# 10 month old with thryoid issue - has anyone else seen this in their younger dog?



## lloyddobler (Nov 30, 2014)

*Lloyd.pdf
*I just received my 10 month old's thyroid results (see attachment above) from my vet via email and they are scaring me (email is below). Lloyd's results came back irregular and indicate hypothyroidism which she says is very rare in young dogs, which leads her to believe it could be caused by an underlying health issue and not the thyroid itself. She goes on to talk about the various potential causes and next steps. This makes me very scared and sad. Has anyone's golden been diagnosed with a thyroid issue this young? If so, how did this issue impact your pup's development? Did you notice any behavioral changes once on medication? Was your pup's thyroid issue caused by an underlying health issue such as a tumor or anything else?

I have been getting more and more upset the more I think about this. My vet didn't call me. She just sent this info and won't be back in the office to talk to me until Friday. I did make an appointment to have the additional lab work she recommends this afternoon, but I'd like to know if I should start him on thyroid medicine right away or if it is important to rule out other causes first. 

The reason I pushed to have the test done was because my dog had shown some sudden aggression about 6 weeks ago. He barked, growled and lunged at a random boxer pup that walked by (both were on leash). It startled me because up to that point, he had never met another dog he didn't like. I discussed it with my trainer and she said that not all dogs will like each other and some dogs just don't like certain breeds. So, I shrugged it off. However, he then got into a full on fight with different boxer at the dog park. I then decided there will be no more off leash interactions with dogs he doesn't know. Since then, the aggression seemed to progressively get worse as he now will bark at any type of large breed dog. This morning on our normal walk around the neighborhood, he barked and jumped towards a person for the first time. 

Email from vet:

Hello Kelly:

Just touching base about Lloyd's thyroid test results- I have attached them to this email. I thought you would like a copy of the results. It will also help aid in our discussion. I am sending an email as there is a lot to discuss. Since the results are not clear cut and it is very rare to see low thyroid in young dogs, I did consult with an internist at Idexx laboratories and she agreed the results are a bit odd when combined with his case.

Results:
Free T4 is low- this would indicate hypothyroidism. Total T4 is low normal- we would expect it to be higher in a young dog, more like 3-4 ug/dL. TSH- low normal? This is typically high with hypothyroidism. 
TSH is Thyroid Stimulating Hormone. This hormone is produced in the pituitary gland in the brain and tells the thyroid gland when to produce thyroid hormone and when there is a enough (to stop production). So, when the body is not producing enough thyroid hormone, the TSH should be high- its levels get higher and higher because it keeps telling a non-functioning gland to produce something it cannot.
THAT SAID, the typical hypothyroidism we see in middle age and older dogs is due to a thyroiditis. This is an auto-immune disease where the body produces autoantibodies to the thyroid hormone. This is similar to hypothyroidism in people and in fact TSH is one of the main tests for hypothyroidism in people. Unfortunately no test is perfect, especially in the hormone world, and up to 30% of dogs may have hypothyroidism and a normal TSH.
But....
Hypothyroidism in a young dog is highly unlikely to be due to thyroiditis. This leaves us with a problem in the pituitary gland itself. That could explain a normal TSH- the pituitary gland is not functioning the way it should. Most of the time we do not know why it is not functioning- atrophy, ischemia due to trauma (loss of blood flow), or (incredibly unlikely in a young dog) a tumor. HOWEVER, young dogs with low thyroid hormones (due to a congenital reason) are what we call 'poor doers'. They are underdeveloped, poor haircoat, stunted, etc. This is why hypothyroidism was not a consideration for me at our first visit- Lloyd is one handsome man! I have seen congenital hypothyroidism once in a whippet and it was a 'poor doer'. I have also seen aggression in young adult and older dogs (due to thyroiditis) with low thyroid without having the other symptoms we see with the disease (chronic infections, poor haircoat, obesity, lethargy, etc.). 

This is a strange case to be sure- the internist agreed. Where do we go from here? Her recommendation, which is a good one, is to get a larger basic data base (labwork) with a complete blood count, chemistry (organ function) and urinalysis to asses overall health and any underlying disease. There is a condition called 'euthyroid sick' where a pet can have suppression of thyroid hormone due to illness. That means a thyroid level may read low, but not actually have hypothyroidism. Yep, I know Lloyd is not feeling poorly and it is absolutely most likely the panels will be completely normal, but if we are to consider starting Lloyd on a thyroid hormone supplement, we need the whole picture. Especially since this isn't clear cut. Why didn't we do this yesterday? Because if the thyroid results were completely normal, I wouldn't think it would be necessary. Unfortunately, we do need to draw more blood and obtain a urine sample from him. As yesterday, it is fine as a technician visit unless you wish to set up an appointment with me to discuss any of this. I of course will be contacting you with the results. I am out of the office the next couple of days, but back on Friday. These panels would be about $200 including the urinalysis.

Final note for completeness sake.. so, what is going on with the pituitary gland? The internist I spoke with mentioned that another piece of the diagnostic puzzle could be brain imaging, specifically an MRI. Do I think this is necessary? Probably not, but I would be doing you a disservice if I did not mention this as an option.

I hope I have not bored you too much. I just thought it was important to explain everything since this isn't a cut and dry situation. Also, I thought you might find it interesting.
I look forward to speaking with you soon.
Kind regards,
Dr. Carson


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## fostermom (Sep 6, 2007)

My 10 year old was diagnosed with hypothyroidism at less than 2 years old. By the time it was finally diagnosed, he had been having issues that I had him at the vet for for at least a year, so he was 12 months old when his issues first showed up (he kept coming up lame).

He's had no other problems or anything else that caused this as far was we know. Like I said, he's 10 years old now and healthy as can be (other than being on soloxine for his thyroid).


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## lloyddobler (Nov 30, 2014)

fostermom said:


> My 10 year old was diagnosed with hypothyroidism at less than 2 years old. By the time it was finally diagnosed, he had been having issues that I had him at the vet for for at least a year, so he was 12 months old when his issues first showed up (he kept coming up lame).
> 
> He's had no other problems or anything else that caused this as far was we know. Like I said, he's 10 years old now and healthy as can be (other than being on soloxine for his thyroid).


Thank you for the reassurance! My pup has had a limp in his hind leg and they did x-rays a while back and said it was likely pano. It likely had something to do with this as well. So frustrating that they don't do this simple test early on to rule it out especially for goldens and other breeds where this is common and cause so many different types of symptoms. 

I'm glad your boy has done so well on the meds and is living a happy and healthy life!


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## lloyddobler (Nov 30, 2014)

Found an article worth sharing regarding hypothyroid and the outcome of behavioral changes (ie aggression) after proper treatment. Sounds like my situation is fairly common.. behavioral changes/sudden aggression at the time of puberty being caused by hypothyroid.

The Effect of Hypothyroid Function Function on Canine Behavior

Again, it's too bad that trainers and vets are not more keen on this type of knowledge. I've literally spent $1000s of dollars on training classes, individual training sessions, vet visits to figure out why my sweet puppy turned nasty seemingly overnight. I blamed myself for doing everything wrong, despite trying to do all the right things. Not one of the vets or trainers I spoke with mentioned to have his thyroid tested. I got that information from this forum! Thank goodness for all the great people here who are sharing their information to help the rest of us!

Anyway, for anyone who is interested, the only other classic symptoms my pup demonstrated was that he seemed to run funny. His hind right leg seemed to cause him pain and was stiff... it was something I could only see when he was running. The vet did an x-ray and said it could be pano. His coat also was not soft and felt a bit dry on his back and neck. He had been such a soft puppy, but his coat changed about the time you would expect them to lose their puppy coat. I actually had mentioned it to the vet and she said that their coats will change many times as they are growing up and didn't seem concerned.

I guess what I've learned is I need to listen to my guy and advocate for my puppy because others won't. I knew that all along, but placed too much trust in the experts.


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## Anon-2130948gsoni (Apr 12, 2014)

Have they tested for tick-borne disease?

My rescue boy Boomer was surrendered as a puppy to rescue due to a staph infection that spread all over his face and legs. The rescue did extensive vet work ups and he was diagnosed as hypothyroid then, which would have been around age seven months.

I had him retested when we adopted him at age one year and he was normal and stayed that way for the rest of his ten years.

Have they considered repeating the test in a few weeks? Errors and mix ups do happen...

Sending you a hug.


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## lloyddobler (Nov 30, 2014)

Thank you for suggesting the tick born disease screening. He has not been tested for that, but I will ask for that today when I bring him back to the vet for other blood and urine tests.


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## lloyddobler (Nov 30, 2014)

We went in for the lab tests and I spoke with a different vet. He said he does not believe the aggression I've seen has anything to do with his thyroid and that my dog's thyroid may be just fine and will always be low. He said he would have never recommended the test because my dog looks and acts healthy. He also said even if we rule out any other underlying health issues that he would not recommend medication as he's never seen hypothyroid in a dog this young.

I'm trying to be patient and work through this, but I feel this vet's office is not listening or taking me seriously. 

I mentioned the research and articles folks have mentioned on here by Jean Dobbs and he said there is a lot of controversy in the vet community about her research and most vets do not feel her studies are valid.

I am going to wait to see what the lab results show, which I will hopefully have in a couple of days and then likely seek a second opinion. 

That said, does anyone have any recommendations for vets in the Seattle metro area?


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## Anon-2130948gsoni (Apr 12, 2014)

How frustrating... I hope someone will have a recommendation for you.

Did they do the TBD test?


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## Chritty (Aug 17, 2014)

Have you read any of the criticism of Jean Dodd's work?


