by: Erin White
Addison’s Disease Last November, my faithful, loyal French Bulldog, Angus, wasn’t feeling well. He had had episodes of vomiting and diarrhea, he wouldn’t eat anything (not even his favorite treats), he was weak and very lethargic. It was obvious there was something seriously wrong with my little guy. I brought him into work with me to see his amazing veterinarian, Dr. Jen, and after many blood tests and IV fluids we had the answer; it’s Addison’s Disease.
What is Addison’s disease anyway?
Let me start with a brief overview of Addison’s disease. It is the common name for hypoadrenocorticism, or adrenal insufficiency. The adrenal, one on each kidney, is made up of two layers, the cortex and the medulla. The outer area, or cortex, secretes corticosteriod hormones such as cortisol and aldosterone. The medulla, part of the sympathetic nervous system, secretes epinephrine (adrenaline), which is generally not affected by Addison’s.
What are the 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 gastrointestinal problems like vomiting and diarrhea. Pain in the hind quarters, or generalized muscle weakness such as a dog that can’t jump onto a bed or couch as he has done in the past is not uncommon. Shivering or muscle tremors may also be present. The most important thing to remember is that you know your dog better than anyone. If something seems amiss, have it checked out. These symptoms may wax and wane over months or years making diagnosis difficult. As the adrenals continue to deteriorate, ultimately the dog will have an acute episode called an Addisonian crisis. This is when most dogs are diagnosed with the disease and by the time they reach crisis level and a diagnosis is made, most patient’s will have already lost approximately 90% of their adrenal glands functionality. Potassium levels elevate and disrupt normal functions of the heart. Arrhythmia 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.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 the sodium (Na) and potassium (K). In addition to looking at these values, it is important to look at the ratio between the two. Electrolyte levels are important,but not a definitive test for Addison’s. Baseline Cortisol should also be tested. If the patient’s sodium to potassium ratio is low and their Cortisol result is low, a diagnosis of Addison’s is certain.
How is it treated?
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).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.
While dogs with Addison’s disease will need medications and monitoring for the rest of their lives, most dogs with Addison’s (like my very own lovable, Angus) can return to their favorite activities. Angus is back to living his normal life thanks to daily oral prednisone and Percorten-V injections every 35 days. He enjoys walks and loves to play with his Frenchie brother and sister, Chopper and Dani. He will hopefully have a normal life expectancy despite his disease. But I know that his condition requires careful monitoring in order for treatment to be successful. You have to learn to read your dog’s signs and react appropriately to them. And if you do that, your Addisonian dog can live a happy and healthy life.
For more information please call any of Peoria Area Veterinary Group’s 3 locations!