I’d love to be able to write an article called “Early Warning Signs of Addison’s Disease,” but I can’t. The reason: there aren’t any.
Addison’s disease is a serious and potentially life-threatening hormonal disease that occurs when the adrenal glands, the tiny little bean-shaped glands that sit just on top of each kidney, stop doing their job, which is production of hormones. These hormones are critically important to a host of bodily processes, mostly those that allow us to adapt to stressful situations.
Addison’s disease fun fact: President Kennedy was a famous Addison’s sufferer.
The first attack of Addison’s usually comes on with absolutely no warning. What’s really scary about Addison’s is that the symptoms can look like a whole lot of other diseases, and your veterinarian has to be paying pretty close attention to diagnose it. What signs should arouse your suspicions that your dog could have Addison’s disease? Read on to find out, and potentially help your dog make it through a life-threatening crisis.
Your dog is a standard poodle or a bearded collie
I told you there weren’t any warning signs of Addison’s, but two breeds seem to be predisposed to this disease at a much higher rate that others, and that’s standard poodles and bearded collies. No one understands why these breeds seem to be affected more often than others, but they are, and they can pass the genes for the disease to their offspring.
If you have one of these dogs it’s a good idea to have them screened for Addison’s. A resting cortisol level, meaning one that’s sampled at any time of the day and without giving any stimulating hormones, that’s above a certain level will rule out the disease 99% of the time. If the resting cortisol is below the level, more testing will need to be done to definitely say whether your dog has the disease or not.
Female dogs in general also have Addison’s more often than males.
Your dog isn’t handling visits too well
Above we discussed how the primary effect of Addison’s disease is to keep the body from handling stress well. This happens because the cortex, or outer layer, of the adrenal glands stops making both glucocorticoids and mineralocorticoid hormones. More on what those are later.
No one really understands why the adrenal cortex stops doing its job, but estimates are that when 90% of the cortex is non-functioning, the clinical signs of Addison’s become apparent. That means there’s a window in time in which your dog technically has Addison’s and it can be detected with testing, but the dog is normal in appearance and feeling fine.
I don’t have any data to support this, but I would bet that the majority of Addison’s cases are diagnosed during the holidays. Family is visiting, the house is full of children and noise, and everyone’s stress level is soaring, including the family dog. The dog might begin by missing meals, then becoming lethargic, then experiencing severe gastrointestinal disease. This is the beginning of what’s called an Addisonian crisis, and it’s a serious emergency that cannot be ignored.
A little stomach upset is really taking a toll
We all know that dogs eat things they shouldn’t. I love the term “indiscriminate eater”, because it’s really just a nice way of saying that dogs are scavengers and they will eat pretty much anything that’s accessible to them. Some are more determined than others, but suffice it to say that the holidays open ample opportunity for dogs to scavenge to their heart’s content.
Given this, you might be tempted to ignore a little diarrhea or one episode of vomiting after your dog has potentially eaten something he shouldn’t have. But if your dog ‘s not bouncing back pretty quickly from GI distress, it’s cause for concern. If you can put it all together into the realization that your dog is becoming listless, hesitant to eat, and possibly showing signs of GI distress during stressful events, you can potentially help to diagnose him with Addison’s before there is a serious crisis.
Your dog collapsed acutely and without warning
The most common presentation associated with Addison’s disease is a young dog, typically 4 or 5 years old, that has collapsed with no apparent warning signs. The vet usually starts general treatments for what’s called circulatory collapse or shock, which is typically aggressive fluid therapy, and sometimes the administration of steroid hormones. Many times the dog starts to look better pretty rapidly. Sometimes the vet doesn’t make the diagnosis, because the dog recovers, everyone celebrates and the dog goes home.
Don’t let this happen to your dog.
If your vet is paying attention, he should realize that circulatory collapse should result in a rapid heart rate, but Addisonian dogs actually have a lower than normal heart rate. “That’s unusual,” Dr. SmartVet says, “I’m going to run some blood work on this dog.”
In a classical Addison’s diagnosis, the dog typically has very high levels of potassium and very low levels of sodium. Calculating the ratio of these two electrolytes often helps us make the diagnosis, but the definitive test has to be run later when the dog has recovered from the acute crisis. It’s the high potassium level that’s slowing the heart rate abnormally in an Addisonian crisis.
Potassium and sodium imbalances occur in Addison’s because of the lack of mineralocorticoid hormones, which are produced in the adrenal cortex of normal dogs. Glucocorticoids manage the body’s fat and sugar balance, and help it respond appropriately to stressful situations.
Summing it up
Luckily Addison’s is not extremely common, but it happens often enough and it’s missed often enough that it’s important to be able to recognize it. Why? Because not doing so can be devastating and deadly.
Addisonian patients can live a normal life if medicated and monitored properly. Usually they require an injection of synthetic mineralocorticoid hormones approximately every month and a daily low dose of synthetic corticosteroids.
Owners need to be taught to anticipate potentially stressful situations and consult with their vets beforehand, as we often adjust the steroid medication dose temporarily in these situations.