Greyhound - hypothryoid?

Re: Greyhound - hypothryoid?

scatty — Mon, 15 Dec 2014 16:57:43 GMT

OK so SG is 1.011 and UPC is 2. This seems to be a persistent finding.

Re: Greyhound - hypothryoid?

scatty — Sun, 14 Dec 2014 21:31:25 GMT

Hmm much the same :( She's not on any meds atm. I will phone Idexx tomorrow and ask them to run a UPC on the sample although I suspect it will still be high. On the plus side there was no blood on the last sediment exam. All she wants for Christmas is a bit of Joie de Vivre and less polydipsia!

Re: Greyhound - hypothryoid?

Anthony Todd — Sun, 14 Dec 2014 20:36:41 GMT

How's that bald-thighed lethargic greyhound?

Re: Greyhound - hypothryoid?

Andrew Kent — Fri, 12 Dec 2014 10:11:24 GMT

The only problem with an LDDST in that dog is the relative poor specificity of the test. Whilst a negative result would make HAC unlikely, the specificity of the test can be as low as 60% and so concurrent disease could give us a false positive which would still be difficult to interpret. Ultrasound of the adrenal glands could be very helpful also.

Both hypertension and proteinuria are associated with HAC unfortunately. What is the UPC and USG currently?

Andy

Re: Greyhound - hypothryoid?

scatty — Fri, 12 Dec 2014 09:47:24 GMT

Ok, so my cortisol/creatinine ratio is 98.4 so I can't rule out Cushings! I hope that she was suitable relaxed. It was taken by owners at home 3 days after I cam round to visit her to check B.P. I'm thinking LDDST for my sins before I contemplate a benazepril trial? Can the increased blood pressure be linked to Cushings directly? (I don't think the proteinuria can be).

Anna

Re: Greyhound - hypothryoid?

Anthony Todd — Sat, 06 Dec 2014 22:34:10 GMT

You can get paediatric cuffs that are tiny, I thought the bigger cuffs might be better in picking up the overall pressure change in the bigger cuff area.

Any hypertensive vet with a biggish dog like to do some testing, be great if they work!?

Re: Greyhound - hypothryoid?

Andrew Kent — Sat, 06 Dec 2014 21:35:34 GMT

[quote user="Anthony Todd"]

[quote user="scatty"]Will try and do a home visit for b.p!! [/quote]

Don't red star me but can you use those DIY BP kits on [ large] dog. Greyhounds, of all breeds are likely candidates.

Even the nurses and doctors use them so they must be foolproof....

Then the owner could do it?

[/quote]

Hi Anthony,

Even in a dog of this size the human cuffs are far too big, the cuff length should be about 40% of the circumference of the leg so the distal limb of pretty much all dogs is too small for human cuffs. They generally struggle to appropriately sense the pulse in dogs legs as well so have never been validated.

In dogs the only techniques that have really been validated are invasive methods (arterial line), doppler and high definition oscillometric with analysis of the wave form (which also has the potential to be wildly inaccurate sometimes).

It would certainly make life easier if it worked though!

Andy

Re: Greyhound - hypothryoid?

Andrew Kent — Sat, 06 Dec 2014 21:31:51 GMT

[quote user="scatty"]

I have just measured her bp at 220 mm Hg at home (although I think she has a degree of white coat syndrome!). SG was 1.012 today and only a trace of blood, still ++ protein on dipstick.

Do you have any particular lab you recommend for sending the cortisol:creatinine urine sample to? ( I couldn't see it in the idexx catalogue although I think they might run it).

Thanks,

[/quote]

Sounds like she is genuinely hypertensive then. I would still make sure we quantify protein with a UPC at each sample, but ++ in dilute urine is likely to be significant. If the sediment is inactive and culture negative I would be heading towards benazepril. The blood is a bit concerning - it could be due to hypertension but may be another reason to image the abdomen if it continues.

Idexx definitely run UCCr, at least they used to and I see no reason they would stop. Otherwise nationwide specialist labs run it.

Andy

Re: Greyhound - hypothryoid?

Anthony Todd — Sat, 06 Dec 2014 20:29:27 GMT

[quote user="scatty"]Will try and do a home visit for b.p!! [/quote]

Don't red star me but can you use those DIY BP kits on [ large] dog. Greyhounds, of all breeds are likely candidates.

Even the nurses and doctors use them so they must be foolproof....

Then the owner could do it?

Re: Greyhound - hypothryoid?

scatty — Sat, 06 Dec 2014 15:51:44 GMT

I have just measured her bp at 220 mm Hg at home (although I think she has a degree of white coat syndrome!). SG was 1.012 today and only a trace of blood, still ++ protein on dipstick.

Do you have any particular lab you recommend for sending the cortisol:creatinine urine sample to? ( I couldn't see it in the idexx catalogue although I think they might run it).

Thanks,

Re: Greyhound - hypothryoid?

scatty — Sat, 06 Dec 2014 13:04:15 GMT

Dear Andy,

Thanks for your reply. That all sounds eminently sensible! Will try and do a home visit for b.p!! The previous urine culture and sediment exam were uneventful but I may repeat them. Will let you know if we are making any headway!

