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I have a 8 year old golden retriever lab mix. Last week I came home to find her panting as if she need to go potty (this is her usual manner of asking). I went to take her out and noticed her back legs were limp and she could barely walk. She started panicking trying to walk but not able to, panting, drooling, but completely coherent and aware of what was going on. I thought she was dying :-( She calmed down after about an hour, I took her potty, then she had an even worse episode during which her back legs and one front leg quit working. She is not in pain when this happens, the limbs effected are completely limp. I have taken her to the vet, they originally thought it was her spine, but xray showed nothing abnormal, other than what one vet thought was a mass, which turned out to be her stomach being pushed by a swollen liver, they gave her a steroid shot and sent us home for the weekend. I came back monday and requested blood and urine tests. Well they then took the swollen liver idea back because her the liver count (sorry do not know the correct term) was only slightly high, but the blood work was done after a steroid shot so slightly high was expected. Her globulin was high as if fighting an infection and her CK (do not know right term) was also high indicating muscles were being attacked (or something, sorry it was a lot to take in and I do not have the results with me). So then they thought maybe blood infection, did more tests ruled that out and then came back saying she might have hypothyroidism and a bladder infection, they put her on antibiotics and thyroid med. Well I am not sure this diagnosis fits because everything I have read does not sound like what is going on with her. She has been in perfect health except for 2 months ago she lost most of her sight in one eye out of nowhere one day, she could see but not normal vision. She would become startled easily if approached from the bad eye, she has since adjusted and does not seem bothered by that eye. Other than that she has had no change in weight, appetite, energy, behavior, sleep, alertness, shedding, or anything at all. Just this intermittent paralysis, which is accompanied by what I think is a panic attack because she cannot catch her breath when her legs go out and she seems scared, sometime crying, I will try to comfort her and she will act like she wants me to hold/pet her, but then not want me, and then want me, it takes anywhere from 20 min to 2 hours for these episodes to pass. My personal opinion is the vets are at a loss and just wanted to stop me from bugging them, I do not think this is hypothyroidism and even if her counts were too low, there is more to this picture. Any ideas or suggestions are greatly appreciated. Thank you for your time.
 

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Does she have a normal temperature? (100-102).
Could she be having mini strokes? Pinched nerve in her spine? Brain tumor? Lyme disease?

Take her records to a different vet for a 2nd opinion. A vet school would be good if you have one near you.

Please update us when you find out more.
 

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I would also have the blood checked by someone who specializes in liver issues, sorry don't know the name. When Amy was pts, her regular liver enzymes were down to almost normal, from a way high when she went in a few days before but there was something showing that showed necrotic something, I'm sorry I don't have it better it was a really tough time about a month ago when it happened. It sounds similar to her, she had other signs, but some of them were similar. If you're going to check with a vet school, or specialist anyway, ask them to be sure it's really not a liver problem.
 

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Hypothyroidism is common in older goldens and it CAN relate to seizures..but really, I would be asking for a referral to a specialist here as it sounds like you may need more/better information on what is going on with your dog. Now it's important to remember that diagnosing these sort of issues is challenging so you often have the doctor say well it could be this, let's try this and this is not wrong as long as it's done in a logical manner and explained to the client.

I hope you get the care you need for your dog, good luck.
 

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When you're getting a lot of information ask them to write it down. I always had a hard time remembering what the vet was telling me about her condition, so I had her write EVERYTHING down, this way I could read it and figure it out later, when I was less emotional.
 

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Discussion Starter #6 (Edited)
When you're getting a lot of information ask them to write it down. I always had a hard time remembering what the vet was telling me about her condition, so I had her write EVERYTHING down, this way I could read it and figure it out later, when I was less emotional.
Thank you all for replying, yes her temp is normal, her coloring, eating habits, drinking, and so forth all normal. Also she still has complete control over her bladder and bowel movements, even during paralysis episodes. I do not think we have a vet school in my area but I will look into it, and I am giving her current doctor until Tuesday or wednesday to come up with something more fitting than hypothyroidism, if they are still at a loss I am going to ask for a referral to a specialists, or return to her previous vet which I liked, but left because the prices became insane! Keep in mind I made the switch long before she started having trouble. Another problem is I have 3 kids and simply do not have the funding to pour into tests, which really makes me sad because I wish I could simply afford whatever it takes. I believe an MRI would show something, but at $1200.00 I cannot take that step :-( Also writing things down is a great idea, I did do further research on the levels mentioned to me, and i plan on requesting a print out of the detailed blood work once all the tests come back. When I get those counts I will post them to see if anyone can help come up with anything. I understand diagnosing anyone is a process of elimination, one problem her is she has signs of many hings but none of them fit into one diagnosis enough for her to be diagnosed. Vet does not think she is having seizures because of the durration of the episodes and the fact she is completely aware, hypothyroidism doesnt fit because she has no other symptoms such as hair loss, weight change, and so on. Liver doesn't seem to fit because she would have trouble right after eating and then be ok if it were her liver (or so the vet said), and she is not effected by food, really too much excitement or movement seems to trigger the paralysis, that along with the sudden vision loss in one eye a couple months back really has me thinking brain tumor, but like I said I cannot afford the MRI.
 