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## lloyddobler (Nov 30, 2014)

Chritty said:


> Have you read any of the criticism of Jean Dodd's work?


No, but my vet referred to it. Do you have any references you can share?

My vet also said there are no tick borne diseases in the PNW, so there is no need to test as well.


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## Chritty (Aug 17, 2014)

I've heard of her before and have my own views on some areas of her work but I think it would be really helpful if that vet who mentioned it could point you towards some of the criticism.


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## fostermom (Sep 6, 2007)

lloyddobler said:


> We went in for the lab tests and I spoke with a different vet. He said he does not believe the aggression I've seen has anything to do with his thyroid and that my dog's thyroid may be just fine and will always be low. He said he would have never recommended the test because my dog looks and acts healthy. He also said even if we rule out any other underlying health issues that he would not recommend medication as he's never seen hypothyroid in a dog this young.
> 
> I'm trying to be patient and work through this, but I feel this vet's office is not listening or taking me seriously.
> 
> ...


I agree that I would have asked him to cite any of those "most" of the vets he is referring to. When someone doesn't have an actual valid argument, they tend to exaggerate to make their beliefs sound true.

I see no reason to NOT put him on thryroid meds to see if they resolve the issues he's having. It certainly can't hurt and may help. 

And yes, google "thyroid rage" and you will see it's a real thing. I had a corgi/chow who suffered from it.


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## Anon-2130948gsoni (Apr 12, 2014)

I did some research and there are TBD in the PNW, although there are far fewer reported cases, true. But given the weird weather patterns the last couple of years and how things are changing...dunno. It's not like ticks get to the state line, see the sign, and then turn around. Have you had your boy out of the state or in heavily grassed areas? Intermittent lameness is just worth a $30 snap test, IMHO.

These vets seem really prone to absolute statements. I wouldn't work well with that kind of vet...I need mine to have an open mind and be willing to explain their reasoning.

Thyroid aggression was a big topic when I attended a dog aggression seminar at Tufts about ten years ago given by Dr. Nick Dodman. Then it seemed to fall out of favor, but just because it wasn't the case for every dog doesn't mean it's not true for some dogs.

Sorry, I'm kind of rambling. I hope you find someone you can work with who can help your boy feel better.

ETA: I've thought more about this...I've been on meds for hypothyroidism for twenty years. The meds come in multiple strengths in tiny increments because the body is so sensitive to these hormones. For me, just the difference between 112 micrograms (most meds are in milligrams--a microgram is one-thousandth of a milligram)) and 125 micrograms was intense...racing pulse, headache, insomnia. Conversely, when my dosage is a fraction too low, I'm exhausted and cranky.

My point, and I do have one , is that low normal might still feel lousy.


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## lloyddobler (Nov 30, 2014)

fostermom said:


> I agree that I would have asked him to cite any of those "most" of the vets he is referring to. When someone doesn't have an actual valid argument, they tend to exaggerate to make their beliefs sound true.
> 
> I see no reason to NOT put him on thryroid meds to see if they resolve the issues he's having. It certainly can't hurt and may help.
> 
> And yes, google "thyroid rage" and you will see it's a real thing. I had a corgi/chow who suffered from it.


Thanks Fostermom. Did your corgi/chow's aggression/rage issues improve once on medication?


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## lloyddobler (Nov 30, 2014)

Thanks Noreaster! I've been questioning if this vet office is the right one for me and I think my answer is likely no. I'm going to wait to get the results of the labs they took yesterday and talk to the original vet who sent me the email and go from there. I actually have an appointment at a Veterinary Specialist office that is about 30 miles away (in traffic it could take well over an hour to get there), but they have internists, neurologists and other specialists that may be able to help us. My vet had said the internist had suggested getting an MRI, so I have that scheduled at the Speciality Clinic. Thank goodness I have pet insurance.... now I just have to confirm they will cover the majority of the MRI. 

Also, thank you for the insight on TBD... I moved here just a couple of years ago and have heard this from multiple vets. It's sad that we have to question the experts on everything, so it seems. I will ask them to do the test on Friday when I go in again.

I'm sorry to hear you also struggle with a low thyroid! I'm glad it's something that is manageable with the right dose. 

I took my boy for a longish walk this morning and we came across a lot of dogs and he had no issues today. Granted, I now am very intentional about not getting too close, but it felt good to see him be successful. I, on the other hand, realized I need to work on me because I'm a nervous wreck (worrying about how he may react) and I know dogs can very easily pick up on that in a big way. In my mind, I've likely been making the aggression a bigger issue than it is. He doesn't react negatively to all or even most dogs. However, it has gradually gotten work each week the last 6 weeks or so. 

Now, I just have to figure out what is going on with this thyroid and rule out other health issues. The vet's email really had me worried that he has a more serious medical issue, so I look forward to getting this all sorted out and hopefully having some peace of mind that he's going to be ok. Then, if the behavioral issues are still there (which I expect they will be at least to some extent) I can focus all my energy on that. 

I do have a trainer who has given me info on BAT training and I'm signed up for a human only session next week to learn as much as I can about it so I can employ it correctly.




Noreaster said:


> I did some research and there are TBD in the PNW, although there are far fewer reported cases, true. But given the weird weather patterns the last couple of years and how things are changing...dunno. It's not like ticks get to the state line, see the sign, and then turn around. Have you had your boy out of the state or in heavily grassed areas? Intermittent lameness is just worth a $30 snap test, IMHO.
> 
> These vets seem really prone to absolute statements. I wouldn't work well with that kind of vet...I need mine to have an open mind and be willing to explain their reasoning.
> 
> ...


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## fostermom (Sep 6, 2007)

lloyddobler said:


> Thanks Fostermom. Did your corgi/chow's aggression/rage issues improve once on medication?


Yes, to a point. She had other issues as well, most of them not her fault, but instead due to her early life before we got her (at 5 weeks old from our vet at the time). We were also inexperienced dog owners and didn't know how to manage her better than we did. But the thyroid rage was very evident in her and did ease up with meds.


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## lloyddobler (Nov 30, 2014)

Chritty said:


> I've heard of her before and have my own views on some areas of her work but I think it would be really helpful if that vet who mentioned it could point you towards some of the criticism.


I did try to seek out some opposing views on Jean Dobb's research and was only able to find criticism on her vaccination protocol. I see there have been other studies that study the effect of thyroid on aggression. The largest study of 1400 dogs didn't make sense to me as the dogs in the study all had normal thyroid levels. While they may have had aggression issues, their thyroid seemed to be functioning normally. 

I'm sure there have been many other studies and info out there that is more directed at how thyroid meds effect dogs with low thyroid who have aggression issues.


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## lloyddobler (Nov 30, 2014)

The more research I do on this topic the more I realize this is may be more complicated. Since my pup's T4 and TSH levels were low, this does not point to hypothyroid, but could be due to an issue with his pituitary gland, such a tumor. 

I really hope that this test was just faulty in some way because I can't stand the thought of something serious being wrong with my boy.

I spoke to the owner of one of my pup's littermate's a few days ago. Lloyd was about 7 pounds bigger than his brother about 2 1/2 months ago. Today his brother is 13 pounds bigger. Grants, Lloyd is 69 pounds and is a big guy (not fat, just big). But, he's only gained about 2 pounds in the last 2 1/2 months (he's now almost 10 months old). I wonder if this is also a symptom of a pituitary issue? I know most dogs' growth slows down around 7 months, so I never thought much of it until now.

I'm just beside myself with worry.


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## Jennifer1 (Mar 31, 2012)

I would try to find a veterinary behaviorist. Someone with both a DVM and a PhD in animal behavior. They can be worth their weight in gold


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## Jennifer1 (Mar 31, 2012)

Here is one I would look into.
About Dr. Wailani Sung of All Creatures Behavior Counseling


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## SwimDog (Sep 28, 2014)

That's actually a great idea - your vet should be able to call any veterinary university with a board certified veterinary behaviorist on staff and talk to that person at no cost (though your vet may charge you for his/her time) - and specifically ask about some of these resutls and how likely this is to be impacting behavior. A different kind of specialist would be the one to ask about the thyroid results and what kinds of further testing/treatments/etc should happen.

One of the benefits of a vet behaviorist is to consider how other health conditions may be impacting behavior and help make any diagnosis that needs to be made that way. Our vet behaviorist had a lot of ideas for my crazy dog and we worked through testing each of those in turn (some easy, blood tests - some harder like trying seizure meds etc.).


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## Anon-2130948gsoni (Apr 12, 2014)

I know it's hard, but try not to make yourself crazy based on one test in such a young dog...I'm no endocrinologist, but when you think about the colossal changes a puppy goes through in seven months...from one pound to seventy, from internal to external testicles that produce viable sperm, from no teeth to baby teeth to a mouthful of huge adult teeth...all of that undoubtedly involves a zillion hormonal changes, handoffs, and interactions. It wouldn't be at all surprising if at any point of testing some levels are going to be "off." We were taught in tech school that roughly 20% of perfectly healthy animals will have some abnormal blood chemistry result.

Wait until you have more information. I know it's hard. As for his growth leveling off? It's supposed to...if he kept going at his previous rate, you couldn't get him in the front door in another six months!

Breathe. Sending you a hug.

ETA: I could be completely full of it on the TBD, but in our immediate area we went from having hardly any ticks to a population explosion of them in five years and we have brutal winters here. I lived in Seattle for about ten years and I remember fighting fleas year-round. Honestly, between the benign weather, the parks, and all the wildlife and pets...tick paradise. They could also enjoy the scenery!


