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Thyroid testing, maybe hypothyroidism
  • curlytailscurlytails
    Posts: 2779
    So we've been warring with Bowdu's allergies all summer. We've been hitting him with Temaril-P (just finished his last of way too many doses), Benadryl, supplements of apple cider vinegar, fish oil, a diet of Primal Raw (he's now on his sixth bag at the rate of about one bag a week), and the cone of shame/pride. Also, occasional rubdowns with soothing skin-friendly lotion. We thought we had it under control. Things had not totally cleared up yet, but they were looking much better.

    Then I went out on a limb and made a batch of home-baked beef liver and blueberry treats with sweet potato flour. We'd been avoiding chicken, he doesn't usually ever get beef in his diet, and I thought it would be fun to make him something of my own. And he loved the stuff! This was last Sunday or so. And on Wednesday or Thursday, I gave him a raw ox tail. Immediately, he started to really itch again, to the point where even the cone wasn't stopping him. And soon enough, he had managed to chew one of his feet bloody again.

    So we're going back to the vet -- this is the fifth visit since March! -- and along with more antibiotics, I'm asking them to do a full thyroid test. I'm suspecting hypothyroidism based on the following symptoms --

    * lethargy, tiring on long walks (which could also be a side effect of the Temaril-P)
    * weight gain (he's at 33 pounds now, up from 29 pounds last fall, about 28 pounds the year before ; not a super dramatic jump in weight, but he is definitely chubby though he only gets 9 nuggets of Primal Raw a day plus minimal treats)
    * skin infections (he's been treated for infections due to broken paw pads twice now, and this upcoming visit will probably be the third, as his paw gets really swollen and pink when he does manage to lick it -- believe me, we're trying to make sure he doesn't!)
    * hair loss (his tail is still quite bushy, no "rat's tail", but there's been significant hair loss around his neck/collar area)
    * musky, distinctive "dog" odor (he's a shiba! He usually NEVER smells like this!)
    * discoloration of the skin (especially inside of his thighs and armpits, it's very pink and even dark gray/black in some spots)
    * dry, brittle hair (his back and chest are fine, but the fur on his back legs is really rough -- it is often like this in the summer, so may be more associated with seasonal coat changes and not necessarily hypothyroidism?)

    ... I just see a lot of signs, so I want to get the test done so I can at least rule it out. Plus, it's a common problem with akitas from what I understand -- but maybe it hasn't been studied enough in shibas for it to warrant an official footnote in standard descriptions? The NSCA site calls hypothyroidism "not uncommon" in shibas.

    Anyway, I wanted to start this thread to get an idea of what to expect from the upcoming vet appointment, what I should bear in mind or understand about the different kinds of tests (I was quoted $74 for a T4 test, or $134 for a "more detailed" test -- I read somewhere, forgot now where, that only a "more detailed" test would give conclusive results that could lead to a final diagnosis of hypothyroidism, so I need to make sure I'm getting that). Plus $166 for a full blood panel. Plus a $67 examination/consultation fee. And whatever they're going to charge for antibiotics...

    Basically anyone else with any other experiences, please share. I'm desperate for information.

    Part of me is almost hoping he DOES have hypothyroidism, so that there can finally be some kind of concrete answer to these skin problems that have gotten worse and worse every year.
    image
    Bowdu 寶肚 (Shiba) and Bowpi 寶媲 (Basenji) with M.C.
    Post edited by sunyata at 2012-08-09 09:54:36
  • curlytailscurlytails
    Posts: 2779
    Also, has anyone here had experience with sending thyroid panel test results to Dr. Jean Dodds with Hemopet in Santa Monica, California?
    http://www.hemopet.org/

    http://www.itsfortheanimals.com/HEMOPET.HTM
    image
    Bowdu 寶肚 (Shiba) and Bowpi 寶媲 (Basenji) with M.C.
  • poor Bowdu. You can ask for Atopica until he find a permanant solution. My pup had all sorts of infections from him constnatly chewing his paws..Atopica was the only thing that helped him. Were going to see a Holistic Vet this week to see if they have some naturals cures and perhaps maybe give him some acupuncture. I know this can be tough..but hang in there.
  • Hemopet is the only place who should be looking at Bowdus blood. They are the place to test thyroids.

    I am sorry you are going through this. We are doing all the same things for Ruby's allergies however her only symptoms are itching and we have narrowed it down to grass pollen and chicken, and eggs.

    I hope that you find some satisfactory results soon.
  • shibaserfshibaserf
    Posts: 247
    Thank you so much for the HemoPet and related links. Lucy has also been diagnosed with hypothyroidism. She had all of the symptoms you describe for Bowdu, except for the skin discoloration. Her behavior was also somewhat inconsistent. She clearly wanted to be friendly and wasn't afraid of other people or dogs. She'd go right up to people and other dogs, but would suddenly back off and start a Shiba scream. Sometimes. Sometimes, she'd settle in for a nice long massage from whoever she could get to do it, whether she knew them or not. We couldn't find any pattern of gender, age, clothing or circumstances. Since her thyroid treatment began about 3 months ago, she's a lot better but still a bit erratic. She should also be losing weight, since she also does not overeat at all. She went from 22lbs to 34lbs in a year. She hasn't really lost any weight yet. I'd love to have her tested more thoroughly. I think she's better but something is still off. All of her fur and odor issues are completely gone. She's still a bit lethargic but that could be due to her weight. She isn't on any other medication besides the thyroid meds. A year and a half ago, she had cancer surgery and was on steroids for a while, to reduce inflammation. but it's been almost a year since her last medication for cancer.

