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My Dog Has Hypoadrenocorticism: What Do I Do Now?


Donna partners with Dr. Cathy Alinovi, a retired veterinarian, to create informative pet health articles.

If your vet says your dog has hypoadrenocorticism, you might panic, especially if you have no idea what a scary-sounding name like hypoadrenocorticism means. Cathy Alinovi demystifies this health problem, also known as adrenal insufficiency, and talks about causes, symptoms, and treatments. Read on to see Dr. Cathy's answers to 15 questions about hypoadrenocorticism in dogs.

1: What is hypoadrenocorticism?

Think about the definitions: hypo (low) adreno (adrenal gland) corticism (endocrine function). Also called Addison's disease, the hypoadrenocortical patient has an under-functioning adrenal gland. Adrenal insufficiency is another name for the disease.

2: How did my dog get Addison's disease?

Conventional teaching says Addison's is most commonly an autoimmune disease where the body's immune system attacks itself, in this case, in the adrenal gland.

Less common causes would be infection or tumor or tissue death due to lack of blood supply. Alternatively, an increasing body of evidence talks about depletion as a cause for Addison's. Depletion due to a lifetime of stress = burnout.

One other cause of Addison's is man-made such as suddenly stopping steroid treatment in a dog that has been on steroids for long-term therapy.

3: What's the frequency of occurrence in dogs?

It is quite uncommon (1 in 10,000), which is another reason it is hard to diagnose.

Dogs at Risk for Addison's

  • Great Danes
  • Portuguese
  • Water Dogs
  • Rottweilers
  • Standard Poodles
  • West Highland Terriers
  • Wheaton Terriers

4: What breeds are at highest risk for Addison's disease?

The highest risk factors are for female dogs between the ages of four and seven years old. However, Addison's disease might affect any breed.

Please refer to the table for a list of dogs with high-risk factors for Addison's.

5: What is the difference between Addison's disease and Cushing's disease?

Both diseases affect the adrenal gland. In Cushing's, the glands make too much hormone, but in Addison's they make too little. In Cushing's, it's really only over secretion of cortisol and it is usually a brain (pituitary) driven problem. In Addison's, it is not only underproduction of cortisol, but also the hormones that regulate salt balance in the body; the problem is usually at the adrenal glands.

6: What are the symptoms?

Addison's disease is actually pretty hard to diagnose. However, that is not because the tests are difficult to administer, but because the symptoms are very vague. Moreover, it will depend on which hormones are lowest.

If the salts get out of balance and cortisol is low, it presents as a dog with general malaise, that blah feeling. These dogs will be dehydrated and have some vomiting and diarrhea.

A day or two in the hospital with IV fluids usually corrects these patients, but this is a temporary fix until the disease is diagnosed. The IV fluids work because they restore the salt and electrolyte balance in the body.

Again, this is temporary, as daily life will use up the salts, and use them up faster if the dog is stressed. Addison's can also present just as a dog with low cortisol. These dogs become fat, have reduced energy, and are quite difficult to diagnose.

As just mentioned, the symptoms are very vague. Addison's can be as mild as vomiting and diarrhea corrected by a night of IV fluids. It can be as major as a full system collapse or anywhere in between.

Because Addison's is the "great pretender," it looks like many other conditions such as dietary indiscretion, pancreatitis, anemia, sugar imbalance, salt (electrolyte) imbalance. Additionally, it can be misdiagnosed or not properly diagnosed at first. Because Addison's is much less common than any of the just mentioned illnesses, it is not commonly tested for.

8: How does a vet diagnose AD?

The definitive test is to give ACTH, which is a hormone that normally stimulates the adrenal gland to produce cortisol. If the blood cortisol level does not change, the patient has Addison's. ACTH stands for adrenocorticotropic hormone, which is a long word that means the hormone that stimulates the adrenal gland.

7: How many types of AD are there?

There are three types of Addison's:

  • Primary
  • Secondary
  • Atypical

Primary is when the whole gland under produces hormones due to something occurring at the adrenal gland like overwhelming stress, autoimmune disease, or trauma.

Secondary is when the brain, through the pituitary or hypothalamus, does not make the hormone signals to the adrenal glands.

Atypical is where only part of the adrenal stops working, so only the stress hormone stops being produced. These dogs do not respond to stress well.

9: What is the short-term treatment for AD?

Fluid therapy and perhaps a dose of steroids will turn the average Addison's patient around in a matter of hours.

10: What are the long-term treatments for AD?

There are pills and/or injections to replace the missing hormones. What form of Addison's disease your dog has then determines which drug or combination is used. The foundation of treatment really lies in a life that does not build stress. High quality, real food, minimal vaccines and medication, and a happy home keep from overtaxing the adrenal glands.

