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Aggression & Thyroid

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Aggression and Thyroid Disease
Kita, a 14-month old female was turned over to ARSA when her owner "moved to an apartment." Kita was purchased from the Petland Pet Store in Northridge, California. She was born at Waconda Kennels in Glen Elder, Kansas and came with a five-generation pedigree marked by a gold seal. Kita may have been born and bred in Kansas, but her pedigree proved that in her third generation, she was from some of the best known breeders in the country. How their dogs ended up as the foundation stock for puppy mills is not the topic of this article.

Kita was lucky for two reasons: (1) She was now in the hands of ARSA who cared deeply about each and every Akita, and (2) I had just received an article from Dr. Jean Dodds discussing "Behavioral Problems Associated with Thyroid Disease."

When Kita first arrived at the ARSA Kennel, she appeared to have a lovely coat and certainly did not exhibit any symptoms one usually associates with thyroid disease. Within a few short weeks, however, she began constantly pacing the perimeters of her kennel and rapidly lost weight. She was friendly and very affectionate with all people and spent the days fence-playing with the other dogs. We attributed her restlessness to being kenneled and had her spayed in hopes of finding her a home.

Kita was with us about two months when we realized her pacing had elevated to an abnormal level. Within days of our awareness of this abnormal behavior, Kita began constantly fence-fighting every dog at the kennel during her exercise time. One day, she turned that aggression toward one of the kennel girls, baring her teeth and charging. She landed a light nip on the hand of the thoroughly surprised employee. Of course, I was immediately notified of this dangerous and abnormal behavior. I had just finished reading Dr. Dodds' new article and decided to take Kita in for a complete blood panel, along with a copy of the article. Dr. Dodds described "sudden onset" behavioral changes as one of the likely cases of dogs suffering from a physical cause rather than a genetic behavioral problem.

During the moment it took to withdraw the blood sample, Kita had to be restrained because she had already shown aggression. This short period of restraint was very stressful to her but we obtained the blood sample without further problems. The blood was to be shipped to Michigan State University for a complete thyroid panel, including the autoantibody test. It would take between 7-10 days for the results to come back. Kita was put on twice daily doses of Phenobarbital to take the edge off her agitation. By now, she was skin and bones; her weight reduced to 61 pounds, though she was receiving 7 cups of Eukanuba daily. Minor coat problems, no skin problems, an excellent appetite, incredible energy levels, bone thin--not one of these symptoms is usually associated with diminished thyroid function.

The phenol seemed to help. Her aggressive behavior slowed, her pacing was not quite as frantic and she was once again friendly and playful. Ten days later, the results came back from Michigan State:

Total Thyroxin (TT4) 23 (Normal: 22-54)

Total Triiodothyronine (TT3) 1.1 (Normal: 1.2-3.1)

Free (unbound) T4 (FT4) 11 (Normal: 8-36)

Free (unbound) T3 (FT3) 1.2 (Normal: 1.0-3.7)

Kita was at the bottom of all normal ranges. Akitas should be at the upper ranges of normal. She was started on Soloxine, thyroid hormone supplementation immediately. Within a few days, her behavior improved greatly and she began to gain back some of her lost weight. She continued to make progress and was placed in a home where she has been maintained on hormone replacement therapy with annual thyroid re-testing. Kita is a very lucky dog. There are many Akitas whose behavior changes result in immediate euthanasia because neither their owners nor the attending vet are aware that sudden onset aggression can be caused by thyroid disease.

Dr. Dodds has given her permission to excerpt from her article, which appeared in DVM Newsmagazine. The article is long but I will share the salient points with you:

" A typical history starts out with a quiet, well-mannered and sweet natured puppy. The animal was outgoing, has attended puppy training classes to prepare for obedience, working, or show dog events, and comes from a reputable breeder whose kennel has no history of behavioral problems. At the onset of puberty, however, which usually varies anywhere from seven months to a year in age, major changes in personality are suddenly observed. Typical signs include one or more of the following: incessant whining, nervousness, schizoid behavior, fear in the presence of strangers, hyperventilation and undue sweating, occasional disorientation and failure to be attentive. These can progress to unprovoked aggressiveness in unfamiliar situations with other animals, with people, and especially with children.... Oftentimes these animals are then neutered, which appears to alleviate the behavioral problems and specifically the aggression for varying lengths of time. For a significant proportion of these animals, however, neutering does not alter the symptoms and they progressively intensify to the point that the animal can be described as flaky, unable to handle any kind of stress, frantically circling, hyperventilating and not being able to settle down. Animals that are used for field work and tracking often fail to follow the scent whereas those at obedience training may lose the scent articles. Their power of concentration is often very short and dogs that were training well at obedience appear to lag behind and become disinterested. With all of these changes in behavior the problem of most concern is unwarranted aggression. When large breeds of dog are affected it poses a significant hazard to family members, friends and strangers.

In some cases affected animals do not show aggression but become very shy and fearful to the point that they are social outcasts and do not make acceptable house pets.... Some dogs will show extreme submissive behavior, roll over and urinate upon being approached.

The third group of dogs showing aberrant behavior are those that experience seizure or seizure-like disorders of sudden onset beginning from puberty to mid-life. These are dogs that appear perfectly healthy outwardly, have normal haircoats and energy, but suddenly seizure for no apparent reason. The seizures are often spaced several weeks to months apart, and occasionally they appear in a brief epileptiform cluster. In some cases the animals become aggressive and attack those around them shortly before or after having one of these seizure episodes.