    Please let me know what you think of the Hemopet testing, if you decide to do it. I'm going to ask Lucy's vet about it at her next checkup and blood work, in October.

    I know several Shibas in my meetup groups who are being treated for hypothyroidism. I would be interested to find any vets/researchers who may work in breed-specific research on hypothyroidism. I often wonder how many Shibas end up in shelters or rescue due to behavioral issues that are symptom of hypothyroidism. It would be great to know if there is a breed prevalence toward hypothyroidism. I'd think that information would be helpful to breed clubs and rescues.
  • I believe there is a breed prevalence toward hypothyroidism. I thought that I saw it once among the list of possible things Shibas could get, but now I'm not sure where I saw that.

    Both my Shibas are hypothyroid, and the only signs I saw were behavioral (though now Toby is quite overweight and probably needs to be retested). I had to insist that my vet do the test based on behavioral issues (aggression, and in Bel's case, confusion) and both came in low. We did not do the entire panel. It would be useful information, no doubt, but we found what we needed from the T4. From my vet it was $60.

    They've improved immensely once they were treated. both calmed down quite a bit, and the aggression issue are gone. (Don't forget to give them the thyroid meds properly, if you get them. It had little effect when I gave it to them with a meal, instead of two hours before a meal!) We didn't have any of the other issues, though.

    anyway, I hope you get some answers and Bowdu is better soon!Lisa and Toby (Shiba), Oskar and Zora (American Akitas) and Leo (Kai Ken)
    From the House of the Fox Dogs blog
    Why it's Not About Dominance
    Bel's thread: the story of a puppy mill Shiba's life
  • curlytailscurlytails
    Posts: 2779
    Thanks for the information and support, everyone.

    I do feel like a bad doggy mommy for possibly setting him off with the beef. We hadn't been going on a full-scale elimination diet, but just pursuing the novelty of a raw diet as a means in itself (flip-flopping between lamb and turkey & sardine formula right now; other raw items in the freezer currently include turkey and pork). And like I said, he was doing really well with these two formulas.

    Frank, we'd chatted about Atopica in another thread, and it is something I've also asked about at our last vet visit, but I don't think we'll be going that route for a couple reasons. The doctor noted that nausea was so common with the few pets at their clinic that have tried it, they usually prescribe an anti-nausea medicine alongside the Atopica, and that just sounds like way too much (given the cost of the drug itself, too). It also sounds like something that would require prolonged dosage, and honestly, I don't want to be spending that much money a month on meds. I already feel like I'm doing plenty to support an exploitative industry as it is (and both my parents work for a major pharmaceuticals company!), it just wouldn't settle right with me...

    Sorry, lemme try to hide that soapbox.

    Basenji folks speak highly of Dr. Dodds and Hemopet's thyroid testing services. I think I'll go to the vet with all their printouts prepared, and specifically request that they send the blood sample to Hemopet. Not sure how they'll respond to that (it's a VCA hospital), but I would be surprised if anything about their care policy requires patients to submit tests only in their labs.

    How necessary is the full blood panel? It certainly can't hurt, and some pet owners do it regularly. We're prepared to do it to get a more complete picture of what's going on with our (not-so-)little guy. I'd just like to note that the only other time Bowdu's gotten a full blood panel was after he ingested a bunch of coffee grounds when he was about 7 months old in Taiwan. The full blood panel? Cost about $38 USD. X-rays? About $12 USD. I know it's not fair to judge, but that vet was really state-of-the-art (higher caliber than most Taiwanese vets) and it really gave me an idea of what top notch medical care COULD cost.

    Bowdu's about 5 1/2 years old now. Behaviorally, he's always been prone to sudden bouts of grumpiness, and I think that's largely our fault and not doing enough to socialize him as a pup. (The conditions weren't as favorable to doggy meetups in Taipei, we got some really asinine advice from our first vet, and we didn't really know what we were doing.) There's been some heightened intolerance to his usual canine "irritants" like hyperactive puppies, slobbery and panting dogs, and unneutered males in the past year or so (he growls and stiffens when these guys approach). But at the same time, he's getting along wonderfully with Bowpi. So I don't really know what to say about behavioral changes. He did bite and put a gash on my hand when I was trying to dissuade him from licking his foot one day -- this was entirely my fault, because I came up on him way too quickly and physically startled him. But this has been on my mind as an 'erratic' behavior that might have an underlying medical explanation as well.

    On hypothyroidism as a shiba-related problem... Well first, I think this chart from the Orthopedic Foundation for Animals (OFA) is interesting:

    http://www.offa.org/thystatbreed.html?view=1

    The akita is there. However, the shiba doesn't even crack the list for "Breeds having at least 50 evaluations January 1974 through December 2009", so I'm wondering if this it's because shibas are *that* rare, or if shiba breeders don't report this kind of information? I think it would help form a more complete picture of what's going on with hypothyroidism in the breed. Beyond that, I don't know what to say except to keep asking other shiba folks for their experiences.
    image
    Bowdu 寶肚 (Shiba) and Bowpi 寶媲 (Basenji) with M.C.
  • curlytailscurlytails
    Posts: 2779
    OMG that vet visit made me physically ill.

    Just a quick summary for now... an hour and a half, some awkward conversation, an almost-bitten vet tech, a bitten boyfriend, doggy downers, doggy revivers, and almost $500 later, we got some blood out of Bowdu. So now we wait until Saturday for results.

