Apollo fought with grace and dignity to the end, My little angel warrior

[lulusmom]

Hi Sonja,

I just looked at Apollo's bloodwork and it looks really, really good. Congratulations! However, I was taken off guard by the low thryoid values. How did we get through 81 pages in your thread and not rule out hypothyroidism as a cause the symptoms that remain unresolved? OY! The thyroid (T4 and Free T4) are most definitely low and I think your vet is probably right to recommend thyroid meds. Hypothyroidism is about the most common canine condition there is so I'm pretty sure your vet is knowledgable. I never really thought about low thyroid but now that I see those numbers, it is definitely possible that the skin issues and the muscle wasting can be due to low thyroid. Still not sure about the knuckling though.

Hypothyroidism is usually diagnosed in middle aged to older dogs so giving thyroid meds to an older dog is norm. I have never seen a warning on Thyroxine stating that it is not recommended for older dogs. About the only side effect you would have with thyroid meds is if the dose was too high and then it would throw the dog into hyperthyroidism. When that happens, you'll know it because dogs with hyperthyroidism have pu/pd. Thyroxin could make a huge difference for Apollo so you may want to discuss treating the thyroid.

Cushing's can cause a transient decrease in thyroid values but with the improvements on the bloodwork, I would think the thyroid values would be higher than they are. I think it is very possible that Apollo has primary hypothyroidism. The numbers are there and he is a breed known to be predisposed to the condition. Lulu was diagnosed hypothyroid at one year old and has been on the same mg thyroxin for almost 8 years. Compared to cushing's meds, thyroid meds are pretty benign.

[Rene]

You gotta love Glynda!

I have a question? What could cause such a drop since Apollo's last tests?

T4 .7(low) was 1.63 RANGE .8-3.8
FREE T4 .35(low) was 1.45 RANGE .55-2.32
T3 46 was 55. RANGE 30-77

[labblab]

You gotta love Glynda!

I have a question? What could cause such a drop since Apollo's last tests?

T4 .7(low) was 1.63 RANGE .8-3.8
FREE T4 .35(low) was 1.45 RANGE .55-2.32
T3 46 was 55. RANGE 30-77

Rene, I think that is a good question. If it were me, I'd probably ask to have a complete thyroid panel performed that includes free T4 by equilibrium dialysis and also the TSH level. I definitely agree with Glynda that thyroid supplementation is typically easy and benign. And you'd probably have nothing to lose by giving it a trial with Apollo. But if his thyroid level was previously normal, that would not explain his ongoing symptoms. I'm thinking these low results may be secondary to another issue or condition.

Marianne

[Squirt's Mom]

Hi Sonja,

I, too, was shocked at his thyroid values. Hypothyroidism would explain much of what you are seeing with Apollo but it also seems odd to me that it dropped so suddenly. Do you have his thyroid tests going back a bit? That might establish a pattern.

The first attempt I made at home cooking for Squirt was a disaster. The diet included quite a bit of cruciferous vegetables like broccoli, cauliflower, cabbage and kale. After being on this diet for a short time, she tested as hypothyroid. But getting her off that diet and all those cruciferous veggies put her levels right back to normal. So, from experience I know external factors can affect the thyroid. Have you changed anything in his diet lately?

Otherwise, his blood work looks pretty good to me but hopefully Debbie will be along to give us an expert reading.

Hang in there!

Hugs,
Leslie and the gang

PS. I also agree with Glynda in that the meds for hypothyroidism are quite benign and easy on them.

[lulusmom]

I'll try to post more later but wanted to quickly say that according to what I've read and the way Dr. Dodd calculates T4 and Free T4 values, Apollo's thyroid values would have been interpreted as being low previously and it isn't that uncommon for those values to continue to drop in the course of a few months, especially if a dog has primary hypothyroidism. Will try to get ya'll some reading material on this later.

