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Metropolitan Veterinary Hospital

Hypoadrenocorticism (Addison’s Disease)

What is Addison’s disease?

  • It is a deficiency in Adrenal gland hormones (glucocorticoids which affect carbohydrate and protein metabolism, as well as affects the immune system, and mineralocorticoids which maintain blood electrolyte balance). It is a disease seen most commonly in young to middle aged female adult dogs. It can be seen in other dogs as well. Hypoadrenocorticism is rarely seen in cats.

What causes Addison’s disease?

  • It may be genetic in certain breeds such as Standard Poodles, Bearded Collies, Labrador Retrievers, and Portuguese Water Dogs, although any breed can be affected.

  • The cause is often unknown. Many times it is caused by immune-mediated destruction of the adrenal glands (the body’s immune system destroying the adrenal glands). Other causes include granulomatous disease of the adrenal gland (inflammatory cells), neoplasia (tumor), hemorrhage, infarction (vascular damage), or overdose of Mitotane (Lysodren) or Trilostane- drugs used to treat Cushing’s disease).

What are the clinical signs of Addison’s disease?

  • Usually clinical signs are vague and signs are often waxing and waning.

  • Gastrointestinal problems such as vomiting, diarrhea, decreased appetite, or abdominal pain.

  • Weight loss and loss of body condition

  • Weakness, collapse, low blood pressure, shivering

  • Dehydration, drinking more and urinating more

  • Clinical signs are usually worse when the animal is under stress because their body is unable to appropriately respond to stress.

What diagnostic tests may be needed?

  • Blood work (may see changes in blood electrolytes: increased potassium, decreased sodium, and decreased chloride., may also see changes in complete blood count, and chemistry profile) and urinalysis

  • ACTH stimulation test (to see how well the adrenal glands can respond)

  • Electrocardiography (ECG) (to see if the abnormal electrolytes are causing abnormal heart rhythms)

  • Abdominal ultrasound (to visualize the adrenal glands)

What treatment is needed for Addison’s disease?

  • An Addisonian crisis is a medical emergency and potentially life-threatening. Please see a veterinarian immediately if your pet begins showing the above clinical signs!

  • Intravenous fluids are often necessary.

  • Steroids such as Prednisolone Sodium Succinate, Dexamethasone Sodium Phosphate, or Prednisone are needed

  • Mineralocorticoid replacement with a daily tablet of Fludrocortisone acetate (Florinef) or with a monthly injection of Desoxycorticosterone pivalate (Percorten-V, DOCP) is needed for life.

  • Mineralocorticoid replacement and glucocorticoids are usually needed for the rest of the animal’s life. Some animals only need glucocorticoids at times of stress.

What kind of monitoring will be needed?

  • Initially the blood electrolytes will be closely watched and medications may need to be adjusted.

  • Animals typically should be rechecked by your veterinarian every 3-6 months

Prognosis is usually excellent with a well-controlled Addisonian!