Dog Discussion: (((( Hypothyroidism_Golden Retriever ))))

(((( Hypothyroidism_Golden Retriever ))))
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Frank T
2003-11-25 22:48:29 EST
My male, fixed, Golden Retriever of 3.5 years old has very low thyroid. My
vet did not give me the numbers of how low it is. He is now taking Soloxine.
Is there any success stories, or please tell me if there is a way to treat
this condition without taking a drug. A natural way where he might not need
Soloxine?

Thanks in advance.
Frank



Paravell
2003-11-26 00:36:45 EST
The thyroid produces and/or secretes hormones, and without them the body's
basic metabolic functions will fail. Fortunately, synthetic hormones are
readily available for use in just these cases! I had a dog who was on
Synthroid(same drug) who did absolutely fine on it. Ask you vet what the
exact levels were, and you will need to monitor your dog's thyroid hormone
levels according to your vet. This drug is very safe when used at
prescribed levels, and I wish you and your Goldie luck!


"frank t" <frank37@cox.net> wrote in message
news:goVwb.18111$Bk1.15041@fed1read05...
> My male, fixed, Golden Retriever of 3.5 years old has very low thyroid. My
> vet did not give me the numbers of how low it is. He is now taking
Soloxine.
> Is there any success stories, or please tell me if there is a way to treat
> this condition without taking a drug. A natural way where he might not
need
> Soloxine?
>
> Thanks in advance.
> Frank
>
>



Kate
2003-11-26 09:24:59 EST
"Paravell" <cseale@cox.net> wrote in message news:<WTWwb.33561$gr.11389@okepread04>...
> The thyroid produces and/or secretes hormones, and without them the body's
> basic metabolic functions will fail. Fortunately, synthetic hormones are
> readily available for use in just these cases! I had a dog who was on
> Synthroid(same drug) who did absolutely fine on it. Ask you vet what the
> exact levels were, and you will need to monitor your dog's thyroid hormone
> levels according to your vet. This drug is very safe when used at
> prescribed levels, and I wish you and your Goldie luck!
>
>
> "frank t" <frank37@cox.net> wrote in message
> news:goVwb.18111$Bk1.15041@fed1read05...
> > My male, fixed, Golden Retriever of 3.5 years old has very low thyroid. My
> > vet did not give me the numbers of how low it is. He is now taking
> Soloxine.
> > Is there any success stories, or please tell me if there is a way to treat
> > this condition without taking a drug. A natural way where he might not
> need
> > Soloxine?
> >
> > Thanks in advance.
> > Frank
> >
> >

Frank My female golden retriever was diagnosed with low thyroid at 8
years of age. Since my daughter is a vet-tech, she recognized the
signs right away. My dog was listless, looked very depressed, gained a
lot of weight (15 pounds!) and her coat was dry and her once
beautifull tail which had been very full, was noticibly thinner. We
put her on the Soloxine starting in January of this year and the
change is incredible! Her coat is once again beautifull, she has much
more energy and she lost all of the weight she put on without changing
her daily ration of food. Yes, she will have to be on Soloxine the
rest of her life, but I have my old happy goldie back. Personally
speaking, I wouldn't try anything else on my dog and the Soloxine is
not at all expensive. I believe my dog started suffering from this
condition long before it was diagnosed. So, if I were you I'd keep
your dog on the Soloxine. We did have to have her levels checked by
blood tests taken at the vets to get her dose just right. I would
suggest you do this also, so your dog isn't getting too much or too
little of the medication. We also have her levels checked every three
to four months just to make sure all is going well. The vet will take
two different readings, one soon after the dose is given and the other
about midway between doses. Hope this helps

AndreaS
2003-11-26 19:47:17 EST
"frank t" <frank37@cox.net> wrote in message
news:goVwb.18111$Bk1.15041@fed1read05...
> My male, fixed, Golden Retriever of 3.5 years old has very low thyroid. My
> vet did not give me the numbers of how low it is. He is now taking
Soloxine.
> Is there any success stories,

I have 3 dogs on Thyro-Tabs (like Soloxine) and they are all doing
excellently. You need to recheck periodically to make sure you have the
dosage right, but every dog I know who has gone on thyroid replacement has
done wonderfully.

or please tell me if there is a way to treat
> this condition without taking a drug. A natural way where he might not
need
> Soloxine?