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## Chritty (Aug 17, 2014)

Millie absolutely skyrocketed to her weight up to about 6 months. 

Now 12 months old she's the same weight at around ~56lbs


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## Chritty (Aug 17, 2014)

fostermom said:


> I agree that I would have asked him to cite any of those "most" of the vets he is referring to. When someone doesn't have an actual valid argument, they tend to exaggerate to make their beliefs sound true.



On the other side of the coin, a medical practitioner may not want to alienate their patient who is stressed out and been searching for answers.


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## fostermom (Sep 6, 2007)

Chritty said:


> On the other side of the coin, a medical practitioner may not want to alienate their patient who is stressed out and been searching for answers.


It sounds to me like they are already alienating the OP. And bolstering their argument by stating that most vets disagree with Dr. Dodds, without provide any proof of this claim.

Thank goodness my vet likes me because I am a total PITA when it comes to my pets. I research and will seek out a second opinion if I don't like the treatment plan she suggests.


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## Chritty (Aug 17, 2014)

*10 month old with thryoid issue - has anyone else seen this in their younger ...*



fostermom said:


> It sounds to me like they are already alienating the OP. And bolstering their argument by stating that most vets disagree with Dr. Dodds, without provide any proof of this claim.



All OP would have to do is ask for some, it's not like it's a conspiracy and the vet, at this stage, hasn't hidden it from her. The vet has just highlighted that there is controversy within their profession regarding her work and told her of his position. It may be valid, it may not be. But being told by a professional in the field may give you an insight that the Internet cannot


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## Chritty (Aug 17, 2014)

Any updates?


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## lloyddobler (Nov 30, 2014)

None yet. Hoping the new labs come back tomorrow. Until then, here's a pic of my handsome boy.


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## Chritty (Aug 17, 2014)

lloyddobler said:


> None yet. Hoping the new labs come back tomorrow. Until then, here's a pic of my handsome boy.



He's so sweet!!


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## lloyddobler (Nov 30, 2014)

All the labs came back normal (CBC, urinalysis, etc.). My next step is to meet with an internist and then and MRI on 7/20. So, until then it is a waiting game. If there is a tumor on the pituitary, the prognosis is not good. So, I have to hope the low levels is normal for him and/or there is another less serious underlying medical condition causing the issue.

Please send positive thoughts to my Lloyd. Thank you all in advance.


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## Prism Goldens (May 27, 2011)

What was the free T4 #? I'd imagine anything around 1.3-2.2 might signal a need for supplementing it, but Goldens do tend to be low normal.


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## lloyddobler (Nov 30, 2014)

FREE T4 (ng/dL) *0.4* 0.6 - 3.7 ng/dL LOW
FREE T4 (pmol/L) *5.1* 7.7 - 47.6 pmol/L LOW

T4 *1.2* 1.0 - 4.0 ug/dL

cTSH *0.06* 0.05 - 0.42 ng/mL

Since the Free T4, T4 and TSH were all low, it appears this may be a pituitary issue, otherwise known as secondary hypothyroidism. The most common cause of secondary hypothyroid is from a tumor on the pituitary. We will have an MRI to hopefully rule that out. But, it sounds like my vet and the internist my vet spoke to from lab where the test was run are both purplexed as these are very abnormal readings.


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## Chritty (Aug 17, 2014)

*10 month old with thryoid issue - has anyone else seen this in their younger ...*



lloyddobler said:


> All the labs came back normal (CBC, urinalysis, etc.). My next step is to meet with an internist and then and MRI on 7/20. So, until then it is a waiting game. If there is a tumor on the pituitary, the prognosis is not good. So, I have to hope the low levels is normal for him and/or there is another less serious underlying medical condition causing the issue.
> 
> Please send positive thoughts to my Lloyd. Thank you all in advance.



Labs being normal sounds positive!

What's the likelihood of pituitary gland tumor? A friend of mine had one. It was non-cancerous but the odds of a pituitary gland tumor in humans is one in two million. Hopefully for Lloyd the odds for dogs are even lower. 

You have Wifey's, Millie's and my positive thoughts!!


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## Anon-2130948gsoni (Apr 12, 2014)

Sending you a hug...did they repeat the thyroid test or just do other bloodwork?


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## lloyddobler (Nov 30, 2014)

They did not re-run the thyroid panel, just the other labs. I'm meeting with an internist on July 20th for a consult and they've scheduled an MRI. I'm going to call that office and see if they would suggest having them re-run the thyroid panel before doing the MRI, in the off chance the results change and can avoid the MRI.


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## lloyddobler (Nov 30, 2014)

Chritty said:


> Labs being normal sounds positive!
> 
> What's the likelihood of pituitary gland tumor? A friend of mine had one. It was non-cancerous but the odds of a pituitary gland tumor in humans is one in two million. Hopefully for Lloyd the odds for dogs are even lower.
> 
> You have Wifey's, Millie's and my positive thoughts!!


I found a stat that said 2 - 15 dogs per 100,000 may have this.


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## SheetsSM (Jan 17, 2008)

Have you talked to your breeder?


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## lloyddobler (Nov 30, 2014)

No, when he was little my vet detected a heart murmur, which has sense gone away... Thankfully. However, I notified the breeder and she webt off on me and said I was accusing her of lying. It was a horrible experience. I will let her know once I have a definitive diagnosis. Right now all I have are a bunch of questions.


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## Brandiann (Jul 24, 2011)

Not as young as yours, but my Lola started showing signs of hypothyroid last year. We put them down to other things for a while, but had her tested a few weeks ago and her levels came back low. She has been on soloxine for less than 2 weeks and the difference in her is amazing.

I would research and meet with a few vets and see what one you feel comfortable with. We had a couple vets before, but I just didn't have that trust with them that I have with our current. I trust that he will always make the best decision for my babies, and if you don't have that trust with your vet, I'd strongly suggest moving on.

As for the breeder, I'm appalled. Her only concern should be the health of your pup (and his siblings)!


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## BajaOklahoma (Sep 27, 2009)

Chritty said:


> Labs being normal sounds positive!
> 
> What's the likelihood of pituitary gland tumor? A friend of mine had one. It was non-cancerous but the odds of a pituitary gland tumor in humans is one in two million. Hopefully for Lloyd the odds for dogs are even lower.
> 
> You have Wifey's, Millie's and my positive thoughts!!


My b-i-l had one. It was discovered when he started experiencing bone growth at age 50. It was removed and he is fine.
Most of them are benign, just a pain to deal with hormone replacement-wise.


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## 3 goldens (Sep 30, 2005)

I have had two goldens with low thyroid. They were full brothers but different litters. About the time he turned 4 Scooter put on a lot of weight, slept a lot more, fur got thin and coarse and he was growling at the boys next door. Now they were monsters and I figured they had been standing on the picnic table throwing things at him, etc. Took him in--low thyroid. Put on Soloxine and diet dog food and in now time the weight was coming off, his fur was nice again, he was wanting to cahse the ball---and he was no longer growling at the boys next door. Did lose him to sudden and very unexpected heart failure a little more than a year later.

Fast forward. I took his brother Buck, in for dental and as always had full blood panel run before dental. My vet was stunned to find his thyroid level was very low. He showed not one symptom. He was 10 years old, trotted rather than walk except when on leash, no change in temperament, fur thick and soft and shiney. I couldn't believe it either.

He put Buck on 1 1/2 times the amount of Soloxine Scooter had been one. There was no change in him once on it because they had been no change before. I lost him 2 years later at age 12 to heart failure. Full brothers, entirely different cases. Scooter much younger, all the symptoms, Buck much older no symptoms.

I was diagnosed low thyroid 7 years ago and my med has been increased 3 times. I had much the same symptoms as Scooter--hair went thin, put on weight, no energy. Don't know that I was grouchy, tho.

Not quite the same, but when my youngest son had just turned 6 months old he had a sudden very high fever. Was late afternoon and our doctor was out of town. Took him to the children's hospital. His temp was over 105, but I don't remember the exact number. He had a lot of chest congestion and their first thought was pneumonia but x-rays eliminated that. He had allergies up there in Akron and always had congestion.

I told them he had been exposed to measles and they said he was to young/ Randy some more tests and then becaue he couldn't sit up and he had not ony been sitting along for a long time he was already pulling up in his crib (was walking at 8 months), they thought maybe meningitis. My God, my heart broke when he was screaming when that put that huge needled in his back. Had a scar for a long time. But that was negative. FINALLY they just said he had a virus and set him hom telling me to give him liquid baby aspirin to keep fever down. Two days later he was covered with measles. They had said he was to young but he was not. So I think anything can happen at any age with kids and dogs. Oh, something else. I can't remember where I read it, but was on a dog forum or Facebook that boxers DO SEEM TO DRAW MORE ATTACKS from other dogs for some reason. Wish I could remember it if was here or another forum or facebook.

Good look with that very handsome man you have.


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## lloyddobler (Nov 30, 2014)

Thank you for the encouraging story! I've set my hopes on him having hypothyroid only and no issues with his pituitary. He just seems so healthy and happy that I can't imagine something that serious being there. Trying to stay as positive as I can! Until then, here's a pic with my boy on our new bed. He would never jump up on the old one. The new bed is lower to the ground, so he's now jumping up and we're having some great snuggles.


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## Harleysmum (Aug 19, 2014)

He's a gorgeous big boofy boy. Hope you get to the bottom of this and that it is an easy fix.