    I hate this process. Hate it.
    image
    Bowdu 寶肚 (Shiba) and Bowpi 寶媲 (Basenji) with M.C.
  • JudyJudy
    Posts: 183
    I used Dr. Dodds with a jindo. I highly recommend sending it to her lab for the 6 panel study. She will send the results back to your vet along with recommendations and will consult with you over the phone if you would like and/or also with your vet. I found the 6 panel test to be cheaper if done by he lab than the 2 panel if it were sent out to our vet's lab. Paying to ship it to CA made it about the same price. The post office will not ship blood, even if from a dog; it had to be done through ups.
  • JudyJudy
    Posts: 183
    Also, my vet would not send it to Dr. Dodds. They would only send it to their lab. I had to convince them to allow me to send it to CA, which became my responsibility to pack it, etc. The vet charged me a minimal amount to draw the blood.
  • shibaserfshibaserf
    Posts: 247
    You will definitely be happy when all this is over and Bowdu begins treatment. It is so worth it. It makes a HUGE difference to the dog and you will likely have a calmer, more even tempered dog with a nice fluffy coat!
  • curlytailscurlytails
    Posts: 2779
    Thank you Judy. That was very helpful, especially the shipping information. I'm actually thinking of calling Hemopet myself, later this afternoon once I've cooled down, to discuss my options, because my vet (short of outright refusing to work with her or Hemopet/life) strongly, strongly discouraged me from going with her tests.

    At the moment we're waiting for test results from my vet's own labs (again, it's a VCA). We thought if the numbers were unclear, borderline, or strongly indicative of hypothyroidism, we could follow up with Dr. Dodds for a second opinion.

    Meanwhile, some of the things that were said about her from my vet who's been in the practice for decades, as long as Dodds herself, he says...

    "Oh. Jean Dodds. [...] She's controversial." "She *calls* herself an endocrinologist..." (Actually, I thought she called herself a hematologist.) "She's been known to overdiagnose greyhounds with hypothyroidism." (But that's what her non-profit does?) He was also telling me we don't really need the whole range of thyroid tests if all we wanted was to get a reading for hypothyroidism (which he never mentioned as even a remote possibility, either -- this is something I've asked him to do on my own).

    I'm trying to get an even-handed understanding of not only Dr. Dodd's practice, but also the role that hypothyroidism plays in allergies or even more specifically, shiba allergies. Because yeah, it could just be that my dog has allergies and there's nothing else wrong with him, and as much as allergies suck, I can't force another miracle answer if there is none! Maybe I'm overprocessing or maybe I'm not not asking the right questions. I certainly don't know how to debate my vet with authority, because obviously he's the DVM, not me.
    image
    Bowdu 寶肚 (Shiba) and Bowpi 寶媲 (Basenji) with M.C.
  • curlytailscurlytails
    Posts: 2779
    Oh, another funny quote from the receptionist when flipping through Bowdu's record book: "Wow, you've been here a long time!"

    "No, we've been here five times since this March."
    image
    Bowdu 寶肚 (Shiba) and Bowpi 寶媲 (Basenji) with M.C.
    Post edited by curlytails at 2010-08-19 19:43:23
  • sunyatasunyata
    Posts: 8429
    Ouch... Poor Bowdu... Hope he is doing okay (and your boyfriend too).

    Do give us some details when you catch your breath!
    Bella 2Mountains 2Nola 2
    Casey, with Bella and Nola, hanging out in the mountains of Virginia.
    I Wander, I Ride
  • shibaserfshibaserf
    Posts: 247
    I forgot to mention that before treatment, Lucy behaved the same as Bowdu at the vet. We thought she just hated the vet. She'd start screaming the minute she walked in the door. We had to muzzle her. She scared other dogs in the waiting room. After about 3 months of treatment (it takes a while for treatment to become fully effective), we took her back for her last tests. She wasn't happy, but there was no screaming Shiba operas and no epic Shiba battles.
  • curlytailscurlytails
    Posts: 2779
    Ohhh, there was definitely some screaming and an "epic Shiba battle." At one point, they took him to the back and attempted to draw blood (this was before sedation). There was a huge THUMP, and then I thought I heard a cat yowling. Then it happened again, and I realized it was his shiba scream. Within a minute, the vet came back and seemed all but ready to give up on drawing blood. I think he was just as flustered as we were, because he was a little incoherent... something about poop and fur and I should just send him to a dermatologist (like a dermatologist is going to be able to examine him either?!).

    But we went there to get his blood drawn dammit, so we were going to get it one way or another. We agreed to sedate him. My boyfriend held him in his arms while they poked his back end -- he got bitten shortly after that when the sedative had started to kick in but hadn't fully incapacitated him yet, and he tried to pick him up off the floor. His teeth clamped down on his hand (broke skin) and wouldn't let go, I think because his muscles weren't functioning right due to the drugs coursing through his body.

    I will be ready to sing the praises of medication if they somehow make him not hate this or any other vet for LIFE, after everything that went down today... guh.
    image
    Bowdu 寶肚 (Shiba) and Bowpi 寶媲 (Basenji) with M.C.
  • JudyJudy
    Posts: 183
    There was a post on the jindo list which says there is a correlation between wheat allergy and autoimmune thyroid disease. Have you tried elimating all wheat from the diet?

    Also, I believe it is the University of Michigan that is also a good place to send the blood for testing. Maybe your vet would be more open to that.
  • JudyJudy
    Posts: 183
    One shiba/akita person I know had an akita who kept getting gum infections. This person knew that it could possibly be thyroid, but it took a lot of convincing for her vet to do the testing. Well, the akita tested extremely low, was started on soloxine, and the gum infections stopped.
  • JudyJudy
    Posts: 183
    One word of warning; I had also had basic blood work done at the same time which required the blood to be kept refrigerated, so I had to pack it special with an ice pack and overnight it. That shipping was 50 some dollars! The thyroid test does not require refrigeration. I think I sent it as a 3 day delivery, so that cost around $20. Now, that was coming from PA.
    If you have one done that does require being kept cold, make sure you have it done early in the week so it doesn't sit out there over the weekend.
  • StaticNfuzzStaticNfuzz
    Posts: 1814
    Poor pup. I feel so bad for them when it is this stressful at the visit. Each incident sets them over the edge more the next time. You know with allergies or thyroid the behavior can be irritable and erratic, so I hope either way you can get to the bottom of it soon. If I had not seen it myself with others and the difference of before and after treatment regarding behavior I would never had believed it. Appropriate meds do help in either situation to reduce the curmudgeon crankiness.

