Hypothyroidism, Could it be?

[sandyz]

I have a vet appt. tomorrow for Chance. Chance will be 6yrs old next month, he had acl surgery Aug. 2003 and did well through his recovery. I did feel as if he was awful depressed after that and when he didnt want to do much, I just figured his leg was sore and he was depressed. Now we are 8 months past his surgery and he is still what I call, depressed. After posting under the general area: Need new exercise ideas, I have tried everything to get him to be a little more happy about doing things. We have walked (only 1 mile per day) and hes pooped after that and I do have to drag him along. I found he loves to chase a tire that I roll, but he tires out really quick, like about after 15-20 min hes panting and is done playing.
I have done some reading on the thyriod and I have seen that Chance is, lethargic,mentally dull ( Im starting to call him DUH :( ) Hes been only eating 1/2 cup Nutro lamb and rice in the AM and another 1/2 at night, and he still needs to lose about 5-10 more lbs ( he was 125 2weeks ago) He does love to find a nice warm place to lay, be it either in the sun coming through the windows, or all curled up in his crate with his blanket (my house is always about 75 degrees). If I didnt drag him for walks and try to get him to move some, he would get up in the AM, eat, go out to pee/poop and then he would be happy to curl up and sleep till the PM feeding.
Since Im going tomorrow to the vet, I would like all your thoughts about what all test I should have, and if anyone here has any other ideas on what this could be, after all, hes only 6
Sorry for the long post, but Im trying to include enough info for you all to think about. Appt is tomorrow at 3:45PM
Thanks

[Rott-Wiley]

A blood test will tell you if he is hypothyroid and while they are drawing blood, I would ask them to run a complete blood panel on him. Otherwise it's hard to say what could be wrong with him. Hopefully the results of the blood work will help diagnose the problem.

[mmgy]

Cutting his food down that far can malnourish him......regulating food is just one facet of losing weight. And that could lead to lethargy. But I think hypothyroidism is a strong possibility, so I'm glad you've scheduled the testing.

I agree he needs a full blood panel, otherwise, if it's not thyroid, you'll have to take him back for it. Might as well have it all done now.

Let us know what they say.

[sandyz]

As to cutting his food that far back, he was just as lethargic before I cut him down. He started off at 130lbs on the 24th of Feb, 125 the 19th of March. I know he does need to weigh a little less.
Im just trying to gather any and all questions before my vet appt.
So far, full blood panel and a thyroid test--is that 2 different tests or one? I dont want to sound as if Im lacking in knowledge, but I do feel if you go into your vets knowing a little more, the better results you get.
Im sure they still have his last full blood panel test from when he had his ACL surgery in August, so they can always compare....right???

[mmgy]

Some vets do an in-house thing before surgeries that skims the basics, 10-12 items. It might pull one or two liver values, one or two kidney values, etc. You'll have to ask what they have on file. But it's good that they do, because they can compare the two.

What you want is a full panel, that covers about 40 items.

If he was lethargic before you cut his food, then that leads me even more to believe it might be thyroid. If it is, it's easy to control and maintain, and he'll feel much better right away.

[JeanT]

there are two thyroid tests. I don't know what they are called. The less complete one (though it may be sufficient) is run in the vet's office or it may be sent with the other panel studies to an outside lab (depending on your vet).

Some member here knows all of the names and differences between the tests. Maybe you can find it in a search. I saw it in the last 2 years, if that helps :)

The more complete one is done I believe somewhere in the Midwest and my somewhat vague recollection is that it cost me about $40.00. I wish I had known about the more complete one when I had Old Mr. Bear, because the "routine" one was normal, but a few months later, shortly before he died, the "routine" one was highly abnormal. I think the more expensive test could have made the diagnosis. (The reason I asked for the test first was because he was gaining a lot of weight no matter how little food I gave him - the vet kept telling me I was overfeeding him) and he was sluggish.

I will always request the more expensive test again if I have any suspicions about thyroid - peace of mind from the results is worth it to me. And hypothyroidism is so inexpensively treatable...