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## Anon-2130948gsoni (Apr 12, 2014)

Not to get too far afield, but a long time ago my husband had a PSA test (for prostate cancer) come back really high, to the point where they him scheduled for a biopsy. He insisted on repeating the test first...and it had dropped dramatically into the high end of normal. Since that time, the PSA test has been largely invalidated as a diagnostic tool, but at the time, it was the gold standard.

Having worked in a vet hospital, especially a busy practice...stuff happens. Samples sit around, they get misplaced, FedEx doesn't show up at their normal time and everything sits out for two hours on a hot day...I would just think that a repeat might be warranted before putting your boy through an MRI, as I assume he would have to be sedated, right?

Sending you a hug...


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## lloyddobler (Nov 30, 2014)

Thanks Noreaster! I used to work in a children's hospital lab and know that sometimes things can happen as well. I agree and plan to call the internal med doc tomorrow to request another thyroid panel be run. You are correct, the MRI would require putting him under and I'd like to avoid that if at all possible. Thanks for your encouraging words. I am really hoping it was a fluke and there really is nothing wrong.


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## Brandiann (Jul 24, 2011)

Just checking to see how your boy is doing and crossing my fingers for favorable results!


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## quilter (Sep 12, 2011)

Did they do the equilibrium dialysis measurement when they repeated the labs? It's called out in the results: "... consider a free T4 by equilibrium dialysis (test code 8499; add-on 8509), or preferably a thyroid confirmation panel (free T4ED, cTSH and thyroglobulin autoantibody; test code 3017; add-on 3018) to provide additional information about the dog's thyroid status." Seems like that would be a reasonable next step, too.


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## lloyddobler (Nov 30, 2014)

Hi Quilter - Thanks for the helpful info. I don't believe the tests you mentioned were run as they did not show up on the results I was sent. I am going to call a different vet's office tomorrow to get another opinion on what the next steps should be based on what my vet has done already and discuss a repeat of the thyroid panel and will ask about the tests you mentioned. I love the helpful people on this forum who know much more than I ever will!


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## dborgers (Dec 7, 2011)

Getting to the bottom of problems and a firm diagnosis can take some time. Thank goodness Lloyd has a huge advocate mom who's ensuring he gets a diagnosis and treatment, if needed. As others have said, he's gone through huge changes as a growing boy you could pick up with one hand not long ago  Hope that's all there is to it. 

*KAZAAM!!!* (I just sent a HUGE dose of super positive vibes )


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## dborgers (Dec 7, 2011)

PS - If it does turn out to be hyperthyroid, we had a fur daughter who started taking thyroid meds when she was 1. She lived to be 16


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## lloyddobler (Nov 30, 2014)

That is wonderful to hear! 16... Wow! Amazing. Did your sweet pup have any issues with aggression before getting on meds? 

My boy is rapidly becoming more and more aggressive by the day. He's barking more at what seems to be nothing. Gets very reactive every time he sees another big dog even if we are not close.

I'm to the point where I am very afraid to take him anywhere as he is not the same dog I had just 2 months ago who loved all dogs. He was more on the submissive side and would routinely greet big and little dogs by rolling over and letting the other sniff away. He was happy and liked to play. It makes me very sad and I do hope better things are awaiting us in the future.

Thank you for sharing your story.


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## 3 goldens (Sep 30, 2005)

I hope you can get to the bottom of this in a hurry. He is such a handsome big boy.


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## Anon-2130948gsoni (Apr 12, 2014)

Is it possible this is partly a fear stage? His submissive actions to other dogs in the past make me wonder if there isn't an anxiety thing happening here in addition to whatever's bothering him physically?

I was looking up theories on the second fear stage, which apparently happens anywhere from six months to 14 months (that's precise, no?) because even Mr. Griff, who has always had more confidence than sense, is becoming a little more cautious these days with new people.

He's also decided he's a partying kind of guy and likes to get me up a few times every night just on the off chance that I'd like to do some dancing or clubbing post-pee. Sometimes we go outside and he does...nothing. No matter how much exercise he gets.

So I'm rambling again but I'm telling you about this because at least your gorgeous cupcake sleeps at night...sigh...


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## lloyddobler (Nov 30, 2014)

So more frustration.... I took Lloyd into my vet today to have his blood drawn to re-test the thyroid (before putting him through an MRI). My vet indicated she wanted to talk to the internist he is scheduled to see next Monday before ordering the tests. After talking with them she said the internist and neurologist both do not believe Lloyd has a thyroid or pituitary issue given that he has no other symptoms, is young, and is developing normally. She re-iterated the aggression due to thyroid issues is anecdotal and is not proven and has not been seen in dogs his age. She said they did not see the need for him to come in for an MRI and suggested I see a behaviorist.

Is it strange that they seemed to have such a strong opinion that this is a non-issue without even seeing my dog? 

I feel at a loss. My vet could not explain why his thyroid panel was so abnormal and/or if it is normal for some dogs to be below or on the low end of normal and function ok. She said the specialists recommended that if I want to re-test that we should send out to have Michigan State run the labs, which I am going to do.

I do believe I need to get a second opinion and am trying to figure out what my next steps should be. Should I go in for the MRI just to rule that out? I would rather do that as a last resort since Lloyd would have to be put under anesthesia for the procedure. Do I wait to get the labs back from Michigan (which will take 5 - 7 days) and then get a second opinion from another vet as to how to proceed? I guess I am leaning toward the latter as hopefully the MSU lab results will provide more information that will help direct next steps.

In the meantime, I am becoming more and more increasingly concerned with his escalated aggression towards other dogs. Should I set up an appointment with the veterinary behaviorist? I spoke to one who is taking appointments 6 weeks out and would require a hefty, non-refundable deposit. I believe there is only one in my area (that I could find), so I don't think I have any other options if I choose to go that route.

It's times like this I really wish I had a significant other to help navigate and talk these things through.


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## SheetsSM (Jan 17, 2008)

I would re-run the thyroid panel; however, I really don't think your guy is hypothyroid. He could have been ill (without showing symptoms) when his first test was run. I most definitely would get a behaviorist on board since you're concerned about his behavior. He's maturing, hormones raging.


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## Chritty (Aug 17, 2014)

*10 month old with thryoid issue - has anyone else seen this in their younger ...*

The thyroid literature that I read told of physical signs like alopecia. 

I think they're probably worried about putting Lloyd through the stresses of diagnostics, not to mention the costs involved that they would have to justify to the insurance company, without having any other symptoms.


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## Anon-2130948gsoni (Apr 12, 2014)

Goldens are weird when it comes to thyroid issues and some vets refuse to believe that one size doesn't fit all. Sigh.

I would probably wait until the tests come back and minimize his exposure to other dogs in the meantime. You might want to check out Dr. Dodds' website and ask for recommendations for vets in your area who are versed in this breed? I posted a question once and one of her folks responded within hours...on Easter Sunday. Impressive.

It's funny...I would think that someplace like Seattle you'd have dozens of vets to choose from! 

You poor thing...sending you a big hug.

P.S. I had no other physical symptoms with my hypothyroidism when it was first diagnosed except that I was exhausted. I had a glossy coat and tail, too.


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## Pilgrim123 (Jul 26, 2014)

.... and I bet it wagged beautifully!:--big_grin:


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## Anon-2130948gsoni (Apr 12, 2014)

I'm sure you found this in your research, but just in case it helps...

Dr. Jean Dodds' Pet Health Resource Blog | Aberrant Behavior and Thyroid Dysfunction


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## Chritty (Aug 17, 2014)

Could insurance cover a behaviourist? It would technically be a medical expense


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## lloyddobler (Nov 30, 2014)

I'm not sure, but it's a great question. I would highly doubt it, but I'd love to be pleasantly surprised! I ended up cancelling the MRI and appointment with the internal med doc for Monday. I scheduled an appointment with a vet who was recommended to me on this forum who is board certified and has goldens and is passionate about them. I hope to have the second panel results from MSU back by then and review my next steps with him on Tuesday of next week. Slowly, but surely, hopefully I will get to a better place where I have a plan forward that I feel good with.


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## lloyddobler (Nov 30, 2014)

Noreaster said:


> Is it possible this is partly a fear stage? His submissive actions to other dogs in the past make me wonder if there isn't an anxiety thing happening here in addition to whatever's bothering him physically?
> 
> I was looking up theories on the second fear stage, which apparently happens anywhere from six months to 14 months (that's precise, no?) because even Mr. Griff, who has always had more confidence than sense, is becoming a little more cautious these days with new people.
> 
> ...


No longer than a month ago, my boy wanted to get up and party with with sun, which was at 4:45 am. I was a walking zombie for about a month. I don't know what changed, but he now lets me sleep somewhere between 5:30 - 6:00 am. I really feel like I've overslept if I get woken up until 6! LOL. These crazy dogs are lucky they are so lovable!


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## Chritty (Aug 17, 2014)

So when will you get the results back from MSU? Was it Tuesday?


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## lloyddobler (Nov 30, 2014)

They told me it should be about 5 days, which would be Monday. I hope that maybe they will surprise me and get it to me tomorrow.


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## Chritty (Aug 17, 2014)

Nothing yet?


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## lloyddobler (Nov 30, 2014)

I met with my new vet to review everything and feel SO MUCH BETTER. He took an hour with me to review every detail. He does absolutely believe Lloyd should be on medicine for his thyroid. He actually said he does not use MSU any longer and only sends his labs to Hemopet. So, I decided to go ahead and have the test run. Once we have the MSU and hemopet labs back, I'll feel very confident that we have all the data points we meed to begin treatment. 

My new vet was amazing and it is shocking how much difference it can make in finding the right vet. He didn't write off Lloyd's behavior as separate from the thyroid, etc. It was very refreshing. 