    Right now I am struggling with allergies with my youngest dog and the vet is going every conceivable route other than allergy so I am off to the a specialty vet since my basic vet won't listen. Drives me bats... I have been through this before with another....Uggh....I am beginning to think the 70% of the Shibas out there are allergy ridden.

    Anyway, to get back on track....Make sure you get copy of all your file records and past blood work for your own files in case you need to find another vet.

    Good luck and keep us posted.
    Snf
    Post edited by StaticNfuzz at 2010-08-19 23:26:18
  • Wow, I'm sorry you had to go through this and that your dogs did!

    I'd change vets too. I understand that not every vet is going to want to send the blood work out elsewhere, but bottom line, you're the person paying for this, and they should agree to this. What disturbs me even more, though, is something I've seen at other VCA's and had forgotten about because I've only gone there in an emergency--I don't like that they take the dog away to treat them. I want to see what is happening with my dog. (Unless it's surgery or something).

    Why was it $500?

    I have to sedate my Shibas before taking them to the vet. My vet gave me acepromazine (sp?) and I give them a very very small dose before I bring them in. Actually, Toby doesn't need it anymore. The vet's hope was that if they had several calm visits, they'd get used to it, and wouldn't need the drugs, and what happened was Toby spent 4 weeks at the vet, so he now thinks of it as a second home. (He's scared, but he goes willing with no theatrics). Bel's just scared, but she gets so scared we figure it is better for her to be lightly sedated.

    anyway, I'm really sorry you're dealing with a difficult vet in addition to everything else....

    Keep us posted....Lisa and Toby (Shiba), Oskar and Zora (American Akitas) and Leo (Kai Ken)
    From the House of the Fox Dogs blog
    Why it's Not About Dominance
    Bel's thread: the story of a puppy mill Shiba's life
  • curlytailscurlytails
    Posts: 2779
    Judy, my shiba has been grain-free since at least this year. Natural Balance sweet potato & fish was the last kibble he got until we recently switched to Primal Raw. Well, my boyfriend was slipping him the heels of loaves of wheat bread as a treat for a while... that also stopped completely when we went to Primal Raw.

    Speaking of Primal Raw, it is interesting that after eating only 9 ounces of food a day (plus approx. 10-20 training treats OR four dried Japanese sardines at the most), Bowdu is still hanging at 33 pounds. A dog his weight "should" be getting 13 ounces, in order to maintain weight. Or a 29 pound dog (which is when his weigh seemed ideal to me) should be getting 11 ounces to maintain ideal weight. Plugging in 33 pounds / weight loss on the Primal Raw feeding calculator gives an estimate of 8 nuggets total a day, but Bowdu's been getting increasingly anxious during feeding times not only because the food is so darn good, but because he's HUNGRY.

    Anyway, I am also in California, along with Hemopet, so hopefully that'll help a little with ease of shipping. The packing instructions for a Thyroid Profile 5, which is what I think we want (includes T3, T4, free T4, Thyroglobulin Autoantibody) says nothing about freezer packs. The Thyroid Profile 5 Plus DOES, however -- but I don't think we need the additional CBC and Chemistry Panel, because that's what we ended up paying VCA to do today.

    I don't mind presenting an itemized vet list:

    * Exam / Consultation fee — $62.50
    * Skin scraping (result: no mites) — $46.50
    * Nursing/injections (quantity 2) — $34.50
    * Dexmedetomid 0.5 mg/cc (doggy sedative) — $27.10
    * Injectable Butorphanol (painkiller) — $23.62
    * Senior Comprehensive bloodwork (SA090, includes Superchem, CBC, and T4, FT4 [ED] thyroid tests) — $230.85
    * Enrofloxacin 68 mg (antibiotics, quantity 20) — $67.50
    * Biohazard waste management — $4.99
    * Nail trimming included — $0.00

    I am a little concerned that they ordered a "Senior" Comprehensive test -- could just be the name of the test. At 5.5 years old, I want them to evaluate Bowdu's levels at what a *dog in his prime* should be, not a senior. But if they're just giving us numbers to interpret, no problem.

    Now I just hope my car can pass its smog test this year...
    image
    Bowdu 寶肚 (Shiba) and Bowpi 寶媲 (Basenji) with M.C.
    Post edited by curlytails at 2010-08-20 05:11:24
  • curlytailscurlytails
    Posts: 2779
    Note: I just found the .pdf file for the Diagnostic Center for Population and Animal Health at Michigan State University (East Lansing, MI, not U of Michigan in Ann Arbor) breaking down thyroid statistics by breed. This file was not appearing on the OFA website when I checked.

    It's located here:
    http://www.animalhealth.msu.edu/Sections/Endocrinology/

    Scroll down to the file "Canine Thyroid Registry Information."

    The stats are up to 2005. Of 305 Shiba tested, 2.3% tested for autoimmune thyroiditis and 3.0% were equivocal. That puts them at rank 127 of 140 breeds.

