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Canine Hypothyroidism: Frequently Asked Questions

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Diagnosing and Treating Underactive Thyroid Problems in Dogs

by Mary Shomon

What is hypothyroidism?

Hypothyroidism is a disorder of the thyroid gland -- two small butterfly-shaped lobes located in the neck. This gland has a number of functions, but is most well known for regulating your dog’s metabolic rate. In hypothyroidism, the thyroid gland is underactive, and unable to secrete enough thyroid hormone. This, in turn, decreases your dog’s metabolism.

How does a dog get hypothyroidism?

Most cases of hypothyroidism stem from the dog’s own immune system attacking the tissues of the thyroid gland. This condition is called autoimmune thyroiditis. The dog’s own system attempts to compensate for this at first by secreting more and more of the thyroid hormone, but eventually the gland is unable to keep up with the attacks on its tissue, and the dog becomes hypothyroid and symptomatic. While there is a genetic predisposition for thyroid disorders, environmental factors such as pollutants and allergies probably play a role as well.

What are the symptoms of hypothyroidism?

  • Lethargic behavior such as a lack of interest in play, frequent napping, tiring out on long walks
  • Weight gain, sometimes without an apparent gain in appetite
  • Bacterial infections of the skin
  • Dry skin
  • Hair loss, especially on the trunk or tail (“rat’s tail”)
  • Discoloration or thickening of the skin where hair loss has occurred
  • Cold intolerance/seeking out warm places to lie down
  • Slow heart rate
  • Chronic ear infections
  • Severe behavioral changes such as unprovoked aggression, head tilt, seizures, anxiety and/or compulsivity
  • Depression
Are there certain breeds that are more susceptible to hypothyroidism?

Most dogs who are affected by hypothyroidism fall into the mid to large size category. Many breeds are affected by this disease, including (but not limited to):
  • Golden retrievers
  • Doberman pinschers
  • Greyhounds
  • Irish setters
  • Dachshunds
  • Cocker spaniels
  • Airedale terriers
Hypothyroidism is rare in toy and miniature breeds of dogs.

Is age or gender a factor?

Most dogs contract hypothyroidism between the ages of 4 to 10. It appears to affect males and females equally, however spayed females are at a higher risk than unspayed females.

How is hypothyroidism diagnosed?

All diagnosis begins with an examination and taking of a history. Your veterinarian will be looking for clinical signs of hypothyroidism during a thorough physical examination of the dog, and will ask questions about your dog’s health and behavior. If hypothyroidism is suspected, a blood test will be ordered. There are a number of different methods for testing the thyroid. They involve some complicated terminology, but it is important to understand the efficacy of these tests when discussing diagnosis with your veterinarian:
  • Baseline T4 Test or Total T4 (TT4): This is the most common test. Dogs with a failure of the thyroid gland will have a lowered level of the T4 hormone. However, there are other conditions that can cause the T4 to decrease, so if this test comes back positive for hypothyroidism your vet should recommend an additional blood test, either the T3 Test or the Baseline TSH test.
  • Baseline TSH Test: Measures the level of Thyroid Stimulating Hormone. In combination with the T4 or T3 test provides a more complete picture of the hormonal activity of your dog’s thyroid gland.
  • Free T4 by RIA (radio immunoassay): The Free T4 test using RIA techniques does not appear to be more or less accurate than the above TT4 test.
  • Free T4 by ED (equilibrium dialysis): This test may provide more accurate data on the level of T4 hormone in your dog’s bloodstream.
  • Baseline T3 Test: In combination with the T4 or TSH test, these two blood tests can give a clearer picture of the hormone levels found in the bloodstream. This test is not reliable when used alone. The T3 Test should always be given in combination with one of the other blood tests.
  • TSH Response Test: In this test, the veterinarian takes an initial measurement of the thyroid hormones in your dog’s bloodstream, and then injects Thyroid Stimulating Hormone (TSH) into the vein. After 6 hours a blood sample is drawn and the level of T4 is checked. If your dog has hypothyroidism, the level of T4 will not increase even after the TSH is injected. This is an expensive test and is being used less often due to decreased production by the manufacturers.
How is hypothyroidism treated?

Hypothyroidism is treated with a daily dose of synthetic thyroid hormone called thyroxine (levothyroxine). Blood samples will need to be drawn periodically to assess the effectiveness of the dosage and make any adjustments necessary.

What should I expect from the treatment?

Most symptoms should clear up after treatment. With regularly scheduled check-ups to ensure correct dosage, your dog should be mostly symptom-free for the rest of his or her life. Hypothyroid dogs who receive proper treatment have a normal life span and are able to maintain good health well into their golden years.
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It should be noted that if your dog is still symptomatic but has normal levels, s/he might need to go up a dose on his/her medication. Also, if your dog is symptomatic and has normal or low-normal levels but isn't on medication or hasn't been diagnosed, barring another diagnosis, your dog may need to begin medication. They have been finding more and more that what is considered normal may vary from dog to dog. It's also worth mentioning that most dogs do better on the non-synthetic medications.
 
