Thursday, September 18, 2008

The ongoing saga of Gio's epilepsy

A couple of days ago I detailed how Gio's epilepsy recently took a dive for the worse. He had been 11 months seizure free, then at the beginning of August had one grand mal. At the beginning of September, he had another bout, this time 3 seizures within 24 hours. That was the first time he had "clustered", with 2 grand mals and a focal. Also the first time he has had a focal, to the best of my knowledge. Though the recovery time for the focal was quite short so for all I know he could be having one every night and I would never notice.

Anyways, as a result, I booked him in at the vet for some bloodwork. He was due for his regular work anyways, and I wanted to run a thyroid test as well. There has been some great research lately that points towards thyroid function affecting seizure frequency in epileptic dogs, and how merely being "within range" might not be enough. The "range" differs based on breed, age, size, sex, etc.

Now, I love my vet. I think he is wonderful. If I ever needed an emergency surgery or procedure, I absolutely trust his abilities. But he is very old-school and if it isn't in his vet manual from 30 years ago, he thinks it's voodoo or something. So when I mentioned that I wanted a 6-panel thyroid test done as well, he literally rolled his eyes at me. What 50-something year old man ROLLS HIS EYES at a client! He got all sarcastic saying "And what do you expect THAT to prove?" I mentioned that there are many epileptic dogs that get good contol of their seizures with a combination of thyroid meds and anti-seizure meds, when the anti-seizure meds alone didn't cut it. He retorted with "Is this Dr. Dodds you are quoting?" It was, and he responded with a "hrmph" and another eye roll. It literally came down to me saying "Look, it's my dog and my money. You're drawing blood anyways, the worst that will happen is that the test comes back perfectly fine and I've wasted a couple of bucks. Just do the test."

Well, the thyroid test, the chem panel, and the bromide levels came back the other day.

Chem panel looks great.
Bromide levels are too high, but we knew that already.
And the thyroid tests were all "within range", but many were on the low end of the range.

My vet calls me up to discuss the results and says that because all the thyroid tests are within range and Gio doesn't have any overt signs of being hypothyroid (you know ... aside from his short/thin coat and hyperactivity/excitability) he doesn't think thyroid meds would do anything. So prescribed phenobarbital in addition to his KBr. A reasonable decision IF I believed him about the thyroid resuls.

So I just nodded and agreed, asking him to fax me the test results as he normally does (I keep my own record of everything, just in case). I then promptly fax the results off to Dr. Dodds in California for interpretation.

I got her interpretation back yesterday ... and Gio is going on thyroid medication ASAP.

When factoring in age, size, breed, diet, etc. his T4, Free T4 and TSH are all too low! Though they show up as technically "within range".

In the chem panel, he had slightly elevated Urea and slightly elevated Calcium. Dr. Dodds noted that those are both normal based on results of raw fed dogs. By "slightly elevated" I mean that his urea was 10.7mmol/L with a reference of 3-10 and his calcium was 3.12 mmol/L with a reference of 2.2-3.

Anyways, back to the thyroid meds. With how difficult it was to even get a bloody test out of my vet, I know he is going to dig in his heels in regard to prescribing the meds that Dr. Dodds recommended. There is a female vet at the same clinic that I have seen a number of times. She is younger and newer and a very good vet. I really like her and believe that she would at least listen to reason about the thyroid thing ... But when I called this morning to speak with her, she isn't in until next week. I don't want to wait that long as it feels like I am pushing my luck already in waiting this long to change meds. So I've booked an appointment with a different vet in the city for tomorow afternoon. I've heard great things about her, she is pro-raw, sells it in her clinic and very geared towards natural medicine. She's hosted a couple of seminars based on Dr. Dodds' thyroid work in the past, so I know she will be a bit more receptive of the recommendation for thyroid meds.

I'm hoping the thyroid meds will help a bit. But even if they do not help with the seizures, they may help with his random other issues. Who knows ... maybe in a couple of weeks Gio will start sprouting a great big coat like a real Sheltie should have!

(For information on testing through Dr. Dodds, visit HemoPet.org)

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