    Akita, by contrast, at rank 46:
    2673 Akita tested, 8.6% autoimmune thyroiditis, 8.2% equivocal.
    image
    Bowdu 寶肚 (Shiba) and Bowpi 寶媲 (Basenji) with M.C.
  • TengaiTengai
    Posts: 275
    In respect to being hypothyroid(low thyroid) and having the itches. I personaly am hypothyroid, have been for 20 years. I also about 10years ago started having a systemic persistant itchy condition. Turns out I have autoimmune hypothroidism, which can manifest with these conditions. I am on zyrtec 365 days a year which keeps it under control. If I miss one dose the itcheness is back. Just wonder if may of the allergies we are seeing in shibas who are hypothroid or borderline hypothyroid are manifesting the same symptoms because of the autoimmune issues related to hypothroidism.
    Just a thought.


    Phil
  • Interesting thought about the hypothyroid causing allergy like symptoms too...I wouldn't be surprised.

    Michigan State has a very good vet school. My former vets (when I lived in Michigan) got their degrees there and they were very progressive--in fact, they got me on the raw diet.

    I guess it looks like your bill is just what it is for where you live, but damn, that is REALLY expensive. I pay about half that for everything, but I don't know what they do in that blood work test....probably check a lot of things? When we do the T4 only it is $50, but I live in NM not CA.

    Anyway, I hope you get an answer....Lisa and Toby (Shiba), Oskar and Zora (American Akitas) and Leo (Kai Ken)
    From the House of the Fox Dogs blog
    Why it's Not About Dominance
    Bel's thread: the story of a puppy mill Shiba's life
  • I don't know if this helps at all but I recently took my pup to a holistic vet and they recommended that I get some "power mushrooms" as it is known to do some amazing things. I have had friends parents/grandparents use it themselves and they really believe in that stuff. I think I'm going to get some pills and see how that goes..in the end I realize all these antibiotics and steroids/medicine is probably doing more damage than harm to my pup. I just need to start getting things to boost his immune system up. Seems to be a little better than before now though. BOL
  • curlytailscurlytails
    Posts: 2779
    Phil, that's very interesting, and I thank you for your anecdote.

    As a breeder, I am also wondering if you might be able to shed some insight as to the prevalence of thyroid testing in breeding Shibas? I was a bit surprised to see the lack of data in the OFA database, though there have been many Shiba tested through MSU. I take it that it's not considered a "standard" test among Shiba breeders, given that the MSU figures suggest it's of low concern. However, considering the prevalence of shibas with allergies, it seems like it'd be something that breeders would want to be mindful of and try to rule out, wherever possible.

    And yeah, my vet's prices definitely need to be adjusted for geographic location, but I do think this vet is on the expensive side. I'm not convinced that they're worth what I pay, especially for things like prescription drugs. When Bowdu was getting dosed for Temaril-P, for example, each pill was over $1. Then we went to a low-cost clinic with the prescription, and they filled it for 70 cents a pill. We got the final batch for 44 cents a pill online.

    ***

    So I just got the voice message that told me the test results... drumroll please...

    Blood panel: everything is perfectly normal. Yay!
    Thyroid: low-borderline. But VERY low borderline. Apparently the reading for the "equilibrium dialysis T4" (is the free T4?) is 9.0; the normal range is considered to be between 8.0 and 40.0. So he's definitely on the low end.

    This makes a lot of sense to me that it wouldn't be completely out of "normal" range yet, given his age and history of symptoms, but it's definitely low (and probably trending lower without treatment).

    I have to wait until the office reopens on Monday to pick up the paper results. But I kind of feel vindicated and want to seek out another vet that actually knows about thyroids and shibas, because the two doctors we saw at this vet never even raised the possibility that it could be an issue.

    If anyone has recommendations for Northern California/Bay Area, please let me know.
    image
    Bowdu 寶肚 (Shiba) and Bowpi 寶媲 (Basenji) with M.C.
    Post edited by curlytails at 2010-08-22 01:43:51
  • curlytailscurlytails
    Posts: 2779
    I am also packing up that vial of blood I have and sending it to Hemopet and sending a link to the entry on my blog where I talk about Bowdu's symptoms (with pictures). Hopefully it's still fresh enough for accurate testing. It's been sitting in the fridge, on a condiment shelf. The blood was pulled on Thursday, and they said it'd be good for about a week, so...
    image
    Bowdu 寶肚 (Shiba) and Bowpi 寶媲 (Basenji) with M.C.
  • I'm not at all surprised that it was thyroid. My female is low normal, but her aggression and confusion problems cleared up with thyroid treatment....my vet was of the opinion that low normal means lets treat it til we get it in the high functioning range, and that has been very successful for us.

    I'm glad you got an answer, and I hope this clears up the skin problems.Lisa and Toby (Shiba), Oskar and Zora (American Akitas) and Leo (Kai Ken)
    From the House of the Fox Dogs blog
    Why it's Not About Dominance
    Bel's thread: the story of a puppy mill Shiba's life
  • curlytailscurlytails
    Posts: 2779
    Hehe. I actually ran into an American Akita at the dog park today whose coat, I noticed, was all choppy, with what appeared to be dark skin underneath. I stopped and chatted with the owners a bit, who said that their 10-year-old Akita had been diagnosed with hypothyroidism earlier in life -- but obviously that didn't stop her allergies altogether. =)

    Still, if this is the worst that Bowdu gets, and if he can eventually manage without a cone, I'll be happy. Soooo happy.
    image
    Bowdu 寶肚 (Shiba) and Bowpi 寶媲 (Basenji) with M.C.
  • JudyJudy
    Posts: 183
    From what I understand, with thyroid, some breeds do better to be kept in the middle or above range. Being in the low normal means they should be treated. Once on the meds, they should be tested at least once a year to adjust if necessary, but once on it, I believe they are on it for the rest of their lives.

