Diagnosis
A thorough physical examination of the patient, knowledge of the advantages and limitations of all available tests, and knowledge of the factors that can influence the results, will allow the veterinarian to correctly diagnose the disease.
Laboratory results should be interpreted in light of history and physical examination findings with the diagnosis confirmed through specific evaluation of the thyroid gland. Table 11.1 contains the main presenting complaints and clinical signs. Table 11.2 contains a summary of the advantages and limitations of the most commonly used thyroid tests in dogs. The presence of typical clinical signs in combination with a decreased total thyroxine (TT4) and increased thyrotropin (TSH) serum concentration is diagnostic and will allow to accurately diagnose approximately 75% of the patients with hypothyroidism. The addition of free T4 (after equilibrium dialysis) and/or measurement of thyroglobulin antibodies can offer additional information. Some cases will require further diagnostic tests, such as thyroid scintigraphy or recombinant human TSH (rhTSH) stimulation test, to make a reliable diagnosis (Daminet et al. 2007; Shiel et al. 2012).
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