# Waiting for the blood work results.



## El Bueno Habanero (Oct 20, 2009)

Hello all,

Yesterday I took Fedja to the vet to do some extended blood work and I specifically asked to check his thyroid levels (thnx Missy). Vet asked a lot of questions, and 'cause my boy is very energetic when on walks he don't think it's his thyroid. Searching on the net i found this info: 
'According to the Michigan State University Thyroid Database, Havanese have the 2nd highest rate of hypothyroidism of 140 breeds (up to 26% affected).' 
He is already diagnosed as being ataxic, and I just found out this is something that dogs do develop if their thyroid is slow working! But he did have it even as a very young pup, and only about 3,9 percent of pups are known to have thyroid problems. Our neurologist didn't check his blood.

The actual reason I decided to get his blood work done is that the last month he acts so lethargic. He was always quiet, even as a puppy, but for a last few weeks more then ever. 
I love to work in the garden, and usually he will stay with me all the time, but now he goes back inside to sleep on the couch. 
When inside and I try to play with him, he is so disinterested and no matter how silly and enthusiastic I do, I can't get him exited about anything. 
We take two long walks and play fetch every day, first time from 1 pm till 3, and then again in the evening for at least 1 hour again. This is the only time that Fedja acts happy and wags his tail. Vet thinks he gets so much exercise that once home he is just being tired. But I just have the feeling that something is wrong. Most of the time he has such a sad look in his eyes, and I can't help myself but to think that he is so unhappy.
Later today I will get to know the results. Of course I would love to hear that he is totally ok, but on the other hand if nothing is found I really don't know what to think or do anymore. I know it must sound weird, but I almost hope they will find something, not serious and easy treatable. I know, I know, this sounds so stupid, but it only shows how desperate I feel right now. 
Will keep you posted. 

Greetz from the rainy Netherlands.


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## ShirleyH (Sep 13, 2009)

*Hoping*

Good morning from Ohio. Saying a prayer that your little one does not have anything serious and that your ver wil be able to give you very good news.

Shirley H.


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## Jplatthy (Jan 16, 2011)

Maybe he is just really wore out from the walks and play time. I know when we take mine to the farm in TN and they run all day they will come home and sleep for HOURS and never move. Sometimes I go ck on them to make sure they are still breathing because they are so still lol but they are always fine! I hope you get good news from your vet that everything is fine and he is just wore out. Sometimes I think they just have a sad expression.....


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## Lizzie'sMom (Oct 13, 2010)

I tend to think it is his personality. Lizzie is not a hyper-type of dog. She has bursts of playing with her toys and then laying around. She does like to go in the backyard and chase the frisbee and then comes in and lays around. There are days that I have to force her to go on a walk. My husband even says to her that she looks sad, but it is just her expression.

Is it hot in the Netherlands yet? We have had a few hot and muggy days here the past few weeks and I notice that Lizzie is very slow moving in the heat. I was working in the yard and she wanted in the house. For being a dog from Cuba, she cannot take the heat!

I am hoping that Fedja's bloodwork comes back normal. Keep us posted!


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## El Bueno Habanero (Oct 20, 2009)

Good morning to you all .
Boy am I glad now that I've listen to my gut feeling and did the blood work anyway! Sadly I don't bring a good news. 
It looks that Fedja's thyroid is working really slowly. According to my vet the normal range of so called T4 hormone lies somewhere between 21 and 46 and Fedja scores only 9. He is also mild anemic. And the value of urea (has something to do with the kidneys) is slightly high...maximum is 9.6 and he has 9.9, so little dehydrated. Creatinine is good. So kidneys are probably ok, because all of the things mentioned above do happen when dogs are hypothyroid. At this moment everything points out to hypothyroidism.

Next step is to send his blood to the big Pet University clinic here in the country, to check his TSH value. Only if this one turns out to be high then they can say for sure that Fedja has hypothyroidism. I will probably not know it before somewhere begin next week. It's going to be a long week for sure :-(((.

Yesterday I came up with the idea to look on the net for both ataxia (his previous diagnosis made by the neurologist) and hypothyroidism, and to my big surprise I read that in extreme cases dogs with slow working thyroid do get ataxic sometimes!!!

'The diagnosis of hypothyroidism is based on diminished
response to TSH-stimulation in a number of studies [4, 10, 11,
12, 15].
Clinical signs include exercise intolerance, general weakness,
initially mild gait deficits which can progress to paraparesis
or tetraparesis, *ataxia*, *reduced spinal reflexes and muscle
atrophy* [1, 4, 10, 11, 12]. *Proprioceptive positioning deficits* and
decreased spinal reflexes are generally more evident *in the hind
limbs*, however reduced spinal reflexes in all four limbs can occur.'