    Even for myself, I was bordering on the low normal. My dr. gave me the option of treating or waiting til it became necessary. I decided to go ahead and start it and it did make a difference.
  • lepercannlepercann
    Posts: 243
    Just as a comparison, Sophie's vet bill was $129 for the skin scraping and bloodwork. My vet tests the blood right in the office. Her fur has stopped falling out since starting the hypothyroid meds and I hope her undercoat grows back. Right now all she has is a fuzzy little head and skinny body. :)
  • curlytailscurlytails
    Posts: 2779
    Just wanted to share some numbers and an update.

    So Bowdu's thyroid readings from the VCA lab (Antech) looked like this:

    Total T4: 0.6, reference range 1.0 - 4.0 ug/dL
    Free T4: 9.0, reference range 8 - 40 pmol/L

    Hemopet came back with the following numbers:
    T4: 0.87, ref. range 0.8 - 3.80 mg/dL
    Free T4: 0.53, ref. 0.55 - 2.32 ng/dL
    T3: <10, ref. 30 -70 ng/dL<br />Free T3: 1.9, ref. 1.6 - 3.5 pg/mL
    Thyroglobulin Antibodies: negative

    Thyroid levels are too low here, and support the clinical issues. The very low T3 reflects concurrent non-thyroidal issue(s).
    Adult Optimal Levels
    T4 1.40 – 3.50 mg/dL FT4 0.85 - 2.30 ng/dL
    T3 35 – 70 ng/dL FT3 1.6 - 3.5 pg/mL

    * Thyroid levels are below minimal expectations for a healthy performance adult (at least 1.4 µg/dL for T4 and 0.85 ng/dL for FT4).
    * Thyroid levels are too low. Recommend 6-8 weeks of Soloxine® or equivalent product at 0.1mg per 12 - 15 lbs twice daily (e.g. 0 . 2 mg BID), followed by retesting thyroid profile 4-6 hours post-pill to monitor response levels. Dose at optimum weight.
    * Optimal therapeutic response levels should be in the upper 1/3 to 25% above the upper limits of the resting optimal ranges at 4-6 hours post-BID thyroid medication.


    Bowdu's been on thyroid meds for one week now. He's still licking his paws a lot and still has to wear his cone to keep himself from chewing himself bloody, but I've already noticed two changes:

    1. he has more energy
    2. he smells less

    I've noticed the slightest patch of fuzz growing back on his armpit too, but his blackened, raw undersides still look pretty terrible. I imagine the itchiness will take some time to go away. I'm really hoping to see more progress before we take him in for his next blood draw which is supposed to be in three weeks, but I'm going to push it back to the 6 week mark because I'm really, really dreading it. I've been looking around for another vet, but so far, don't have any leads as to local docs who know either shiba or thyroids.
    image
    Bowdu 寶肚 (Shiba) and Bowpi 寶媲 (Basenji) with M.C.
  • curlytailscurlytails
    Posts: 2779
    Oh, and a couple things about my experience with Hemopet --

    I tried to ship the blood sample at first with FedEx, and it was awful. The lady at the counter was REALLY FREAKED OUT that I wanted to mail a vial of blood and was just being totally unhelpful, so I left. And packed it in thick paper towel and put it in a plastic bag and put that bag in a bubble envelope and put the bubble envelope in a box, and mailed it USPS Priority Mail. The clerk asked if I had anything fragile, liquid, perishable or potentially hazardous, and I started to describe the way I packaged up the vial. He interrupted me and said, "Okay, but it's not potentially hazardous, right?" I said no. And he mailed it with no further questions.

    The test itself took a few days to run and receive the results by e-mail. Hemopet claims to offer "interpretive results" which reflect their individualized handling and testing, but I really didn't get more out of the information they mailed me as compared to what came from my vet. However, I did e-mail back with specific questions, and Dr. Dodds was VERY helpful there in helping me understand what was going on. She even e-mailed me back on a Sunday, which I was not expecting.

    I was a little disappointed that she wasn't able to offer more insight about Shiba Inu and thyroid readings. However, she said that their database currently only has about 100 shiba at the moment; it's just not a breed that is regularly tested, particularly not through their labs. So if more shiba owners want to send lab results to help build their database, that could be useful (though it'd then be skewed towards shibas who are predisposed to thyroid problems -- i.e., people probably wouldn't be sending blood samples for dogs they expect to be healthy).

    She also explained why the thyroxine should be given either 1 hour before a meal or 3 hours after. Apparently, it binds to calcium and soy in food, a chemical property which she said is told to humans but not veterinarians. I had asked my vet specifically about timing the drug, and they told me it doesn't matter. So I take it as another indication that my vet is NOT staffed with people who know thyroids or their drugs.

    And also, the drugs they gave me are set to expire 10/10 (I noticed this after I got home, and after I paid about 40 cents a pill at the vet, which I now know is just bloodthirsty considering they can be purchased online for 5 cents a pill from Pet Food Direct or KV Vet Supplies). I'll take this as an indication that they don't deal much with thyroids, don't prescribe thyroxine often, and don't have much on hand.
    image
    Bowdu 寶肚 (Shiba) and Bowpi 寶媲 (Basenji) with M.C.
    Post edited by curlytails at 2010-08-31 05:11:58
  • Thanks for the update. Glad to hear you boy is already improving, and am also really thankful for all the information you posted here. It is really useful, and gives me a better sense of what is going on with my dogs too.