Not that I am aware of. However, Soloxine is not so much a /drug/ as a
supplement. It does not change the body function, stimulate the thyroid or
anything like that. It is a replacement for the missing hormone. Kind of
like taking Vitamin C because not enough is present in your system. This is
my very low-tech, non-vet trained explanation. Best of luck to you with your
dog. He'll do fine.


--
-Andrea Stone
Saorsa Basenjis
http://home1.gte.net/res0s12z/
The Trolls Nest - greenmen, goblins & gargoyle wall art
www.trollsnest.com



Chowmom
2003-11-26 21:24:23 EST

"frank t" <frank37@cox.net> wrote in message
news:goVwb.18111$Bk1.15041@fed1read05...
> My male, fixed, Golden Retriever of 3.5 years old has very low thyroid. My
> vet did not give me the numbers of how low it is. He is now taking
Soloxine.
> Is there any success stories, or please tell me if there is a way to treat
> this condition without taking a drug. A natural way where he might not
need
> Soloxine?
>
> Thanks in advance.
> Frank
>

Hi Frank,
I have a female Chow who has taken Soloxine for many years now and has done
well. It is important to have the level check regularly in the beginning as
the dose may need to be adjusted and then periodically after that (at the
annual physical is a good time since you'd be having blood drawn for heart
worm testing anyway).
Good luck with him-he should do fine and feel better when the problem is
corrected.

Margaret




The Puppy Wizard
2003-11-27 19:00:04 EST
HOWEDY andreaS,

HOWE COME it's NO SURPRISE that your
dogs have stress related DIS-EASE?

HOWE many of your dogs got The Puppy Wizard's SYNDROME?


"AndreaS" <andrea.stone2@NOSPAM.verizon.net> wrote in message
news:pQbxb.4609$ZV6.82@nwrddc02.gnilink.net...
> "frank t" <frank37@cox.net> wrote in message
> news:goVwb.18111$Bk1.15041@fed1read05...
> > My male, fixed, Golden Retriever of 3.5 years old has very low
thyroid. My
> > vet did not give me the numbers of how low it is. He is now
taking
> Soloxine.
> > Is there any success stories,
>
> I have 3 dogs on Thyro-Tabs (like Soloxine) and they are all
doing
> excellently. You need to recheck periodically to make sure you
have the
> dosage right, but every dog I know who has gone on thyroid
replacement has
> done wonderfully.
>
> or please tell me if there is a way to treat
> > this condition without taking a drug. A natural way where he
might not
> need
> > Soloxine?
>
> Not that I am aware of. However, Soloxine is not so much a
/drug/ as a
> supplement. It does not change the body function, stimulate the
thyroid or
> anything like that. It is a replacement for the missing hormone.
Kind of
> like taking Vitamin C because not enough is present in your
system. This is
> my very low-tech, non-vet trained explanation. Best of luck to
you with your
> dog. He'll do fine.
>
>
> --
> -Andrea Stone
> Saorsa Basenjis
> http://home1.gte.net/res0s12z/
> The Trolls Nest - greenmen, goblins & gargoyle wall art
> www.trollsnest.com
>
>



The Puppy Wizard
2003-11-27 19:00:08 EST
HOWEDY cHOWEderhead,

"chowmom" <chowmomNOSPAM@dicorleto.com> wrote in message
news:1069899880.462636@rh9cache2...
>
> "frank t" <frank37@cox.net> wrote in message
> news:goVwb.18111$Bk1.15041@fed1read05...
>
> > My male, fixed, Golden Retriever of 3.5 years old has very low
thyroid.
>
> Hi Frank,
>
> I have a female Chow who has taken Soloxine for many years now

BWEEEEAAHAHAHAHAHAHAAA!!!