[apollo6]

Dear Glynda, Leslie and Marianne
First I want to thank you for all the work and input you put in this forum. I am amazed how you can do all this. Thank you my angels.
Thank you Addy and Rene.
The thyroid issue is baffling because we did the full Thyroid panel in April which I think I wrote beside the figures I posted. Off trilostane his thyroid number were low, then when he was put on Trilostane again his number were normal. Now his numbers are low? So is it that he need more Trilostane or is it hyperthyroidism. Will look back at his previous readings. Think he may have been low, will let you know.
What is baffling is in the last two months the black spots with black dots(plugged hair follicles oozing out grey greasy substance, then sometimes the actual hair will come out.) and the knuckling in the front paws(bending the paw backward) not being able to get up without difficulty and the stiffness in the back legs. He also tires out so easily-out of breath, and he overheats easily. But he still has spirit barks if he needs help or is hungry.
Leslie I did change is diet barely a month ago to add in Nature's Variety raw frozen Chicken. I mix in 1 pellet with the Embark. His stomach gurgling has gotten better. But I am concerned about the jaw trembling which started when he restarted the Trilostane.
As Rene had said is his body eating up his muscles? He has a good appetite.
Will post later.
Hugs Sonja and Apollo

[addy]

Hoping and praying things become clearer for you soon. You are such a good Mom dearest friend.

Love,
Addy

[ktzndgs]

It might help to find a neurologist. The folks here suggested I find one and I managed to get an appointment with Dr. Jay McDonnell. It turned out to be very helpful. Especially since you're seeing knuckling under of the front feet.

Kathy

[lulusmom]

Hi Sonja,

Can you remind us exactly what symptoms Apollo has? Here is a long list of things you might see in a dog with hypothyroidism. This list was compiled by Dr. Jean Dodds and is pretty comprehensive. I was unaware of some of these symptoms and I was surprised to see knuckling on the list.

Alterations in Cellular Metabolism

lethargy mental dullness
exercise intolerance neurologic signs like
polyneuropathy
seizures
weight gain cold intolerance
mood swings hyperexcitability
stunted growth chronic infections

Neuromuscular Problems (like loss of smooth muscle tone)

weakness (esp. hind end) stiffness
knuckling/dragging feet laryngeal paralysis (bark changes)
incontinence facial paralysis (droopy)
head tilt "tragic" expression (looks old/sad
drooping eyelids muscle wasting (temporal, withers)
ruptured cruciate ligament megaesophagus (reflux gastritis)

Dermatological Diseases

dry/scaly skin and dandruff coarse, dull coat
hyperpigmentation "rat tail" "puppy coat"
chronic offensive skin odor pyoderma or skin infections
myxedema
bilaterally symmetrical seborrhea with greasy skin
hair loss (or dry skin)
demodetic mange

Reproductive Disorders

infertility prolonged interestrus interval
lack of libido absence of heat cycles
testicular atrophy silent heats
hypospermia (low sperm) aspermia (no sperm)
pseudopregnancy weak, dying or stillborn pups


Cardiac abnormalities

slow heart rate (bradycardia) cardiomyopathy (esp. in
cardiac arrhythmias (Greyhounds, Dobies and Salukis)

Gastrointestinal Disorders

constipation diarrhea
vomiting

Hematological Disorders

bleeding
bone marrow failure, which can lead to low white blood cells, low
red blood cells, low platelets
Ocular Diseases

corneal lipid deposits corneal ulceration
uveitis keratoconjunctivitis sicca (dry eye)
infections of the eyelid glands
Meibomian gland, Vogt-Koyanagi-Harada Syndrome

Other associated diseases

IgA deficiency loss of smell (dysosomia)
loss of taste

[apollo6]

Dear Kate, thanks may do so.
Dear Glynda
Pretty tired will post Apollo's symptoms:
black spots with black dots(hair follicles when squeeze grey greasy discharge then hair comes out sometimes)some hair is starting to come thru.
Vet said the muscle wasting and skin infections might be caused by the thyroid. But what about the jaw trembling and loose teeth in lower front?

good bowel movement
no diarrhea
no vomiting
jaw trembling
stomach gurgling seems to be less.
don't know if can say gaining weight?
heat intolerance-overheats very easily
lower teeth a little loose with gum separating
knuckling in front paws
stiffness in hind legs
hair is growing back on tail-bumps disappearing
still very alert
muscle wasting in head somewhat
tries to walk on own.
falls down to side sometimes but does get up on own
listens to my commands
If I can think of something else will post.
You are such a wonderful person Glynda.
Will check in tomorrow.
Rest my dear Glynda
Hugs Sonja and Apollo