Hypothyroid-associated neurologic signs in dogs - Veterinary Medicine
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Hypothyroid-associated neurologic signs in dogs
Explore three cases of dogs with neurologic signs that were found to have hypothyroidism, and see when you should test for this disease in your patients with neuromuscular signs.


VETERINARY MEDICINE


CONCLUSION

The link between hypothyroidism and neurologic disorders remains difficult to prove definitively. Consequently, a presumptive diagnosis of neurologic dysfunction secondary to hypothyroidism is challenging, especially when other supporting clinicopathologic data are not present. These three cases indicate that clinicians should consider pursuing thyroid testing in dogs with neurologic deficits that are unexplained through a basic diagnostic work-up.

Although the dogs in the aforementioned cases had blood work changes consistent with hypothyroidism, this is not the case with all dogs in the literature.9-11,13,16 In addition, the dogs reported herein did not have clinical signs or a presenting complaint that is often attributed to thyroid hormone deficiency.

In particular, dogs with dysfunction of the neuromuscular system, dogs with multiple cranial nerve deficits primarily involving cranial nerves VII and VIII, and dogs with clinicopathologic data and imaging findings consistent with ischemic injury to the central nervous system should undergo appropriate testing of the pituitary-thyroid axis. These tests should accompany a systemic work-up including a CBC, a serum chemistry profile, a urinalysis, and an otoscopic examination in dogs with vestibular involvement or facial nerve deficits. Moreover, exclude from consideration euthyroid-sick syndrome, the impact of drugs that can alter thyroid hormone concentrations, and other etiologies to which the observed neurologic deficits could be attributed to before making a presumptive diagnosis.

Ultimately, in dogs with a definitive diagnosis of hypothyroidism and unexplained neurologic deficits, empirical thyroid hormone supplementation followed by close monitoring of the resolution of neurologic deficits should be judiciously undertaken.

Abigail Bertalan, VMD
School of Veterinary Medicine
University of Pennsylvania
Philadelphia, PA 19104

Eric N. Glass, DVM, MS, DACVIM (neurology)
Red Bank Veterinary Hospital
197 Hance Ave.
Red Bank, NJ 07701

Marc Kent, DVM, DACVIM (internal medicine, neurology)
School of Veterinary Medicine
University of Georgia
Athens, GA 30602

Alexander de Lahunta, DVM, PhD, DACVIM (neurology), DACVP
Department of Biomedical Sciences
College of Veterinary Medicine
Cornell University
Ithaca, NY 14853


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Source: VETERINARY MEDICINE,
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