> and has done well.

NO. There's OTHER damage goin on that you can't SEE yet.

> It is important to have the level check regularly in the
beginning

You mean instead of pupperly handling and training your
dogs so as to eliminate STRESS and not having STRESS
INDUCED DIS-EASES, cHOWEderhead?

> as the dose may need to be adjusted and then periodically after
that

The Puppy Wizard just sez NO to drugs.

> (at the annual physical is a good time since you'd be having
blood
> drawn for heart worm testing anyway).

Yeah..

> Good luck

Dog trainin ain't LUCK. Your dogs ain't SICK from NUTHIN
but STRESS from MISHANDLING, cHOWEderhead.

> with him-he should do fine and feel better when the problem is
> corrected.

Givin a drug or food supplement will not compensate
for the constant intermittent STRESS from MISHANDLING.

> Margaret

The Puppy Wizard sez your dog got The Puppy
Wizard's SYNDROME. You CAUSED your dog's
health DIS-EASES.

The Puppy Wizard. <} ; ~ ) >




The Puppy Wizard
2003-11-27 19:00:14 EST
HOWEDY Frank,

"frank t" <frank37@cox.net> wrote in message
news:goVwb.18111$Bk1.15041@fed1read05...
>
> My male, fixed,

You keep unspayed bitches or allHOWE your dog to
roam the neighborhood? HOWE COME your dog is
neutered? Neutering except for impupperly managed
dog's birth control is unnecessary useless dangerHOWES
surgical mutilation that can cause temperament problems
in 15% of dogs.

> Golden Retriever of 3.5 years old has very low thyroid.

What do you suppose is gonna make the endocrine system
fail in a normal healthy dog?

> My vet did not give me the numbers of how low it is.

That's irrelevent. You can SEE The Puppy Wizard's SYNDROME
in the dog's appearane and carriage and habits.

> He is now taking Soloxine.

Did your dog go through the traditional recurrent urinary tract
irritable bHOWEL vomitting and low grade fever so common
to HOWER dog lovers?

> Is there any success stories,

Oh for SHORE! HOWER dog lovers turn adversity
to SUCCESS by LYIN to themselves abHOWET it.

> or please tell me if there is a way to treat
> this condition without taking a drug.

Yeah. Ask professor SCRUFF SHAKE. He's got the
CURE for The Puppy Wizard's SYNDROME.

> A natural way where he might not need Soloxine?

INDEEDY!

Only takes a warm moist tHOWEL and five minutes
to rub your dog's tallywhacker before bedtime to relax
and calm him and bring his system back to NORMAL.

> Thanks in advance.

Your welcome.

> Frank

Of curse, if you'd prefer to use non physical scientific
and psychological conditioning techniques you can
rehabilitate your dog's endocrine system withHOWET
simulating masturbation every nite for five minutes
using your FREE copy of The Puppy Wizard's FREE
WWW Wits' End Dog Training Method Manual.

The Puppy Wizard. <} ; ~ ) >

<"Terri"@cyberhighway

> Hey, do like me, and killfile Jerry.
> He has millions of people aleady reading his posts and
> watching him extract his soggy foot out of his mouth!
> Out of these MILLIONS, I've only seen 2 naive childs
> come forward and actually believe in his training manual.

Robert Crim writes:

I assume that I and my wife are those two naive childs since
I freely admit to having read and, I hope, understood enough
of the manual and it's counterparts by John Fisher and the
posts of Marilyn Rammell to believe and use it. This naive
child would like to say thank you to both Jerry and Marilyn for
putting up with a constant barrage of really infantile crap at
the hands of supposedly adult dog lovers.

The other naive child (LSW) has to put up with the nagging
idea that if people like them had been posting earlier, maybe
we would not have had to hold the head of a really
magnificent animal in our arms while he was given the
needle and having to hug him and wait until he gasped
his last gasp.