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Discussion Starter #7
Now they are thinking she may have Myasthenia gravis, but still she does not fit all the symptoms such as the enlarged esophagus. Still clueless and I am still frustrated :-/
 

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Let me get this straight. They put yoru dog on levothyroxine without doing any specific thyroid tests?????
no they did a full blood work panel and her thyroid level was very low, near non existent; however, that can happen if the immune system is working over time to fight something, which is why I do not think it is her thyroid. I have stopped the thyrosin meds anyway because she obviously does not have hypothyroidism and I was worried it would effect her thyroid function when or if she ever does get better. she has had a good two days so far no bouts of leg trouble or panting episodes, last night she was acting like herself 100% jumping around and acting a fool, maybe she is getting better? Or maybe I am giving myself false hope?
 

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Her T4 levels were exceedingly low and you don't think she has hypothyroidism? EVen if she does have something else going on, the mere fact that her levels that low would speak to adding the levothyroxin to try to keep her in balance. By the way, if you looked up the other symptoms of hypothyroidism, weight gain and ski/hair issues are only two of MANY symptoms which may occur...she does not have to have gained weight OR be losing hair to be hypothyroid.
To suddenly take her off the levo when she is not producing enough hormones to keep her system in balance (unless okayed by the vet first) could be a foolish undertaking.
If her immune system is working overdrive there should be other immune related signs...did anything in her blood work show excessive WBC?

Regardless, she should probably be on the levo.
 

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Her T4 levels were exceedingly low and you don't think she has hypothyroidism? EVen if she does have something else going on, the mere fact that her levels that low would speak to adding the levothyroxin to try to keep her in balance. By the way, if you looked up the other symptoms of hypothyroidism, weight gain and ski/hair issues are only two of MANY symptoms which may occur...she does not have to have gained weight OR be losing hair to be hypothyroid.
To suddenly take her off the levo when she is not producing enough hormones to keep her system in balance (unless okayed by the vet first) could be a foolish undertaking.
If her immune system is working overdrive there should be other immune related signs...did anything in her blood work show excessive WBC?

Regardless, she should probably be on the levo.
The vet did authorize taking her off the thyroid med because she started vomiting the other day all day. So I was told to take her off it because she may not need it, and to watch to see if she started acting better because since starting the thyroid meds she started drinking more water and acting more tired. Stopped the medication and she stopped vomiting, resumed drinking normally, and regained energy. The past 2 days she has not had any episodes of paralysis or any of her other symptoms, which is weird. Her legs seem a little weak and slightly wobbly sometimes but other than that she seems ok, maybe she will pull through it on her own? Or maybe eventually the vet will figure something out, either way I think they have eliminated thyroid for the time being and are going to recheck her blood work next week. I will stop by to get a copy of her blood work tomorrow and get back to you on the exact blood count. Thank you for your response :)
 

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stopped and got the blood and urine test results below I will list the abnormal levels....
Albumin 2.2 LOW
Globulin 4 HIGH
Albumin/Globulin .6 LOW
AST (SGOT) 290 HIGH
ALT (SGPT) 156 HIGH
Alkaline Phosphatase 149 HIGH
Cholesterol 1144 HIGH
Triglycerides 1290 HIGH
CPK 2541 HIGH
T4 .3 LOW
Urine results
Microalbuminuria >30 HIGH
Specific Gravity 1.012 LOW
Protein 3+ HIGH
Blood 2+HIGH

If anyone can help me I REALLY would appreciate it, I am at a loss I can come up with several things but she never fits the whole picture of anything I have read :-/ Also I am unsure why the vet did not mention all these other levels being off when I spoke with them on the phone, sort of aggravated about that and will likely be switching vets first thing Monday
 

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What are her RBC, platelet, and WBC counts (WBC wil be broken down into specific 'types') and did they do a clotting factor? Did the doctor do a CBC (Complete Blood count) it's a fast and easy test to do and can give a HUGE amount of information.
 

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What are her RBC, platelet, and WBC counts (WBC wil be broken down into specific 'types') and did they do a clotting factor? Did the doctor do a CBC (Complete Blood count) it's a fast and easy test to do and can give a HUGE amount of information.
Those counts were normal as far as I can tell...
RBC 7.83 (normal range 4.8-9.3)
Platelet 273 (Norm:170-400)
WBC 7.7 (Norm: 4.0-15.5)
everything else on the CBC appears normal also, I can give more detail if needed. Thank you for helping, oh and I do not think they checked the clotting factor? Is there a specific term for that?
 

