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Pet Forum / Miscellaneous / Animal Health / October 2006Euthyroid sick
Hey, This is a general question, not to do with any of my animals. If a dog is very ill and thyroid function is just about zilch, finally diagnosed just recently with malabsorption syndrome, is almost half the proper weight, should he be given thyroid meds? The line of thinking in humans is no, as most very ill people have abnormal thyroid readings and they're not sure if it may do harm. I'm not sure what the thinking is WRT dogs, as the owner is getting conflicting opinions - one says no, dog is euthyroid sick not hypoT, 2 more say well, it may help. My thinking is it would be a huge mistake to try and bump up the metabolism when the dog is virtually starving to death. Like giving speed to a cancer patient. Makes them feel better but they burn out faster. ....so that's the specifics, but in general would you supplement a euthyroid sick animal with thyroid meds? buglady take out the dog before replying > Hey, > This is a general question, not to do with any of my animals. [quoted text clipped - 13 lines] > sick animal with thyroid meds? > I didn't know there was that much controversy regarding this subject:-) My opinion, if you care, is that the dog's primary problem should be addressed and, once that's under control, the thyroid level should be rechecked. It certainly may be that the dog is hypothyroid AND has a cause for malabsorption, but we always like to try to give an animal one problem, if possible. There are more in-depth thyroid panels which may help prove euthyroid sick, but they won't always be definitive. Assuming the dog isn't clinically hypothyroid (obese, poor hair coat, greasy skin, lethargic), the known problem should be treated before supplementing with thyroid hormone. Sandy, DVM >> Hey, >> This is a general question, not to do with any of my animals. [quoted text clipped - 29 lines] > > Sandy, DVM Ditto ;-) Deborah, DVM > Ditto ;-) ......a woman of few words! Hey, if you're still in FL, you operate in tick country - seen much tick disease? And if you get full blood panels with a few thyroid readings, are they usually low? .....boy we sent those hurricanes AWAY this year huh! Trouble is we're in drought now..... buglady take out the dog before replying > .....boy we sent those hurricanes AWAY this year huh! Trouble is we're in > drought now..... You can't have a hurricane right now. Your tree and electric crews are up here trying to restore power to the folks affected by the storm 11 days ago! >> Ditto ;-) > > ......a woman of few words! Hey, if you're still in FL, you operate in > tick > country - seen much tick disease? And if you get full blood panels with a > few thyroid readings, are they usually low? I'm actually surprised at how little tick borne disease I see around here. Just lucky, I guess ;-). They few I have seen haven't had low thyroid, but I admit I don't always routinely check thyroid on these guys. > .....boy we sent those hurricanes AWAY this year huh! Trouble is we're in > drought now..... I know....I keep waiting for the other shoe to fall....hurricane season not over yet.... We're having a great cool snap right now, it actually feels like fall and I could finally open windows and turn the a/c off! Deborah, DVM > buglady > take out the dog before replying > I didn't know there was that much controversy regarding this subject:-) ........seems like there is amongst vets! The two 6 panel thyroids that were run (Dodds and MSU) both suggested dog is euthyroid sick and not to supplement, but some of the general vets out there seemed to feel it might help and that it wouldn't hurt. As you might imagine, this leaves a client in a quandry. I ran across one recent study using ultrasound to distinguish between hypoT and euthyroid sick, which they claimed was a diagnostic challenge. > My opinion, if you care, ..........yes of course! is that the dog's primary problem should be > addressed and, once that's under control, the thyroid level should be > rechecked. It certainly may be that the dog is hypothyroid AND has a > cause for malabsorption, but we always like to try to give an animal one > problem, if possible. ......well, this poor animal seems to have more than one, was also diagnosed with some nebulous brain disease, but most of us are wondering about causitive organisms - one thought is Neospora, but most of us are yelling about tick disease, though this dog lives in an area where TBDs are supposedly not a problem, so vets don't test -- sigh. What I'm also hearing is that many dogs with tick disease are thought to be hypoT and very often vets supplement while they are treating the TBD, but I don't get that either as TBDs can cause abnormal thyroid readings, so in essence they might be euthyroid sick. There are more in-depth thyroid panels which may > help prove euthyroid sick, but they won't always be definitive. > Assuming the dog isn't clinically hypothyroid (obese, poor hair coat, > greasy skin, lethargic), the