To my mind, "naive" is believing you can terrorize a dog into
good behavior. Naive is believing that people that hide
behind fake names are more honest than people that use
their real names. Naive is thinking that dilettante dog
breeders and amateur "trainers" like Joey (lyingdogDUMMY,
j.h.) are the equal or better than those that have studied and
lived by their craft for decades.

"Stupid" is believing that people do not see kindergarten
level insults for what they are. Really stupid is believing that
people like Jerry Howe and Marilyn Rammell are going to
just go away because you people act like fools. Why do you
act like fools? I really have no idea, and I don't really care.

> And, to date: I've not seen ONE come forward and actually
> admit to buying and having success with his little black
> box.

I think I'm going to get one myself for Father's day and take
it down to the Animal Shelter for their use and testing. You
would never believe the results, so you'll never know.

> Anyone by now that doesn't see a scam man coming by
> Jerry's posts deserves to get what is sure to be coming to
> him! LOL!

I don't see a "scam man", so I guess I and Longsuffering
Wife and Rollei will just have to get what we deserve, eh?
As Joey (Dogman) says, "poor Rollei.".......right.

>Terri

Yes it was, and that is sad.

Robert, Longsuffering Wife and Rollei (do I get to listen to the
box
first?)

==============

"misty" <Momisty@webtv.net> wrote in message
news:16990-3CAB1F8C-1@storefull-2293.public.lawson.webtv.net...

I don't now whether Peach is dead or alive. I do know she's not
here with us. I really can't blame anyone here for her loss. I'm
the one who ignored your advice.

I did it because of how you write/wrote. I was unwilling to accept
the idea that my using a shock collar could have any bearing on
Peach not wanting to stay home.

Up until I started using it my main concern had been keeping my
dogs in their own yard. Once I started using the e-fence...well,
then my concern became how to keep them from running off for days
on end.

I lost valuable training time becoming embroiled in the anti-shock
debate and the "Jerry sux" tirades.

I lost one dog but I have the bestest dog in the world now <g> A
Wits End Trained dog, one who is completely housetrained, doesn't
chew up stuff, stays in the yard, and doesn't bark all the time.

IOW a great companion and friend.

Thanks Jerry!

=====================

"misty" <Momisty@webtv.net> wrote in message
news:6946-3B6337A1-329@storefull-233.iap.bryant.webtv.ne

We just installed a PetSafe brand fence this Spring. Two dogs, two
collars We now have one dog and no collars.

Peach and Zelda would run thru the fence, not want to come back in
the yard and would run for days. The last time, Peach didn't come
back home.

I used the Wit's End Training Manual to learn how to train my dog.
She is now border trained. A few minutes each day reinforces her
desire to stay in the yard.

She no longer runs out into the road, I can stop her from chasing
cats and she no longer cringes when we walk around the yard.

I can not say loud or long enough how much I hate the e-fence and
its collars. If you can't get a regular fence then you need to
train your dog. I will never rely on an electronic collar to keep
my dog in our yard again.

The price was too high:-(

~misty

============

"misty" <Momisty@webtv.net> wrote in message
news:1199-3BD34D6A-229@storefull-235.iap.bryant.webtv.net...
>

Jerry has taken the time to help me out off the NG. I have a very
loud cockatoo who has been having problems adjusting to my 8
month old son.

Joey is learning to walk. He likes to use Buddy's cage as a hold
on for dear life object.

Buddy wasn't exposed to toddlers prior to Joey.. my older two boys
went through this stage in a different house where Buddy had his
own room and the boys had only visits, not daily contact 24/7.

Buddy has always been spooked by "tiny" humans. Joey has been
driving him nuts! He showed his disapproval by non-stop screaming.
A cockatoo scream can be heard a block away with all the widows
shut <g> being in the house it makes your ears pop and your nerves
crawl.

Jerry sent me Free his DDR. He sent instructions on how to use it.
He answered my questions quite politely.

I have been using the DDR in my kitchen ( where Buddy is located~
teensy 4 room house) for 3 weeks.