All things in bold refer to Fedja's condition. 
This is just unbelievable. When nothing showed up after MRI-scan was done, why didn't neurologist came up with blood check?! If nothing else only to be sure that there are no other health issues?

I can't help but to think that Fedja has had this thyroid thing going on for a very long time, if not his whole life, and I'm so sad right now I didn't check it earlier. Everyone was telling me that he always was so quiet, and that if he was sick he wouldn't be that energetic outside and eager to go for walks. The only good thing is that it's treatable condition (yes, I'm almost sure of what the results will be) and won't affect quality of his life once we start with medication.


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## Suzi (Oct 27, 2010)

I'm happy you are finding out answers to why Fedja's been so mellow. You are a good mom and have always had a feeling something was not quite right. My goodness you even tried a friend for him. I hope the week goes fast for you and you will get your answers and he can be treated with medication. :hug:


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## Kathie (Jul 31, 2008)

Sena, I'm so glad you've finally gotten a definitive answer. It is too bad he has this condition but at least now you know what it is and can treat it. Let us know how Fedja does on his medication.


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## Lizzie'sMom (Oct 13, 2010)

Sena, I am glad that you pursued this and got an answer. You followed your instinct. Poor Fedja, he is probably exhausted. At least it is a treatable condition and once on medication you will notice a great difference. Our neighbors Labradoodle is being treated for hypothyroidism and they noticed a change immediately. Plus, she lost like 15 pounds! I am curious as to why lab work was not the first thing done rather than an MRI.

Good Luck!


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## Pattie (Jun 25, 2008)

Sena,

It's so good that we know our dogs so well and you suspected that Fedja was not feeling well. It is good that he can be treated medically. It is also very good information for us all to know. Thank you for sharing. Best to you both.


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## clare (Feb 6, 2010)

Well done you for diagnosing Fedja.I hope everything works out well for you both,and that Fedja is soon dashing about and doing RLH.


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## El Bueno Habanero (Oct 20, 2009)

Thank you all for such kind replies. 


Pattie said:


> It is also very good information for us all to know.


That's what I was thinking too Pattie. You never know who it might help. And beside that it also feels good to share this problems with ppl who love havs and know how special they are. 
Fedja never showed some of the very specific signs of hypothyroidism such as weight gain (maybe cos we are walking a lot), coat change/hair loss, choosing warm places to sleep, or low tolerance for exercise. This made everyone, including the vet, believe that it can't be his thyroid.

Clare, some RLH around here would do me so much good, it's been a while since I last saw it. 
Lynne, I so hope you're right. Will let you all know (when diagnosis is final and he gets some meds) if he is doing better. 


Suzi said:


> My goodness you even tried a friend for him.


Crazy isn't it? It was mainly Fedja's great activity outdoor that got us all fooled for a long time. I really believed he was only lonely and bored. I still think that a friend would do him good, so maybe I've to reconsider that again when he gets better hopefully. If he has such a low thyroid values its not strange that he is being disinterested in other dogs. They're just to much for him to handle at the moment. 
Will keep you posted. And again thanks for reading and taking time to respond.

Big hug to you all,
Sena


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## davetgabby (Dec 29, 2007)

Hi Sena, glad you have looked into this. Not sure if you saw my thread last week http://www.havaneseforum.com/showthread.php?t=14271&highlight=great+book You would enjoy this book.


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## El Bueno Habanero (Oct 20, 2009)

Hi Dave, what a coincidence you posted about thyroid issues just a few days before! I wasn't very active on the forum lately, so i missed your post. With such unusual (for Netherlands) nice spring weather past month I was mostly busy trying to make the garden look beautiful (and with Fedja too). And that's not an easy work lol, so in the evening I would go to bed early. 
Will definitely look into that book! I would never thought to specifically ask for a thyroid tests if it wasn't for Missy. In an other thread she gave me advice to check Fedja's thyroid levels. Yesterday the vet in the first instance didn't even want to run this test (only the basic other ones) because based on my story about Fedja's activity he thought it wasn't thyroid issue. I told him that I wanted it done anyway just to be sure. Curious what he has to say on our next visit. 
Thank you very much for the tip! Will check Amazon for this book.


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## davetgabby (Dec 29, 2007)

yeah Sena ,you can check Amazon, but I know you can also get it at Dogwise the link I provided. If results are not difinitive, check that you vet is not just doing the T4 test alone. A lot of vets are behind on the latest tests. They need to test total T3 and Free T3. Get the book LOL.


