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Topic Dog Boards / Health / Plechner's Syndrome?
- By Nikita [gb] Date 11.11.11 21:16 UTC
Two people have suggested this to me today for Remy and I'm just wondering if anyone's heard of it or has any experiences?

Long story short, Remy has been clinically hypothyroid since just after her turned 2, diagnosed hypothyroid in May 08, his dose was started at 0.5mg soloxine twice daily then raised twice up to 0.8mg; then down to 0.7mg this year.  Never been any improvement to his symptoms at all (hair loss, lethargy, weight gain if I'm not ridiculously strict (and bluddy hard to get it off if he does put it on - took me over 4 years to shift 9kg and he's still 1kg over, it just won't go), cold intolerance and this year I've noticed he's getting less responsive which is down as a common symptom on the Hemopet website).

Yesterday evening I got his latest results back and it's gone a bit crazy.  His symptoms remain the same - the lethargy has worsened over the last couple of years though.  But, his T4 is double the max; free T4 not far off the same; T3 is elevated too although his free T3 is fine.

Now, I believe he needs higher levels than most - he is not showing a single sign of soloxine overdose (quite the opposite as he is still hypothyroid in symptoms), when he was checked over a couple of months back the vet said he looked like he was not being medicated properly for his condition (i.e. not enough) and he is brachycardic.  But higher levels is one thing - double the max is more than high and I would expect some improvement!

Now I've started trying to find a solution to find out what the heck's going on, hence the two suggestions of Plechner's.  It seems to be similar to adrenal fatigue in humans (which would make sense as that interferes with thyroid function/thyroid hormone uptake in people).

So, has anyone any experience of it?  Or any other suggestions?  He was thoroughly investigated at the end of last year for his lethargy and no joy, everything normal except mild bronchitis (treated, no change to his symptoms) and elevated liver enzymes (returned to normal of their own accord within a month, cause unknown).
- By Frogs [gb] Date 12.11.11 10:05 UTC
I read this and started nodding, though my girl has improved immensely on Soloxine (0.8) 1 x daily
Her activity level and cold intolerance remain the same, but her coat and temper have improved.

She has high T4 depsite showing no signs of overdose, it is baffling the clinicians - she has also summer allergies and has had several lumps removed and has a few more they are leaving as well as sensitive skin. I still have to feed her less and exercise her more to keep her weight under control... it is driving me crazy as I feel there is some kind of answer outside of simple hypothyroidism, also as she is line bred this inherited link would be plausible as well...

I am going to google some more, limited info available it seems but I will watch with interest.
J x
- By Pedlee Date 12.11.11 10:52 UTC
Have you e-mailed or spoken to Dr Dodds at all? She has always been very quick to reply to e-mails and has answered a few questions I've put to her in the past.

Having said that Lottie, who was diagnosed hypothyroid at about 3 (is now 9), has never shown any improvement coat-wise even on the supposed correct dosage of thyroxil (0.3mg, twice a day). Her ears are still very sparse and bodily her coat isn't at it's best.
- By Nikita [gb] Date 12.11.11 11:27 UTC
I have emailed her - Remy and Paige's samples were sent to her for testing, but from what i understand, she tested Paige's but was then away until Friday.  Remy's came in Thursday afternoon from a different vet, with comments basically just stating what the numbers said (i.e. too high, reduce dose) - no mention of the A4 side of notes/history I'd put in the box.  So I've emailed with a fair few questions and mentioning the notes, not heard anything back as yet though.

Frogs - did you mean to write 1x daily?  The dose should be split over the day, two doses 12 hours apart and given at least an hour before food or 3 hours afterwards for proper absorption.  If she's getting the whole lot in one go then being tested that might explain the high T4.

Remy is on the right schedule just about and still has these problems though :-(

As for the Plechner's, I've been point towards Dr Plechner's book (Pets at Risk) - just ordered it from this place:

http://www.sheilaharper.co.uk/

Cheapest by far.  I shall be reading with interest!
- By Frogs [gb] Date 12.11.11 14:08 UTC
Yes it is split after a read here about the half life, and fed in a small piece of meat 1 hr before feeding in the morning. 2nd 1/2 is given 4 hrs after feeding

If we even drop her down to 0.7 her symptoms worsen, it is bizarre
- By Nikita [gb] Date 12.11.11 14:10 UTC
Yeah, I'm dreading reducing Remy's for the same reason :-( Going to try and persuade the vet otherwise but I'm not sure I'll have much luck.

I know some dogs need more than average and I think Remy's one of them but it's not just that with him (not if he's no better at double the usual maximum!) but maybe it is for your girl?
- By Frogs [gb] Date 12.11.11 17:02 UTC
The vet said he was happy that she was not exhibiting signs of overdosing, and said that sometimes the physical symptoms were a better guide and he was happy to leave her on that dose and review in 6 mths
- By Nikita [gb] Date 13.11.11 11:17 UTC
Well, I've just had an email back from Dr Dodds.  She suggested that perhaps his body was trying to excrete the T4 to prevent toxicosis so he wasn't getting the full benefit of his meds - I can understand that although it doesn't explain why he has never improved, even when he was first treated and results were OK.  So I'm still suspicious of an underlying thing.  She did say the only other reason would be a secreting tumour in his neck or chest.

She's suggested that we do the dose reduction as per the report, and add in a small dose of T3 also so I'll be speaking to the vet about that (and the possibility of a tumour, and Plechner's syndrome) next week.

Someday, I'll have a normal dobe!!
- By Pedlee Date 13.11.11 12:56 UTC

> Someday, I'll have a normal dobe!!


Is there such a thing?!
- By Nikita [gb] Date 13.11.11 12:57 UTC
I am starting to wonder!
- By Nikita [gb] Date 14.11.11 13:25 UTC
Seen the vet today, she's checked Remy over and confirmed he's not responding as one would expect to his huge T4 level.  But does agree that it needs to be lowered.  I'm dropping off his past full panel results and his page of notes shortly, she's also going to email JD to discuss him.  In the meantime he's been taken down to 0.6mg twice daily.

She's looking into the T3, happy to do that once she's sourced it and also looking into Plechner's (once i'd written it down lol!).
Topic Dog Boards / Health / Plechner's Syndrome?

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