Jacey's vet called today with results of her T4.
Back in October, when she was taking .8 mg of thyroxine daily, the vet ran a T4 on Jacey. She showed a 1.2 result, which technically is "normal" but not by much. (Below 1.0 is "low"; 1.0 to 4.7 is "normal," but dogs being tested 4-6 hours after they took their pills should test high-normal.) Since Jacey wasn't showing any improvement physically at that dosage, the vet okayed going up .4 mg a day, but we didn't run another T4 then. (The test costs $40, so it's not something you want to do too often.)
Jacey has been on the increased dosage--1.2 mg daily--since October. For a while, that worked, but she's shown signs for the last few months that the dosage is inadequate. However, the vet didn't want to increase her dosage because he considers 1.2 mg a fairly large dose for a 55-pound dog (which is what Jacey's supposed to be).
He drew blood yesterday for another T4 and got the results today. Despite our having gone up 50% on her dosage nine months ago, Jacey is returning just a 1.4 on her blood work when the blood is drawn 5 hours after she took the meds. So we can safely go up on her dosage, which means she'll be able to go back to eating what she and I consider a "normal" meal. God knows what Jacey's doing with all the thyroxine she's taking, but it's not showing up in the lab work, and we can increase her dosage.
But we're working on the crusty-butt situation. It's either worse than it was yesterday, or I'm just seeing places I didn't see before. Either way, the vet wants to clear up the skin situation--or at least give the spray treatment a serious try--before he adjusts thyroid meds because thyroid problems can influence skin problems. He'd prefer to tamper with just one set of conditions at a time.
So Jacey will stay on her current thyroxine dose of 1.2 mg a day. And she'll stay on 2.5 cups of kibble a day (instead of the 3 cups she wants--and Sam gets). About the time Sam runs out of antibiotics, we'll make decisions on whether the spray is helping Jacey and whether we should then adjust her thyroid dose or try something else for her skin.
Meanwhile, the skin problem isn't bothering her--no signs that she's itchy--and the food "deprivation" she's experiencing isn't going to do her any harm. And Sam's coping with the new antibiotic.
But Jacey and her thyroid will drive the poor vet crazy. He takes what he thinks is a safely conservative course, only to find that--for Jacey, at least--it's so conservative as to be pointless.