Addisonian patients may present with lethargy, diarrhea, vomiting, increased thirst, increased urination, and unplanned weight loss. Intermittent shaking episodes are sometimes seen. The signs may wax and wane.
While the consequences can be serious, dogs can live a full life if properly treated. If left untreated, Addison's can result in death. Reduced aldosterone production can result in different serum levels of chloride, sodium and potassium.
All treatment for Addison's disease involves medication. You will be given hormone replacement therapy to correct the levels of steroid hormones your body isn't producing. Some options for treatment include oral corticosteroids such as: Hydrocortisone (Cortef), prednisone or methylprednisolone to replace cortisol.
Other causes include congenital adrenal hyperplasia, congenital lipoid adrenal hyperplasia, X-linked adrenoleukodystrophy, familial glucocorticoid deficiency. Various syndromes associated with Addison's disease include Triple A syndrome, Smith-Lemli-Opitz syndrome, Kearns-Sayre syndrome.
During an addisonian crisis, affected individuals may develop a sudden loss of strength; severe pain in the lower back, abdomen or legs; vomiting and diarrhea potentially causing dehydration; and low blood pressure and loss of consciousness.
People with Addison's disease must be constantly aware of the risk of a sudden worsening of symptoms, called an adrenal crisis. This can happen when the levels of cortisol in your body fall significantly. An adrenal crisis is a medical emergency. If left untreated, it can be fatal.
Addison's disease, scientifically known as hypoadrenocorticism, is a disease with serious consequences for dogs, although fortunately with proper treatment, dogs diagnosed with Addison's disease are expected to have normal lifespans.
One component of therapy is to replace the cortisol deficiency with an oral steroid (prednisone). This is easy to do and inexpensive. It is equally critical to replace the aldosterone deficiency as this hormone helps maintain normal electrolyte concentrations, fluid balance, and acid-base status.
An ACTH stimulation test takes 1 hour to perform: a blood sample is taken, a small amount of synthetic ACTH hormone is injected and another blood sample is taken 1 hour later. Cortisol levels are obtained and if the second cortisol is elevated Cushing's Disease is diagnosed.
A resting cortisol is a single, random blood cortisol level. The ACTH stimulation test is performed by measuring the cortisol levels before and one hour after a medication is then given that stimulates the adrenal glands.
For chronic management, all patients with Addison's disease will require replacement of glucocorticoids (usually prednisone), and most patients require replacement of mineralocorticoids with either desoxycorticosterone pivalate or fludrocortisone.
The pathophysiologic mechanism driving hypoalbuminemia in hypoadrenocorticism is unknown. Loss of albumin into the GI tract or decreased intake/assimilation of proteins, is the main suspected cause (4).
Cushing's syndrome is the opposite of Addison's: it is an excess of cortisol. However, other levels of the adrenal cortex are usually not significantly affected, therefore, electrolytes are normal.
Secondary adrenal insufficiency occurs when the pituitary gland is unable to make enough adrenocorticotropin hormone (ACTH). ACTH sends a signal to the adrenal glands and stimulates them to make cortisol. If the pituitary gland does not make enough ACTH, the body will have low levels of cortisol.
Medical treatment can be as low as $50 a month or as high as $200, depending on the dog's response to treatment and the drug(s) selected. Frequent lab work must also be factored in to the cost structure to ensure that patients are responding appropriately.
Development Stages of Autoimmune Adrenalitis
| Stage | Symptoms |
|---|
| 2. Precipitating event starts antiadrenal autoimmunity | None |
| 3. 21-hydroxylase antibodies present | None |
| 4. Metabolic decompensation | Fatigue, anorexia, nausea, hyperpigmentation |
| 5. Decreased response to ACTH stimulation | Hypotension and shock (addisonian crisis) |
They may also experience appetite and weight loss. Signs of muscle and joint pain, nervousness, and depression are also common in dogs with Addison's disease.
When a pet is stressed, its adrenal glands produce more cortisol, which helps them deal with the stress. Because dogs with Addison's disease cannot make enough cortisol, they cannot deal with stress, so the signs may occur or worsen when stressed.
A study held in 2009 states that the average life expectancy of women with Addison disease is 75.7 years and men with Addison disease is 64.8 years, which is 3.2 and 11.2 years less than the respective life expectancy in otherwise normal women and men.
Toxicity – Exposure to many toxic substances including chocolate, nicotine, and snail bait may cause trembling or shaking. Addison's Syndrome – Dogs that have Addison's disease have a problem with their adrenal glands that does not allow them to have enough natural cortisol in their bloodstream.