He recommended that Lloyd be neutered as soon as possible and we talked through the pros and cons. The pros definitely outweigh the cons.

He also recommended I see a local veterinary behaviorist and nutritionist. He left no pebble unturned and gave me a lot of hope.

I'll keep you all updated once the labs come back and we decide our next step. 

Feeling so much more hopeful today than yesterday.


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## Anon-2130948gsoni (Apr 12, 2014)

I'm soooo happy for you! Why more vets (and human doctors for that matter) don't view the whole organism when behavior changes I don't know. I have clinical depression that runs in my family and I've had several episodes over several decades...yet I've never once been asked about my diet, exercise, or other medications.

Mental health and physical health are so intertwined. I'm just so happy you stuck to your guns and found an advocate.

Hooray!!!


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## Chritty (Aug 17, 2014)

Have the MSU results come through?


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## Rookie's Dad (Feb 19, 2014)

We have used Jean Dodds lab work several times, while our vet did not say anything negative about Dr. Dodds, they did suggest that she was a little off main stream. That being said, we found her to be much more in tune and up to date on GR's than the other labs that many of the vets use, also less expensive. I would suggest that there is a reason that many vets use certain labs, and it's not necessarily the quality of work. When we were looking at selecting a vet, and we asked it they used Dr. Dodds lab for blood panels, most said "No" and they were required to use a specific lab. There is a reason they do that, as they say, "Follow the $$$".

FYI-Hemopet is Dr. Dodds in So. Calif.


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## lloyddobler (Nov 30, 2014)

The MSU results have not come in yet. My old vet, who sent the blood work to MSU is very much getting sick of me calling to check every day. They told me 5 - 7 days and today was day 8. Hopefully tomorrow.

My new vet said he prefers to consult with Dr. Dodds and her colleagues at Hemopet on cases like mine and sends all of his labs there. So, my pup's labs would have been there this Tuesday and I'm not sure what the turn-around is for them.

By the way, my old vet charged me $450 for the thyroid panel that was sent to MSU and $250 for the first lab that was sent to a different lab. My new vet charged ~$200 for the panel that was sent to Hemopet. I've now spent over $1000. Hopefully it is money well spent.

I'll update once I have more details!


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## Anon-2130948gsoni (Apr 12, 2014)

$450 for a thyroid panel?????

That's...nuts. Yet another reason to put them in the rearview mirror.

(The vets I worked for had a 100% markup on outside lab work...but I'm thinking that might be even higher. Yowza.)


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## Chritty (Aug 17, 2014)

*10 month old with thryoid issue - has anyone else seen this in their younger ...*



Rookie's Dad said:


> I would suggest that there is a reason that many vets use certain labs, and it's not necessarily the quality of work. When we were looking at selecting a vet, and we asked it they used Dr. Dodds lab for blood panels, most said "No" and they were required to use a specific lab. There is a reason they do that, as they say, "Follow the $$$".



I may also suggest that Dr Jean Dodds' use of non-scientific, non-evidence based, non-medical methodologies in certain parts of her career philosophy could also make vets not want to use her labs.


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## SwimDog (Sep 28, 2014)

The last one I had at MSU was around $100... as a consumer I don't know if there's anything you can do now, but their fees seem kind of ridiculous/inappropriate. I'm so sorry that it's been such a challenge. (Note - that our vet also didn't want to do it for a behavior problem but otherwise healthy dog... they refused! I had to switch vets.)


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## lloyddobler (Nov 30, 2014)

SwimDog said:


> The last one I had at MSU was around $100... as a consumer I don't know if there's anything you can do now, but their fees seem kind of ridiculous/inappropriate. I'm so sorry that it's been such a challenge. (Note - that our vet also didn't want to do it for a behavior problem but otherwise healthy dog... they refused! I had to switch vets.)


Wow. I may need to be treated for rage and aggression now too. My former vet is clearly robbing me blind. I guess this is the icing on the cake.


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## Chritty (Aug 17, 2014)

lloyddobler said:


> Wow. I may need to be treated for rage and aggression now too. My former vet is clearly robbing me blind.



I'd definitely want a breakdown of that cost! That's a lot of coin!!


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## flatcoated (Feb 3, 2013)

That is definitely high (to put it nicely). MSU only charges $47 to run the panel itself.

http://animalhealth.msu.edu/Misc/AD.ADM.REF.005.pdf


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## lloyddobler (Nov 30, 2014)

You will all love this. I've been anxiously awaiting the MSU thyroid results and been calling the vet's office and checking in daily. Every day the person who answers the phone says my vet will call me back as soon as she has the results. My vet sent me an email with the results attached and said to call if I have any questions. I'm beyond livid. Thank goodness I found a new vet that I like and trust. The MSU lab indicates his result to be normal. However, I know young dogs and specifically goldens can by hypothyroid when they are within the "normal" ranges or on the low end of normal. 

Here were the results. Feel free to tell me your assessment:

THYROID PANEL 
#5Test Result Reference Range Low Normal High
T4 *23* 11 - 60 nmol/L
T3 *1.4 * 0.8 - 2.1 n
FREE T4 (EQUILDIALYSIS) *10* 6 - 42 pmol/L
FREE T3 *5.8* 1.2 - 8.2 pmol/L
T4 AUTO-AB *8* 0 - 20 %
T3 AUTO-AB *8* 0 - 10 %
TSH *0.03* 0 - 0.58 NG/ML
THYROGLOBULINAUTOANTIBODY *1* 0 - 35 %


Comments:1. TGAA REFERENCE RANGE: <20% NEGATIVE 20-35% INCONCLUSIVE >35% POSITIVEA modification of the canine thyroglobulin autoantibody (TgAA) ELISAhas been implemented. The result of a sample will now be calculated asthe percentage of a standardized positive control that was used in thepast. Cutoff values for a positive (>35%), negative (<20%) andinconclusive (20-30%) result have been defined for this new procedure.Endocrinology InterpretationCirculating concentrations of thyroid hormones and thyroid stimulatinghormone are normal and do not provide support for adiagnosis of hypothyroidism. The negative autoantibody results furtherdecrease the likelihood of lymphocytic thyroiditis inthe thyroid glands of this dog.Referral test performed at Michigan State University.

So, I still have results coming next week from hemopet, so hopefully that will help rule out or rule in hypothyroid.


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## Anon-2130948gsoni (Apr 12, 2014)

For $450, you at least deserve a phone call.

(Also drinks, dinner, a mani/pedi, and a massage.)


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## lloyddobler (Nov 30, 2014)

Quick update, my new vet called me and shared the results from Dr. Dodds hemopet lab came back today and indicate Lloyd is hypothyroid and recommend starting him on meds. I can't tell you how much this has felt like an epic battle to finally get some answers. I went from getting a very strange results with his first labs, to what appeared to be "low normal" at MSU to labs that indicate hypothyroid issues at hemopet as they take into consideration a dogs age, breed, etc. Thank you all for bearing with me through this process. I'll let you all know if I see any changes in Lloyd's behavior once he is on the meds. Thank you all again!


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## 3 goldens (Sep 30, 2005)

Sometimes vets (and doctors) can be so hair pulling frustrating. Like when I was told my son COULD NOT have measles at 56 months because he was still immune. They ran all those test including that horrible spinal tap--and two days later he was covered with measles. I remember a couple of folks on here being told their year old golden was "to young": for thyroid, and when FINALLY test, they were low thyroid. 

And then like our Scooter showed almost every single symptom about the time he turned 4. Several yeas later a full brother, later litter was diagnosed when his low thyroid was caught during a pre dental panel about the time he turned 10. He had not a single symptom. They do not have to have every symptom in the book to be low thyroid as seen with my town--almost all symptoms in one, none in the other.
I will be watching for updates on your boy and I certainly hope that shortly he will be be just fine.


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## solinvictus (Oct 23, 2008)

I am so glad you have found a vet willing to follow up on theossibility that it may be related to the low thyroid. Hoping this and the behaviorist will
Set you on the right course of action.


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## Rookie's Dad (Feb 19, 2014)

Happy to hear you are feeling better about the test results, you may already know this, but if you have any additional questions about the results, you can contact Hemopet directly by phone or email. In the past, I have done this several times concerning some of the test areas that I didn't understand. Just a thought.


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## lloyddobler (Nov 30, 2014)

Thank you! I actually talked to my vet today at length and he explained all the results and the interpretation of the results. He is so awesome and helpful. I feel like we're on the right path. Lloyd started his thyroid meds tonight, we meet with a nutritionist tomorrow, he will get neutered next week, behavior adjustment training starts in 2 weeks, and we meet with a vet behaviorist next month. I am feeling very good about where we are headed.


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## Chritty (Aug 17, 2014)

*10 month old with thryoid issue - has anyone else seen this in their younger ...*



lloyddobler said:


> we meet with a nutritionist tomorrow, he will get neutered next week, behavior adjustment training starts in 2 weeks, and we meet with a vet behaviorist next month.



This may sound like a stupid question but if the hypothyroidism is the cause of Lloyd's issues wouldn't all these other things be a waste of time, effort and money? Now that he's on the thyroid meds?


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## lloyddobler (Nov 30, 2014)

I think hypothyroid is a contributor to many of the behavioral things I see, but I still think there are other underlying issues that will need addressed in addition to treating the thyroid. I think I just happened to get a pup that is going to be a challenge. The DVM/certified nutritionist said she sees that he is not very confident but also wants to be in control which is creating a severely confused and anxious pup.

