely to rear its ugly head at middle age or older. Surgery is an option for those whose condition has become life threatening but it’s highly unlikely that dogs older than middle age would be a good candidate for surgery.
I now could full in those ranges both were 1.3 but when I asked about the abnormal values on the rest of the blood that famous saying of I'm not concerned about that was my answer. Well I am concerned about that because now I have no explanation for his cough which is getting worse. she said she didn't want to treat cushings until it was severe. she didn't even mention trying to see what type he had.
I’m glad the vet doesn’t want to treat for cushing’s because there is no way a cushing’s diagnosis should have been confirmed with such scant clinical evidence. As I mentioned earlier, if it were me, I wouldn’t spend any more on pursuing a cushing’s diagnosis nor would I spend any money trying to figure out what type of cushing’s Maurice has. It’s my layperson’s opinion that Maurice doesn’t have cushing’s. What you can do is talk to the vet, whichever one you are currently in contact with, and ask about putting Maurice on a bronchodilator . My last pup with this problem was put on aminophylline but it killed his appetite completely. This is a common side effect so ask the vet about Theophylline instead. It really helped my Jasper. He also had heart disease and I remember thinking I was going to lose him. His excitement to see me come home from work set him off on a coughing jag that I thought would never stop. Once we got him on Theophylline, he could walk and spin around circles as usual without coughing so much. I also raised his food and water bowls so you should try to do that for Maurice as well. If you go with Theophylline, it’s given every twelve hours on an empty stomach one hour before or two hours after a meal. Always have water available and always give the pill whole, never crush or cut it.
she just told me to keep giving the soloxine prescribed by the vet I no longer trusted. i asked him for a liver supplement but he said it wasnt necessary but i noticed his alp decreasing while he was taking it and increased when i ran out. so i asked her to give me some which she did. but I had to ask for it.
Dogs with untreated cushing’s don’t see drops in ALP. They see consistent increases so this is just one more piece of evidence that doesn’t support a cushing’s diagnosis. FYI, you can buy Milk Thistle, a great liver support supplement, over the counter. If buying human product, dosing is based on size, I’ve included a dosing chart below:
Dog's size Dose as % of adult human dose
5 lbs 10%
5-10 lbs 15%
11-20 lbs 20%
21-40 lbs 30%
41-70 lbs 50%
71-100 lbs 75%
100 lbs 100%
So after all these vets and 2500.00 dollars I still don't know if my baby has primary hypothyroidism or if it's secondary to cushings. his symptoms are still the same no energy and panting and that cough that he has mostly when he's excited. it's like he has something stuck in his throat. Hell give 2 hacks then a final cough like he got whatever it is out only nothing came out and now it's the exact same cough only more often and even at rest.
That sound like a collapsing trachea cough. It’s a honking cough with a final gack, like they are trying to cough up phlem. It could be very possible that Maurice has primary hypothyroidism and if he isn’t showing signs of hyperthyroidism, I’d keep him on the medication and continue to monitor. Dogs with primary disease usually have bad skin and often time the skin pigmentation turns completely black. The coat is dry, brittle and loss of coat is common on the flanks with normal coat on head, feet and legs. Low thyroid dogs can gain weight eating the same amount or even less. They become lethargic and don’t like to exercise. Does Maurice have problems with his skin or coat?
I read that it can be dangerous to treat a secondary hypothyroidism dog with thyroid supplement. you have to treat the primary condition first then the thyroid will fix itself if it's not too far gone.
It is rare that dog would die from over supplementing with thyroxine. As I mentioned before, if the thyroxine dose is too high, you’ll know it rather quickly by the marked increase in drinking and peeing. If Maurice’s low thyroid is due to an underlying condition that is transiently effecting his thyroid, you’ll need to figure out what underlying problem he has. It is quite common for dogs with cushing’s to have low T4 but based on all the information you’ve presented, I don’t think cushing’s is the problem. It could be that Maurice really does have primary hypothyroidism and will require thyroxine for the rest of his life. Hypothyroidism does causean increase in ALKP but elevations are usually more mild than cushing’s.
Member
Re: Please someone help me figure all this out
Re: Please someone help me figure all this out
Posting Permissions
Reply With Quote