Something's lacking

I saw two 8 year old labs, littermates, for their annual exams today. The male was bouncy, perky, with a glossy coat. His sister looked at least 3 years older. "She's always been mellow," her owner said, "and always had dandruff." She had incredible dandruff, and now she had a "rat tail" - her tail was scaly and sparsely haired, with a big ugly bald patch on top. Her heart rate was slow.

"Seriously, we call her Eeyore, because that's how she acts." She had Eeyore's posture, head drooping, tail slack. The difference was striking compared to her alert, tail wagging brother.

"I really think she has hypothyroidism," I said. "It's common in older dogs, especially labs, that as they age their thyroid glands don't produce enough of the hormone that allow them to set their metabolism. They seem like they've aged rapidly, have lower energy levels, often have dull scaly haircoats and dandruff. The rat tail is a classic sign. They also gain weight while on a diet."

When she said the dog was eating a lot less than usual but her weight hadn't changed. A thyroid blood test is $50, although I'd prefer a senior panel for $100.

"What is that really going to tell me?" the owner asked.

Well, if she's hypothyroid, it's an easy cure, she just takes a pill twice a day that replaces the hormone. A three month supply of pills is $20.

"Yeah, but seriously, what difference is that going to make for her?" she asked again.

Well, her skin will look much better, she'll have more energy, she'll be less prone to infections. When I've put dogs on thyroid supplement, their owners say they act so much younger. People who are hypothyroid say they have low energy and are cold all the time without treatment.

"I know," she said, "I'm hypothyroid. I just don't think it would make that much difference for her. These dogs are costing us a lot of money. I just don't think we would treat her."

What is wrong with this woman? Her female dog is so different from her male. It's probably been coming on slowly for years, so she hasn't noticed it. But, when I'm pointing it out to her, with a perfect normal control for comparison, how can she deny it? Hypothyroidism is one of the easiest, cheapest, and most rewarding diseases to treat.

I gave her some space to think about it, and fortunately at the end of the exam she consented to the thyroid level. "You should have told her you'd refund her money if it wasn't low," my tech said. I can't really do that, but it crossed my mind. I feel confident enough that I posted it here. Hopefully results will tell tomorrow.