Last night, I received a call from the vet. Bear B’s blood work results were in. They are concerning.
First, his white blood cell count was a little high. It was 19,000. Ideally, it should range between 6,000 and 17,000. At this time, the vet is not too concerned about his wbc count. Due to the fact that he had a cluster of seizures in the twenty four hours before the visit, a higher than normal count was to be expected.
The most concerning was his liver enzymes. The doctor said only that they were really high. This is a concern that the phenobarbital is starting to do some damage. We won’t know how extensive the damage until we have weaned him down or off of the phenobarbital. The good news is that the liver is really good at healing itself once the toxin is removed.
The last test that the doctor discussed with me was his T4 test. T4 is a thyroid hormone. It was at .6, and normal is between 1 and 4. The vet is going to have them test the blood for thyroid stimulating hormone (TSH). If the TSH level comes back high while the T4 level is low, then Bear B is suffering from hypothyroidism caused by his thyroid not giving off enough hormone. If the TSH comes back low, then he is suffering from hypothyroidism caused by his pituitary gland and (according to the vet) possibly Cushing’s disease.
I should receive a phone call about those results today. At that time, we will discuss the plan of action. We already know that he plans to put Bear B on Keppra XR. This is another anticonvulsant. The goal would be to reduce or eliminate the phenobarbital. If he does receive a diagnosis of hypothyroidism, he will also start taking Levothyroxine. This is a synthetic thyroid that will provide hormone replacement for the remainder of his life.
As is my way, I hung up the phone with the vet and began researching. Here is what I have found:
Dogs with hypothyroidism may suffer from lethargy. Bear B is definitely lethargic. The people who own his parents had named him Eeyore because he just moped around and didn’t play with the other puppies. He had a belly full of worms, so we always equated it to that. He never became a really active dog, though. We just figured it was his personality. He played, just not a lot and not for very long periods at a time.
Greasy dandruff and chronic skin infections. This is the one that leaves me a little upset with every vet (present one included) that has ever seen Bear B. He gets these rough patches of greasy dead dry skin. He also suffers from chronic acne. I have brought these skin conditions up at numerous vet visits. I always felt there was something to it. They always blew it off as him having sensitive skin. As a sufferer of sensitive skin myself (who recently spent the weekend covered from head to toe in a rash, feeling the itch of it in my lungs) I didn’t push too hard.
Dull, dry coat and excessive shedding. The vet always attributed this to age and stress. Being epileptic is stressful. This excessive shedding coupled with the fact that hair growth is slowed leads to bald patches. This can include rat tail. This is where much of the tail is bare except for a little tuft at the end. Bear isn’t quite there, yet, but he does have a lot of bareness on his once fluffy, full tail.
The one that caught my attention. The one that leaves me the most upset is that hypothyroidism can cause seizures. Why, then, has Bear B never had his thyroid tested before? While it is possible that he does suffer from epilepsy, or that the damage done by the hypothyroidism is permanent and he may need anticonvulsants for the rest of his life, it is also possible that the seizure activity stems from the thyroid problem and he could ultimately be seizure free for the rest of his life.