Thyroid, the itchies, and Java

[Marty]

I had Java in again, more for an eye check than anything else, but the itchies are getting bad again...actually everytime she is done with AB's and medrol, they come back. She has had several thyroid tests in the past few years, and they come back borderline, but I don't know the numbers on them, and the office didn't feel we needed to pursue it further at the time.

I wrote it down this time... 1.3 where normal is 1.0 to 4.0. We were going to send her blood out for allergy testing, but Dr. H decided to send it out for the equilibrium thyroid test first. I totally agree after doing a bit of research, and think maybe it should have been done sooner...but that is water under the bridge now.

I know low thyroid could cause her symptoms, but is this low enough?

Java is a 12 yr mixed breed, 34 lb...double coated, thick wavy hair...who knows what mix...corgi, chow...whatever.

Oh, the eye check...it looks like she may have scratched it from the itchies, so we have drops for that. Her eye pressure was normal, so we can eliminate glaucoma...

[Traci]

Doubtful of the thyroid.

It sounds like something is going undetected, because it may respond to antibiotics but resumes after the course of antibiotics. Which means, maybe it's not actually responding to antibiotics.

How many cultures have been done in the last 6 months to a year, and what was the vet looking for? Was a food trial considered? Any changes in the environment?

[Marty]

Ok, I won't hold up hopes that it is as easy as thyroid...and go back to the allergy theory.

No cultures have been done recently except for the ears. I have changed her food several times with no luck. No environmental changes with the exception that she no longer goes outside because of her blindness. My son brought her up using puppy pads, so it was easy to go back to them.

The Vet seems to just want to make her comfortable because of her advanced age...skin problems are so evasive. There are no specialty Vets within 2 hours of here, so it would be difficult to pursue that.

[Traci]

Then process of elimination would be the only alternative diagnostic. Unfortunately, this is difficult and takes a considerable amount of time.

The vet should at least do a simple skin scrape and/or culture to rule out parasites (like mites, dust/food/house mites etc). If you regularly treat for fleas, rule out flea allergy dermatitis too.

While I can understand the difficulty in getting to a specialist, I detest vets who do nothing and just attempt to "make them comfortable". Maybe if the vet had the itchies non-stop 24/7, he's rethink that approach. It really is uncomfortable for the pet and can lead to interruption of daily activities, depression, withdrawal in severe cases or cases never treated properly. If Java is also blind, this only compounds the problem for her.

[Marty]

Well, you were correct...it's not thyroid. That came out at a normal 17. So we are sending some blood out for allergy testing. I'll let you know in 2-3 weeks what that says.

[Marty]

Well, she is allergic to eggs, carrots, oatmeal, yeast, fleas, mites, bees, pecans (ha ha, we live in an old pecan orchard) and several other things to a lesser extent. The nice thing is that I got a list of acceptable foods for her, so I decided on Avoderm Beef...Kibbles and Bits or Gravey Train just doesn't do it for me. I can also switch the other 2 dogs over to this, as it is available locally, and just makes things easier.

Now I have to decide about the sensitivity shots. I am leaning towards it, since I have gone this far, and she probably has several yrs to live yet. Yes, they are expensive, but so are the Vet visits to get her straightened out again.

Traci, or anyone, is your experience with the shots favorable? My Vet says they have fairly good results...

[Traci]

Intradermal allergy testing is always better than blood testing, since you can detect reactions with nearly 100% accuracy. Blood testing is not so specific (and is also controversial), and if steroid therapy was given anytime prior to testing, this can alter the tests. I'm surprised your vet didn't (or wouldn't) recommend the intradermal testing (there isn't that much difference between costs).

So, you might have some unexpected results with immunotherapy, you have to monitor her extremely closely with each injection and notify the vet immediately so he can record it and adjust the therapy when necessary.

In any event, it can take as much as 4 months to an entire year or so to achieve good results with immunotherapy, but as long as you have a pretty good baseline of known allergies, AS WELL AS taking steps to reduce those allergens in the environment, the success rate is usually pretty good. Some dogs require extended immunotherapy, others for life.

It kind of bothers me that he wasn't truly willing at first to consider testing and further exploration and treatment, but then used blood allergy testing rather than intradermal testing. I hope he knows what he's doing and how to adjust the schedule for the injections!!

Here's a good site for pet owners about this, and also a client sheet for giving the injections. (PDF file)

[Marty]

Thanks for the info, Traci. I have read over that info and will keep referring to it as needed. We have our injections, got instructions, did it once in the office and once at home. No problems yet.

In the beginning, he did mention the intradermal testing, and he said she could not be on antihistamines, predisone, no treats...nothing but her normal food for several weeks before testing. I hemmed and hawed about that, and honestly, neither she nor I can handle the constant scratching and crying day and night. It was a mutual decision to go this route...either that or send me to the looney bin!

I do think he is familiar with this. Most of the techs in the office have told me they are treating one or more of their own pets and rescues this way. They are super friendly and willing to share their experiences.

[Traci]

Good to hear, keep us updated on how it's going.