Questions about Pebbles

[oconnorjoy]

I need some advise please. I am thinking it may be time for me to find a new vet. A bit of background...My hubby and I went away in April and I left Pebbles and Buddy with my Mom. I notified my vets office that I would be away and let them know that if there were problems with Pebbles my Mom would call them. She got fairly sick (I think because she was stressed) and my Mom called them...they said they were too busy to see her and sent her to another vet across town. They ended up giving her antibiotics and pain medication that knocked her out for 24 hours. I was just relieved that she was ok when I got home.
Pebbles is being treated for hypothyroid problems and gets her blood tested every two weeks as her medication still isn't within the therapeutic blood levels. Yesterday she started honking and spitting up white foam. She does have mild collapsing trachea. She seems to take much longer to recover than she used to. She is not on any medication for that and all I know about it is what I read on the internet...everytime I ask they tell me not to worry about it. I went in today for her blood work and asked them to have a look at her as I was worried. The receptionist told me that they were too busy to see her...they were very happy to take my $45 to take her blood but couldn't find time to check her out. Money is not the problem...I would have gladly paid more. The vet will be calling me tomorrow or Monday with the blood work results. Two questions....one, what should her blood levels be?...and do I have the right to ask for print outs of her blood work from the last few times so I can bring them to a new vet?
Sorry this is so long...I am still upset.
Joy

[Traci]

Do you mean her thyroid panel results? Here is a general reference range for dogs:

Total T4 - between 15-50
FreeT4 - between 12-33
T3 - 1.0-2.5

When was her last full blood profile/CBC/urinalysis? Were all results normal or? Within the last couple months, has your vet considered looking for secondary health issues, other than the hypothyroidism? If not, he should be doing so, with a new full blood profile. Was esophagitis ever ruled out?

When was she diagnosed as hypothyroid?

Did you tell the clinic yesterday you were worried about Pebbles' coughing, spitting up?

Yes, you can request full copies of her bloodwork, they might charge you a few cents for copies, but most vets won't. If you're going to establish a new vet, I'd get full and complete copies of her entire health record or ask the new vet to call the other clinic and have them faxed.

[oconnorjoy]

Hi Traci,
Now I am really confused...the vet called me today and said that Pebbles thyroid levels are within the therapeutic levels. I asked her what her levels were and she said 40...then I asked what the therapeutic level is and she said 39 to 79. Do we measure it differently in Canada? She wants me to up her medication to .1mg of levothyroxine every 12 hours as Pebbles is still sleeping lots and is exercise intolerant. She suggested I consider putting her on a prescription diet...Hills or Medi-cal. I will discuss this with her next week when I take Pebbles in for a check on her cough. I did tell her that I was very upset that no one would look at her yesterday when we were in. She says that is is collapsing trachea and that Pebbles needs to lose weight. While I agree that Pebbles needs to lose weight I am not sure I like her being diagnosed without being seen. Pebbles is doing much better today. She has only honked a few times and is no longer spitting up the white foamy stuff. Esophagitis was never mentioned let alone ruled out. I am still considering going to another vet for a second opinion.
Pebbles had a full blood panel and CBC on June 12th...all was well except for the thyroid levels and her glucose was a bit high. I was told not to worry about that...she said it was probably because of stress from having the blood drawn. - on a side note, Pebbles is excellent about having her blood drawn...she doesn't move or fight them at all. The vet tech says she is a little trouper.

Thanks for your help Traci...it is much appreciated.
Joy

[Traci]

Which of the thyroid tests was done, that would give you an idea of the proper reference range.....and yes, canadian vets might use SI units instead of conventional units, it also depends on who's doing the testing (human lab).

[oconnorjoy]

the test is listed as Indexx T4 on my bill. They have an inhouse lab.
Joy

[Traci]

If the reference range is 39-79, and Pebbles is 40, then she is in low normal range, with may necessitate a slightly higher adjustment in dose to be within median range (or attempt to get there). This is why frequent retesting is so important for gauging therapeutic levels, you don't want to go too low and you don't want to go too high. I'm wondering if your vet is using an Idexx in-house analyzer or a T4 snap test. Either way, the equipment comes with a reference range guide, so the good news is that Pebbles is not TOO low, but she probably wants that a bit higher in the normal (median) range. Be prepared for a few more tests within the next 3 months to ensure she is at a median range.

Have you found a new vet yet? I think I would get Pebbles re-evaluated quickly for that collapsed trachea, and rule out esophagitis, lesions, etc to make sure it isn't being compromised with something else (irritation, inflammation, infection etc).