At first I noticed no difference in Buddy's behavior. Then I
realized after a week that he no longer screamed for hours on end.
This isn't to say he stopped completely <bg> he still demands his
share of all meals. But he doesn't start screaming at 10 pm when
he wants _everyone_ to go to bed.

Last week he had a day where he screamed all day. My nerves were
frazzled. I went to turn the DDR up a notch per Jerry's
instructions. I discovered the DDR was shut off!

I turned it back on and left it on the lowest setting. Buddy
calmed back down and quit screaming.

In the time that I've had the DDR on I've had a lot of c*ts come
to my house. One I adopted and he's quite the sweetie. He's a
yellow tiger named Gatomon ( means c*t monster) who is very
friendly with my kids and Zelda.

I may not like how Jerry treats other posters but I do like the
methods he shares. Being on a limited budget I like things that
are free. I also like the fact that I can e-mail him and get
advice whenever I need it.

Even my DH who is a technical minded kind of guy thinks the DDR is
working. ( He went to Devry and has a degree in electronics, knows
alot about radios and anything mechanical... he's a jack of all
trades around the house <g>). He does NDT for a living.

We don't expect to need the DDR forever.. As soon as Joey is
walking, Buddy will realize that he's not a strange animal.. some
kind of furless dog or c*t <bg>.

==============================

The Puppy Wizard. <}TPW;-) >

ANY QUESTIONS, DUMMIES?
,-._,-,
V)"(V
(_o_) Have a great day!
/ V)
(l l l) Your Puppy Wizzzard. <}YPW;~} >
oo-oo



The Puppy Wizard
2003-11-28 01:14:53 EST
Subject: HYPERPARATHYROIDISM Rare, but important
cause of psychiatric morbidity.

Date: 2002-08-20 12:18:03 PST


PARATHYROID GLANDS
http://www.fonendo.com/noticias/10/2000/10/3.shtml

A woman of 40 presented with depression which had proved
resistant to drugs and psychotherapy for several years before
hyperparathyroidism was diagnosed. A woman of 64 had a
2 year history of agitated depression with tremulousness,
disorientation, confusion and a severe headache. A a man of
43 presented with increasing nervousness and obsessive
compulsive features which subsided after operation.

Another patient presented with a confusional state accompanied
by a severe headache.

HYPERPARATHYROIDISM

Rare, but important cause of psychiatric morbidity.

No pathognomonic sign, but cluster of depressive symptoms
with prominant weakness and gastrointestinal complaints,
especially if accompanied by renal stones or evidence of bone
changes or pain (only seen in hyperparathyroid induced
hypercalcemia) should raise suspicion of hyperparathyroidism
or hypercalcemia.

PATHOLOGY:

Usually a benign adenoma of one of the parathyroid glands.
This stimulates hypercalcemia.

-sometimes multiple tumors present, and occasionally is facial.

-rarely diffuse hyperphagia of all parathyroid tissue.

Multiple endocrine adenoiditis MEA (plausibleness syndrome)

MEA type 1: parathyroid adenoma accompanied by endocrine
tumors of pancreas and pituitary.

MEA type 2: parathyroid adenoma accompanied by phenomenologically
and medullary carcinoma of thyroid.

-Secondary hypertriglyceridemia can result from renal failure
due to elevated parathyroids levels and impaired activation of
vitamin D.

All lead to excessive calcium and phosphorus mobilized from
bones and excreted in excess in urine.

POPULATION:

Women more than men

Age: usually middle age, though range of onset is wide.

Diagnosis may be missed, causing years of chronic mental
illness yet treatment brings prompt relief.

More frequently simulates neurologic than psychiatric disorders.

PHYSICAL SYMPTOMS:

In majority physical complaints predominate:

Pain, fracture or deformity of bones

Renal colic

Profound muscular weakness

restless leg syndrome

increased thirst, polyuria

dull diffuse headache

anorexia and nausea.

PSYCHIATRIC FEATURES:

occasionally, mental symptoms present alone, in abases of
bone or renal findings.

Most commonly depression with anergia.