Thanks,

Anna

Re: Greyhound - hypothryoid?

Andrew Kent — Fri, 05 Dec 2014 21:20:18 GMT

Hi Scatty,

the proteinuria and hypertension would fit with the greyhound glomerulonephropathy. Is the UPC still around 2? And what is the USG now?

Cushing's would be a difficult call in this dog - it would tick some boxes but is not a classic. Abdominal ultrasound might help if the owners want to pursue this possibility further, assessing adrenal size etc. This may also be a good idea to exclude other causes of hypertension (e.g. pheochromocytoma). If the dog is stressed at the surgery but relaxed at home then a urine cortisol:creatinine ratio on a home collected relaxed sample might allow exclusion of cushing's if low. Any more dermatological signs? Any polyphagia? You don't see many Greyhounds with Cushing's, having said that we saw one just last week - it had the thinnest skin I think I have ever seen on a dog!

With the blood I would agree about a urine culture and get a sediment exam also. Also any chance of a visit to measure BP at home? Might give a more reliable reading if the dog gets very stressed. If consistently hypertensive and proteinuric then yes a benazepril trial would sound a good idea, starting at low doses and monitoring urea/creatinine to ensure the reduction in GFR doesn't cause any problems.

Hope that helps,

Andy

Re: Greyhound - hypothryoid?

scatty — Fri, 05 Dec 2014 20:42:17 GMT

Still confused about this greyhound!!! Her b.p appears to be high. It seemed to be measuring really high on our equipment - I measured it as >200 mm Hg with our Doppler (NB I am not am not that well versed in getting b.p readings!). NB She is always very panty and stressed in the vets but much less so at home with the owner.

I repeated the biochemistry after several weeks as she had been NSAIDs and after your comments Andy I was worried about the kidneys.

This time I ran an in house Idexx chem17 and got the following enzyme raises:

ALT 127(10-100)

GGT 8 (0-7)

Amylase 1,532 (500-1500)

Lipase 2690 (200--1800)

However she wasn't azotaemic. The owner reported he was definitely noticing an increased thirst and she is now drinking 6 pints a day. NO vomits or sickness at all. She is still eating as normal. Her urine was dilute and now showed some blood on the dipstick . I decided to run an ACTH stim and I got 182 nmol/l and 693 nmol/l post . I ran an ionised calcium - negative. No imaging done as of yet.

I do wonder if she is genuinely Cushingoid just as I was wondering if she was genuinely hypothyroid!! I would have expected her to have a raise in ALKP? Maybe her stress levels have affected this?

Logical next steps anyone? In particular Andy what do you think now?!? I could run LDDST or take survery radiographs/ultrasound. Maybe I need to repeat urine culture as I saw blood on the dipstick this time. Proteinuria is consistent in the urine also. The owner's main concern is the drinking levels currently. Maybe a fortekor trial?

Re: Greyhound - hypothryoid?

Andrew Kent — Tue, 11 Nov 2014 12:55:17 GMT

Have you measured blood pressure? In this breed proteinuria in this context probably represents the glomerulonephropathy that is seen in lots of greyhounds and may be accompanied by hypertension.

If this is a repeatable finding then it may warrant treatment.

Andy

Re: Greyhound - hypothryoid?

scatty — Tue, 11 Nov 2014 12:52:00 GMT

Sorry guys,

For those of you that remember this thread, another weird update now! As promised I did finally get urinalysis done for the sake of completeness. UPC is high @2. NAD on sediment: nothing significant on cytology or culture. Therefore as no sign of azotaemia on bloods OR any sign of infection/inflammation on urine I am a bit stumped why this would be high. She is on the borderline of being polydipsic from calculations as her water intake is 4-5 pints.

The metacam trial is going reasonably well and owners are altering the diet. Heart rate is always moderate between 60-70 bpm when owners measure it at home (can be higher in the vets when stressed).

At the moment, I am not doing much apart from planning to monitor her and possibly repeat UPC/bloods for renal enzymes regularly as she is on the nsaid.

Unless anyone has any other thoughts? (Don't want to miss anything with her)

Re: Greyhound - hypothryoid?

Martin Atkinson — Fri, 17 Oct 2014 11:42:51 GMT

[quote user="Anthony Todd"]She sounds a bit like me......[/quote]erm...do you mean short, stumpy and balding?

Re: Greyhound - hypothryoid?

Anthony Todd — Fri, 17 Oct 2014 00:24:46 GMT

[quote user="scatty"]at 33kg for the last 4 years.[/quote]

What would her racing weight have been?

"but has become a bit more lethargic lately" [from the first history]

Not to be too picky, but if we had known she was overweight and arthritic at the beginning I wouldn't have rushed into thyroid supplements [or not.]

She sounds a bit like me......

Re: Greyhound - hypothryoid?

Robin Grimmer — Thu, 16 Oct 2014 13:52:43 GMT

I agree. There doesn't seem to be much wrong with this greyhound. I would do a week's trial of nsaid first and get on a weight reducing programme.

Re: Greyhound - hypothryoid?