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## El Bueno Habanero (Oct 20, 2009)

Ok, I get it, i just have to get that book lol. No, serious, i will, but I would love to buy a real copy and not ebook version. Since I live in Europe the shipping costs are high, and if I place an order over 25 pounds on UK Amazon then I get free delivery. Have you got some other good books on your list for me to check out?


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## El Bueno Habanero (Oct 20, 2009)

Lizzie'sMom said:


> I am curious as to why lab work was not the first thing done rather than an MRI.


Looking back me too Lynne. I suppose we tend to think that this ppl know what they're doing. The diagnosis was purely based on Fedja's walking manner. After a minute or so of Fedja walking around and some physical examination neurologist without doubt knew everything (that's probably the answer to our question). The whole diagnosis was made in like 10 minutes. And this is a well respected neurologist in the country, so who am I to question his opinion. He did tell us it's possible to do MRI scan just to be sure that there is no some kind of tumor pressing his spinal cord or so, but he didn't expect it to be the case. In his opinion we didn't need to do it at all. An MRI is darn expensive (600 euro), so he probably wanted to spare us for in his eyes unnecessary costs. My boyfriend and i decided to do it anyway, and like neurologist expected nothing showed off. In his last correspondence he told us this is a good news, cos it means that the problem is 'on some cellular level', very minor. In other words nothing was found. 
Maybe this problem has nothing to do with Fedja's slow working thyroid after all, but I won't be surprised if it happens to be the case.

I don't know how this things work in the US, but annual exam over here means that they just check the pets eyes, ears, listen to the heart, and do some physical examination. No blood work is ever done if there are no weird things going on. I think this is probably because it costs so much. For the blood work I just did I had to pay 170 euro. That's really a lot of money for most people, and I'm no exception, and if there are no some very obvious reasons to do it, most people don't do it. 
Reading lately how much dogs are affected with this issue, I truly believe that it must become a standard procedure to check for thyroid function, at least once in a while. I see so many overweight dogs on the streets, and first thing the vets do is to prescribe some expensive diet you only get to buy at the vets office lol. Nobody first checks this poor dogs for possible underlying issues.


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## davetgabby (Dec 29, 2007)

El Bueno Habanero said:


> Ok, I get it, i just have to get that book lol. No, serious, i will, but I would love to buy a real copy and not ebook version. Since I live in Europe the shipping costs are high, and if I place an order over 25 pounds on UK Amazon then I get free delivery. Have you got some other good books on your list for me to check out?


Lots of good books. But it would take a lot of books to reach 25 lbs. One , if you don't already have it, is Culture Clash by Jean Donaldson.


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## El Bueno Habanero (Oct 20, 2009)

LOL, I was talking about UK currency.


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## El Bueno Habanero (Oct 20, 2009)

*Thyroid issue or not?*

Hallo all,

Last Friday I got the blood test results, but didn't have the time to post sooner. I expected that the TSH value would be high too, but Fedja's TSH is on the low side!

TSH Normaal range: <0.60 ug/L, and Fedja has <0.03. 
His T4+ is tested again. Normal would be between 19-46 nmol/L, his T4 is 10 (first test showed 9). This is really low, especially when I read that toy breeds are supposed to be on a higher end of a normal reference range anyway.

So, in the end we don't know anything for sure. There is still like 30 percent of the dogs who do have thyroid problems even if TSH value isnt hight. This makes it even more difficult to diagnose thyroid issues in dogs.

Next step would be to go to the specialists and maybe do some scan of Fedja's thyroid gland, and some other things too. My vet thinks that it would be best to put Fedja on thyroid medication for a month. If it is thyroid issue he has to improve big time, if it's not the meds are not going to make things any worse, especially since his thyroid is to low anyway. It is only the question if the problem lies in thyroid, or if there are some secondary issues that are causing thyroid to work so slow. 
I decided to try the medication first, but only because I want to spare him any (unnecessary?) tests (according to my vet this isn't going to do any harm to Fedja's thyroid if it happens that thyroid self isn't the main issue). Jean Dodds confirms this in one of her letters I found online:

'Contrary to some popular wisdom, treatment with thyroid hormone does not destroy or suppress the potential of the gland to respond on its own once treatment is stopped for whatever reason. The latest veterinary research shows that it takes the thyroid gland up to 30 days to recover its full potential once therapy is withdrawn. Therefore if an animal has been medicated, where the diagnosis is unclear, treatment should be withdrawn (if it's clinically safe to do so) for 30 days before the animal is retested with the complete type thyroid profile described above.'

