Hi all its a been a good few years since I've posted but now in need of some advice. We have an 11 year old spayed KC Reg Parsons  Terrier.   Two years ago she was very poorly and diagnosed with inflammatory bowel disease. It took sometime to get it under control and resulted in weight fluctuations and lots of flare ups. She has always been a very sensitive dog and suffers terrible separation anxiety that's got worse with age. She's lucky and never left any more and comes pretty much everywhere with us or goes to my very understanding parents! We home cook skinless chicken thighs, sweet potatoes and vegetables as she can't tolerate dry food, and it's cheaper that way. Slow cook large batches and freeze them in portions (yes spoilt dog!) she is on very low dose steroids prednisone and also has 0.2 ml propalin for incontinece, which luckily hasn't made her anxiety any worse. After all her tests and her lasts scan well over a year ago her hair never grew back from shaving and round her back legs started to get patchy, she has since been diagnosed with under active thyroid. Her bloods are now within normal range and she is doing well but she has been left with hair still not growing and very thin and patchy around back legs, slight black patches and very dry skin and is also loosing her now on her ear tips which are a bit crusty. She also has some muscle weakness I her back legs as she can't get on the bed always. (Yes she escapes to our bed away from the noisy kids!)  I know her time is running out but she is happy, loved and not in any pain. I'd like to think we can do more for her and I worry her diet is not good enough or needs supplementing. I feel she could look a little healthier. She has had her t3 and t4 tested but is no longer insured due to the £1800 pa renewal! Ideas and thoughts welcome. TIA

Really sorry about your old girl and even more so about the what I think is an horrendous sum to insure her.   This in a breed that really isn't prone to too many health issues I'd have thought!    Anyhow, re her ongoing care, I think you really should take your advice from the treating vet.   It could well be that she could do with extra supplements - vitamins etc., but I'm not experienced enough to know what.   Your vet should be?   I hope you have her for a good few more years yet - 'Jackie' -jackies almost all live well into their teens but not necessarily with the problems your old girl has, has to be said.

Send all the thyroid results to Dr Jean Dodds of Hemopet for interpretation,along with a brief history of that and the other conditions.  The prednisolone may be inhibiting hair growth but it's worth checking if her thyroid really is right, and Dr D has specific reference ranges for breed, age etc which will be more precise than the catch-all ranges used by the vet.  It may be that she needs a higher dose, which may help both her anxieties and the IBD as well.

Sorry to learn of all the problems you are having with your girl. Steroids certainly can cause hair loss but an under active  thyroid will cause significant loss also. You say that her T3 and T4 levels have been checked but the most relevant test for hypo/under active thyroid is TSH or Thyroid Stimulating Hormone. You need to speak to your vet about this. Not all understand thyroid disease adequately. it can be treated very easiyand the results are most gratifying. My Cassie became hypothyroid a few years ago. She looked dreadful with sparse coat,lethargy ,weight gain etc but on treatment she is back to her old sleek active self.

TSH is the least relevant test, actually - it's the most inaccurate.  Between 20 and 40% of dogs with underactive thyroid will have normal TSH.  My first hypo dog had perfect TSH his entire life, as his thyroid got worse and worse and worse and his symptoms with it.

It's a pituitary hormone - the only thing it tells us is the functionality of the pituitary gland, and not very usefully at that.  To test thyroid function, we need to test thyroid hormones.  Which reminds me, Chloe and Bufy - did your vet check the free T4 and free T3 or the total T4/T3?  Total is not helpful, it needs to be free as this is what is actually available to the body for conversion/use.

This is not correct.  Thyroid Stimulating Hormone (TSH) is the most sensitive test of thyroid function and also adequacy of thyroid replacement therapy.  The circulating thyroid hormones T3 and T4 negatively feedback to the thyrotrophe cells in the anterior pituitary (TSH rises when T4 deficient, falls when T4 in excess), the negative feedback 'servo' system controlling the amount of TSH produced by the anterior pituitary.  This pathway applies to all mammals (including man, which is why in humans TSH is now used as the first line test for thyroid disease).  Unfortunately, not all vets are aware of this detail (including my own!) and will test the circulating hormones T4 and T3, the levels of which may miss early thyroid insufficiency or adequacy of thyroid hormone replacement.

TSH is unreliable in people also.  I am hypo, my T4 and T3 levels were both dropping lower each time I was tested, yet my TSH remained "perfect".  If it was such a good indicator, it would have risen as the others fell.  It is more reliable than in dogs, but a multi-factor panel of at least free T4, free T3, antibodies and TSH is still required for proper diagnosis.

Going back to dogs; to quote Dr Dodds herself: "TSH is NOT a reliable assay when used by itself in the dog, and generally has poor sensitivity and predictive value in the dog. This is in contrast to the use of endogenous TSH assays in people which work very well."

Or another... "In dogs, only ~70 percent of thyroid hormone regulation is controlled by TSH, so this test has relatively poor predictability of primary hypothyroidism.  The remaining 30 percent of canine thyroid regulation is controlled by growth hormone. So, although elevated cTSH usually indicates primary thyroid disease, ~30 percent discordance is observed between expected and actual results in normal dogs, hypothyroid dogs and those with NTI or pituitary-dependent hypothyroidism."

Free t3 and t4 were checked but to be honest I find it all a bit confusing and overwhelming! Thank you for all your comments, I just wish all the blood tests didn't cost hundreds of pounds!

Having done a. Google search Dr Jean Dodds is in the U.S. Will she look at results for us? Does anyone know what she charges? Are the tests she does available in the UK? I had though the prednisolone maybe stopping her hair growth but she just doesn't do well without it.

To have her do the tests with her charity Hemopet, you'll need to send serum samples to her in CA.  Not as daunting as it sounds, I've done it a few times and it's a lot easier than it used to be in terms of getting the package shipped.

You can get full panels done here but the cost when I've looked into it is the same or more than sending it away, inclusive of the shipping charge.  And not all vets have access to the full run of tests - mine don't, they can't get any T3 tests.

The current cost for the usual 5-factor test is around £72, shipping when I did it last was just under £60 and a couple of quid for packaging.

All that being said: she will look at results and give her interpretation without charge (you can always donate to Hemopet if you want to though).  She's been invaluable to me with ongoing dosage tweaks over the years, and with getting Remy diagnosed in the first place.

Thank you Nikita, we have asked for a full copy of her notes from the vets and will get them looked at and then maybe see what she says before going any further. I'm just so sure we can be doing something more. She is happy just not looking healthy or could look healthier! I never expected these problems from a PRT but her anxiety causes so many problems. And yes we have tried everything for that too!

The anxiety can come with the territory when you're dealing with thyroid and steroids, unfortunately.  It's one of the reasons I suggested getting it looked into further.

I've known a couple of PRTs like this sadly - one was severely stressed just being outside the home, and needed prescription meds for it, and the other is just a wreck.  Morbidly obese most of her life, her hair barely grows and is thinning more down her sides, severe arthritis from the weight.  She can be quite reactive these days too.  It's so obvious she's got a thyroid problem but the owner is completely hopeless and the vet's even worse!

Thank you. She's had her thyroid tested so many times over the years, as that's what I always thought, but think the steroids have really affected her and made it more prominent. I wish I knew then what i know now, and still wish I knew lots more, but she's still happy as long as she doesn't get left and at 11 that isn't going to change now. She would rather spend hours in your car in a car park than ten minutes on her own. Luckily I work for myself so it can be done and if for some reason I can't my parents have her. A bit of pain but not the end of the world. And she hates a change in routine!