My vet also agrees with me and thinks that Lloyd will be much easier to manage once he feels better (thyroid) and is neutered (hormones) but I will need to work on his confidence and recondition his response to things like other dogs.


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## Rainheart (Nov 28, 2010)

IMO, the MSU panel is pretty much the gold standard. I do not know much about Dr. Dodds/Hemopet, but diagnosing dogs hypothyroid that clearly aren't (I'm referring the bloodwork you posted) really is frustrating. Your dog is not hypothyroid... I think you need to find a behaviorist and work through the aggression issues. I also think a lot of people think that thyroid issues is a common cause of aggression and it really isn't, either. That is my own educated opinion, from someone else in the veterinary community.


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## lloyddobler (Nov 30, 2014)

Dr. Dodd's labs came back with a low T4 and low Free T4. He also had another lab done before the MSU where the T4 and Free T4 were off the chart low. So, they were low in 2 out of 3 panels that have been run in the last month. I learned from my new vet, that my previous vet didn't actually sent the labs to MSU to be run. They were however interpreted by an endocrinologist there. That is a whole different story as she changed me over $400 for labs run at MSU. Anyway, even on the labs there were reviewed by MSU, the T4 and Free T4 were on the low end.... and younger dogs should be on the high end of normal. 

So, I do believe my new vet that Lloyd is hypothyroid. However, we will of course re-test him in about 5 weeks and see if the medicine is normalizing his T4 and Free T4. I'm also hoping that it does help him feel better as he clearly is out of sorts.

I've had a terrible 24 hours as he is now becoming more reactive to humans he doesn't know. The DVM/nutritionist I saw yesterday said he is clear very manic.

I cannot tell how you stressful this is and has been. When at home, he will randomly start barking (and he has the loudest bark I have every heard). He will be laying down and appear calm and jump up and start barking at what seems to be nothing. It's so loud I swear my heart stops. He's becoming more aggressive with me, which typically starts as biting on the leash and then he will start growling and tugging and jumping on me. 

When on walks, I now have to get off the sidewalk when people walk by since sometimes he will bark and even jump towards them. He literally caused a grown man to scream yesterday. He was going potty and this man walked by... Lloyd didn't give any warning that I saw, and lunged toward the guy and started barking and showing teeth. To avoid all dogs and humans is not even realistic given I live in the city. We certainly try, but sometimes like yesterday I don't know how I could have avoided it.

My stomach is in knots and I'm in tears as this is not the life I wanted for him or myself. Reflecting back on everything I've done since I brought him home, I do believe I have done the best I can for him. We've taken 5 different obedience classes since he was a puppy (he's now 10 1/2 months old). I took socializing him very seriously and didn't miss any opportunities to expose him to new things. He never seemed afraid of things when he was younger, but I may have missed the signs. He always seemed confident and sure of himself. He's had almost daily play dates with 2 other very stable dogs that are close to his same age since he was 3 months old. He's always gotten 2 - 3 walks a day. Before he became reactive, I took him to parks to play fetch nearly daily. Looking back the only things I would do different is NEVER take him to a dog park as that is where I first saw the reactive behavior and be more consistent in my own training. He's always been very stubborn and hard-headed. I know I guilty of not following through on commands, etc. as he has always had his own ideas.

I've given him 4 doses of the thyroid meds so far. I'm going to adjust his diet based on the nutritionists' recommendation. He will be neutered next week. I start behavioral adjustment training (BAT) in mid-August, and see the vet behaviorist after Labor Day. This is literally costing me $1000s of dollars I didn't have. 

I'm heartbroken that this is how his life is turning out. While I think I've mostly all the right things, I take full responsibility for and know it is a direct reflection on me. I will do everything within my power to help him have a good life. However, I think I'm going to have to come to terms with the fact it is not going to be anything like the life I had hoped for.


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## Anon-2130948gsoni (Apr 12, 2014)

IT IS NOT A REFLECTION ON YOU. NOT NOT NOT. !!!!!!!!!

You said it yourself...you've done everything you could for him AND STILL ARE. 

We have some control over some aspects of their outlook and their skill set. We DO NOT have 100% control over what hardware and software they were born with, what experiences they might have had before they came home, OR what will happen when they mature. There could be a million hormonal things going on...there could be some neurological things going on...you don't know.

I've been there...hey, I'm still there. Until you've ended up with a project dog, it's easy to sit back with your great, easy dogs and assume it's all you, so anyone who's even thinking about judging you at this point had better watch their karma. I had six easy, trainable, sociable dogs in a row and thought I knew stuff. Then came my Aussie...curling her lip at strangers at age nine weeks.

Stuff happens. Good, kind, conscientious owners end up with project dogs. It's not fair and it's no fun, but please please stop judging yourself.

Sending you a big hug.


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## GoldinPNW (Jun 23, 2015)

Some hopeful words. My Riley that just passed was a "project dog", he was Marley for sure. 

I took him to the best just for Golden Puppy classes at a Golden Rescue in MA and the trainer said " He is beautiful to bad that he has the devil in him". Had to fire that trainer:-(

I can tell you that in the end I loved that dog more than any pet that I have ever had and most humans and really miss him. Lived 10 yrs 10 months.

Its going to take time to figure out. I can tell you up until his last day that dog ran the house but he was super smart and had a great personality.

I bit different because he did not have the aggression. He loved all dogs he just was never going to be told what to do but he could do it, if he wanted to, he could out place just about any dog in many competitions. Just very head strong everything was his way or the highway...

First clue in puppy class is their was not a trainer out there that could do the roll the puppy on his back test.... was not going to happen ever, you would have broke a limb getting him upside down. 

My coworker did have an extreme case dog that ended up on Prozac as a last resort. I don't advocate for that but it was a last resort and helped.

Hope things get better, maybe the meds are making him worse? You may have to go to that specialist in Kirkland in the end, even if it is Thyroid I'd ask why?


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## SwimDog (Sep 28, 2014)

Call the vet behaviorist/receptionist. Say that things have gotten worse, you are very concerned, can you be put on the cancellation list. The vet behaviorist here has a 3 month wait list but those who are on that list often get in within a week or so.

You have a lot going on with the various pieces here.

Some temporary management: Use the head halter when you come/go. If you feel like a longer walk is useful, put him in the car and drive elsewhere (store parking lots after hours can be great). Look up the product called a "calming cap" - maybe get one or make your own to reduce visual stimuli. 

Management like your yestreday example: See someone coming either move him away, between cars/buildings/behind a tree. Body block. Have him in an obedience "front" position, constantly nibbling treats with a short leash (so if he lunges he can't go far). Up the value of your food - we need something good but also that is easier to use as a distraction. "food tubes" (like toothpaste tubes) with cream cheese or canned food can be great. 

See if you can get into the vet behaviorist sooner. Maybe email the behavior specialist you saw before, say things have gotten worse, you want to see the vet behaviorist, are there any recommendations on how to get in faster... that person may have ideas.

We know you don't want this. And we know your dog doesn't either. He doesn't enjoy feeling that way either.

A few other thoughts:
1) Could this be a bad reaction to the thyroid meds?
2) Could you board him somewhere to give yourself a short break?
3) He seems like a highly likely candidate for anti-anxiety meds...the problem is you don't want to be starting too many things at once... call and talk to your vet and explain about the things that are getting worse. (behavior meds are NOT a last resort: Reactive Champion: Why People are Resistant to Behavioral Meds for their Dogs... And Why You Shouldn't Be) 

(her whole blog is a good reading: Reactive Champion: Best Of - though it does have a happy ending. Most behavior dogs are somewhere in the middle. We get to a point where we have a nice compromise.... sometimes things are happy and sometimes families decide they don't want to go on. That's okay too.)


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## lloyddobler (Nov 30, 2014)

All! Thanks for the helpful words. I appreciate it more than you could know. I so needed them right now too. 

Swimdog - Thank you for the suggestions. I am on the cancellation waiting list for the vet behaviorist already. Keeping my fingers crossed that I get in soon. My appointment is now scheduled for 9/8. That seems like forever from now. 

He just started this reactive behavior with people and yesterday's incident was unlike anything he's done before. I will definitely move him away between cars, buildings, etc. However, yesterday he started to go #2 and was finishing up when the man came around the corner. I literally didn't have time to do anything as I was picking up his poo. It was scary. Thankfully, I did have him on a very short leash, so he wasn't able to get close enough to bite. I always have treats on me and try to distract with those as well when not picking up poop.

I like the idea of taking him to a empty parking lot area or somewhere like that. Hadn't thought of that one. 

I was wondering if the thyroid meds are making him worse, but thought that would be unlikely as he's only had 4 doses. However, with the luck I seem to be having, I wouldn't doubt it. I will call the vet and see what he suggests. 

I wish I could board him, but don't even know where to start with that. He's not neutered (until next week anyway), is reactive to dogs and now some people, so I just don't think it would be fair to him to do that. He would be extremely stressed and I'd hate to think about what could happen if he's not managed appropriately. I'm not sure who would even take him if I wanted to.

Thank you again. I'll read the links you sent. 

Noreaster - Thank you! I know you too have struggled with some of these behavioral issues and have for a lot longer than me. I'm amazed at your positive outlook and hope to get there myself one day soon. I think I'm actually grieving right now for the dog I thought I had and the life I thought we would have. I realize that these emotions are helping anyone, including Lloyd. He is who he is and I need to figure out how to have a life with him that we can both enjoy (which feels impossible at the moment). I'm sure you've been there done that. Thank you for always being such a positive person.

