Canine Addison's Disease

The diagnosis of Canine Addison’s disease is not an automatic death sentence for a dog. It can, in fact, come as a relief since the disease is yet another one that is difficult to diagnose. After a diagnosis occurs, treatment is straightforward, and a dog with Addison’s stands as good a chance as any dog of living a normal life. Addison’s disease appears to have some genetic properties and occurs in young to middle-aged dogs, more female than male dogs, and in breeds such as Labrador Retrievers, Portuguese Water Dogs and Standard Poodles.

Contrary to initial beliefs, Addison’s disease is not a disease of the kidneys. It is a disease of the adrenal glands – two glands, one on each side – that sit on top of the kidneys. Addison’s disease, known as hypoadrenocorticism, equates to adrenal insufficiency. As it mimics other diseases, it is often difficult to diagnosis and owners should begin to log a dog’s symptoms, as soon as they start to appear "off".

The adrenal glands have two layers:

1. The outer layer – the cortex: The cortex produces corticosteroids including cortisol and aldosterone.
2. The inner layer – the medulla: This layer is usually not affected by Addison’s disease and produces epinephrine (adrenaline).

• Primary
• A-typical
• Secondary

Primary and atypical forms are a result of damage by the immune system to the adrenal glands. The secondary form is the result of the pituitary gland's inability to create the ACTH (adrenocorticotropic) hormone.

Left untreated, Addison’s disease can cause serious heart problems, a serious drop in blood pressure and, ultimately, kidney failure.

Canine Addison’s disease takes place over a period of time and has its active and non-active phases. That is another reason to be alert to your dog’s overall energy levels and involvement with daily activities. You are your pet’s first line of defense in this or any other disease. It is simple to use a calendar or create a log in a notebook or on the computer to keep track of your dog's activity level. In fact, making it a daily habit to record behavior and note changes such as the ones listed below for Addison’s disease can make a big difference to you, your dog and your vet in the immediate treatment and prevention of Addison’s and other health problems.

• Watch for a drop in overall energy level of the dog, especially if your dog seems to lose his enthusiasm and seems to rest or sleep more than usual.
• A drop in appetite is typically followed by periods of vomiting and diarrhea when your dog does eat.
• General overall muscle weakness is another symptom, especially if your dog seems to have trouble standing and moving.
• Pain in your dog’s hindquarters can be yet another indicatore of this disease.

Your dog may experience symptoms that, if left untreated, can result in an emergency called an Addisonian Crisis. Your dog’s heartbeat becomes arrhythmic, his potassium level drops and the kidneys begin to shut down. An immediate infusion of hydration via IV seems to immediately bring your dog back from the brink of death.

Of course, it is best to avoid diagnosis via an emergency. Talk to your vet about having your dog’s electrolyte levels checked. Your dog’s blood will be drawn and his sodium and potassium levels checked. Low sodium and high or elevated potassium levels should be enough to cause your vet to suggest an ACTH Stimulation Response Test.

You will be instructed to bring your dog back in for another blood test. His resting level of cortisol is tested. Next, your dog will receive an injection of ACTH hormone. His blood level is re-tested after an hour. Should the cortisol level remain unchanged or only slightly elevated, a clear diagnosis of Addison’s disease is the result.

The treatment for Addison’s disease is medication. Your dog will be on this medication for the rest of his life.

Primary Addison’s is treated with the oral drug, Florinef™ (fludrocortisone), and a drug given by injection, Percorten-V™ (desoxycorticosterone pivalate or DOCP), that replaces missing aldosterone that in turn controls electrolyte levels. Dogs with primary Addison’s receive an oral dose of prednisone or hydrocortisone. Dogs with Secondary and Atypical Addison’s disease receive only the prednisone or hydrocortisone since their electrolyte levels remain balanced.

Your dog may also develop skin irritation and scaling with Addison’s disease. Special medicated shampoos are used to treat this symptom.

Will your dog be able to live a happy, healthy life with Addison’s disease? As mentioned at the top of this article – yes. It will take time and monitoring of your dog’s reactions to the medication (like humans, this may have to be adjusted) as well as reducing things that cause excessive stress to your best friend. You can generally count on a course of several months to a year of working with your pet and vet to restore your dog's full enthusiasm and energy. Patience, a calm demeanor and vigilant attention are just another part of the Rx for the cure of Addison’s disease.

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