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There are several clotting factors, most predominant in dogs would be for von Willibrands, but it wouldn't show up like this. Now surewhy I even asked about that one, thats what I get for only having about 2 /12 hrs sleep.

Honestly, the results point to liver problems, perhaps an obstuction? (can happen from infections or parasites) Odd that the AST is higher than the ALT though, in most liver problems the opposite is true. I think I would get a second opinion or a specailist on this one.
 

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This is a tough one, really tough.

First things first - You must realize that we see cases come through our small animal internal medicine ward with multiple endorinopathies all the time. These guys will have nasty, nasty combinations of hypothyroid/cushing's/addisons/diabetes mellitus/etc... and they are super tough to crack. Also, you also have to know that just because a dog doesn't fit the "classical" picture of a disease doesn't mean anything. I find most dogs don't read the book before they come in and they just like to make things difficult. Havign said that, this really is tough.

The low T4 makes me super suspicious. Personally, I'd want a Free T4 run on this dog since the Total T4 was so low. The Free t4, while it does cost more, is really the gold standard for making the diagnosis of hypothyroidism. However, those elevations in liver enzymes are not typical of hypothyroid dogs. The urine is dilute, which combined with the high Alk Phos, points more toward a Cushing's dog.

Then there's the AST and ALT. CSchellen, the AST isoenzyme has a good bit shorter half life than ALT so you're right in that in theory it should be lower. But, ALT is truely specific to the liver(indicating hepatocellular necrosis) whereas AST is not. You'll see AST levels raise in cases of muscle damage or necrosis and with hemolysis of red blood cells (not evident by the normal RBC count here). Something else that supports muscle injury or necrosis is the high CPK.

So, hmm, yes I like idea of going ot a referral practice. What state do you live in Violet? If you're in an area I know I might be able to recommend some specialists over others.
 

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This is a tough one, really tough.

First things first - You must realize that we see cases come through our small animal internal medicine ward with multiple endorinopathies all the time. These guys will have nasty, nasty combinations of hypothyroid/cushing's/addisons/diabetes mellitus/etc... and they are super tough to crack. Also, you also have to know that just because a dog doesn't fit the "classical" picture of a disease doesn't mean anything. I find most dogs don't read the book before they come in and they just like to make things difficult. Havign said that, this really is tough.

The low T4 makes me super suspicious. Personally, I'd want a Free T4 run on this dog since the Total T4 was so low. The Free t4, while it does cost more, is really the gold standard for making the diagnosis of hypothyroidism. However, those elevations in liver enzymes are not typical of hypothyroid dogs. The urine is dilute, which combined with the high Alk Phos, points more toward a Cushing's dog.

Then there's the AST and ALT. CSchellen, the AST isoenzyme has a good bit shorter half life than ALT so you're right in that in theory it should be lower. But, ALT is truely specific to the liver(indicating hepatocellular necrosis) whereas AST is not. You'll see AST levels raise in cases of muscle damage or necrosis and with hemolysis of red blood cells (not evident by the normal RBC count here). Something else that supports muscle injury or necrosis is the high CPK.

So, hmm, yes I like idea of going ot a referral practice. What state do you live in Violet? If you're in an area I know I might be able to recommend some specialists over others.
V, I was going to suggest cushings (and the free T4), I then deleted the post as I know that TYPICALLY cushing presents with VERY swollen belly from all the cortisol released, a friend had a Mare with Cushings and I've know a few humans with it, all were overweight with a LOT of belly fat and the humans typically had very swollen faces (think of someone on Prenisone treatments). Perhaps this a early stage and the abdominal weight just hasn't Started
 

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Discussion Starter #20
wondering if there is an update?
Hello, my dog has been perfectly fine out of nowhere since about 4 days before Labor Day weekend. I took her back into the vet because she was vomiting and had soft stools the Friday before Labor day and they gave her a shot for nausea. She started eating and returned to normal. Her legs have not had any trouble at all and her energy levels are back to normal. Totally bizarre! Only illness I can come up with at this point is Coonhound paralysis caused by a intestinal virus she may have caught from eating a diaper when one of my kids was ill. Her symptoms were not quiet as sever as typical coonhound paralysis but maybe that is because it was from humans instead of a raccoon? I really have no clue! The real kicker here is her so called "doctor" has not even called once to check up on her! I certainly will not be taking her back to that doctor if she becomes ill again. Perhaps she is better, or maybe it will flare back up? I will repost if her symptoms return, but as of now it seems I get to keep my best friend for a while longer :)
 
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