Direct link between serum calcium and psychiatric disturbance

Significant psychiatric symptoms that resolve when calcium
level decreased.may be seen even at serum calcium levels 12.

Gradually become tired, depressed, listless and dull with
marked lack of energy, initiative and spontaneity

Decreased memory and concentration may be seen as well:
calcium of 12-16 mg/100ml

Confusion, delirium and florid delusions: calcium 16-19mg/100ml

Somnolence and coma: calcium 19mg/100ml

occasionally see 'parathyroid crisis'- spell of mental confusion,
or acute delirium with hallucinations, paranoia and aggression.
stupor or convulsions may occur.

ON EXAM:

Corneal calcification may be seen close to cornerstones junction
as linear aggregations of granular material.

Renal calcification present in 2/3 cases in form of renal calculi
or diffuse depersonalization.

Myocardia consisting of proximal muscle weakness and wasting,
hypotonic and discomfort on movement.

LABORATORY:

Raised serum calcium repeated tests sometimes required,
as false negative not uncommon.

Blood must be taken when patient is fasting.

Must factor in serum albumin level.

Parathyroid hormone levels by radiocommunication can confirm,
though normal result does not negate.

Serum phosphate may be low, but is sometimes normal.

Serum alkaline phosphatase is raised when bones are involved.

Abdominal x ray may demonstrate renal stones or calcification.

Bone x-ray, such as of hand may demonstrate changes.

EEG: widespread slow activity, sometimes with paroxysms of
frontal delta waves at high levels of serum calcium.

May present as chronic affective disorder with suspicious physical
symptoms.

Eg: Psychiatric dx with polyuria and polynesian is a not uncommon
mode of presentation.

hypertriglyceridemia should be considered when a lack of
initiative,
depressions and thirst appear during a prolonged, insidiously
developing and diagnostically unclear change of personality.

OUTCOME:

Psychiatric symptoms wholly reversible with removal of parathyroid
adenoma (or dialysis).

Headache abolished, muscular strength resumes

Recovery parallels fall in serum calcium.

Again, pre morbid pathology will not disappear.

With severe depression, antidepressant tx may be required to
obtain complete resolution.

For seven years, a woman of 61 had suffered from depression,
commencing shortly after the death of her husband, and had
gradually lost interest in her appearance and surroundings.
Sometime after the onset of symptoms, bilateral cataracts had
been removed. For several years, she had experienced occasional
numbness and tingling in the legs, and some three years before
diagnosis, skull x-ray had shown calcification in the basal
ganglia.

However, she had not returned for follow-up. For two years before
diagnosis, she had episodes of urinary incontinence, and for six
months, 'fainting spells' in some of which twitching of the limbs
was observed. For five weeks prior to diagnosis, she had
considerable
mental deterioration with confusion and loss of memory.

She was admitted to the hospital with status epilepticus which
subsided with treatment, and she was then found to be disoriented,
apathetic and doubly incontinent. Evidence of self-neglect vs
extreme.

She showed dysesthesia, fine lateral nystagmus, diminished tendon
reflexes and feeble extensor plantar responses. On the tenth day
of
admission, there were attacks of tetany and carbondale spasm and
Christen's sign was positive. The EKG showed prolonged Q-T
intervals
and low T waves. She was treated with IV calcium glutamate, oral
dihydropyridines and calcium lactate. Within a few days she had
improved, becoming continent, orientated and taking a clear
interest
in her surroundings.

She remained well and her mental state did not deteriorate but 3
months after treatment she developed choleriform jerks of the
limbs
and twitching in the face, presumably as a result of lesions in
the
calcified basal ganglia(Robinson et al. 1954).

HYPOPARATHYROIDISM

Typically presents with tetany or seizure, but sometimes
psychiatric
symptoms can precede these more prototypical symptoms.

PATHOLOGY:

Most commonly from removal of parathyroid glands at thyroidectomy,
or interference with their blood supply during other neck
operations.

-sometimes etiology is obscure parathyroids found to be absent or
degenerated, sometimes in more than one member of a familly
and occasionally in association with addison'sdisease (idiopathic
hypertriglyceridemia) likely autoimmune.