GoldinPNW - Thank you for your post as well. I have no doubt I'm learning more about dogs than I ever knew there was to know! I do hope that he and I develop a bond through this learning process that makes it all worth while.


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## Anon-2130948gsoni (Apr 12, 2014)

Did I mention my Aussie puppy was supposedly going to be trained to be a therapy dog? :doh:

You have the dog you have and you do the best you can. I know too well those embarrassed, scared, and disillusioned moments. 

But our girl is a sweetheart to the few that she trusts. My husband always says, "She IS a therapy dog...but just for us!"

:smooch:


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## SwimDog (Sep 28, 2014)

Boarding: You would be surprised with what kennels are able to handle... I don't know that it would be good for Lloyd to be boarded (many dogs are stressed by it) - but it may help give -you- a break. And your health is important for his long term care.


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## GoldinPNW (Jun 23, 2015)

http://www.aocb.com/

If you need to board I have boarded here and trust these folks with a dog like yours. They also rehab dogs with behavior issues so maybe they can help. I had not thought of them until you said boarding.

They have a training program that you can also leave your dog at for a few weeks. If you hit the end of the rope maybe worth looking into.
http://www.aocb.com/training/board_and_train

I don't board anymore I have someone come in but if I had too it would be here.

My husband always said that the breeder knew that they were giving us a project dog and picked us because we were young and had no kids. 

I always say that had Riley been matched with anyone else he would have been to the pound 6 times. His cuteness, amazingly good looking, hopefully would have gotten him out, but he likely would be right back... poor fella.

His last few years he was amazingly great, probably another signal that I missed that he was sick:-(

I can say he really loved our house in WA more than MA. There was a lot more room and his favorite activity was to lay on the back deck and just stare out into the yard, I think that calmed him down quite a bit, maybe the secret was lack of stimuli and he needed his own space to reflect.

Again I would not have missed a days time with Riley but his teen years were a challenge too.

My other dog barely moves all day complete opposite and now that I reflect on it a very good pair for Riley, Benjamin will submit would never fight... totally lazy but very afraid of things.

With Riley gone we can see now the Benjamin has zero courage and was always totally behind Riley, unfortunately now he is very depressed having lost the leader. So I have the opposite issue at home completely depressed doggie.


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## Cpc1972 (Feb 23, 2015)

You should be applauded for the effort your taking to make this a better situation. Do you know how many people would just get rid of this dog and not even try. His fate would already be sealed. He should be lucky he has you as a mom.


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## quilter (Sep 12, 2011)

lloyddobler said:


> I was wondering if the thyroid meds are making him worse, but thought that would be unlikely as he's only had 4 doses. However, with the luck I seem to be having, I wouldn't doubt it. I will call the vet and see what he suggests.


 I wasn't going to mention it, because everyone else seemed to have the opposite experience. Back in the 90's, I started my 8-year-old golden on thyroid meds. He had the typical symptoms, particularly with his skin and coat. Within a couple of weeks, he started attacking our other dog. Not viciously, just starting scuffles. Maybe he was feeling better and had the drive to put the younger dog in his place. But it was completely unlike him, he'd never even growled in his entire life. So it I took him off the meds and he stopped going after the other dog. He still had the dull coat and flaky skin, but was otherwise healthy. 

I've heard good things about BAT training. Whether the root problem is the thyroid or not, it would be a good complement to the meds. Casper and I just finished a Control Unleashed class. We put a lot of time into the Look At That game. He still notices things, but now he'll notice and then look at me for the treat. Sometimes, anyway. Hey, owner, there's a dog barking, where's my treat? Dog playing fetch in my space, do I get a treat for that?


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## Chritty (Aug 17, 2014)

If the labs weren't sent to MSU how come they were totally different results? How did the FREE T4 double?


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## Rainheart (Nov 28, 2010)

I saw the first thyroid panel that was posted, and those results still were not consistent with a hypothyroid dog. None of the bloodwork that you have posted has been consistent with hypothyroidism. Not to mention his signalment, other typical clinical signs you usually see in a hypothyroidism dog. I will yield to those who are superior to me in practice, but with other vets also saying that no, your dog doesn't have hypothyroidism... I agree with that statement. Just because one panel says he is, one that I don't personally trust, that doesn't mean it is going to be a magic cure for your problem. I'm glad you are seeing a behaviorist, which I think is what he really needs.


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## lloyddobler (Nov 30, 2014)

Rainheart said:


> I saw the first thyroid panel that was posted, and those results still were not consistent with a hypothyroid dog. None of the bloodwork that you have posted has been consistent with hypothyroidism. Not to mention his signalment, other typical clinical signs you usually see in a hypothyroidism dog. I will yield to those who are superior to me in practice, but with other vets also saying that no, your dog doesn't have hypothyroidism... I agree with that statement. Just because one panel says he is, one that I don't personally trust, that doesn't mean it is going to be a magic cure for your problem. I'm glad you are seeing a behaviorist, which I think is what he really needs.


I've stated above in response to Chritty's question, I do not believe thyroid meds are the cure. I understand there are many things going on and I'm addressing everything in as many facets as possible. Thanks for your opinion. I'm already completely overwhelmed, sought out more than one opinion, and have decided I trust my new vet very much. He is the only board certified canine vet in the Seattle area. He sat down with me for about an hour and discuss all aspects of Lloyd and provided me many recommendations on a multi-modal approach to treat Lloyd. We agreed to try to the thyroid meds on a trial basis as it is not a clear cut and dry case.


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## Rainheart (Nov 28, 2010)

lloyddobler said:


> I've stated above in response to Chritty's question, I do not believe thyroid meds are the cure. I understand there are many things going on and I'm addressing everything in as many facets as possible. Thanks for your opinion. I'm already completely overwhelmed, sought out more than one opinion, and have decided I trust my new vet very much. He is the only board certified canine vet in the Seattle area. He sat down with me for about an hour and discuss all aspects of Lloyd and provided me many recommendations on a multi-modal approach to treat Lloyd. We agreed to try to the thyroid meds on a trial basis as it is not a clear cut and dry case.


What is a board certified canine vet??? Because I've never heard of that before... You cannot get board certified in 'canine medicine.' 
If you try to many things at once for the fix, you are never going to know what actually solved the problem. Plus, you are going to suppress his own ability to produce thyroid hormone by supplmenting him if he actually doesn't have hypothryoidism.


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## Jessie'sGirl (Aug 30, 2010)

Not everyone believes in Dr. Dodds protocols but I definitely do. My boy Jess became grumpy with certain dogs, nervous( he hid in a corner while a workman was installing a new woodstove, normally he would be doing a happy dance ),looking over his shoulder on nighttime walks,waking during the night just for reassurances. A year and a half later, he is happy and relaxed, enjoys the company of other dogs. I am still cautious with meeting new dogs but he does well with controlled meetings.


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## lloyddobler (Nov 30, 2014)

Rainheart said:


> What is a board certified canine vet??? Because I've never heard of that before... You cannot get board certified in 'canine medicine.'
> If you try to many things at once for the fix, you are never going to know what actually solved the problem. Plus, you are going to suppress his own ability to produce thyroid hormone by supplmenting him if he actually doesn't have hypothryoidism.


ABVP – American Board of Veterinary Practitioners

My vet is board certified in canine and feline practice.


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## lloyddobler (Nov 30, 2014)

quilter said:


> I wasn't going to mention it, because everyone else seemed to have the opposite experience. Back in the 90's, I started my 8-year-old golden on thyroid meds. He had the typical symptoms, particularly with his skin and coat. Within a couple of weeks, he started attacking our other dog. Not viciously, just starting scuffles. Maybe he was feeling better and had the drive to put the younger dog in his place. But it was completely unlike him, he'd never even growled in his entire life. So it I took him off the meds and he stopped going after the other dog. He still had the dull coat and flaky skin, but was otherwise healthy.
> 
> I've heard good things about BAT training. Whether the root problem is the thyroid or not, it would be a good complement to the meds. Casper and I just finished a Control Unleashed class. We put a lot of time into the Look At That game. He still notices things, but now he'll notice and then look at me for the treat. Sometimes, anyway. Hey, owner, there's a dog barking, where's my treat? Dog playing fetch in my space, do I get a treat for that?


I'm excited for the BAT training as well! However, I won't be able to go if he keeps up being reactive to humans. Human reactive dogs aren't allowed. However, I could still get a trainer from Ahimsa (the training center) to provide one on one training. Hopefully it will work out. 

Did your pup have lab work done to confirm he was hypothyroid before starting the meds? I'd assume so, but wondered why he would have had that adverse reactive if he was hypothyroid? I guess no one thing works for every dog, just like with humans. I'll have to research the various responses to hypothyroid drugs so I know what to watch out for. 

I'm happy to report that Lloyd is much calmer tonight than he was last night. We encountered several people and dogs on our evening walk and he didn't act like he wanted to kill anyone I'm sad to say, that is progress. However, I never hold my breath because he's very up and down. The next walk may be the opposite.


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## Jessie'sGirl (Aug 30, 2010)

I think with a hypothroid dog, you need to do a combination of medication and behavior modification to counteract some behaviors. We also did a lot of de- sensitizing/ counter- conditioning with Jess. And he too still looks for his treat.


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## fostermom (Sep 6, 2007)

lloyddobler said:


> ABVP â€“ American Board of Veterinary Practitioners
> 
> My vet is board certified in canine and feline practice.


I'm not sure why some of the posters here are attacking the fact that you were trying to find the answer for your pup and his behavior by seeking a second and third opinion. Just because they don't believe in Dr. Dodd doesn't mean you are a terrible dog owner for seeking better answers than you felt you were getting. I personally think it's wonderful that you have done so much advocating for your dog!

