ADDISONS DISEASE

Addison’s disease (hypoadrenocorticism) is caused by a lower than normal production of hormones, such as cortisol, by the adrenal glands. The adrenals are small glands that are located near the kidneys. Adrenal hormones are necessary to control salt, sugar and water balance in the body. 

Addison’s disease occurs less commonly than the opposite condition, Cushing’s disease (overproduction of cortisol) in dogs, and is rare in cats. 

Addison’s disease occurs most commonly in young to middle-aged females with an average age of 4 years. The signs of Addison's disease are often vague, and may mimic other disease conditions.

The symptoms may be severe and appear suddenly, or may occur intermittently and vary in severity. Symtoms may include weakness, depression, lack of appetite, vomiting, diarrhea, and occasionally increased thirst (polydipsia) and increased urine production (polyuria).

When a dog is stressed, their 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. What a dog finds stressful depends upon his/her temperament. For many dogs, any change in their day-to-day routine, such as being boarded or having house guests, is stressful and may precipitate or worsen signs of Addison’s disease.

On examination of dogs with Addison’s disease one may see depression, weakness, dehydration, weak pulses and sometimes a slow, irregular heart rate.  Routine laboratory tests often show a low blood sodium and high blood potassium. Loss of water, in vomit and diarrhea, can lead to dehydration. Severe dehydration increases waste products in the blood (creatinine and blood urea nitrogen = BUN) that are normally eliminated by the kidneys. Addison’s disease can be confused with primary kidney disease. Some dogs with Addison’s disease have low blood sugar.  Your vet will perform a full blood count to get a complete will also most likely run a urinalysis. Anemia and abnormally high levels of potassium and urea in the blood, along with changes in the levels of sodium, chloride, and calcium in the blood, are symptomatic of Addison's.

Sick dogs often show a pattern of changes in their white blood cells (WBCs) called a stress leukogram. This pattern of changes in the WBCs is caused by cortisol. The absence of a stress leukogram in a sick dog may be a clue to consider Addison’s disease. The urine is often dilute.

There are two stages of treatment for Addison’s disease - in-hospital treatment and long term treatment. Very sick dogs with Addison’s disease require intravenous fluids, cortisol-like drugs and drugs to neutralize the effects of potassium on the heart. 

Long-term treatment involves the administration of hormones in one of two forms, either a daily tablet or an injection that is given about every 25 days. Because dogs with Addison’s disease cannot produce more cortisol in response to stress, stress should be minimized whenever possible. It may be necessary to increase the amount of hormones given during periods of stress (e.g. boarding, surgery, travel, etc.). 

If a dog receives corticosteroid-containing medications such as prednisone over a prolonged period, the normal production of cortisol by the adrenal glands is reduced. If this medication is withdrawn rapidly, the adrenal glands will not be prepared to suddenly resume cortisol production. Therefore, a temporary condition similar to Addison's disease may result. Addison's disease may occasionally occur following treatment for hyperadrenocorticism (Cushing's disease). This form of Addison's disease is termed iatrogenic (caused by clinical intervention).

With appropriate treatment for Addison’s disease, dogs can live a long and happy life.

This information is not meant to be a substitute for veterinary care. Always follow the advice provided by your veterinarian.