    I think next time I test them I will send it to Hemopet. I'd like to have more comprehensive information then I get from just getting the T4 numbers I get from my vet. Also, it was VERY useful to get why they should have the pills 1 hour before a meal or 3 hours afterwords (I thought it was two hours before, so this is useful too....). I asked my vet about timing when I found out--here on the forum--that I was doing it wrong, and she said exactly what Dr. Dobbs said....she was never told that in vet school and did not have a lot of experience with thyroid issues. We talked about it later, and she'd done some research, heard that people needed it before a meal, and was now telling everyone how to do it correctly. (Actually, I had to really convince them to thyroid test my dogs because they had no obvious symptoms--haircoat problems, etc.--but now I hear them recommending thryoid tests all the time!

    Re finding a good vet: you may not find one that familiar with Shibas or thyroid issues, but if you find one more open to learning more and listening, you'll probably do well. I consider myself lucky that my vet listens and learns as well as teaches me. They're pretty old school, but inspite of that, good to work with. (And I'm at the vet A LOT so I need that!)Lisa and Toby (Shiba), Oskar and Zora (American Akitas) and Leo (Kai Ken)
    From the House of the Fox Dogs blog
    Why it's Not About Dominance
    Bel's thread: the story of a puppy mill Shiba's life
  • Great news, Sophie's levels are perfect. Retest in 3 months. Her fur is even growing back.
  • JudyJudy
    Posts: 183
    I purchased soloxine from 1-800 pet meds and it was very reasonable. It took a little to get the vet to agree to write the prescription.
  • Lepercann, I hope to have good news soon, too!

    We hit another speed bump. So our old vet wanted us back in after FOUR weeks time of starting thyroid supplements. We want to push it to 6-8 weeks, given Hemopet's recommendation, chatting with other hypothyroid dog owners, the literature that I myself have read, and Bowdu's extreme stress at the vets. But in the meantime, we need more thyroid meds.

    So I ordered from 1-800-PETMEDS.

    They contacted my VCA vet.

    My VCA vet contacted me to tell me that they don't deal directly with online pharmacies, but they'll write me a prescription. But just so I know, the vet is willing to sell me 250 pills (the whole bottle) for the SAME PRICE that I paid for 60 pills.

    Of course, they didn't mention this until I decided I wanted to go somewhere else for the meds that Bowdu's likely to be on for the rest of his life.

    I'm so mad at them about this. All the more reason for me to find another vet.
    image
    Bowdu 寶肚 (Shiba) and Bowpi 寶媲 (Basenji) with M.C.
    Post edited by curlytails at 2010-09-16 03:52:12
  • That sucks! Yes, get another vet! My vet sells me the entire bottle of just a bit above cost, which I have always appreciated!

    I did want to thank you again for writing about your experiences though. I'm going to meet with a behavioralist for Toby's aggression/reactivity, and she asked me to get a full thyroid panel done first (rather than just the T4 I've done) so I'm going to send my stuff to Hemopets, too, and now I know how to do it, thanks to this thread! I'll report back, too, when I find out more.
  • Glad to have been of help. Also take note of Judy's advice on packing the blood above, as she mentioned that her USPS clerk would not ship it out. I must've gotten a nice clerk. But your experience may vary, as well.

    Oh, and I went in and "broke up" with my VCA vet today. We actually parted on amicable terms -- they have all been nice *people* there, I'm just leaving because I don't like how they do things. And I explained in some detail as to why I was looking for another vet.

    As for the med prices, they explained that there's an "introductory price" for the first dose, then there's a "chronic med price" which was what I was offered when I tried to get them to authorize my purchase from 1-800-PETMEDS. My response to explanation was that once you start the first dose, you're basically *expected* to keep the dog on chronic thyroid medication, since hormone supplementation will basically result in his own thyroids shutting down, if they weren't already mostly non-functional to begin with. If they had actually considered the medication they were offering as more than something to look up on a price chart and ring into the register, they would've known that.

    So at any rate, they failed to mention this or other things I could've done to get medications cheaper elsewhere (like the fact that I could've just asked for the prescription and gotten it filled at a pharmacy of my choice at any time), and for that I fault their policies. I've spent nearly $1000 there since March, and I think the majority of that money was spent on DRUGS.
    image
    Bowdu 寶肚 (Shiba) and Bowpi 寶媲 (Basenji) with M.C.
  • JudyJudy
    Posts: 183
    Something else to check into is that often the thryoid meds for dogs are the same as for humans and it can be filled at a regular pharmacy. I had taken the written prescription my vet gave to walmart where they have the 30 days/$4 and 90 days/$10, but the dogs' doseage wasn't one that was included. Had the vet written the prescription differently, they would have filled it; didn't care if it was for a dog. I knew of a person who's dog was on some other human medication and this is what they did; filled it at a regular pharmacy.
  • JudyJudy
    Posts: 183
    The USPS guy I had even pulled out the book to show me where it said "no blood" when I protested it was canine.
  • My policy is not to tell USPS what is in the package.
  • I just read the notes on the 1996 International Symposium on Canine Hypothyroidism with some interest:

    Available online from the AKC Canine Health Foundation:
    http://www.akcchf.org/pdfs/whitepapers/96hyp.pdf

    1996 really isn't that long ago, in my opinion. It's interesting to see how much was unknown at the time. The vets in the report were saying they didn't even have a standardized system for diagnosing hypothyroidism, there was still a lot of misdiagnosis at the time, and the absence of a lot of information. A lot of breeders (towards whom much of this report is directed) also weren't testing for thyroid problems then. But I noticed a spike in thyroid testing after 1996 in the OFA database, and it wouldn't surprise me if this major symposium was the reason for that statistical jump.

