Ali HamzaAddison's Disease (Hypoadrenocorticism) in Dogs - The Parents Guide
No pet owner wants to have an experience like this: one day your dog is normal, the next it’s shivering, weak, and lethargic. You hurried them to the clinic and the preliminary tests weren’t conclusive. After a couple of days they recover and a few weeks later, a strange illness takes hold again. The sad cycle of Addison’s disease (hypoadrenocorticism) in dogs is very common.
Often times, veterinarians refer to this disease as “The Great Imitator” because it closely resembles 12 different diseases in dogs, ranging from common stomach viruses to serious kidney disease. Addison’s disease (hypoadrenocorticism) in dogs can be a moving target to diagnose as it can mimic other conditions. When the mystery is solved, however, it evolves from a frightening, concealed threat to a completely manageable condition. Let’s shed some light on this endocrine disorder: the way it affects your dog’s body, how you can tell if your dog is entering an emergency crisis and what it takes to give an Addisonian puppy a long, happy life.
Addison's Disease (Hypoadrenocorticism) in Dogs: What is it?
Understanding the issues that arise when a pet develops Addison’s disease (hypoadrenocorticism) in dogs means examining two small but powerful organs, the adrenal glands. These glands are located directly next to the kidneys and they release hormones that maintain the body’s normal functioning during stressful periods.
The adrenal cortex secretes two important hormones:
Glucocorticoids (Cortisol):
The natural stress hormone in the body. It assists to control blood sugar, digest protein and fat and enables the body to deal with physical or emotional strain.
Mineralocorticoids:
A hormone which regulates internal thermostat for fluids and electrolytes. It regulates sodium and potassium, which are essential for blood volume, blood pressure and heart function.
Addison’s disease (hypoadrenocorticism) in dogs is the result of the immune system attacking and destroying the outer layer of these glands. The structural damage results in a tremendous and harmful weakness in cortisol and aldosterone production. All of these hormones are essential to the ability of a dog to cope with stress and to keep their internal electrolytes in balance or balance, or they will be completely ill.
The Triggers and Breeds at Risk
Addison’s disease (hypoadrenocorticism) in dogs is an immune-mediated disorder in 99% of cases, in which the dog’s own immune system attacks its adrenal gland(s). It is still somewhat of a mystery why, but there is a clear trend for some breeds.
Any dog can get this disease, but it is found more often in Standard Poodles, West Highland White Terriers, Great Danes, Bearded Collies, Portuguese Water Dogs and Nova Scotia Duck Tolling Retrievers. It is far more common in young to middle aged females, but can affect males and senior dogs.
The Great Imitator" is a type of spotting.
Dogs with Addison’s disease (hypoadrenocorticism) have characteristic symptoms that come and go. If a dog experiences a stressful event such as a thunderstorm, boarding, a veterinary visit, etc. and then appears “better” on their own afterward, they are likely ill because of the stress.
Watch for the following changing indicators:
Intermittent, chronic lethargy:
Your dog is noticeably tired, sluggish and/or depressed for no apparent reason.
Bad Appetite:
Progressive pickiness with food and/or loss of appetite
Gastrointestinal Distress: Persistent vomiting and diarrhea, frequently attributed to “dietary upset” and irritable bowel syndrome.
Severe shaking and trembling: In severe shaking or trembling the dog shows general muscle weakness and shivering as if it was being attacked by the cold or frightened.
High sodium and urination: The body is unable to maintain proper sodium and potassium balance, thus, the kidneys are unable to retain water.
A painful or stiff gait: Hind limb weakness or complete refusal to go onto furniture.
The Ultimate Danger: The Addisonian Crisis
If the hormone deficiency is untreated, it will eventually lead to an Addisonian Crisis. It is a dangerous and chilling total collapse. The dog’s blood pressure becomes dangerously low, potassium rises to a toxic level slowing the dog’s heart rate and hypovolemic shock occurs. Addisonian crisis is a true medical emergency, in which immediate and aggressive veterinary care is required to prevent cardiac arrest.
This is a guide to the Diagnostic Maze.
Dogs with Addison’s disease (hypoadrenocorticism) require several special laboratory tests to confirm the diagnosis, due to the fact that symptoms can be confused with many other conditions.