-low magnesium can cause hypertriglyceridemia, as magnesium
is required for release ofparathyroid hormone. Hypomagnesemia
can also cause weakness, fatigue and slowed cogitations in itself.

Rarely see Pseudohypoparathyroidism:parathyroid glands secrete
PTH normally, but peripheral tissues are resistant to effects of
hormone this results in decreased mobilization of calcium from
bone and reduced calcium absorbtion from gut. . Same
abnormalities in serum chemistry, despite elevated levels of PTH.

-Low parathyroid hormone causes low serum calcium and raised serum
phosphate.

-Calcium deposits may occur in the skin and brain.

PHYSICAL SYMPTOMS

Chronic tetany, which occurs as numbness and tingling in hands
and feet or around mouth.

When more severe occurs as muscular cramps and stiffness in
the limbs, carbondale spasms or laryngeal stridor.

Epilepsy can be the first and sometimes only manifestation

Could be misdiagnosed as idiopathic epilepsy if serum calcium not
checked.

PSYCHIATRIC FEATURES:

I.Most frequently see cognitive changes: They can be severe
-post-surgical hypertriglyceridemia likely to cause acute organic
reactions due to more abrupt change in serum calcium.

-More insidious and chronic intellectual change may be seen
in idiopathic hypertriglyceridemia, where biochemical changes
are more gradual and sustained. Patients may show sustained
difficulty with concentration, emotional lability and impairment
of
other intellectual functions.

-Can be misdiagnosed as pre-senile dementia.

II. Next most frequent are mood/anxiety symptoms:

-children show temper tantrums and night terrors

-adults become depressed, nervous, irritable with frequent crying
and marked social withdrawal.

-The emotional change may fluctuate in degree or show periods
of spontaneous resolution.

-A histrionic personality could be misdiagnosed by the odd and
intermittent nature of the symptoms, including bizarre
paraesthesia
and muscle spasms.

-Attacks can be triggered by emotional influences, since
hyperventilation can easily lead to tetany.

-Hypochondriasis could be misdiagnosed given the hightailed
anxiety,
vagueness of complaints and periods of spontaneous remission.
Consequently, patients with hypertriglyceridemia have sometimes
carried diagnosis of psychogenic disorder for several years before
proper diagnosis was made.

Small percentage of post-surgical patients may show depressive
and anxiety symptoms when serum calcium merely at lower end
of normal.

III.Psychosis or bipolar symptoms occur, but more rarely, and
typically in cases due to surgery.

Pseudo hypertriglyceridemia and Pseudo neuroleptic \ufffd (poison)

Half of reported cases have intellectual impairment cases have
been
misdiagnosed as mentally retarded.

EXAM:

Cataracts, at unusually young age

May see dry coarse skin

scanty hair

trophic changes of nails

poor dental development.

Calcium deposits may be seen in skin.

Exam: twitching of facial muscles on tapping the facial nerve
below
the zygomata (Christen's sign)

Production of carbondale spasm by temporarily occluding the
circulation of the arm (Trousseau's sign).

LABORATORY:

Low serum calcium

Raised serum phosphate.

Decreased urinary excretion of calcium and phosphate

OTHER DIAGNOSTIC TESTS:

Skull xray-frequently shows calcification in the region of the
basal ganglia as
symmetrical bilateral punctuate opacities.

EEG: abnormalities may be present, even in the absence of
epilepsy, usually generalized but sometimes focal.

(in neuroleptic \ufffd (poison) hormone, same abnormalities of serum
chemistry exist, but infusion of parathyroid hormone does not
raise
excretion of phosphate and cAMP in the urine. )

OUTCOME:

-Acute organic reactions (example, post-operatively) improve
promptly

Chronic cognitive impairments, for example from idiopathic
hypertriglyceridemia improve in about half.

In Pseudo hypertriglyceridemia, cognitive impairment more
limited with correction of calcium.