The number of animals showing various types of aberrant behavior in these three classical modes (aggression, extreme shyness or seizure-like activity) has been increasing in frequency over the last decade. Consequently, we began to examine these animals by using the stepwise diagnostic approach outlined above [ Complete history; clinical examination; neurological work-up; routine laboratory testing of CBC, blood chemistry and thyroid profiles, urinalysis, fecal exam and x-ray; additional specific laboratory tests as indicated; examination of cerebral spinal fluid; more specialized neurological examinations). We were surprised to find that in many cases studied, significant abnormalities were found in the thyroid profile. Some cases also had changes in the liver enzyme patterns, specifically with abnormal increases in resting and postprandial bile acids and elevated gamma glutamyl transferase levels. About 10% of these young dogs had abnormalities of the liver profile and a few also had changes in renal function. For the majority, however, the primary abnormality was attributable to abnormal thyroid function. This thyroid dysfunction would classically express high levels of T3 and/or T4 autoantibodies [Ed. note: Kita did not have high levels of autoantibodies.], with an artifactual, apparent elevation of T3 level. It would not be uncommon to find circulating T3 levels that read as high as 3,000-5,000 ng/dl. While not all affected animals had documented evidence of T3 and T4 autoantibodies; some of these had positive anti-thyroglobulin antibody (ATA) tests. In either event, the diagnosis was confirmed as autoimmune thyroiditis.

The autoimmune thyroid disease present in these patients is apparently inducing some type of physiological change at the cellular level, which leads to their aberrant behavior. This supposition can be made with some assurance because treatment of the thyroiditis with appropriate doses of thyroid hormone given twice daily along with a one month tapering course of low-dose corticosteroids has successfully reversed the behavioral problems within 4-8 weeks. Dramatic changes in behavior have been recognized in a few cases after only 10 days of therapy. However, it usually takes 5-7 months of thyroid replacement therapy to effect disappearance of the circulating antithyroid antibodies. These dogs should be maintained for life on the appropriate dose of thyroid hormone, which may need to be adjusted periodically.

Another subset of affected dogs does not have demonstrable anti-thyroid antibodies but have baseline thyroid profiles that are clearly abnormal. In these cases, levels of Total T3, Total T3, free T4 and free T3 are usually below the lowest limits of the adult normal ranges or are in the low-normal or borderline ranges. The latter situation is of particular significance in young dogs of about 9-15 months of age. When these dogs are treated with standard twice daily doses of thyroid replacement therapy (0.1 mg/10 lbs. of body weight BID) the clinical signs associated with aberrant behavior rapidly resolve.... Animals on therapy have successfully returned to obedience activities, completed show championships, and have undertaken active field and tracking work.

CASE 1.

A four-year old male Akita, weighing 110 pounds, suddenly attacked the owner and bit her in the face. The dog had been owned by the same family since early puppy hood and had been a remarkably even-tempered, well-behaved and non-aggressive pet with people and other animals. After seeking the advice of two veterinary clinicians and a major teaching hospital, the owner was about to give up in despair because no physical abnormalities could be found. She was then referred to us by an Akita rescue group, as this pattern of behavioral change has been associated with thyroid dysfunction in Akitas. A complete thyroid panel, which had not been performed earlier, was suggested and the animal was found to be significantly hypothyroid. Thyroid therapy was initiated on a twice-daily basis. The dog's exemplary temperament returned and he has not shown any unusual behavior for over a year. An interesting complication of the case was a moderately severe thrombocytopenia, which has also resolved with low doses (5-10mg) of alternate day steroid therapy along with the thyroid medication.

...For those animals that show occasional seizure disorders, thyroid medication alone will usually suffice. Anticonvulsant medication is needed along with the thyroid therapy to control cases with more severe seizure clusters. The anticonvulsants of choice would be Phenobarbital or alternatively, sodium bromide, particularly if the patient has abnormalities of liver function. Because many of these animals have autoimmune thyroid disease, concomitant medical management includes avoiding environmental factors that can further challenge the immune system. This means placing the animal on a hypoallergenic "natural" diet preserved without chemical additives (e.g. lamb and rice based lower protein kibble), avoiding drugs that may alter the immune system such as the potentiated sulfonamides and monthly heartworm preventatives, and withholding vaccination boosters until the thyroid function is properly balanced and the behavioral abnormalities are resolved. If animals are due for annual vaccine boosters during this period, vaccine antibody titers for distemper and parvovirus can be determined to assess the need.

In conclusion, the onset of sudden behavioral changes in an otherwise healthy young dog, should alert the practitioner to the possibility of an underlying thyroid imbalance as shown by presence of thyroid autoantibodies, low baseline levels of thyroid hormones, or failure to triple baseline T4 levels in response to challenge with TSH."

If you breed Akitas, we encourage you in the strongest terms to PLEASE test your Akitas for thyroid disease BEFORE breeding. The disease is very much a part of the Akita and not simply an intermittent, environmental condition. We are seeing epidemic proportions of thyroid disease in our dealings with Akitas--there is little doubt in the minds of most open-minded folks that a genetic cause is responsible. TEST.

Perhaps you've been surfing the Internet for an answer to sudden onset aggression in your own Akita. TEST. Unexplained aggression is often linked to health problems. Begin your search by having your Akita tested for thyroid disease. 

For a basic understanding about one cause of thyroid malfunction in all dog breeds, take a moment to read this article:   Pesticides and Aggression

for more information, visit these sites:

http://canine-epilepsy-guardian-angels.com/InterviewDrDoddsAndJoanneCarson.htm

http://www.kerryblues.info/index.html?http%3A//www.kerryblues.info/HEALTH/THYROIDITIS.HTML

http://www.uspharmacist.com/index.asp?show=article&page=8_1498.htm

http://www.gsdhelpline.com/hypothyroid.htm

TEST! TEST!  Before you euthanize an Akita for behavior changes, TEST!

1993 B. Bouyet