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Dr. Barbara
Dr. Barbara, Board Certified Veterinarian
Category: Vet
Satisfied Customers: 1614
Experience:  Thirty years experience in small animal medicine and surgery.
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DOG HAS THYROID PROBLEMS VET HAPPY WITH IT;S T4 , BUT DOG

Customer Question

DOG HAS THYROID PROBLEMS VET HAPPY WITH IT';S T4 , BUT DOG VERY LETHARGIC, HAS BEEN BLEEDING FROM BACK PASSAGE, BLOOD IN URINE, ANEMIEA ALSO LOW BLOOD PROTEINS, ANEIEMA CONRTOLABLE WITH DIET UNABLE TO GET PROTEIN SORTED.

DOG LICKS HIS PAWS ALOT POO VERY DRY AND CRUMBLY REFUSING WALKS DOG IS 3YRS OLD
Submitted: 3 years ago.
Category: Vet
Expert:  Dr. Michael Salkin replied 3 years ago.

I'm puzzled by the history you've provided.  Chronic bleeding from both the gastrointestinal tract and urinary tract suggests a bleeding disorder such as immune mediated hemolytic anemia or, less commonly, a coagulation defect such as hemophilia.  Chronic bleeding will cause hypoproteinemia (decreased blood proteins).  Can you tell me, please, if testing directed toward these types of bleeding disorders has been performed - a careful exam of the red blood cells for the presence of spherocytes (a shape suggestive of autoimmune hemolytic anemia), testing for autoagglutination (pathognomonic - particularly indicative of - for autoimmune disorders), ANA and LE prep testing?  Has the anemia been classified as non-regenerative (your dog can't replace the red blood cells he's lacking) or regenerative (your dog is replacing the red blood cells he's lacking).  This is done by checking his reticulocyte count.

I'm also puzzled by "thyroid problems" at 3 years of age.  Thyroid levels can be depressed secondary to systemic disease.  The thyroid gland may actually be healthy.  Until his bleeding disorder can be clarified, I wouldn't put much stock in a low T4 at this time.

I need to know quite a bit more to be more accurate for you.  I'd be pleased to review any testing that's already been performed.  You can upload test results to our conversation.  If you need help doing so, please contact [email protected] 

Please respond with additional information and further questions or concerns if you wish.

Customer: replied 3 years ago.
Relist: Incomplete answer.
Customer: replied 3 years ago.
Relist: Incomplete answer.
Expert:  Dr. Michael Salkin replied 3 years ago.
The posted text was garbled. It should have said the following:
I'm puzzled by the history you've provided. Chronic bleeding from both the gastrointestinal tract and urinary tract suggests a bleeding disorder such as immune mediated hemolytic anemia or, less commonly, a coagulation defect such as hemophilia. Chronic bleeding will cause hypoproteinemia (decreased blood proteins). Can you tell me, please, if testing directed toward these types of bleeding disorders has been performed - a careful exam of the red blood cells for the presence of spherocytes (a shape suggestive of autoimmune hemolytic anemia), testing for autoagglutination (pathognomonic - particularly indicative of - for autoimmune disorders), ANA and LE prep testing? Has the anemia been classified as non-regenerative (your dog can replace the red blood cells he's lacking) or regenerative (your dog is replacing the red blood cells he's lacking). This is done by checking his reticulocyte count. I'm also puzzled by the diagnosis of thyroid problems at 3 years of age. Thyroid levels can be depressed secondary to systemic disease. The thyroid gland may actually be healthy. Until his bleeding disorder can be clarified, I wouldn't put much stock in a low T4 at this time.I need to know quite a bit more to be more accurate for you. I'd be pleased to review any testing that's already been performed. You can upload test results to our conversation. If you need help doing so, please contact [email protected] Please respond with additional information and further questions or concerns if you wish.

I see that you've relisted and so I'll opt out. Please don't respond to me which will dissuade other vets from chiming in.
Expert:  Dr. Barbara replied 3 years ago.
Hi,
My name is Barbara, and I too am a licensed veterinarian. I do agree with Dr. Salkin that it sounds like from what you are saying that your dog has a clotting problem which leads to blood loss in his urine and rectum and probably internally also. This leads to anemia which is making him very lethargic.
Clotting difficulties most commonly in a young dog are from rodenticide ingestion (rat poison) or from an immune mediated thrombocytopenia. . .he has low a low platelet count because something has triggered his body to produce antibodies that are destroying his platelets.
Is it possible that he got into rat poison? Was he vaccinated in the past 6 to 12 weeks. Is he on any medications other than a thyroid supplement?
Dogs can of course have a mild anemia if they are hypothyroid, but to be losing blood like he is makes me most concerned about his ability to clot.
Hope to hear back from you soon!
Dr. Barbara