Undiagnosed condition

Started by Julie Beardieye, October 10, 2018, 09:21:10 PM

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Catherine

There could be a couple of things going on but at 13 years old Buffy's thyroid could be wearing out anyway. It could be non-thyroidal illness but that is why a FreeT4 test and a TSH test are done along with the T4.

How is Buffy now, any more symptoms?

Julie Beardieye

Buffy is still lethargic and pants alot on walks and in the evenings.
Is it true that an infection can affect the thyroid results?
I wanted her thyroid checked asap but vet now wants to discard the blood they took yesterday and put her on a 1 week course of antibiotics instead, saying that if the lymph nodes are swollen due to infection, it could affect the thyroid results.


Catherine

I do not know if an infection will affect the results. But I thought that is why the extra tests are done to help diagnose Hypothyroidism or a non-thyroidal illness, an infection say. Taken from Jo's earlier post: "Measuring TT4 alone is not enough to make a definitive diagnosis as the dog could be suffering from a non-thyroidal illness (NTI), that is an illness affecting the amount of thyroid hormone within the circulation, rather than a primary autoimmune destruction of the glands.  Non-thyroidal illness should be suspected if the dog has a low TT4 and a low TSH."

This chart and information may explain it better: https://www.veterinarypracticenews.com/how-to-test-interpret-thyroid-function/

I would still go ahead and test the thyroid with the blood taken. Try to avoid potentiated sulphonamide antibiotics as they have been known to make some dogs very ill.

Julie Beardieye

Ok, thanks.
If the vet hasn't already thrown the blood I'll ask them to send it for testing anyway.
I'm picking up the antibiotics tomorrow. Don't know what they are called.

Jo CIMDA

Hi

I don't know that 'infections' can cause alteration in thyroid hormones but illness can and so can many drugs including some antibiotics.

Jo

Julie Beardieye

Ok, so Buffys full thyroid test came back showing she is hypo but the vet wants to finish the course of antibiotics before putting her on medication.
If Buffys lymph nodes aren't back to normal after the antibiotics, the vet will consider investigating the lymph nodes further before starting thyroid medication.
Does that sound like the right way to go?

Catherine

Did the vet give a reason for delaying starting thyroid medication? It seems to me that if Buffy is hypothyroid then the sooner she starts on the medication the sooner some of her symptoms may improve. Delaying, surely only increases the risk of more problems?

How is Buffy?

Julie Beardieye

Something about possibly another underlying condition other than thyroid affecting the lymph nodes and if there is another underlying condition it might give false thyroid results.
Even though the biopsy results came back inconclusive they still haven't ruled out cancer for some reason.
The lymph nodes have reduced slightly but not sure they will be back to normal after the antibiotics.

Catherine

I thought that was the reason for having the extra tests to get a more accurate result. Was the TSH high? What cancer are they talking about?

Julie Beardieye

I assume they think cancer of the lymph nodes. Not that I've ever heard of that before.
I don't know what the TSH is just that the FT4 is low.
I'll be getting a print out of the full results at our next appointment on Wednesday.
Buffy has become less tolerant of exercise so it looks like the anti-inflammatorys aren't helping and maybe the antibiotics are making her feel groggy too.

Jo CIMDA

Hi

I don't know of any good reason why if the FT4 and TT4 is low that a vet wouldn't treat with thyroid replacement hormone. 

Buffy has clinical signs of hypoT and now the lab results to back up a diagnosis of hypothyroidism.  If there is underlying problem then replacement thyroid hormones when a dog isn't able to produce them can only do good.  The thyroid  hormone is essential to every part of the body.

I would ask for her to be treated and if your vet refuses then find another vet.
Good luck
Jo

Catherine


Here is an assessment chart from Hemopet that might help:
http://www.hemopet.org/clients/14145/images/Hemopet-magnet5-4-2014-blue_(1).jpg

If the anti-inflammatories are not helping I would stop them as they could cause more problems. What is the name of the antibiotics?

I agree with Jo that as the clinical signs and test results point to Hypothyroidism then the sooner Buffy starts treatment the better.






Julie Beardieye

Hi.
The antibiotics are called Noroclav (Amoxicillin and Clavulanic acid)
We've got one more days worth of these antibiotics and Buffys left lymph node has reduced and feels normal but her right side still feels very hard, although it doesn't feel like it's surrounded by squidgy/fluid anymore but the actual lump has not reduced at all. This is also the side they took the very first blood sample from that they had real trouble getting the needle in the vein and were, in her words, jabbing in the dark.
This is also the side they took the biopsy from.
I'm guessing the vet will want to open Buffy up and have a look at her lymph node next. I'm not sure about that given her age.
So you suggest I stop the anti-inflammatorys? They don't appear to of helped in any way.
I'll have more info on the thyroid results on Wednesday.
Thanks

Catherine

Those antibiotics should be fine.

I do not know Buffy so I shall just throw out a few things. The right hand lump - has it reduced any, do you remember the size before Buffy started having problems?. It is probably not something that is noticed until a dog is unwell, but could the right hand lymph node have always been bigger than the other one?

If the anti-inflammatories are not helping why give them to her? You can always start again with them if you really think they will help.

Can you remind me of Buffy's symptoms again please?

I would not be rushing to have her undergo an operation and anaesthetic at her age unless it was life saving. I would certainly want to try her on the thyroid medication first if you do go down the exploratory operation route because if her thyroid is not working so well it could affect other parts of her body and make things riskier. I would also want to know what the vet was thinking it could be and whether she could be cured. If not, why put her through an operation just to get a diagnosis? If the lump has not become bigger or there are severe problems for Buffy it would be a good idea to "wait and see" before any operations.

Catherine

I do know how difficult it can be to go against a vet's advice. That is why it helps to find out as much as possible and your options and also to go by your own gut feeling. Perhaps you can compromise with the vet. If you really think it would help to have a trial of thyroid medication then I can not see why your vet would not be amenable to that. After all your vet was not keen on the thyroid test and look what that showed!

Another route would be to take Buffy to see a specialist.