[sandyz]

mmgy: Im not worried if the test reveals that he is hypothyroid, it would be a relief. His lethargy is driving me nuts now and I have read about this subject all weekend, so I know that its easily controlled. I would love to see Chance be more energetic!!
Jean: I have read that there are basic, less complete test and then the more complete ones. I would pay gladly for the more expensive test just to know why Chance is feeling this way.

I guess what I need to know now is do I just say I want the complete thyroid test, or do I have to say exactly that I want the: total T3&T4, the Free T3, THS, and the TgAA.
I dont want to have to tackle Chance for blood (Chance is a real handful at the vets and will NOT be nice as we take blood) and then find out I didnt get all the test I needed.

Thanks for all your patiences with me and putting up with my rambling the night before I have to go into the vets and say what I want, and not sound as if Im totally lost.

[mmgy]

Originally Posted by sandyz

I dont want to have to tackle Chance for blood (Chance is a real handful at the vets and will NOT be nice as we take blood) and then find out I didnt get all the test I needed.

Exactly! Make sure you're very specific about what you want, BEFORE they take the blood.

I'm a lousy patient myself. Before I got married I was scheduled for a physical, so went ahead and asked them to do the state blood test while I was there. I was very specific about it. Well, the nurse didn't get the message, and didn't get enough blood. I was livid. Before I was done, everyone in that building knew they had screwed up!!!!!!!!!!!

[samanthac]

Lorrie has a thyroid dog. Here is some info she posted about a week ago.

Diagnosis of Thyroid Disease

Total T4

Measuring serum T4 alone is considered by most experts to be unreliable for
diagnosis of thyroid disease, because it can: over diagnose hypothyroidism;
under diagnose hyperthyroidism; may fail to detect early stages of the
compensatory disease; and cannot identify the presence of thyroiditis. This
test is greatly influenced (lowered) by the presence of non-thyroidal
illness (NTI) and specific drug therapy (e.g. corticosteroids,
anticonvulsants, potentiated sulfonamides, nonsteroidal anti-inflammatory
agents).

Free (Unbound) T4

The serum free T4 represents the small (<0.1%) biologically active fraction
of the total T4, and is therefore less likely to be influenced by NTI.

As a single test, accurate measurement of free T4 has been shown to have the highest sensitivity, specificity, and accuracy for diagnosing canine
hypothyroidism.

The techniques used in veterinary medicine for assaying free T4 include:
direct radioimmunoassay (RIA) determination after equilibrium dialysis (ED),
considered by many to be the "gold standard"; one-step solid phase or
liquid-phase analog RIA; enzyme-linked immunosorbent assay (ELISA); and
chemiluminescence. The advantages and disadvantages of current free T4
assays have been vigorously debated. Currently, methods used routinely at
Antech Diagnostics include the ED and solid-phase analog RIA, both of which
have been validated repeatedly, and correlate well in most cases.

Total T3

Measuring serum T3 alone is also not recommended, although it can be useful
as part of a thyroid profile or health screening panel. For example, if
levels of total and free T4, and total T3 are all low, the patient most
likely has a NTI rather than hypothyroidism. If total T3 levels are high or
very high in a dog not receiving thyroid supplement, the patient most likely
has a circulating T3 auto-antibody (the most common type), which has
spuriously raised the T3 level.

Free (unbound) T3

Like the free T4, free T3 represents the biologically active fraction of
total T3. Levels may be elevated slightly in euthyroid dogs with increased
tissue metabolic demands, and are typically spuriously high or very high in
dogs with T3 auto-antibodies.

Endogenous Canine TSH (cTSH)

In primary hypothyroidism, as serum free T4 levels fall, pituitary output of
thyroid stimulating hormone (TSH) rises in a regulatory, compensatory
response. In human medicine, highly sensitive and accurate endogenous TSH
assays are available which make diagnostic testing straightforward, as
virtually all hypothyroid patients have elevated TSH levels. However, in
veterinary medicine the new canine-specific TSH assays are not as sensitive
or specific as the human ones. When measured as part of a complete thyroid
panel or along with free T4, the cTSH assay offers another analyte to more
completely assess canine thyroid function. Recent experience with this test
indicates about 20-30% discordancy between expected and actual results in
normal dogs as well as in confirmed cases of hypothyroidism or NTI. Two
recent studies showed that the specificity of diagnosing hypothyroidism
increased when the cTSH assay was combined with either free T4 or T4 assays,
but the sensitivity and accuracy of diagnosis were lower when cTSH was
measured alone. Thus, the cTSH assay by itself is not recommended for
diagnosing canine hypothyroidism, and spuriously low or high cTSH levels can
be seen in some hypothyroid or euthyroid dogs, respectively.