DIABETES MELLITUS

Pathology:

Absolute or relative deficiency of insulin production by pancreas,
leads to disturbed carbohydrate metabolism with hyperglycemia
and glycosidic. Additional changes occur in metabolism of protein
and fat, the latter leading to ketosis and acidosis.

Age of onset:

Physical symptoms:

-fatigue and weight loss are prominent early symptoms that could
be attributed to depression

Psychiatric symptoms:

Higher lifetime rate of psychiatric disturbance among diabetics
maintaining poor glucose control.

Depression is by far most common psychiatric diagnosis (8-27%
prevalence, versus 2-9% in community)

Also see anxiety disorders, most notably phobias.

Commonly complain of forgetfulness.

Hypoglycemia affects all aspects of neuro psychological
functioning,
especially tests of associative learning, attention and mental
flexibility.

Anxiety, due to autonomic activation very common in acute
hypoglycemia.

Recurrent episodes of hypoglycemia associated with cumulative
worsening
of cognitive functioning.

Insulators: Psychiatric symptoms in majority. Hypoglycemia here
can
present with wide range of psychiatric symptoms, such as psychosis
and mood changes. Suspicion should be raised by episodic nature of
the symptoms and by worsening during food deprivation, with relief
by meals.

A woman of 61 with a strong family history of affective disorder
complained of depression and anxiety for 18 months which had
recently intensified markedly. She had severe insomnia and
marked psychomotor retardation alternating with periods of acute
anxiety and agitation. Blood pressure vs 180/100 and there were
minor hypertensive retinal changes.

Treatment with antidepressants, choreoathetosis and ECT therapy
was begun. After the first electroconvulsive treatment, she
complained
of severe headache associated with sweating and tachycardia, and
the
blood pressure was found to be 120/60. In view of the drop inblood
pressure, 6-hourly recordings were instituted before further ECT
was given.
During the period of observation, it was found that bouts of
severe headache,
dizziness and sweating were associated with peaks of greatly
elevated
blood pressure, for example to 300/170. A philoprogenitive was
confirmed
and removed successfully (Gilbert 1972).

PHAEOCHROMOCYTOMA

PATHOLOGY:

tumors of the chromatism cells of the adrenal medulla.

Secrete excess adrenalin and nor adrenalin, output being
continuous
or paroxysmal, leading to great variation in clinical features.

PHYSICAL SYMPTOMS:

Generally presents with paroxysms, lasting between 5 minutes and
several hours at time.

Physical symptoms generally overshadow emotional or cognitive
components of attacks.

Paroxysms consist usually of severe palpitations, flushing or
blanching,
sweating, dizziness and tremulousness.

Violent tachycardia is common, sometimes with substernal chest
pain or acute shortness of
breath.

Nausea and vomiting may occur.

Acute rise in blood pressure can be accompanied by severe headache
and may lead to a
cerebrovascular accident, convulsion or myocardial infarction.

Death may result from ventricular fibrillation.

After a severe attack, the patient is left exhausted for hours or
sometimes days.

Attacks are precipitated by physical exertion, change of posture
or
raised intra-abdominal pressure, but sometimes also by emotional
factors such as excitement, shock or panic.

Cases may also be more subtle, with minor attacks with feelings
of faintness, palpitations or episodes of sudden anxiety.

PSYCHIATRIC FEATURES:

During attacks, intense fear often present at start, and patient
may experience sense of impending death.

Anxiety generally remains severe throughout the attack.

ON EXAM:

Hypertension always present during attacks and commonly persists
in between.

LABS:

Marked hypertension between attacks and usually in between.

Many patients have elevated blood sugar.

Transient glycosidic may accompany the attacks.

Essential investigation is demonstration of greatly increased
catechization in the plasma or urine or or their metabolites in
24 hour samples of urine (met adrenaline, methamphetamine
and vanilmandelic acid)


--

DSM IV is the fabrication upon which
psychiatry seeks acceptance by medicine
in general. Insiders know it is more
a political than scientific document.
To its credit it says so

--Loren R. Mosher, M.D.


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