    Dr. Dodds was part of that group of panelists. So was another DVM who, at the time, was practicing at a clinic about 25 minutes away, but she has since moved on to another place that's about two hours away. Damn!
    image
    Bowdu 寶肚 (Shiba) and Bowpi 寶媲 (Basenji) with M.C.
  • Very interesting!

    I just sent off Toby's sample for the thryroid panel, so we'll see how he does! And on the issue of mailing blood via USPS, my vet says they do it all the time, and she was surprised that USPS has any policies against it.

    (When I sent mine in just now, they didn't ask what was in the box and I didn't tell them!)
  • curlytailscurlytails
    Posts: 2779
    Going in for another blood draw tomorrow, with a new vet. Should be exciting...

    Bowdu's been on 0.2 mg of Soloxine twice daily for about six weeks now. His fur has grown back beautifully, his weight and lethargy no longer seems to be a problem, and his temperament has improved, though he's still a little sh*t sometimes -- even levothyroxine can't change his Shibaness, after all.

    One new thing that has occurred about three or four times since we started his supplements is episodes of confusion or anxiety or... I don't know what. Basically he'll get really clingy, try to wedge himself into corners of the room, or under tables, or do weird things like this video below, where he's got his tail down and he's pawing at the paper shredder in the corner (which he knows is there and never had a problem with before). He did not need to go to the bathroom or anything, and at any rate, this is not how he usually tells us he needs to go out.



    I'll be discussing this, as well as his continued habit of mutilating his own paws until they're bloody and pustulant, with the new vet.
    image
    Bowdu 寶肚 (Shiba) and Bowpi 寶媲 (Basenji) with M.C.
  • BradA1878BradA1878
    Posts: 2240
    I'm sorry I am so late to this thread, but you've done a great job documenting all this. That's very helpful to anyone else that finds them self looking into thyroid issues. Thanks.

    We have a shiba who is Hypothyroid, she struggles with weight gain and energy levels. That's it for her tho, I guess she's "lucky".

    We used to have an Akita Inu who was Hypothyroid too, she would become disoriented and act similarly to the way you are describing above. She really had a hard time due to her thyroid issues, it was so sad.

    We used hemopet for both Lani and Kaia, and Dr. Dodds was great - really helpful.

    About the issues you describe above, and I'm sorry if this is covered already, but when to you give Bowdu his Soloxine? With Lani, we made the mistake of giving her Soloxine with her food for a while and then learned that giving her Soloxine with her food was basically rendering the supplement ineffective. Its very important that you follow the direction for Soloxine, which I think is to give it to them 1 before feeding or 3 hours after feeding - check the bottle tho, I may be wrong, that's off-the-top of my head. It could be that his new symptoms are from him receiving his Soloxine too close to feeding time. Just a guess.

    ----
  • shibaserfshibaserf
    Posts: 247
    Thanks, everyone who has contributed to this thread. Lucy still struggles with her hypothyroidism. She was doing better for a while, but her fur started getting brittle and oily in spots again. She's much better than she was but she's still not right. She also managed to gain 2 lbs. She really doesn't eat much at all and it's all home cooking - meat with vegitable - no other carb (well, does the occasional bite of pizza really count?). Fortunately, the weight gain and messed up fur are her only symptoms I see. She hasn't seemed disoriented. I really hope the vet can find a way to help and Bowdu gets better!

    She was back at the vet today, with her best Shiba Opera performance yet. The vet is going to run a wide range of blood tests, not only for thyroid but for other stuff that could be causing weight gain and lethargy.

    Lucy is also on Soloxine and thanks to you, Brad, we've tried really hard to give it to her an hour before meals.

    Curlytails - how much does Bowdu weigh? Lucy is about 36lbs (at least 12 lbs more than she should be) and she's on .3mg. Either the dose is too low or she's got other issues. I suppose she could also be diabetic but she almost never eats non-vegetable carb. Not even potato or rice. She doesn't even like sweets or bread.

    What's your dog's weight and how much is she on, Brad?

    Hopefully, I'll hear more about the blood tests tomorrow.
  • BradA1878BradA1878
    Posts: 2240
    Kaia gets 0.1mg twice daily, she's 15lbs (Kaia is very small, so 15lbs is kinda fat for her)
  • bobc33bobc33
    Posts: 287
    Shibaserf,

    I checked with my two, and both were emphatic that bites of pizza do NOT count.
  • Huh.....wierd about Bowdu, but I can tell you his behavior looks VERY familiar to me, because that is how Bel acts when she's in one of her
    "crazy" phases. She gets really interested/obsessed with something, and she keeps looking at it, pawing it, with her tail down, etc. Last time she did it she got very interesting in the puppy's wading pool (granted she found a dead bird in it once) and she just would not leave it alone--kept pawing the water, etc. But Bel only does it if I misdose her--like if I forget to give her her morning pill, or something. (I ran out of thyrosin last week, and she missed two doses before I got some--that's when she started with her wierd pawing).

    But you did the whole hemopet thing, so you know what is levels are.....very puzzling. (I haven't done more than a T4 with Bel, though I did the full panel with Toby. I'll probably do the full panel with Bel at some point too).

    I actually think there is something else wrong with Bel....beyond thyroid issues. I don't know how to describe it except I really think she might have some sort of mental/emotional disorder....since so much of that stuff is based in brain chemicals it doesn't seem out of line to me to think dogs could have them too....But I don't know. She's been great since we got the puppy, but she does have moments still...

    Bel is 32 lbs and gets .3 mg of thyrosin twice a day. Bel is lean. Toby is 43 lbs (fat) and gets .4 mg. twice a day. Hemopet said his levels were good on the dose he's on. But he is still lethargic and fat, and I feed him very little...

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