Primary Veterinarian Check-Up and Internal Medicine Specialty Exam

January 12, 2023

Despite an increase in his Thyro-Tab (Levothyroxine) daily dose, Porter’s coat had been increasingly thinning and a thyroid panel showed low T4 (1.1) , low FT4 and low TSH. Our primary veterinarian suggested that at this point it would be a good idea to see an Internal Medicine Specialist.

February 13, 2023: Internal Medicine Exam

Porter saw Dr. Alan Klag, Chief of Internal Medicine at BluePearl Pet Hospital in Levittown, PA.

Porter hangs out under the desk of the Internal Medicine Department’s nurse (pic taken by the nurse)

The Exam:

Dr. Klag noted that it is difficult to interpret Porter’s prior lab results, as the TSH level would typically be high with hypothyroidism. Dr. Klag explained that he cannot eliminate the possibility of the multiple drugs Porter is on for seizures having an effect on his coat and thyroid hormone measurements. At this time, Dr. Klag is not certain that Porter has true hypothyroidism and is also not convinced that the thyroid is the cause of his alopecia.

Dr. Klag’s plan is to increase Porter’s Thyro-Tab (Levothyroxine) dose in an attempt to get Porter’s T4 into the target region (3-4 ug/dl) to see if this has any effect. If in two weeks after the medication increase Porter’s T4 is not in the target range, then Dr. Klag would discount hypothyroidism as a cause of Porter’s hair loss and consider tapering him off the thyroid supplement.

February 14, 2023: Lab Results

The Good News:

Porter’s overall lab results looked good and his Albumin level is normal (it had been at abnormal levels in the past).

The Not-So-Good News

Although Porter’s T4 had risen to 2, Dr. Klag would want to see Porter’s T4 level at a 3 or 4. Dr. Klag had us increase Porter’s ThyroTab daily dose once again. In two weeks, Porter will have another T4 blood test. At that time, Dr. Klag will make a decision on what path we take.