known problem should be treated before > supplementing with thyroid hormone. .......that's what I think, and no, the dog doesn't have any standard symptoms (other than hair loss, which considering how thin he is now, is understandable), and is half the usual weight, but she went without a diagnosis of malabsorption for a long time. .......well, anyway, may be a topic for future vet meetings huh! Might be surprised at the difference of opinion. ;-) Thanks! buglady take out the dog before replying >>What I'm also hearing is that many dogs with tick disease are thought to >>be hypoT Any idea why? "Tick disease" and hypothyroidism don't present that similarly to my mind, but then I just got out of vet school five minutes ago. > Any idea why? "Tick disease" and hypothyroidism don't present that > similarly to my mind, but then I just got out of vet school five minutes > ago. .............Tick disease can apparently cause abnormal thyroid readings (as can many severe nonthyroidal illnesses). I don't know if those people with dogs with tick disease got 6 panel thyroids run or not. A few have said that their dogs were found to be hypoT, but I'm just wondering if they were *diagnosed* as hypoT on the basis of the T4 that usually come with complete blood panels now. I doubt the vets ordered thryoid tests, it's just that it's now so common to get these readings on a full blood panel that more vets are aware of thyroid readings. .....To further confuse the issue there's a thread in rec.pets.dogs.health about abnormal thyroid readings a vet wants to treat for hypoT, a larger blood panel reveals not much and an endocrinologist said it's probably not hypoT but euthryoid sick, and dog shows zero symptoms - of anything. The dog had had a senior blood panel run with T4 which started this whole thing. As yet a 6-panel hasn't been run. ......If you want to read it, thread is labeled Thyroid Testing Question, dated 9-20-06. Vet seemed OK with supplementing with just a T4 reading. Later thread with more test results is Ongoing Thyroid Saga dated 10-18-06. .....I'm curious as to how many vets would go ahead and supplement with just a T4 reading and no symptoms. Now it could be that the dog is on the verge of being hypoT, don't know, but the main vet seemed confident that the T4 reading indicates the dog is definitely hypoT. .....hey josh, got a job? <g> buglady take out the dog before replying > .............Tick disease can apparently cause abnormal thyroid readings > (as > can many severe nonthyroidal illnesses). Just about any illness can monkey with thyroid levels. I'd pretty much be very suspicious of euthyroid sick syndrome if I could document another illness in dog. Or cat for that matter, although it's a bit different for them. > .....I'm curious as to how many vets would go ahead and supplement with > just > a T4 reading and no symptoms. Not me. > .....hey josh, got a job? <g> Yes. I'm a highly paid intern. I'm earning about seven bucks an hour the last time I figured it. > Yes. I'm a highly paid intern. I'm earning about seven bucks an hour the > last time I figured it. .......sheesh, that's pretty pitiful. :-( buglady take out the dog before replying > Hey, > This is a general question, not to do with any of my animals. > > If a dog is very ill and thyroid function is just about zilch, finally > diagnosed just recently with malabsorption syndrome, is almost half the > proper weight, should he be given thyroid meds? I'd think it'd depend on what you mean by "almost zilch". A T4 level on a sick animal isn't reliable. You'd need a TSH and Free T4 to even begin assessing, and then I'd still wait until your other problem is more controlled before deciding how meaningful your numbers are. > I'd think it'd depend on what you mean by "almost zilch". A T4 level on a > sick animal isn't reliable. You'd need a TSH and Free T4 to even begin > assessing, and then I'd still wait until your other problem is more > controlled before deciding how meaningful your numbers are. ........hey josh, dog had 2 6-panel thyroids run and both said dog is not hypothyroid but euthyroid sick. Despite this some vets thought it might be helpful to supplement. It's that part that confuses me. buglady takeout the dog before replying >> I'd think it'd depend on what you mean by "almost zilch". A T4 level on >> a [quoted text clipped - 9 lines] > buglady > takeout the dog before replying Seems odd to me too. If you don't have signs of thyroid disease, why supplement? I'll be honest, I will supplement even with apparently (low) normal thyroid readings, when I have a dog with clinical signs of hypothyroidism. If I see a good response in the first month, I'll continue. If no change, I stop. After all, "normal" ranges are just that....ranges....which means that a small percentage of animals will have readings outside that range but still be either normal, and vice versa could have readings within that range but be abnormal for that animal. Deborah, DVM |
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