Addison's Disease is seen frequently in young and middle-aged female dogs.
Disease is a function of the lack of aldosterone (impaired ability to conserve
sodium and excrete potassium) and insufficient cortisol. Emesis, diarrhea,
and anorexia are common and contributes to the pet's deterioration. Weight
loss is frequently severe.
In treating your pet, the most costly and critical period is the first 24 hours.
Usually this a life long problem that is possible to control, but not cure. Long
term maintenance (oral) is usually inexpensive, with occasional rechecks
necessary for blood tests (lytes / ACTH). You will find injectable maintenance
therapy more convenient but more expensive.
When in crisis, it is an EMERGENCY, fortunately these are rare. Need to
differentiate from primary renal failure or severe GI upset:
Clinical Signs of a Crisis:
1. Depression and lethargy 7. Weight loss
2. Weakness 8. Abdominal pain
3. Anorexia 9. PD/PU
4. Shaking and shivering 10. Weak pulse and bradycardia
5. Vomiting 11. Dehydration
1. IV catheter (jugular catheter if possible) with .9% saline solution.
2. If very shocky, place an indwelling urinary catheter and monitor
3. Lead II EKG / Urinalysis
4. Draw pre-treatment bloods (general panel + electrolytes)
5. STAT sodium and potassium levels
6. ACTH response test if possible (non-critical status)
7. Rapid IV infusion of normal saline or 2.5% glucose in 0.45% sodium
chloride (OK to add 50 ml of 50% dextrose per liter of sodium
chloride), at a rate of 20-40 ml/# BW.
8. 50-200 mg. solu-delta-cortef IV -- cortisone is "the key" to stabilizing
9. Add 1-2 mg/kg. dexamethasone to IV fluids
10. Continue rapid IV fluid administration until blood pressure rises, and
urine output has returned to normal, then change to maintenance
11. Administer mineralocorticoids (DOCA) at 0.2-0.4 mg/kg IM, every 24
(DOCA acetate has been discontinued - use it if you have some)
12. If EKG shows life threatening bradycardia or ventricular arrhythmia,
use regular insulin IV at 2 units per 10# BW, followed by 4 cc. of 50 %
dextrose per unit of insulin given IV.
13. Routine antibiotics
If your pet is in crisis, expect the pet to be hospitalized for at least 24 hrs. Followup
care upon discharge, if it has been critical, or not stabilized.