Introduction
Addison’s disease, medically known as hypoadrenocorticism, is potentially life-threatening condition in dogs which cannot be cured but, if caught early, can be treated and controlled. The signs of Addison’s are caused by an inability or insufficiency of the adrenal glands to produce the necessary amounts of adrenocorticol hormones for use by the body. These signs tend to wax and wane over time. Hypoadrenocorticism can cause a variety of symptoms in dogs ranging from mild gastrointestinal upset to acute collapse.
The disease normally causes progressively frequent and increasingly severe signs, as the dog’s body becomes damaged from the effects of insufficient cortisol production. Normally, by the time a dog is definitively diagnosed with Addison’s, emergency medical treatment is needed for an addisonian crisis. Once the dog has been stabilized, proper assessment can be made and proper treatment protocols can be prescribed. Treatment for Addison’s focuses on stabilizing cortisol levels and minimizing any harmful symptoms, such as shock, vomiting or diarrhea, that the disease caused before treatment began. Normally, the owner will be able to treat their dog at home through oral medications and supportive care.
Treating Addison's Disease
The aggressiveness of treatment for Addison’s will depend in large part on the dog’s clinical status at the time it arrives at the hospital. Dogs suspected of being in an acute addisonian crisis should be treated immediately as if they have hypoadrenocorticism, even before the disease is confirmed. Waiting for the results of an ACTH stimulation test may result in the dog’s death. The goals of treatment include replacing bodily fluid volume, correcting electrolyte imbalances and providing an immediate source of corticosteroids. Treatment of severe Addison’s symptoms includes placing the dog on intravenous fluids (usually normal saline) and giving injections of appropriate glucocorticoids. Dogs often show marked improvement within 24 hours of treatment. ACTH stimulation testing should be done after the dog is stabilized.
In most cases, treatment of Addison’s disease will need to be continued for the rest of the dog’s life. After fluid levels are restored and hormone levels are stabilized, and after the dog has recovered from any other adverse effects of the disease, the owner can take the dog home. Chronic treatment will involve lifelong oral supplementation with corticosteroids, the choice of which will be made by your veterinarian based upon whether your dog’s Addison’s is primary or secondary. Addison’s patients should have urine and blood tests performed periodically to monitor their cortisol and electrolyte levels. If elevated blood potassium levels persist, the dog may need additional drug therapy.
The prognosis for dogs with Addison’s disease is excellent as long as the owner is conscientious about daily drug treatment and periodic veterinary monitoring through blood and urine tests. Excellent communication between owners and their veterinarians can be critical to the success of treatment for this disease.