Addison's disease is also
known as hypoadrenocorticism. It is an insufficient production
of adrenal hormones by the adrenal gland. Since these hormones
are essential for life, this is an extremely serious disease and
it must be treated as such.
Adrenal insufficiency can be primary or secondary. Primary adrenocorticism
affects salt/potassium balance in the body and glucorticoid as
well. Secondary adrenocorticism usually only affects the glucocorticoids.
It is not known why primary adrenocorticism occurs but it may
be an immune mediated process. Secondary adrenocorticism probably
occurs most often when prednisone or other cortisone being administered
for medical reasons are suddenly withdrawn. It can occur as a
result of pituitary cancer or some other process that interferes
with production of hormones that stimulate the adrenal glands.
Most dogs with Addison's disease initially have gastrointestinal
disturbances like vomiting. Lethargy it also a common early sign.
Poor appetite can occur as well. These are pretty vague signs
and it is extremely easy to miss this disease. More severe signs
occur when a dog with hypoadrenocorticism is stressed or when
potassium levels get high enough to interfere with heart function.
Dogs with this problem will sometimes suffer severe shock symptoms
when stressed, which can lead to a rapid death. When potassium
levels get high heart arrythmias occur or even heart stoppage
which also is fatal. In some cases, especially secondary Addison's
disease, there are no detectable electrolyte changes.
This disease can be picked up by changes in the ratio between
sodium or potassium by accident at times. When this happens it
is still extremely important to treat for it. It is confirmed
by an ACTH response test -- administration of this hormone should
stimulate production of adrenal hormones. If this does not occur
then hypoadrenocorticism is present. In cases in which the electrolyte
levels are normal this is the only test for the problem and it
will be missed unless it is looked for specifically. At times
this disease can be hard to differentiate from renal failure because
the symptoms and even the bloodwork can be similar ---- so the
ACTH response test may be necessary to differentiate them. Treatment
for this disease is usually done by oral administration of fludrocortisone
acetate (Flurinaf), salting the food, and administration of corticosteroids
like prednisone. In a crisis situation this disorder must be treated
more aggressively with intravenous fluids, IV glucocorticoids
and correction of acid/base balances.
You have to pay close attention to a dog with this problem.
Don't ignore any changes in appetite, GI disturbances or anything
else that makes you think your dog is ill. If you work with your
vet and are careful about following his or her directions this
disease has a good prognosis when it is discovered before a crisis
occurs.