Martin Atkinson — Thu, 16 Oct 2014 13:47:52 GMT

[quote user="scatty"]I'm thinking I just need to get her on a better diet, more fit and possibly try NSAIDs. Or maybe this is too simplistic?[/quote]Always think simple things first. The least you'll do is get the dog on a better diet. As my mentor the late Wyn Jones used to say, 'common things occur commonly'!

Re: Greyhound - hypothryoid?

scatty — Thu, 16 Oct 2014 10:50:48 GMT

OK, so for those of you that were following this thread I have some results from Idexx for a cardiac profile: (I have included the results which are out of range only):

RBCs 9.38 (6.6-9.30),

Haemoglobin 23.3 (16.7-22.8)

Sodium/potassium ratio 28.27 (28.8-40).

For reference: potassium 5.27 (3.6-5.6) and sodium 149 (135-155)

Glucose 6.3 (3.6-5.9).

ProBNP 570 If <900 then unlikely that cardiac disease.

All in all, none of these results seem that remarkable for a greyhound from the bloods.

The owner didn't mention the diet until I questioned him more thoroughly - she is fed an 8 oz fried steak for breakfast and dinner on top of bakers! He has fed this ever since he got her 4 years ago. She was spayed just before he acquired her as a rescue. Her BCS is 7/9 and she is overweight but this has been stable at 33kg for the last 4 years. She does feel stiff when her joints are palpated and I suspect that she is overweight and not very fit with a degree of arthritis. Her heart rate in the vets is elevated at 120 and she pants a lot but is also very nervous whenever she comes in. I need to get the owner to try and get a heart rate for her at home.

I also need to get urinalysis done and measure drinking intake as owner thinks she is more thirsty then she used to be.

I'm thinking I just need to get her on a better diet, more fit and possibly try NSAIDs. Or maybe this is too simplistic?

Re: Greyhound - hypothryoid?

Martin Atkinson — Tue, 07 Oct 2014 09:03:22 GMT

[quote user="Anthony Todd"]I'm off to bed[/quote]OK Zebedee its time for bed for the whole thread until the OP comes up with some more data.

Re: Greyhound - hypothryoid?

Anthony Todd — Tue, 07 Oct 2014 00:57:15 GMT

[quote user="robloxley"]Cowan LA, Refsal KR, Nachreiner R and Schoning P (1997) Thyroid hormone and testosterone concentrations in racing greyhounds with and without bald thigh syndrome. J Vet Intern Med 11, 142[/quote]

Back to square one.

Cherry picking again, but:from the reference

Bald thigh syndrome of Greyhounds: Lesions suggestive of an endocrine dermatopathy; may be due to hyperadrenocorticism or hypothyroidism

Still now I know that extra thyroxin is unlikely to make a difference.....

Re: Greyhound - hypothryoid?

Anthony Todd — Tue, 07 Oct 2014 00:47:06 GMT

[quote user="John Flynn"]

OK Anthony, I think I follow that you are querying whether bald thighs in a greyhound should lead to a trial of thyroid supplement.

There are plenty of vets who do this in my experience, with mixed results.

There are plenty of vets whoh do not do this also, with mixed results.

[/quote]

Finally!!

So not because the thyroid parameters are low, high, in between or whatever but because, when you try it ,it doesn't seem to make a consistent difference.

All I was ever trying to get across!!

I'm off to bed....

Re: Greyhound - hypothryoid?

John Flynn — Tue, 07 Oct 2014 00:35:18 GMT

OK Anthony, I think I follow that you are querying whether bald thighs in a greyhound should lead to a trial of thyroid supplement.

There are plenty of vets who do this in my experience, with mixed results.

There are plenty of vets whoh do not do this also, with mixed results.

In summary:

Lots of greyhounds have bald thighs;

Thyroid levels lower than in other dogs are very common in greyhounds;

The greyhounds with the bald thighs don't seem to have lower thyroid levels than the greyhounds with hairy thighs;

Sometimes hair grows back on the bald thighs after thyroid supplementation, sometimes it grows back without thyroid supplementation; sometimes it grows back after the owner has had her hair cut;

There is no particular reason to believe that the supplementation of thyroid hormone to a greyhound improves bald thighs any more than it improves their teeth, even if I consider non-pruritic bald thighs to be a problem (which I don't) I still wouldn't have any particular inclination to supplement thyroid hormone any more than to supplement testosterone, melatonin, zinc etc etc.

Re: Greyhound - hypothryoid?

Rob Loxley — Tue, 07 Oct 2014 00:22:54 GMT

[quote user="Anthony Todd"]And nobody has because, as everyone, including yourself keeps saying, the greyhounds with bald thighs are not hypothyroid based on the reference range of young fit...etc.[/quote]

OK, put it another way - if bald thighs are related to thyroid levels then if you take affected and unaffected dogs, compare their thyroid parameters, and there should be some difference?

Cowan LA, Refsal KR, Nachreiner R and Schoning P (1997) Thyroid hormone and testosterone concentrations in racing greyhounds with and without bald thigh syndrome. J Vet Intern Med 11, 142