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Client Library Article
HYPOADRENOCORTICISM = ADDISON’S DISEASE
| About Addison's disease |
| Hypoadrenocorticism is commonly referred to as Addison’s
disease, a serious life threatening endocrine disorder. Addison's
is caused by damage or malfunctioning of the adrenal glands which normally
release two types of natural steroids, the glucocorticoids including
cortisol, and mineralcorticoids. Both are required in adequate amounts to
facilitate normal metabolic function. In Addison's, the adrenals fail
to secrete the steroids Mineralcorticoids are needed to maintain
normal electrolyte balance in the blood, including sodium (Na+), potassium
(K+), and chloride (Cl-). Electrolyte imbalance leads to heart, liver,
kidney, and gastrointestinal damage, and in acute crisis, can cause death
due to severe shock & cardiac arrest (when the heart stops beating).
Often Addison’s goes undetected for long periods of time causing mild but
chronic signs such as weight loss and intermittent diarrhea & vomiting.
Eventually, the disease progresses to a point where the animal decompensates
and presents in a life threatening “Addisonian crisis".
Aggressive medical care is required to stabilize the dog, and once
diagnosed, treatment for Addison's must be continued for life. |
| Symptoms- usually a
progressive onset |
- Weight loss
- Progressive anorexia
- Increased
urination and drinking (PU/PD)
- Weakness / lethargy- intermittent
- Diarrhea-
intermittent
- Vomiting- intermittent
- Muscle wasting
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| Symptoms- Addisonian
Crisis- A Medical Emergency |
- Acute collapse quickly progressing to being flat out and
non-responsive
- Severe dehydration
- Severe shock- cold extremities, weak pulses
- Non stop vomiting and diarrhea- often turning bloody
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| Diagnosis |
- An ACTH STIMULATION TEST- will confirm a
diagnosis of Addison's disease.
- If a dog has a history of intermittent symptoms such as vomiting,
lethargy, and weight loss, they should be tested for Addison’s to rule out
the disease
- Dogs with a heavy load of whip worms in their intestines can also
present with similar signs as a dog with Addison's disease
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| A Presumed diagnosis
of Addison's in a dog suffering an Addisonian crisis is made
on clinical signs until the results of the ACTH stim test are available. |
- Low heart rate (bradycardia) despite severe dehydration, hypovolemic
shock, and low blood pressure
- Blood work shows electrolyte imbalances- a high potassium level and
low sodium level in the blood (sodium/potassium ratio- less than 25)
- CBC will show an abnormally high percentage of eosinophils- a
particular type of white blood cell
- Additional blood work often shows low albumen (a blood protein) and
low glucose (blood sugar)
- Rapid improvement when treated aggressively with intravenous (IV)
fluids and steroid injections.
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| **As mentioned previously, many animals go
undetected as symptoms wax and wane, until they go into a full crisis. |
| Treatment-
a life long commitment for confirmed Addisonians |
Addisonian dogs must be given supplemental
steroids for the rest of their lives
- Mineralcorticoid replacement- tablets given orally on a daily
basis, or a injection of long acting steroids given approximately once a
month by your veterinarian.
- Glucocorticoid replacement- a low dose of prednisone given
orally daily or every other day.
- Special attention must be given to animals in stressful situations
such as when boarding at a kennel or being hospitalized. Your veterinarian
may adjust the dose or frequency of the prednisone administration during
these times.
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| Treatment- during a
Addisonian Crisis |
- Aggressive intravenous fluid therapy
- Steroid administration
- Supportive care & treatment of organ damage secondary to the crisis
(kidney, heart, GI tract etc.)
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| Prognosis |
- Confirmed Addisonians that are medicated properly at the correct
dosage and monitored throughout their life should have a normal life
expectancy.
- Owner compliance is very important to successful treatment of Addison’
s disease.
- The prognosis for patients presenting in an Addisonian crisis varies
widely depending on how long they have been in crisis and how quickly they
receive emergency care. The sooner the medical care is initiated, the
better the prognosis.
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