Routine blood tests and electrolyte levels.
Typically, the first indicator is a routine blood chemistry profile. The sodium/potassium ratio will be carefully considered by vets. In Addison’s disease (hypoadrenocorticism) of dogs, potassium levels will be dangerously elevated, and sodium and chloride levels will be dangerously low. You might also have higher levels of kidney markers (BUN and creatinine), which is caused by low blood pressure.
This test is called the ACTH Stimulation Test.
The veterinarian may also perform an Adrenocorticotropic Hormone (ACTH) stimulation test if blood tests are abnormal and are suggestive of a problem. Addison’s disease (hypoadrenocorticism) is the only definitive diagnosis made in dogs.
A baseline blood sample will be taken to see the level of cortisol when the animal is at rest, then an hour later, the second blood sample will be taken after the vet administers a synthetic form of the hormone, which stimulates the adrenal glands to generate cortisol. In a healthy dog, cortisol level will rise dramatically. For dogs with the Addison’s disease (hypoadrenocorticism), the low adrenal glands will not respond, thus confirming the diagnosis.
The treatment involves stabilizing and controlling the condition. Treatment of Addison’s disease (hypoadrenocorticism) in dogs can be broken down into two stages: emergency stabilization and life long maintenance therapy.
Emergency Crisis Management
When a dog is rushed to the hospital with an active Addisonian crisis, the first priority is to save the dog’s life. The team of vets will insert an intravenous line to provide intense fluid replacement, increasing blood volume, blood pressure and flushing toxic build-up of potassium. Your vet will also give you some quick-release intravenous (IV) steroids to replace the missing hormone at the time.
Lifelong Maintenance Therapy
The long-term management of Addison’s disease (hypoadrenocorticism) in dogs starts when a dog is stable and eating. The adrenal glands cannot “recover” so, for life, the dog must be given the missing hormones. This is usually accomplished with two drugs:
DOCP (Percorten-V or Zycortal) Injections
Long acting injection of a mineralocorticoid drug, administered every 25-30 days to keep sodium and potassium in balance.
Daily Oral Corticosteroids (Prednisone): A tiny daily dose of oral prednisone to replace the missing glucocorticoids (cortisol).
Stress Protocol: Owners should temporarily give a higher dose of oral prednisone during predictable periods of stress, like during surgery, holidays, fireworks, or when moving into a new home. The dog’s body doesn’t make additional cortisol to deal with stress, so it is necessary to give them that “stress buffer” by hand.
Conclusion
When your beloved is diagnosed with an endocrine disorder that is chronic and life threatening, it’s very alarming. But the prognosis is extremely optimistic for dogs with Addison’s disease (hypoadrenocorticism). After the proper dosages of the correct medications are determined, these dogs live a completely normal, very active and long life. They are able to run, play, hike, and cuddle like any healthy pup. Addison’s disease (hypoadrenocorticism) can easily be managed in dogs by learning to know the symptoms of a hormonal crisis and working closely with your veterinarian to monitor your dog on a regular basis.
Frequently Asked Questions (FAQs)
Q: No, Addison's disease doesn't hurt dogs.
A: When a flare-up or crisis occurs, dogs are very uncomfortable because of the intense nausea, cramping, weakness of muscles and low blood pressure. Once stabilized and taking the daily maintenance medication, however, they are pain free and feel completely well.
Q: In dogs, is it possible to live a normal life with Addison's disease (hypoadrenocorticism)?
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A: Absolutely. Dogs with this condition usually have a normal, full canine lifespan with consistent administration of medication and routine veterinary monitoring and checks for electrolyte levels.
Q: The cost of treating Addison's disease (hypoadrenocorticism) in dogs vary depending on the severity of the condition.
A: The first diagnosis for a crisis may be expensive and may result in crisis hospitalization. Long-term expenses are largely based on dog size since the hormone injections (DOCP) are based on weight and are administered on a monthly basis. Smaller breeds will require lower and less costly doses, whereas very large breeds will be more expensive.
Q: If I forget to give my dog the medication, what do I do?
A: If you miss one dose, your dog may fall into a sudden hormone deficiency, and be susceptible to illness or a life-threatening Addisonian crisis. If a dose is missed by accident, please call your vet right away for instructions on how to safely catch up.
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