11: How does my vet decide which treatment is right for my pet?

There is a little trial and error in balancing the Addisonian dog based on response to treatment. Once the patient is stabilized, medication starts. Initially, monthly blood work will evaluate the salt balance in the body. Small adjustments to the medication will be made if the salts (electrolytes) are out of balance.

A well-rounded approach to treating the Addison's patient will include diet changes, consistent exercise, and can include herbs or nutraceuticals. Exercise stimulates the body to release beta-endorphins, which are natural pain relievers that inhibit stress and the need for cortisol.

Changing the diet to remove grains and carbohydrates reduces stress on the body significantly. This means skipping dry kibble as it takes a minimum of 30% carbohydrates to form a crunchy bite of kibble. Alternatives would be a high quality canned food, a raw diet, or a balanced home-prepared diet.

Nutraceuticals would aim to decrease stressors (dysbiosis) and support the adrenal gland with its precursors. Herbal therapy addresses the root of the cause, which is an easily stressed patient with weakened reserves. (Kidney Jing deficiency in Traditional Chinese Veterinary Medicine).

12: What is the prognosis for dogs with AD?

Once diagnosed, the prognosis can be fair to good depending on how well the owner manages the things that stress the adrenal glands (see next question). If the owner makes no changes, the crises may worsen in frequency and severity, and it can become life-threatening.

13: How will I manage my dog's AD?

Most likely, there will be daily medication to replace missing hormones. There may also be supplemental medications to address underlying issues. However, building a healthier lifestyle is your best management technique. The steps to a healthier lifestyle including feeding your dog the same food you would eat and maintaining a consistent exercise program with your dog.

Consistent exercise doesn't necessarily mean jogging for miles each day, but it does mean getting moving for 10-20 minutes five days a week. If your dog is small, chasing a toy in the house can be enough. For a bigger dog, a vigorous walk around the block is perfect.

14: What quality of life does an Addison's disease dog have?

The Addisionian dog can have a great life if it is well regulated, on a low carb diet, and getting consistent exercise. Stress and poor diet make it harder for the dog with Addison's to have extended good quality as relapses will occur.

15: What suggestions do you have for pet parents?

Prevention is ideal. By the time a dog is diagnosed with Addison's a lot of time has passed. Real food and consistent exercise in a low stress home heads off many issues.

Consider waiting to spay your dog to allow her hormones to bring her to full development first. Of course, there are advantages and disadvantages to waiting to spay your dog. The key is to start the conversation early with your vet.

Disclaimer

This veterinary medical information is based on information provided during a telephone interview with a professional, qualified, retired veterinarian. However, it is provided for educational purposes only. It is not intended to replace the advice of your own veterinarian. Always seek your veterinarian’s advice about your pet’s health.

While this information is periodically researched and updated (under the guidance of veterinary input) in the attempt to be timely and factual, no guarantee is given the information is correct, complete, and/or up-to-date.

Recommendations as to therapeutics, diagnostics and best standards of practice in the veterinary industry and/or opinions between professionals may differ or change as technologies and information changes. You should not use this article as your sole source of information on any matter of veterinary health or attempt to self-diagnose or treat your pets as the information herein may not be appropriate for your pet. The safest option for you and your pet is to rely on the advice of your veterinarian to diagnose and recommend the best treatment options.

© 2014 Donna Cosmato


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U.S. Food and Drug Administration

You have probably seen and heard a lot about the coronavirus (COVID-19) and how to keep you and your family safe. But what about the other, furrier members of the family—your pets? Below, the U.S. Food and Drug Administration offers some questions and answers to help keep you, your family, and your pets safe during the pandemic.

Q. Can I get COVID-19 from my pet or other animals?

A. Based on the limited information available to date, the risk of pets spreading the virus that causes COVID-19 in people is considered to be low. At this time, there is no evidence that animals play a significant role in spreading the virus that causes COVID-19. A small number of pet cats and dogs have been reported to be infected with the virus that causes COVID-19 in several countries, including the United States. Most of these pets became sick after having close contact with a person with COVID-19.

Until we learn more about how this virus affects animals, treat pets as you would human family members to protect them from a possible infection. This means:

  • Don’t let pets interact with people or other animals outside the household.
  • Keep cats indoors when possible to prevent them from interacting with other animals or people.
  • Walk dogs on a leash maintaining at least 6 feet (2 meters) from other people and animals.
  • Avoid dog parks or public places where a large number of people and dogs gather.

If your pet gets sick or you have any concerns about your pet’s health, talk to your veterinarian.

Q. If I get sick with COVID-19, could I infect my animal with the virus?

A. We are still learning about this virus, but it appears it can spread from people to animals in some situations. If you are sick or think you are sick with COVID-19, the Centers for Disease Control (CDC) recommends that you limit contact with animals until more information is known about the new coronavirus.