I hope he continues to calm down. Do you think his human reactiveness is aggressive or is he just showing his excitement inappropriately?


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## lloyddobler (Nov 30, 2014)

fostermom said:


> I'm not sure why some of the posters here are attacking the fact that you were trying to find the answer for your pup and his behavior by seeking a second and third opinion. Just because they don't believe in Dr. Dodd doesn't mean you are a terrible dog owner for seeking better answers than you felt you were getting. I personally think it's wonderful that you have done so much advocating for your dog!
> 
> I hope he continues to calm down. Do you think his human reactiveness is aggressive or is he just showing his excitement inappropriately?


Thank you! I'm not sure where the human reactiveness is coming from. He seems to only bark at men, which is strange because he's been around me of all shapes, sizes, and colors his whole life and never had a bad experience with any of them! I don't think it's because he wants to play. He barks and it is a loud, deep bark and he tries to lunge. The whole thing looks like he's giving out a warning (stay away from me!!!!). 

Yesterday, he wasn't reactive, but this morning he barked at one poor soul. I've been getting off the sidewalk to let people pass by going around cars, or crossing the street and most he doesn't even pay attention to. But, every once in a while a person will get his attention and he will bark. I do try to distract with treats too, but find it's hit and miss for him. Sometimes, he just too excited/nervous to take treats even when no one is around. Sometimes, he's not. He definitely is my project dog.


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## Rainheart (Nov 28, 2010)

Wanted to edit a minor thing and my whole post got deleted. My only intention in posting was to be sure he is getting the correct and proper treatment. I may still be in veterinary school, but I can at least say that based on the two blood panels you posted before, he isn't hypothyroid (not by a long shot). I don't want him to be treated for a condition he likely doesn't have- that was my intention when I posted here.


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## Anon-2130948gsoni (Apr 12, 2014)

As a former LVT, I have seen vets who have worked together for years have a ten minute screaming match over whether a patient's treatment was appropriate. As much as it would make everything easier, there is no single right answer that applies to every dog. A vet I worked for who had been practicing for thirty years always used to say, "the dog didn't read that book."

LloydDobler, you've found a vet you're comfortable with who is actually there to witness your dog's situation. As much as we all want to help, the internet is no substitute for that. Best of luck with everything.


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## lloyddobler (Nov 30, 2014)

Noreaster said:


> As a former LVT, I have seen vets who have worked together for years have a ten minute screaming match over whether a patient's treatment was appropriate. As much as it would make everything easier, there is no single right answer that applies to every dog. A vet I worked for who had been practicing for thirty years always used to say, "the dog didn't read that book."
> 
> LloydDobler, you've found a vet you're comfortable with who is actually there to witness your dog's situation. As much as we all want to help, the internet is no substitute for that. Best of luck with everything.


Thanks Noreaster. As a patient it's clear that every vet is different! I'm sure it is interesting to be behind the scenes. My current vet took my pup's entire situation into account. We are in the process of a trial period on the meds and will re-evaluate if they are helping as we go. He will be retested in about 4 weeks. My previous vet only looked at what the lab reports said and didn't take into account anything else as his case isn't textbook, which was extremely frustrating as a dog owner. I knew there was something wrong with my pup. My previous vet disagreed and left it at that. She said, "I don't know what to tell you". With no other suggestions at all. 

We may learn over time that Lloyd isn't hypothyroid. I believe we will be able to tell quickly based on how his body responds to the meds. However, I do believe he is hypothyroid. Normal dogs his age would typically be on the high end of normal ranges. His T4 has been below the reference ranges or near the bottom on all three labs that have been performed.


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## Chritty (Aug 17, 2014)

fostermom said:


> Just because they don't believe in Dr. Dodd doesn't mean you are a terrible dog owner



I think you're putting words into people's mouths


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## fostermom (Sep 6, 2007)

Chritty said:


> I think you're putting words into people's mouths


It was implied.


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## Chritty (Aug 17, 2014)

lloyddobler said:


> He will be retested in about 4 weeks. We may learn over time that Lloyd isn't hypothyroid. I believe we will be able to tell quickly based on how his body responds to the meds.



It might be worth knowing that because he has been put on meds now that it might invalidate the tests that have already been done







http://www.ashgi.org/home-page/genetics-info/immune-mediated-diseases/thyroid-itch

Also, I have searched the literature and I cannot find anywhere where is says that you should adjust the parameters based on sex, age, or race (breed). The only instance of this I can find is with Hemopet. It's not something that is done by any other endocrinologists


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## lloyddobler (Nov 30, 2014)

I'd hate for this space to become a thread that turns negative. This thread has been my safe space to seek advice, vent, cry, and chat with people who understand what I'm going through. Essentially, it's felt like my life-line. We will never all agree and we are all passionate about these dogs. Can we all try to please not attack one another? Thank you all. I've very much appreciated everyone's comments, suggestions, and help through.


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## lloyddobler (Nov 30, 2014)

Chritty said:


> It might be worth knowing that because he has been put on meds now that it might invalidate the tests that have already been done
> View attachment 551985
> 
> Thyroid Disease - Australian Shepherd Health & Genetics Institute
> ...


My vet disagrees and believes based on his 20 - 30 years of experience that young dogs should fall on the high end of normal and has treated dogs like mine with great success. There is literature that actually is supported by MSU that certain breeds have a lower normal (sight hounds, etc.). Had had a full workup well before we started meds to rule out that other underlying causes were what was causing the low t4. 

I thank you all for your concern, but I am confident I am on the right path with Lloyd and trust my vet and his experience to guide us in the right direction.


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## GoldinPNW (Jun 23, 2015)

Hi Lollyddobbler;

If you are not allowed in your BAT classes then definitely check out this place as an option. It is run by a behaviorist and they are very open about taking the whole dog into consideration. They even have progressive opinions on vaccinations, they titer after age 7 for their own dogs. Not sure if you took a look as you may have been swallowed up by the Hypothyroidism debate. Also good place for you to know about if you do need to board ever. A trip for you but I think a safe place for you to board him where he'd get good treatment.
Hope things are going better.

http://www.aocb.com/

If you need to board I have boarded here and trust these folks with a dog like yours. They also rehab dogs with behavior issues so maybe they can help. I had not thought of them until you said boarding.

They have a training program that you can also leave your dog at for a few weeks. If you hit the end of the rope maybe worth looking into.
http://www.aocb.com/training/board_and_train


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## lloyddobler (Nov 30, 2014)

GoldinPNW said:


> Hi Lollyddobbler;
> 
> If you are not allowed in your BAT classes then definitely check out this place as an option. It is run by a behaviorist and they are very open about taking the whole dog into consideration. They even have progressive opinions on vaccinations, they titer after age 7 for their own dogs. Not sure if you took a look as you may have been swallowed up by the Hypothyroidism debate. Also good place for you to know about if you do need to board ever. A trip for you but I think a safe place for you to board him where he'd get good treatment.
> Hope things are going better.
> ...


Yes! I looked at that yesterday and I was very excited to learn there is a place for him to go where he and the other dogs will be safe! Thank you so much for sharing! I hadn't found them in all my research and it sounds like just what I was looking for!!


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## quilter (Sep 12, 2011)

lloyddobler said:


> Did your pup have lab work done to confirm he was hypothyroid before starting the meds? I'd assume so, but wondered why he would have had that adverse reactive if he was hypothyroid? I guess no one thing works for every dog, just like with humans. I'll have to research the various responses to hypothyroid drugs so I know what to watch out for.


 I think he did, but I had two toddlers, two dogs, two cats, a husband, a job, it was 20 years ago... I can't say why he reacted that way. My best guess is he felt better and didn't like the other dog. The other dog would, (hate to admit), jump on his back. Being a puppy and all. He did stop eventually.

About the Look At That game. Someone mentioned distraction. It's sort of counterintuitive, but it's not distraction. When the dog looks at something, you click. Then his head spins around to get the treat. Eventually, the dog skips the head turn and just wants the treat. When Casper and I are "in the zone" training-wise, Casper will just move his eyes back and forth. It works so well, because you give the dog permission to be distracted and avoid so much of the tight-leash thing. Or it seems so. Casper isn't reactive, but he's very aware of his surroundings. He's distracted by everything! With Look At That, he knows he can look. As long as he's not staring down some dog (which is rude), he gets to look all he wants. Sort of like letting him sniff. I'm kind of off track of the thyroid subject now. Sorry.


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## Chritty (Aug 17, 2014)

Hey!

How's your beautiful boy doing?


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## lloyddobler (Nov 30, 2014)

Hi Chritty! Thanks for thinking of us! I'm almost afraid to say it as we are now only on on day 5 or 6 of the thyroid meds, but he does seem to feel better and acts more like he did when he was 5-6 months old. Much sweeter and calm. We have gone on several long walks and he hadn't reacted to any dogs. He barked at a boxer this morning, but that was in my building. I opened my door and we stepped out into the hall and the boxer was standing at the elevator just 10 feet away. The bark was loud (because that's how my pup rolls) but I was able to have him sit and take treats. It really didn't seem to be the same aggressive, I want to eat you kind of response he had doing. 

I'm cautiously optimistic that the meds are helping him feel better and thus he behaves better. 

It's still early and maybe I've just gotten lucky so far and he will go back to how he was before. My fingers are crossed though.

I will still keep our distance from other dogs and try to avoid the opportunity for him to react and continue with my plan to go through BAT training, etc. However, I do think this was the first right step to getting my sweet Lloyd back!


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