Addison’s disease
What is it?
Addison’s disease is an endocrine system disorder that occurs when the adrenal gland fails to
produce enough hormones to keep the body functioning normal y. The adrenal glands secrete glucocorticoids and when proper amounts of these are not produced, an animal's metabolic and electrolyte balances may be upset. Addison’s disease is fatal if left untreated. Causes
Most cases of Addison's Disease are natural y occurring and are idiopathic (cause unknown). Some
are genetic, others appear to be autoimmune related. The currently accepted explanation for the disease is that it is due to an inappropriate immune response being mounted against the adrenal gland. This results in the gland being destroyed and hormone production ceases. However, this is by no means certain yet, other causes may wel become apparent in the future. Addison's disease mostly affects young to middle-aged female dogs, the average age at diagnosis is four years old and about seventy percent female. Nevertheless, Addison's disease is stil relatively uncommon in Symptoms
Symptoms of Addison's disease in canines can include:
In general, Addison's disease in canines is under diagnosed. Addison's Disease is very easily confused with other diseases that have very different treatments. General y, diagnosis is made by firstly ruling out other diseases, blood work including kidney function and sodium/potassium analysis. If the kideny test results are normal, and sodium/potassium tests are abnormal Addison's Disease wil be very strongly suspected. A final test is then needed to confirm Addison's Disease. Treatment
The long term treatment of Addison's Disease is by replacement of the missing hormone,
aldosterone. However, aldosterone itself is not available, so we have to use a drug that has similar properties. This is cal ed fludrocortisone acetate, and is marketed as Florinef®.It is very important to monitor the dog to check the effect of the drug. This is done by regularly testing the levels of sodium and potassium within the blood. If the drug dose is too low, then sodium wil be too low, and potassium too high. In this case, we increase the dose and may even give it twice daily. The first blood test is done about a week after starting treatment, and each week after that until satisfactory maintenance is achieved. Once stable, we usual y recommend to test every 6 months Side Effects
High blood pressure, fluid retention and low potassium levels are al possible if the dog is
overdosed, and not monitored sufficiently. If the dog needs a high dose of Florinef® to maintain normal sodium and potassium levels, then the cortisol-like effect of the drug wil be greater than is required. In this case, side effects associated with excessive levels of cortisol wil occur. These are mainly increased thirst, appetite, and weight gain. In comparison with other dogs taking oral steroids, these symptoms are general y mild, but can be significant.It can help to give a salt supplement with the diet, especial y in dogs that require high doses of Florinef®. Ordinary table salt is adequate, but not the reduced sodium salts as they have high levels of potassium. In most cases, the long term use of salt supplementation is not necessary.
Outlook for Affected Dogs
Most cases of Addison's Disease return completely to normal with treatment, and those that are not completely normal have a more than adequate quality of life. However, it is a potential y life threatening disease, and you have to be vigilant. Al dogs with Addison's Disease require lifelong treatment. It is vital that the medication is given regularly, even when the dog looks better. Also remember that at times of stress, or if the dog is not eating, vomiting or lethargic, it is likely that some cortisol is required. You should be prepared to give some prednisolone at these times, and even if you hardly ever use it, remember to keep some just in case.

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Journal of Nutritional & Environmental MedicineMay 2007; 16(2): 149–166MARGARET MOSS, MA (CANTAB), UCTD (MANCHESTER), DIPION, CBIOL,MIBIOL, Director of the Nutrition and Allergy Clinic11 Mauldeth Close, Heaton Mersey, Stockport, Cheshire SK4 3NPAbstractPurpose: To collate evidence on nutrient deficiencies caused by drugs. Design: Search of Medline and other databases, and published litera

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