This means you should avoid contact with your pet, including petting, snuggling, being kissed or licked, and sharing food or bedding. If possible, have another family member care for your pet while you’re sick. If you must care for your pet or be around animals while you are sick, wash your hands before and after you interact with your pets, and wear a cloth covering on your face.

Q. Should I get my pet tested for COVID-19?

A. No. Routine testing of pets for COVID-19 is NOT recommended at this time. We are still learning about this virus, but it appears that it can spread from people to animals in some situations. Based on the limited information available to date, the risk of pets spreading the virus is considered to be low. If your pet is sick, consult your veterinarian.

Q. Can animals carry the virus that causes COVID-19 on their skin or fur?

A. Although we know certain bacteria and fungi can be carried on fur and hair, there is no evidence that viruses, including the virus that causes COVID-19, can spread to people from the skin, fur or hair of pets.

However, because animals can sometimes carry other germs that can make people sick, it’s always a good idea to practice healthy habits around pets and other animals, including washing your hands before and after interacting with them.

There are no products that are FDA-approved to disinfect the hair or coats of pets, but if you do decide to bathe or wipe off your pet, first talk to your veterinarian about suitable products. Never use hand sanitizer, counter-cleaning wipes or other industrial or surface cleaners, as these can penetrate the skin or be licked off and ingested by your pet. If you have recently used any of these products on your pet, or your pet is showing signs of illness after use, contact your veterinarian and rinse or wipe down your pet with water.

Q. Are pets from a shelter safe to adopt?

A. Based on the limited information available to date, the risk of animals spreading COVID-19 to people is considered to be low. There is no reason to think that any animals, including shelter pets, play a significant role in spreading the virus that causes COVID-19.

Q. What animal species can get COVID-19?

A. We currently do not fully understand how COVID-19 affects different animal species. We are aware of a small number of pets, including dogs, cats, and a ferret reported to be infected with the virus that causes COVID-19 after having had close contact with a person with COVID-19. Infected pets might get sick or they might not have any symptoms. Of the pets that have gotten sick, most only had mild illness and fully recovered.

Recent research shows that ferrets, cats, fruit bats and golden Syrian hamsters can be experimentally infected with the virus and can spread the infection to other animals of the same species in laboratory settings. Mice, pigs, chickens and ducks did not become infected or spread the infection based on results from these studies. Data from one study suggest that dogs are not as likely to become infected with the virus as cats and ferrets. These findings were based upon a small number of animals and do not indicate whether animals can spread infection to people.

Large cats in captivity, including several lions and tigers in a New York zoo, a puma in South Africa, and tigers in a Tennessee zoo have tested positive for SARS-CoV-2, as have several gorillas at the San Diego zoo, after showing signs of respiratory illness. It is suspected that these animals became sick after being exposed to zoo employees with COVID-19.

The virus that causes COVID-19 has been reported in minks on farms in the Netherlands, Denmark, Spain, Italy, Sweden and the United States. Once the virus is introduced on a farm, spread can occur between mink as well as from mink to other animals on the farm (dogs, cats). Because some workers on these farms had COVID-19, it is likely that infected farm workers were the initial source of mink infections.

For any animal that tests positive for SARS-CoV-2 at a private or state laboratory, USDA's National Veterinary Services Laboratories performs additional testing to confirm the infection and posts the results on this page: Cases of SARS-CoV-2 in Animals in the United States.


My Dog Has Hypoadrenocorticism: What Do I Do Now? - pets

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 female dogs. The average age at diagnosis is about 4 years old. The signs of Addison’s disease may be severe and appear suddenly, or may occur intermittently and vary in severity. Signs may include weakness, depression, lack of appetite, vomiting, diarrhea, and occasionally increased thirst (polydipsia) and increased urine production (polyuria).

When a pet 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. See What Do Those Lab Tests Mean? for additional information about laboratory tests.

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.

Increased blood potassium can cause life-threatening abnormalities in the heart rhythm. These abnormalities can cause the heart rate to be slow and irregular and can be seen on an electrocardiogram (ECG).

X-rays of dogs with Addison’s disease do not show any specific abnormalities. The heart may appear smaller than normal and rarely the esophagus (tube from mouth to stomach) can be enlarged.

The history, physical examination, and initial laboratory tests provide suspicion for Addison’s disease, but a more specific test, an ACTH challenge, should be performed to confirm the disease .

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 pill or a shot 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.).

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

Washington State University assumes no liability for injury to you or your pet incurred by following these descriptions or procedures.

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Watch the video: Dr Ferox on Cushings Syndrome (August 2021).