Addison’s Disease is a potentially fatal condition in dogs that usually cannot be cured but typically can be well-managed medically. Normally, by the time a dog is diagnosed with Addison’s, about 90% of its functional adrenal tissue has been damaged or destroyed, making immediate treatment essential. The goals of treating a dog in an acute Addisonian crisis are to correct life-threatening low blood volume, low blood pressure, elevated circulating potassium and low blood glucose. Once the dog has been stabilized, therapeutic goals are to increase circulating fluid volume (reestablish hydration), correct electrolyte imbalances, relieve the dog’s discomfort and normalize blood levels of adrenal corticosteroid hormones.
How aggressively a dog will be treated for Addison’s depends upon how sick it is when it arrives at the hospital. Dogs suspected of being in an Addisonian crisis will be treated immediately on the assumption that they have hypoadrenocorticism. Waiting for a definitive diagnosis of Addison’s under those conditions can put the dog’s life at great risk. Emergency inpatient treatment for a dog with severe symptoms probably will include placing it on intravenous fluids (usually normal saline) and giving injections rather than oral doses of corticosteroid hormones. Dogs with Addison’s Disease usually show marked improvement within 24 hours of this treatment. An ACTH stimulation test usually will be performed after the dog’s medical crisis has stabilized. If Addison’s is confirmed by the results of that test, the medical team will come up with an appropriate treatment and management protocol, and will discuss the various options with the patient’s owner. Once the dog’s fluid, electrolyte and adrenal hormone levels are normalized, and after it has recovered from any other adverse effects of the disease, it will be discharged from the clinic.
Most dogs with Addison’s Disease will need to be treated for the rest of their lives. Medical management involves lifelong supplementation with oral corticosteroids. The attending veterinarian will recommend which drug(s) to administer based upon the nature and extent of the particular dog’s disease. Urine and blood tests will probably be performed periodically to monitor the dog’s circulating levels of sodium, chloride, potassium, glucose, blood urea nitrogen and adrenal corticosteroid hormones. If abnormalities in those levels recur and persist, the dog may need more intensive advanced therapy.
Unfortunately, most cases of Addison’s Disease can’t be completely cured. Fortunately, however, the prognosis for dogs with Addison’s is usually very good, as long as the condition is caught and treated fairly early in its course. The owner must be conscientious about administering daily medications and taking her companion to the veterinarian for regular blood and urine monitoring.