It should be noted that if your dog is still symptomatic but has normal levels, s/he might need to go up a dose on his/her medication. Also, if your dog is symptomatic and has normal or low-normal levels but isn't on medication or hasn't been diagnosed, barring another diagnosis, your dog may need to begin medication. They have been finding more and more that what is considered normal may vary from dog to dog. It's also worth mentioning that most dogs do better on the non-synthetic medications.

This is actually what we are battling right now.. Fine tuning his medication has been challenging to say the least.. It almost seems like he produces his own thyroid occasionally so finding the magic number has been elusive.
 
It can be really tough. Have you tried the twice a day meds versus the once a day (or vice versa)? Sometimes that will make a difference, although you have to be really careful to give them at the same time everyday -- you can have the right dose but it not be effective because it's not being given at the same time consistently.

Another thing to consider is brand of medication. Some dogs (and people) are more sensitive to the binding agents that are used or the way it is delivered. This means that even if two medications are essentially the same thing, they might affect an individual differently, and one might be less effective than another. Of course, some vets are more willing/able to play around with this than others.

I don't know if this is done with dogs, or if it's something that you'd even want to consider if it was, but I do know with people whose thyroids will work intermittently and therefore have trouble with medication, they will sometimes have the thyroid removed. That way, the person has to rely entirely on medication, but the thyroid isn't interfering with finding the right dose.

When Drake, my lab, was diagnosed, it took us a while to finally get his dose right. Unfortunately, he couldn't focus on working anymore, and we placed him with a family with kids. Their vet didn't have much experience with thyroid problems and promptly cut Drake's dose in half because he was on "too high" a dose. His new family called me shortly after that, freaking out because, among other things, he had hot spots (that their vet didn't know what they were or what was causing them) and had gained a ton of weight in a short period of time. So, I sent them to my vet,and all was well again.

Sorry, no real point in that anecdote. Just that dosing is important and I was thinking about Drake. Hope you get it figured out with your boy.
 
It can be really tough. Have you tried the twice a day meds versus the once a day (or vice versa)? Sometimes that will make a difference, although you have to be really careful to give them at the same time everyday -- you can have the right dose but it not be effective because it's not being given at the same time consistently.

Another thing to consider is brand of medication. Some dogs (and people) are more sensitive to the binding agents that are used or the way it is delivered. This means that even if two medications are essentially the same thing, they might affect an individual differently, and one might be less effective than another. Of course, some vets are more willing/able to play around with this than others.

I don't know if this is done with dogs, or if it's something that you'd even want to consider if it was, but I do know with people whose thyroids will work intermittently and therefore have trouble with medication, they will sometimes have the thyroid removed. That way, the person has to rely entirely on medication, but the thyroid isn't interfering with finding the right dose.

When Drake, my lab, was diagnosed, it took us a while to finally get his dose right. Unfortunately, he couldn't focus on working anymore, and we placed him with a family with kids. Their vet didn't have much experience with thyroid problems and promptly cut Drake's dose in half because he was on "too high" a dose. His new family called me shortly after that, freaking out because, among other things, he had hot spots (that their vet didn't know what they were or what was causing them) and had gained a ton of weight in a short period of time. So, I sent them to my vet,and all was well again.

Sorry, no real point in that anecdote. Just that dosing is important and I was thinking about Drake. Hope you get it figured out with your boy.

well i for one appreciate the effort put in to your posts regarding this issue.. I was never told how important it is or isnt as far as a consistent schedule.. That could very well be an issue since summer began our schedules are all over the map and ive never really given him his medicine at a specific time of day..
 
I'm glad I can help. ^.^ I remember how stressful it was trying to figure Drake's medication out. I was lucky to have a really great vet at the time (need to find me another one of those), and while she was extremely knowledgable, she was the first to admit if she didn't know something or needed to update her knowledge base. But it sounds like for you, it may be that you're not keeping him on a schedule. You might try that for a few weeks and then reasses; it may be one of the other issues that I brought up (or something else entirely) but I'd wager that he will get better with a schedule.

I did want to add these links for anyone else who needs the info. The first is the website for Dr. Jean Dodds's laboratory. As of right now, they are the premier lab for thyroid issues. They do a full thyroid panel that may be different than what your vet calls a full panel, and they also interpret the results differently, based on the updated protocols. The second link contains several articles about thyroid health in dogs (and some might be related to cats too).

Home
Thyroid-Articles
 
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Quick question related to this. How long does it take for the thyroid meds to start kicking in? Albert will be on them for 3 weeks tomorrow and it seems to look like some of his thinning hair spots are growing back in, but it might be my imagination too. ;)

He goes back for a recheck in the next couple of weeks so it will be interesting to see how the readings are after starting the med.
 
Quick question related to this. How long does it take for the thyroid meds to start kicking in? Albert will be on them for 3 weeks tomorrow and it seems to look like some of his thinning hair spots are growing back in, but it might be my imagination too. ;)

He goes back for a recheck in the next couple of weeks so it will be interesting to see how the readings are after starting the med.
I felt like the hair started coming back really quickly as did the weight loss. It really picked up once we had his levels figured out. Now I swear he has more hair than before!
 
Great to hear Jess! Well maybe not the more hair part since we don't need more to sweep up. LOL
 

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