Today is his 4th day on meds, and he is already running like crazy outside. 
But the changes have to be spectacular when on meds, otherwise we have to look further. This is a little bit of a problem for me to judge, because Fedja was always so quite, and I don't know if it's his character or if he has had some issues his all life. So I'm not sure what should qualify as 'spectacular' in his case.

Have a nice day,
Sena


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## davetgabby (Dec 29, 2007)

Sena, at least you've got some results. This is a difficult diagnosis for a lot of vets. Jean acknowledges this. You are learning as you go. Hopefully this is a start and the hormone treatment will work. Keep us posted.


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## Pattie (Jun 25, 2008)

I echo Dave. Please keep us posted because we are all interested and want to be supportive.


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## Lizzie'sMom (Oct 13, 2010)

Hi Sena, thanks for the update on Fedja. Just an FYI- many many people are hypothyroid with what is considered a "normal" TSH level. It is best to look at the T4, T3, and free T3. Most people do best if they are treated "symptomatically" rather than by lab values. Not really sure if this works for dogs, but I would think so. BTW not sure if Europe fluoridates and chlorinates their water, but that is one of the biggest causes of thyroid failure. Fluoride, Chlorine and Bromine (it is added to flour here in the US) compete with Iodine in the body and win.


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## davetgabby (Dec 29, 2007)

Lizzie'sMom said:


> Hi Sena, thanks for the update on Fedja. Just an FYI- many many people are hypothyroid with what is considered a "normal" TSH level. It is best to look at the T4, T3, and free T3. Most people do best if they are treated "symptomatically" rather than by lab values. Not really sure if this works for dogs, but I would think so. BTW not sure if Europe fluoridates and chlorinates their water, but that is one of the biggest causes of thyroid failure. Fluoride, Chlorine and Bromine (it is added to flour here in the US) compete with Iodine in the body and win.


Lynne said..."It is best to look at the T4, T3, and free T3. " .. . That's what Jean mentions. Not all tests look at all these. Yeah I don't drink city water either. Bottled spring water here.


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## El Bueno Habanero (Oct 20, 2009)

Thank you all for the interest, and I'll keep you updated.



Lizzie'sMom said:


> BTW not sure if Europe fluoridates and chlorinates their water, but that is one of the biggest causes of thyroid failure.


Didn't know this, thnx! I don't know how it works in other European countries, but here in the Netherlands this two are forbidden. Fluoride since 1973, and chlorine since 2005.



Lizzie'sMom said:


> It is best to look at the T4, T3, and free T3.


Dodds advices 'to run complete thyroid profiles (i.e., T3, T4, free T3, free T4, T3 and T4 autoantibodies, plus thyroglobulin autoantibody and TSH where indicated) rather than just one or two analytes (e.g., T4, TSH, free T4).'

I have asked my vet about this, but sadly for some reasons this is not how it works around here. Next thing usually done is to take an CRT scan of thyroid gland. Other method is to inject the dog with TSH hormone (and after few hours take his blood again) to see if the thyroid reacts to TSH. This is an (rather expensive and time consuming) method that is not often used anymore. 
Wish I could consult dr. Dodds about all this .


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## Missy (Nov 6, 2006)

Sena, I am sorry to read this. But then again, I am glad that you may have an answer.

I wanted to say you can in fact write Dr. Dodds. for a consult. I wrote her asking if I could pay her to consult on Jasper's test results because they seemed to be confusing to my vet. I just emailed her the test values, They were not confusing to her. She sent me a very clear diagnosis based on the new normal test levels. She refused to take payment-- so I made a donation to hemopet.

[email protected]

as far as spectacular results... I would say running in the yard is spectacular. Fedja is not going to be a different dog. perhaps if it was a sudden onset...meds would make a huge difference...but happy is good.

after discussing with my (new) vet I decided to try a holistic approach first but will be retesting in July (with dr. Dodds) and if his levels are not improved we are going to go on thyroid meds.

I hope this is the answer for Fedja. I am glad you followed your instincts.


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## davetgabby (Dec 29, 2007)

Great advice Missy.


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## El Bueno Habanero (Oct 20, 2009)

Missy said:


> I wanted to say you can in fact write Dr. Dodds. for a consult.


Thnx for the advice Missy. I think the problem is that I only have test results for T4 and TSH (and other basal things like red/white blood cells, liver, kidneys, glucose etc). I'm afraid that this is not enough for a clear diagnosis. But I'll write here an email anyway.



Missy said:


> after discussing with my (new) vet I decided to try a holistic approach first


I hope with all my heart that this will going to work for Jasper. Please let us know the results!


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