How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Dr. Stacy Your Own Question

Dr. Stacy
Dr. Stacy, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 921
Experience:  10 years of experience in general practice.
Type Your Dog Veterinary Question Here...
Dr. Stacy is online now
A new question is answered every 9 seconds

my 14 year old dog is very tired. Total T4 is 0.5 ( but did

Resolved Question:

my 14 year old dog is very tired. Total T4 is 0.5 ( but did have one dose of cortisone drops in ears before test) Free t4 is 12 and the thyroglobulin auto antibodies is 1. The free T4 is on the low side I think ( range 8-40). Would giving her thyroid medicine help? If so, how much?

Additionally, her Alk Phoshate has been running high for at least a year. Last august it was 1208 and this August, 1703 Alt last August 74 this August, 157. All other bloods are normal, including her liver and calcium numbers.

Thank you.
Submitted: 7 months ago.
Category: Dog Veterinary
Expert:  Dr. Stacy replied 7 months ago.

Dr. Stacy :

I don't think this is a primary thyroid problem and I don't think thyroid medication will make a huge difference. Has your veterinarian discussed Cushings with you?

Dr. Stacy :

Cushings is a hormonal imbalance.... one of the most common ones in older dogs. It often causes increases in the AP such as you have been seeing in the last year.

Customer:

I apologize, I forgot to state that she just had the whole cushings test , she does not have cushings.

Dr. Stacy :

Symptoms of cushings include: increase thirst and urination, increased appetite, decreased energy, decreased muscle strength, increased panting, decreased coat quality, sometimes they develop a 'pottbelly'.

Dr. Stacy :

Which test can I ask? ACTH stimulation or Low dose dex supression?

Customer:

she got either 3 or 4 blood draws, so i think dec supression

Dr. Stacy :

That sounds like Dex supression. Does she have increased drinking and urination?

Customer:

No symptoms, I know all about cushings symptoms and all vets say--- she doesn't have it.

Dr. Stacy :

Does she have any other symptoms of thyroid disease other than being tired? Has she gained weight or does she have a poor hair coat?

Customer:

not really,just very tired. She seems nauseous though she doesn't throw up. drink and appetite good.

Customer:

urine tests good too

Customer:

her nose is very dry!

Dr. Stacy :

Cases like this are frustrating. Your veterinarian has done a good workup. I agree, it does not sound like Cushings.... It also does not sound like hypothyroidism either. Thyroid hormones are very susceptible to other problems in the body. The free T4 is less susceptible to other problem in the body and is in the normal range. I'm pretty satisfied that the thyroid is normal even with this low normal number.

Dr. Stacy :

I don't think thyroid is the primary problem, I don't think thyroid medications will help much, however, they are very safe and if you wanted to try them I don't see any risk in doing that.

Dr. Stacy :

I suspect that she has disease elsewhere in her body and it is just not severe enough to show up on any of the routine tests your vet has done. You may get an answer with more aggressive testing, such a a liver biopsy.

Customer:

any surgery would be too hard are her. her liver numbers are good and sono looked good.

Dr. Stacy :

I would consider trying some supplements that can support her liver and immune system. I like milk thistle and SAM-E. You can get them at a health food store or some vets carry them. Fatty acids can help too. I have seen theses things help when we know that the liver is struggling, but can't find a cause.

Customer:

what makes the alk phos high?

Dr. Stacy :

alk phos come from the liver. There are 2 types... one that is just liver related and another that is produced in response to cortisone in the body. That is why we always consider cushings when a dog has an elevated AP.

Dr. Stacy :

Any 'stress' on the liver... from toxins to cancer... can cause it to go up. It is also elevated in dogs that have cushings or are being given oral steriods. Steriod in the ear can cause it too, but only after very long term use.

Customer:

do you think ginger root is good for a little nausea? She is on milk thistle. While would vet thinking Bile duct blockage? l

Dr. Stacy :

Yes, ginger is good for nausea. Your vet might thing that because Alk Phos is in a higher concentration in the cell that line the gall bladder and bile ducts than in other part of the liver. He may have also thought the gall bladder looked distended on the ultrasound.

Customer:

vet is a she! gall bladder fine on ultra sound. She wants me to use Ursodiol, 1ml a day

Dr. Stacy :

That I would absolutely do. We don't entirely understand all the ways that ursodiol works, but we know it has a lot of beneficial effects in the liver, especially with the gallbadder.

Customer:

She also want me to give her DHEA, a daily small dose, for energy, do you think that is a good idea?

