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HYPOTHYROIDISM What
is the thyroid gland, and what does it do? The
thyroid gland is one of the most important glands in the body.
It is located in the neck near the trachea (windpipe)
and is composed of two lobes, one on each side of the trachea.
This gland is controlled by the body's master gland, the pituitary gland,
located at the base of the brain. The
thyroid gland regulates the rate of metabolism (body chemistry).
If it is hyperfunctional, metabolism speeds up.
If it is less functional than normal, metabolism slows down.
The latter is the basis for the clinical signs of hypothyroidism. What
causes hypothyroidism? Hypothyroidism
is almost always caused by one of two diseases: lymphocytic thyroiditis or
idiopathic thyroid gland atrophy. The
former disease is the most common cause of hypothyroidism and is thought to be
an immune-mediated disease. This
means that the immune system decides that the thyroid is abnormal or foreign and
attacks it. It is not known why the
immune system does this. Idiopathic
thyroid gland atrophy is also poorly understood.
Normal thyroid tissue is replaced by fat tissue in what is considered a
degenerative disease. These
two causes of hypothyroidism account for more than 95% of the cases.
The other five percent are due to uncommon diseases, including cancer of
the thyroid gland. What
are the clinical signs? When
the rate of metabolism slows down, virtually every organ in the body is affected
in some manner. Most affected dogs
have one or more of several "typical" physical and/or chemical
abnormalities. These include:
(a) Weight gain without an
increase in appetite
(b) Lethargy and lack of
desire to exercise
(c) Cold intolerance (gets
cold easily)
(d) Dry haircoat with
excessive shedding
(e) Very thin haircoat to
near baldness
(f) Increased pigmentation
in the skin
(g) Increased susceptibility
to skin and ear infections
(h) Failure to re-grow hair
after clipping or shaving
(i) High blood cholesterol
Some
dogs also have other abnormalities that are not the typical findings.
These include:
(a) Thickening of the facial
skin so they have a "tragic facial expression"
(b) Abnormal function of
nerves causing non-painful lameness, dragging of feet, lack of co-ordination,
and a head tilt
(c) Loss of libido and
infertility in intact males
(d) Lack of heat periods,
infertility, and abortion in females
(e) Fat deposits in the
corneas of the eyes
(f) Keratoconjunctivitis
sicca or so-called "dry
eye" due to lack of proper tear production. How
is it diagnosed? The
most common test is for the T4 level. This
is a measurement of the main thyroid hormone in a blood sample.
If is below normal and the correct clinical signs are present, the test
is meaningful. However, testing for
the T4 level can be misleading because some dogs that are not hypothyroid may
have subnormal levels. This happens
when another disease is present or when certain drugs are given. If
hypothyroidism is suspected but the T4 is normal, other tests can be performed.
These are more expensive so they are not used as first line tests. Can
it be treated? Hypothyroidism
is treatable but not curable. It is
treated with oral administration of a thyroid replacement hormone. This drug must be given for the rest of the dog's life. How
is the proper dose determined? There
is a standard dose that is used initially; it is based on the dog's weight.
However, after about one month of treatment, further testing is done to
verify that the thyroid hormone levels are normal. In some dogs, the dose will need to be further adjusted every
6-12 months. Close liaison with
your veterinary surgeon is necessary in order to ensure that the dog is neither
overdosed nor underdosed. What
happens if the medication is overdosed? Signs
of hyperthyroidism can be caused. These
include hyperactivity, lack of sleep, weight loss, and an increase in water
consumption. If any of these occur, please let us know immediately. |