July, 2007
A Linked Marker Test for Fanconi Syndrome
Below are two articles; the first on hypothyroidism, the second on IPSID.
You will also find some more health links.
Here's what a complete thyroid panel looks like, in a youngster testing low, with nomal TgAA
Hypothyroidism
in Basenji Dogs
by Karen Christensen
Since my own dog. Selket, was diagnosed with hypothyroidism (HT), I have had some time to research the symptoms of the disease. I have become something of a crusader, suggesting thyroid testing to dog owners for symptoms ranging from weight gain to seizures to infertility: the overweight, 4 year-old golden retriever (HT is very common in Goldens) at the kennel, who was having seizures; a friend whose year-old basenji is losing the fur from her puppy buns; the woman in the dog park with the greyhound (another high-HT breed) whose skin was callused, greasy and smelly, like Selket's; the couple at the vet whose 2 year-old lab is so overweight you could serve dinner on his back....
The reasons for this are simple:
The literature indicates that Hypothroidism is the most common endocrine disorder in dogs, and we know, for people, Synthroid is the third most used pharmaceutical in the USA. All of the above symptoms can be related to hypothyroidism.Using the proper tests, HT is relatively easy and inexpensive to diagnose. HT is extremely easy to treat with daily replacement therapy; and Treatment makes such a huge difference in the quality of life for the dog and therefore for its owner.
The case for regular thyroid screening for all dogs is easy to make. While treating a HT dog is not difficult, it is not a characteristic anyone would want to encourage in breeding, and which needs to be understood in breeding stock. Hypothyroidism in basenjis has shown up in dogs as young as 12 months old.
Here's what a complete thyroid panel looks like, in a youngster testing low, with nomal TgAA
Why to treat twice a day
A lack of thyroid hormone can cause a vast array of symptoms that are also common to other illnesses. Thyroid screening can thus be used to rule out hypothyroidism as the cause of some symptoms, as well as ruling it in. Many of the conditions, such as weight gain, lethargy, and joint problems, when seen in older dogs, are considered unavoidable symptoms of age. I considered Selket an old dog at 8 years, due to her lack of energy, thick skin, and lameness in her shoulder; at 11 years, I do not consider her old at all as I watch her romp with a much younger dog. The difference has been the diagnosis and treatment of hypothyroidism.
The reason for the symptoms is that thyroid hormones control metabolism of fats, carbo-hydrates and lipids; energy transfer; and cell maturation. This last is the cause of poorskin/coat quality, joint problems (cartilage does not regrow fast enough to replace what is worn off), and sterility (sperm and eggs do not mature.) Because lipids are not metabolized, a hypothyroid dog may have high cholesterol, which can cause seizures and heart problems due to plaques in the coronary arteries (atherosclerosis, the same cause of heart disease as in humans), as well as strokes.
The thyroid hormones regulate metabolism.
The high cholesterol that accompanies hypothyroidism (too little thyroid hormone) can, however, lead to atherosclerosis and strokes in dogs.
Thyroid function tests are affected by many things, including stress and medications. Several recent studies have demonstrated that phenobarbital therapy causes falsely low values on some thyroid tests. Recent seizures will also cause false lowering of the values, presumably due to the stress they cause. So test results need to be interpreted with these caveats in mind. If an animal tests truly low on thyroid function, then a trial of thyroid supplementation is indicated.
The blood serum sample from a hypothyroid dog may look like a strawberry milkshake - cloudy, thick, and bright pink. This is from the lipemia/high cholesterol and from hemolysis. I was pretty shocked and upset when I saw this in Selket's second sample (after a month on a low dose of levothyroxin, the synthetic thyroid replacement normally prescribed), since I expected a clear, pale yellow liquid. When I spoke to Dr Dodds (see below) she said this was a strong indication of hypothyroidism (which makes me wonder why we even had the sample analyzed instead of just upping the dose). Literature indicates the presence of high cholesterol makes measurement of one form of thyroid, T3, inaccurate for diagnosing hypothyroidism.
Monitoring your dogs:
Of course it is preferable to diagnose hypothyroidism before the dog becomes ill. Since it is relatively common in basenjis, it is not unreasonable to begin annual testing, as Wellness Care, after puberty. Testing must be done in anestrus, which means count 100 days from the first day of the heat cycle. By the way, you should do the same for male dogs who are around bitches in season.
