Addison’s Disease in Dogs: Diagnosis & Crisis Management

Addison’s disease, also known as hypoadrenocorticism, is a relatively uncommon but serious hormonal disorder in dogs. It occurs when the adrenal glands, small organs located near the kidneys, fail to produce sufficient amounts of cortisol and aldosterone. These hormones are vital for regulating various bodily functions, including stress response, blood pressure, electrolyte balance, and glucose metabolism.

Diagnosis: Unmasking the Great Pretender

Diagnosing Addison’s disease can be challenging as its symptoms are often vague and mimic other conditions. It’s often called “the great pretender.” Common signs include:

• Lethargy and weakness
• Loss of appetite and weight loss
• Vomiting and diarrhea
• Dehydration
• Muscle tremors
• Increased thirst and urination (sometimes)

If Addison’s is suspected, your veterinarian will perform a series of tests. A complete blood count (CBC) and biochemistry profile may reveal abnormalities like hyponatremia (low sodium), hyperkalemia (high potassium), and elevated blood urea nitrogen (BUN) and creatinine. However, these findings are not specific to Addison’s disease.

The definitive diagnostic test is the ACTH stimulation test. This test measures the adrenal glands’ ability to produce cortisol in response to an injection of synthetic ACTH. A low cortisol response confirms the diagnosis.

Addisonian Crisis: A Medical Emergency

An Addisonian crisis is a life-threatening situation caused by a severe deficiency of cortisol and aldosterone. It can be triggered by stress, such as illness, surgery, or even travel. During a crisis, the dog experiences:

• Severe weakness and collapse
• Profound dehydration
• Electrolyte imbalances (particularly dangerously high potassium)
• Slow heart rate
• Shock

Crisis Management: Immediate Action Required

An Addisonian crisis requires immediate veterinary intervention. Treatment focuses on stabilizing the dog’s condition by:

• Intravenous fluid therapy: To correct dehydration and electrolyte imbalances. Isotonic saline solutions are typically used.
• Glucocorticoid administration: Injectable corticosteroids, such as dexamethasone or prednisolone sodium succinate, are given to replace the deficient cortisol. Dexamethasone does not interfere with the ACTH stimulation test, so is often preferred during the diagnostic phase.
• Mineralocorticoid administration: Once stabilized, a mineralocorticoid replacement, typically desoxycorticosterone pivalate (DOCP or Percorten-V) or fludrocortisone acetate (Florinef), is started to replace the missing aldosterone and maintain electrolyte balance.
• Monitoring: Continuous monitoring of electrolytes, blood pressure, and heart rate is crucial.

Long-Term Management

Once the dog is stabilized, lifelong medication is required to replace the missing hormones. DOCP injections are typically given every 25-30 days, while fludrocortisone is administered orally daily. Regular monitoring of electrolytes is necessary to adjust the medication dosage. With proper diagnosis and management, dogs with Addison’s disease can live long and happy lives.

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