Hypothyroid dogs treated with intravenous levothyroxine

The purpose of this retrospective study was to report clinical and clinicopathologic findings, response to treatment, and outcome of hypothyroid dogs treated with levothyroxine intravenously (IV). Seven levothyroxine IV treated hypothyroid dogs and 799 other hypothyroid dogs examined during the same period were included. Rottweiler dogs were overrepresented in the group of levothyroxine IV-treated hypothyroid dogs compared with other hypothyroid dogs (P < .0001). Common physical examination abnormalities were obese or overweight body condition (5 dogs), mental dullness (5 dogs), and nonpitting edema (4 dogs). Anemia (4 dogs) and hypercholesterolemia (5) were common, although 1 dog had neither. Concurrent disease (most commonly infection) was observed in 5 dogs. Glucocorticoids and nonsteroidal antiinflammatory drugs had been administered to 2 dogs before examination. Surgery was performed in 2 dogs before treatment with levothyroxine IV. Four of the 7 dogs received 4-5 microg/kg of levothyroxine IV. Subjective improvement in mentation or ambulation (6 of 7 dogs) and systolic hypotension (2 of 2 dogs) occurred within 30 hours of levothyroxine IV administration. Six of the 7 dogs responded well to therapy and were discharged from the hospital. It was concluded that physical examination and clinicopathologic findings of dogs with a hypothyroid crisis are nonspecific, although Rottweiler dogs may be at increased risk. Concurrent disorder, such as infection, concurrent administration of thyroid hormone-altering medication, and surgery, may be associated with development of a hypothyroid crisis. Resolution of abnormal mentation, ambulation, and systolic hypotension should be expected within 30 hours. Prognosis is good in most treated dogs.