Thyroid storm is a life-threatening condition of the hyperthyroid state. 26 It most commonly occurs in patients with Graves' disease but may also occur in those with multinodular goiter or toxic adenoma. 27 It is treated by correcting the hyperthyroidism and treating the precipitating events. 26 Correction of the hyperthyroid state involves using drugs such as propylthiouracil or methimazole (Tapazole), beta blockers or corticosteroids, which decrease the peripheral effects of thyroid hormone and the conversion of thyroxine (T 4 ) to the more potent triiodothyronine (T 3 ). 22 , 26 Dexamethasone can be used for that purpose, at a dosage of 2 mg intravenously every six hours, and can eventually can be switched to an oral dosage of 2 mg every six hours. 28
The next step is to look at glucocorticoid dose. Often when a dog is first diagnosed, the vet will prescribe doses of prednisone (or other glucocorticoids) that cause side-effects such as excessive drinking and urination – often referred to by the technical term PU/PD for polyuria/polydipsia. Lowering the dose of prednisone, after your dog is properly stabilized, will often resolve this type of incontinence. If this is causing the problem for your dog, he may also be exhibiting other symptoms of too much prednisone such as excessive appetite and/or irritability.