Customer:

Anyside effects with Urosodiol? ( don't worry, my last question)

Dr. Stacy :

There used to be some concern that it could cause pain and problems if it caused the gallbladder to contract to hard, but it is not something we see in real life. DHEA is good, I would also ask if she has a milk thistle supplement.

Dr. Stacy :

Best of luck to you.

Customer:

Thank YOu!

Dr. Stacy :

Your welcom

Dr. Stacy :

welcome

Dr. Stacy, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 921
Experience: 10 years of experience in general practice.
Dr. Stacy and 2 other Dog Veterinary Specialists are ready to help you
Expert:  Dr. Stacy replied 7 months ago.
Hi Chris,

I'm just following up on our conversation about Honey. How is everything going?

Dr. Stacy

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • It was so professional, so personally concerned (as we were) and you answered all of our questions. George and I are so happy that I found "JustAnswer" on my Google search -- you are now in my "Favorites" list! And, yes we do love our kitty - she makes our life complete! Bev & George Boca Raton, FL
< Last | Next >
  • It was so professional, so personally concerned (as we were) and you answered all of our questions. George and I are so happy that I found "JustAnswer" on my Google search -- you are now in my "Favorites" list! And, yes we do love our kitty - she makes our life complete! Bev & George Boca Raton, FL
  • Wonderful service, prompt, efficient, and accurate. Couldn't have asked for more. I cannot thank you enough for your help. Mary C. Freshfield, Liverpool, UK
  • This expert is wonderful. They truly know what they are talking about, and they actually care about you. They really helped put my nerves at ease. Thank you so much!!!! Alex Los Angeles, CA
  • Thank you for all your help. It is nice to know that this service is here for people like myself, who need answers fast and are not sure who to consult. GP Hesperia, CA
  • I couldn't be more satisfied! This is the site I will always come to when I need a second opinion. Justin Kernersville, NC
  • Just let me say that this encounter has been entirely professional and most helpful. I liked that I could ask additional questions and get answered in a very short turn around. Esther Woodstock, NY
  • Thank you so much for taking your time and knowledge to support my concerns. Not only did you answer my questions, you even took it a step further with replying with more pertinent information I needed to know. Robin Elkton, Maryland
 
 
 

Meet The Experts:

 
 
 
  • Dr. Debbie's Avatar

    Dr. Debbie

    Dog Veterinarian

    Satisfied Customers:

    902
    Companion animal veterinarian practicing for over 10 years.
< Last | Next >
  • http://ww2.justanswer.com/uploads/DE/debkatreyn/2011-11-28_33650_682e.64x64.jpg Dr. Debbie's Avatar

    Dr. Debbie

    Dog Veterinarian

    Satisfied Customers:

    902
    Companion animal veterinarian practicing for over 10 years.
  • http://ww2.justanswer.com/uploads/VE/vetforyou/2012-6-20_33122_PearlPhoto.64x64.jpg Dr. Andy's Avatar

    Dr. Andy

    Medical Director

    Satisfied Customers:

    13796
    UC Davis graduate, emphasis in dermatology, internal medicine, pain management
  • http://ww2.justanswer.com/uploads/doggfone1/2009-07-16_133633_vet_pic.jpg Dr. Scott's Avatar

    Dr. Scott

    Veterinarian

    Satisfied Customers:

    9550
    12 years of small animal, equine and pocket pet medicine and surgery.
  • http://ww2.justanswer.com/uploads/RY/rydergar/2012-6-6_192240_IMG0328.64x64.JPG Dr. Gary's Avatar

    Dr. Gary

    Dog Veterinarian

    Satisfied Customers:

    7758
    DVM, Emergency Veterinarian, BS (Physiology)
  • http://ww2.justanswer.com/uploads/AN/andrewDVM/2012-4-27_12585_iStock000011751407XSmall.64x64.jpg Dr. Drew's Avatar

    Dr. Drew

    Dog Veterinarian

    Satisfied Customers:

    6598
    Small Animal Medicine and Surgery
  • http://ww2.justanswer.com/uploads/1I/1ISUDVM/2011-3-1_22028_Honeymoon2005075294928803490646858.64x64.jpg Dr. Bruce's Avatar

    Dr. Bruce

    Veterinarian

    Satisfied Customers:

    6377
    13 years of experience as a small animal veterinarian
  • http://ww2.justanswer.com/uploads/BI/bigislandvet/2013-2-21_214244_IMG0357.64x64.JPG Dr. Michael Salkin's Avatar

    Dr. Michael Salkin

    Big Island Vet

    Satisfied Customers:

    6049
    University of California at Davis graduate veterinarian with 41 yrs. of experience.