July 28, 2013
Landon came in a couple weeks ago because he vomited the night before and just wasn’t acting quite himself. As I walked into the exam room, I could tell Landon wasn’t quite himself. Anyone who didn’t know him would think he looked like a pretty normal, healthy dog. However, a normal Landon was never this quiet. A normal Landon would be bouncing all over the room greeting everyone who walked within a leash length. He did greet me, but he definitely was more reserved than normal.
As I examined Landon the only thing that really stood out was that he had lost 10 lbs. since he had last been seen just 3 months ago. The owner stated that his appetite had been off for a little while, although until the last day he had been acting normal. We talked about the most likely causes of gastrointestinal upset in a 3 year old lab mix. Things like eating stupid things outside, parasites, foreign bodies, and hemorrhagic gastroenteritis. I ran a blood count which was normal except showing he was somewhat dehydrated. The owner couldn’t think of anything Landon could have gotten into and eaten. I treated him with a couple shots for GI upset with instructions to have him rechecked if there wasn’t pretty rapid improvement.
Landon was brought in a couple days later and he was noticeably worse. He was lethargic and wasn’t eating or drinking anything. The owner had even observed an episode of collapsing briefly in the yard. The owner had recalled he had eaten some bones a few days prior, so we took abdominal x-rays which showed no obvious problem. We decided to run more extensive blood tests which showed a very obvious problem. Besides showing continued dehydration, Landon’s electrolytes were really messed up. His potassium level was extremely high and his sodium level was low! Is this a case of Addison’s Disease?
Addison’s Disease, or hypoadrenocorticism, is not a very common disease. I have only diagnosed about five cases in my 25 year career. This condition is due to the adrenal glands not being able to produce two types of cortisone. One of these types, glucocorticoids, is similar to prednisone. A deficiency in it can certainly cause a dog to not act quite normal, but usually won’t cause severe signs. A lack of the other type though, mineralocorticoids, can cause many problems.
The diagnosis is made difficult due to a combination of it not being very common and the fact that the clinical signs can go along with many other more common diseases. These clinical signs can also wax and wane over months before the dog appears to finally become very ill. The clinical signs can include just about everything, including not eating, vomiting, dark bloody diarrhea, weight loss, shaking, drinking excessively, urinating excessively, abdominal pain, and hair loss. When they quickly get extremely ill, like Landon did, the signs include collapse, weak pulse, shock, slow heart rate. The reason Addison’s Disease causes these suddenly very severe signs often is related to a very high potassium level. Seeing this on “Landon’s” blood work suddenly brought this potential diagnosis to the forefront.
I hospitalized Landon and put him on a high rate of intravenous fluids through the night. Dogs with Addison’s Disease will often show marked improvement just by giving lots of fluids to help bring down the potassium level. By the next day Landon was noticeably better. Not normal for him, but better and even eating a little. I continued fluids until the next day when I was able to test him specifically for Addison’s Disease. The next morning I took a blood sample to send in to measure the cortisol level and then gave him an injection of a hormone to try to force the adrenal glands to work and pump out cortisone. Two hours later I took another blood sample to also measure the cortisone. With the test being done, I then gave Landon a big shot of a short-acting cortisone since it would no longer affect the testing. Within a few hours, the old Landon was back!
When I got the results back the next day from the testing, I wasn’t shocked to find that Landon’s adrenal glands weren’t working correctly and he did indeed have Addison’s Disease. This condition can’t be cured, but it can be treated with life-long cortisone supplementation. Today I saw “Landon” for his first recheck after starting him on the medicine. He was back to barking greetings to us bouncing all over the room. It is good to have him back.
Dr. Chad Higgins has owned Amanda Animal Hospital for the last 16 years. He sees dogs, cats, and other little furry critters.