It is very important to have the right tests done. To run the correct panel of tests, send blood samples to:
Hemopet
11330 Markon Drive Garden Grove, CA 92841
714-891-2022, fax 714-891-2123
Instructions for preparing & sending specimens to Dr. Dodds
I use Dr. Dodds because she gives her opinion along with the test results, and the fee is very reasonable (your vet may charge you the same fee they would charge to send it to their usual lab). And you can talk to her. You SHOULD talk to her, if you suspect your dog is hypothyroid, if you have results from a different lab, or if your vet gives you a hard time. Just call her at Hemopet. She will return your call.
Total T4 or T3 measurement alone, or T3 & T4 alone, are not accurate for diagnosing HT. You need to have results for T3, T4, Free T3, Free T4, T3 AA, and T4 AA. If you are breeding your family of dogs, you need to have TgAA done as well. TSH levels are not particularly useful.
Treating the hypothyroid dog is inexpensive and easy. They simply get a small pill twice a day of levothyroxine (T4). A typical dose is 0.1 mg per 10 lb (4.5 kg), although your vet may opt to start out with a lower dose, and a very few dogs end up needing very high doses (2 mg per 10 lb). It costs about $20 per year to treat a basenji on an average dose of Soloxine, if you buy it in bulk from Omaha Vaccine (800-367-4444).
IT IS VERY IMPORTANT TO USE THE BRANDS, SOLOXINE, or Thyro-Tabs (manufactured by Vet-a-mix), as the generic is not as effective (in people or dogs.) One thing suggested to me when Selket's thyroid levels had elevated into the normal range but some of her symptoms were still a problem was to switch brands, and this made a big difference in her case.
Soloxine (Daniels Animal Health, www.soloxine.com) is the gold standard of T4 therapy for dogs and that is what she takes now. Maybe her cells can use it better, but I'm not as concerned with the reason as I am with the fact that it works.
As some of us have experienced in the past, generics are NOT equivalent to Soloxine, and your pooch may experience problems on the generic.
Finally, I have heard of some people who are reluctant to use thyroid replacement because it is synthetic, because it is a pharmaceutical, a drug. Well, it is a chemical the dog normally has. There is no herbal equivalent for synthetic levothyroxine. The synthetic drug contains only the T4 and no other biologically active molecules. As for the drug companies possibly making money off of us, I'd say they make their profit based on the huge amount that's sold, because the per-dose cost is so low, it cannot be much more than it costs them to manufacture and distribute it.
Here is a list of symptoms of hypothyroidism (that improve when T4 therapy is given); one or more other diseases or conditions could also cause most of them but it is such a common condition, and is inexpensive and easy enough to test for.
Lethargy,
Mood swings,
Aggression,
Loss of energy,
Vestibular (ear) disease,
Poor coat, scaly skin,
Hypo pigmentation,
Body odor,
Skin lesions,
Weight gain,
Weight loss, picky eater,
Seizures,
Sterility,
Testicular atrophy,
Aspermia,
Absence of heat cycles,
Too many heat cycles,
Prolonged interestrus,
Pseudopregnancy,
Reproductive failure,
Re-absorption of fetus,
Joint problems,
Slow heart rate,
Stiff or slow movement,
Dragging front feet,
Head tilt,
Tragic expression/facial paralysis,
Balance problems,
Frequent vomiting,
Diarrhea,
Cardio-myopathy,
Megaesophagus,
Ruptured knee ligaments,
Corneal ulcers,
Dry eye syndrome,
High cholesterol,
Atherosclerosis,
Cold intolerance,
Heat intolerance,
Exercise intolerance,
Chronic infections,
Anemia,
Low white blood cell count,
Bone marrow failure,
Chronic hepatitis, etc.
An update to Karen and Selket’s story:
Her sassy beautiful girl Selket passed away on Saturday, December 15, 2001. (Mooties Alpha Centauri Selket ~ 12/24/87 to 12/15/01)
In Karen’s own words:
Fast as a basenji can run....That's how fast Selket left me & crossed the Rainbow Bridge today just before lunchtime. She was lying under a blanket in her favorite chair, and seized and that was the end -- it took about 15 seconds and she was gone. I'll miss her terribly. She was just a few days shy of her 14th birthday (Christmas Eve). I hope those of you who knew her in her better days will remember her as the smart, sassy, self-possessed beauty I always saw her to be.
I'll take comfort in the fact that, as Karen Sahulka said, "she died just like Jim did, in his chair," -- Selket was within a few feet of Jim when he died in 1999. Now, says, Suemaw, they are likely enjoying Szechuan chicken livers together!