Canine Thyroglobulin Auto-antibodies (TgAA)

An estimated 80% of cases of canine hypothyroidism result from heritable
autoimmune (lymphocytic) thyroiditis. The top ten dog breeds diagnosed with
autoimmune thyroiditis include: Golden retriever, Shetland sheepdog,
American cocker spaniel, Labrador retriever, Boxer, Doberman pinscher,
German shepherd, Akita, Old English sheepdog, and Irish setter, although
many more breeds are also affected.

The presence of elevated TgAA levels confirms thyroiditis, promotes early
recognition of the disorder, and facilitates genetic counseling. The
currently available commercial assay for canine TgAA uses an ELISA method.
False positive results can occur if the dog has been vaccinated recently.
Dogs on thyroid supplement should be off this medication for at least 90
days to obtain accurate TgAA results.

T3 and/or T4 Auto-antibodies (T3AA/T4AA)

Whereas essentially all cases of autoimmune thyroiditis should have elevated
TgAA in their serum, only about 20% have elevated serum T3 and/or T4 AA.
Thus, the presence of elevated T3 and/or T4 AA confirms a diagnosis of
autoimmune thyroiditis but underestimates its prevalence, as negative
(non-elevated) serum T3 and/or T4 AA levels do not rule out thyroiditis.
Most circulating antibodies are against T3 (~70%), some affect both T3 and
T4 (~25%), and only a few affect T4 alone (~5%). When these antibodies are present, measurement of T4 and T3 levels will be spuriously high.

[sandyz]

Looks like Im going to need to speak a new language for this ;)
Sure would be nice if we could just say run the FULL test, meaning all that T this and T that. The more I surf and read the more Im going to sound like Im trying to say my ABC's like Im drunk at the vets :D

[frontierrots]

Just tell the vet you want the 6 panel thyroid test through Michigan State University

[ILoveRotts]

Definitely request the full panel test through Michigan State as Frontierrots suggested. Drake had the simple blood test at 1st & showed up ok. And his thyroid was severely off. It's worth the extra money.

By the way, Drake was also 6 when he was diagnosed. He's now a very bouncy 8 (almost too bouncy :D )

[sandyz]

:D THANK YOU!!! Asking for a 6 panel test done at Michigan State is going to be alot easier :D Im really hoping this is what it is, because I really miss having a dog that does more than sleep :( I will admit, that through his ACL recovery, it was nice that he was so laid back, I was wondering why people were having problems with thier dogs and keeping them quiet. Im thinking that maybe hes been in need of this test for awhile now.
Once again, thanks for giving me a easier way to ask for this.
Ughhh, now I can start to prepare myself for todays wrestling match, there are times that I wish I wasnt one of those hands on moms at the vets,but, I am.
Thanks again :)

[sandyz]

Well I took Chance for his appt. today and Chance was NOT anything like he usually is there. He was letting all pet him and when it came to the blood collection, he was no problem. The one vet tech that really knows Chance was also very shocked by Chances attitude today and least they too saw that he wasnt being himself. I did get the superchem profile/CBC and they are sending the thyroid panel to Michigan. I should have the superchem/CBC by tomorrow, IF the other vet calls me, if not I will call my vet Thurs morning. My preferred vet has tomorrow off. Then I have to wait for the other results from Mich. UGHHHH, the waiting is going to kill me!!! My vet did comment that he thinks Chance was a little anemic :( and they had some trouble getting enough blood for the test. This scares the crap out of me cause the last time something like that was stated to me, I lost my Bullmastiff a day later. Soooo, Im going to be waiting and hoping that we get a answer and its not all bad news. Thanks for listening to the ramblings of a very worried mom.