ADDISONS DISEASE
The following information is simply informational. It's intent is not to replace the advice of a veterinarian nor to assist you in making a diagnosis of your pet. Please consult with your own veterinary physician for confirmation of any diagnosis. Your pets life may depend on it.
ADDISONS DISEASE It is the common name for hypoadrenocorticism, or adrenal insufficiency. It is a disease with symptoms that are common to many other ailments, making diagnosis difficult and sometimes a process of elimination. But once Addison's is correctly diagnosed, a properly treated dog can live a normal, active life.SYMPTOMS The symptoms of Addison's disease can be vague. More importantly, they are similar to the symptoms of many different problems. Initially, the dog may be listless, or seem depressed. Many dogs are described as just seeming off, or losing the normal sparkle in their eye. Lack of appetite is a good indicator. Other symptoms include gastro-intestinal problems like vomiting and diarrhea. Pain in the hindquarters, or generalized muscle weakness other common symptoms are listed below
Vomiting
Diarrhea
Lethargy
Depression
Lack of appetite
Tremors or shaking
Muscle weakness
Pain in hind quarters
weightloss
If the adrenals continue deteriorating, ultimately the dog will have an acute episode called an Addisonian crisis. Potassium levels elevate and disrupt normal function of the heart. Arrhythmias can result and blood pressure drops to dangerously low levels. BUN and creatinine levels, generally indicators of kidney function, are often elevated. At this point many animals are diagnosed with renal failure, as the kidneys are unable to function properly. Typically animals are given IV solutions for rehydration, which may produce an almost miraculous recovery. This too, is a great indication that failure of the adrenals rather than of the kidneys is creating the symptoms.
How to be sure its addisons
One of the first things to look at when Addison's disease is suspected are the electrolyte levels. The two that are of greatest concern are sodium (Na) and potassium (K). In addition to looking at these values, it is important to look at the ratio between the two. This number is derived by dividing K into Na and should be between 27 and 40. For example, a dog with a Na level of 145 and a K level of 4.5 would have a ratio of 32. A dog in an Addisonian crisis will typically have a low Na level, elevated K and low ratio
While electrolyte levels are important indicators, they are not the definitive test to determine Addison's disease. In fact, with secondary and atypical hypoadrenocorticism, electrolyte levels may not be affected. For definitive diagnosis the dog is given the ACTH stimulation or response test. This tests the ability of the adrenal glands to produce the corticosteroid hormone cortisol.
To perform the ACTH stimulation test, an initial blood sample is drawn and the cortisol level is measured. The dog is injected with a form of the pituitary hormone ACTH that tells the adrenals to produce cortisol. After an hour, blood is drawn again, and the cortisol level measured. Resting cortisol should range from 1-4 µg/dl in the average dog, and should be significantly higher, in the range of 6-20 µg/dl, post-stimulation. (These numbers may vary depending on the lab.) If resting cortisol is low and the dog has no or a low response to the stimulation, the diagnosis is Addison's disease. Be aware that some glucocorticoids, such as prednisone, can affect the results of the ACTH test, while dexamethasone does not.
There are several medications used to treat Addison's. The first type acts as a mineralocorticoid and replaces the aldosterone – the hormone responsible for maintaining electrolyte levels. It is replaced with either an oral medication called Florinef ™ (fludrocortisone acetate) or the injectable Percorten-V™ (desoxycorticosterone pivalate or DOCP). For dogs that have atypical or secondary Addison's neither of these medications are used because the production of aldosterone isn't effected and electrolytes remain in balance.
In addition to replacing the aldosterone, the cortisol, or glucocorticoids, normally secreted by the adrenals must also be replaced. This is typically done with an oral form of prednisone or hydrocortisone. With atypical and secondary Addison's the glucocorticoid is the only medication given
While your dog with Addison's disease will need medications and monitoring for the rest of his life, most dogs with Addison's can return to their favorite activities. You will learn to read your dog, understand what his stress triggers are and follow your instincts in his care. Together, you will overcome ADversity and learn from this experience. You will help your dog lead a normal, active and fun-filled life
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