HEALTH WEBSITE LINKS
Dr. Dodds - Immune System & Disease Resistance
HEALTH CONTACTS
IPSID ~ Dr. Willard tel: (409-845-2351)
or Cindy Griswold
Hypothyroidism ~ W. Jean Dodds,DVM
Hemopet
11330 Markon Drive Garden Grove, CA 92614
714-891-2022, fax 714-891-2123
IPSID stands for immunoproliferative small intestine disease, but it is a disease of many names. It is also called basenji enteropathy, immunoproliferative lymphoplasmacytic enteritis, basenji diarrheal syndrome, and malabsorption. It is one of several different types of inflammatory bowel disease, which result in the dog not being able to utilize and absorb nutrients correctly from food. The human equivalent is Chrons disease.
While IPSID is considered to be inherited, inheritance alone appears to be only one of the factors involved. When genetically normal Basenjiís have food allergies, a viral or bacterial infection and they become sick, at worst, they will come down with inflammatory bowel disease (IBD). With proper medical care they can be cured or maintained for life. A dog genetically pre-disposed to IPSID and its resultant immunicological weakness might start with plain vanilla IBd and eventually progress to IPSID. Stress of a physical or emotional nature also seems to be a factor.
Symptoms can include diarrhea (both large and small bowel), vomiting, weight loss, protein loss, increased or decreased appetite, depression, and gas. The type of symptoms and their severity differ form dog to dog, and from one time to another. Dogs with IPSID often show improvement before the dog again takes a turn for the worst. While some dogs go into remission, they usually relapse and eventually die.
Most of the time vets will use a process of elimination to diagnose IPSID. My vet started out by ruling out giardia. From there, we did a complete blood panel. Everything was normal except the protein levels, which were low. Next, we did a barium x-ray, which showed an enlarged section of the intestine. Last was a biopsy, which is the only reliable way to diagnose IPSID. The biopsy was also done to rule out cancer and systemic fungal infections.
Treatment success is generally limited to improving the quality and length of life. Prednisone is started at 1 mg/kg twice a day to suppress the immune system. Over time the pred can generally be lowered or eliminated until the symptoms resume. However, if the pred is eliminated and restarted it might not be as effective as it was previously. Other drugs that are used are metronidazole, tylosin, and other antibiotics to treat the severe bacterial infections that the dogs are susceptible to. IPSID dogs seem to be a bacterial reservoir, which can cause infections in other household dogs.
The dogís diet is also changed to a hypoallergenic food. A division of Natures Recipe produces prescription diets, venison/potato, rabbit/potato and duck/potato, that work well for IPSID dogs. Dr. Willard of Texas A&M suggests switching diets on a monthly basis to help prevent the intestine from becoming sensitive to what it is being fed can be appropriate. A homemade diet also can be used. Additional vitamin supplementation may be indicated.
The Basenji Club of America is currently, through Dr. Johnson, accepting blood samples of dogs suspected or diagnosed with IPSID. The sampling requirements are a 5 ml EDTA tube shipped overnight Mon.-Thurs. Include with the sample the dogs name, AKC number, a three generation pedigree if possible and a notation that the sample is for the basenji enteropathy study. All blood samples stored by Dr. Johnson are available for other research studies.
Dr. Willard is a gastroenterologist that teaches and does research at Texan A& M University. A couple of years ago he did a preliminary study on IPSID and apotosis. Apoptosis is when the cell doesnít die as scheduled and growth is uncontrolled. Cancer is a form of apoptosis as is IPSID. In IPSID, the intestine over produces lymphocytes and plasmacytes. As part of his study he was using preserved intestinal tissue. What he is looking for is preserved tissue samples of dogs diagnosed with IPSID. If you or anyone that you know have had a dog biopsied in the last 10 years through a vet college please contact either Dr. Willard at 409-845-2351, e-mail address or myself at 830-868-7649, e-mail address griswold@moment.net.
Additional references:
1. Cornell University College of Veterinary Medicine Animal Health Newsletter Vol. 10 number 10: Sept. 1996 pgs.3-6.
2. Immunoproliferative Enteropathy of Basenjis By Edward Breitschwerdt, Seminars in Veterinary Medicine & Surgery (small animal), Vol. 7 no 2 (May), pp 153-161.
Last updated Feb. 10th, 2009