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Addisons Disease (Hypoadrenocorticism)

Addison's disease is caused by an insufficiency of adrenal hormones from the adrenal gland, the adrenal glands are paired glands located near the kidney.

Some of the clinical signs:
Lethargy and depression, Vomiting, Weakness, Poor appetite, Weight loss, Dehydration, Diarrhoea, Hypothermia, Shaking/trembling, Polyuria (increased urination), Polydipsia (increased drinking), Slow heart rate, Collapse and shock (may occur in later stages of condition).

The adrenal gland produces three types of hormones:
Mineralcorticoids e.g. aldosterone
Which have an effect on the levels of the minerals; sodium, chloride and potassium in the body.
Without mineralcorticoids, the potassium levels in the body can become so high that they interfere with normal heart function causing shock and rapid death.

Glucocorticoids e.g. cortisol,
Which have an effect on the blood glucose levels.

Androgens e.g testosterone,
Which are steroid hormones.

There can be primary or secondary reasons for addisons disease. Primary reasons usually involve levels of mineralcorticoids (regulating salt/potassium balance) and glucocorticoids, however secondary addison's is normally associated with just a glucocorticoid deficiency.

Primary addison's disease is thought to be an immune mediated disease. Management for the acute condition initially involves immediate intravenous fluid therapy with saline solution and glucocoticoids (although if the levels of hormones are too rapidly corrected this can cause further complications), once the animal has improved mineralcorticoids will be administered. Glucocoticoids used in acute primary addison's include Hydrocortisone sodium succinate, Prednisolone or Dexamethasone

Once the addison's patient has been stabilised, the owner will have to administer mineralcorticoid and glucocorticoid hormones throughout life. However, prognosis for these animals is excellent if the owner is well informed of the condition.

To maintain an addison's patient the following drugs may be used:

  • Fludrocortisone
  • Deoxycorticosterone pivalate (this is not yet available in the UK or Europe yet, just the USA)
  • Cortisone acetate
  • Prednisolone
  • Dexamethasone

(Some of the drugs mentioned have mineralcorticoid action and others have glucocorticoid action, some have both. It will depend on each individual situation on which drug your pet will be given).

Secondary addison's disease can be caused by sudden with-drawal from steroids and may sometimes be induced by the medication used to treat Cushing's disease. It may also be induced by pituitary cancer, tumours and injuries.

Addison's is less common in the dog than Cushing's disease (hyperadrenocorticism). It is a disease that often goes undiagnosed and is very rare in cats. A study in 1989 by Peterson and Greco, showed that only 8 cases of cats with addison's disease had been recorded. (1)

There does not seem to be any breed of dog that is more likely to suffer from addisons, and it does not seem to necessarily be a disease of the older dog, it is thought to be more likely in female dogs (Peterson and Kintzer, 1996). (2)

Dietary management of Addison's

  1. Foods high in potassium should be avoided, although the food should contain adequate sodium and chloride levels. The diet should contain a highly digestible protein source and salt supplementation has been found to help this condition in the early stages of management.

  2. As with most disease conditions food allergy/intollerance may be responsible. If this is so, then fed correctly, Burns can be useful in managing Addison's disease in cats and dogs, although we always recommend consulting Burns Pet Nutrition before changing diets.

  3. Natural herbal remedies may include: dandelion, parsley and nettles which help to control the balance of steroids and aromatherpy using rosemary, ginger and lemon grass is thought to strengthen steroid production. (3)

(1) Source 'Textbook of Small Animal Medicine' ,Edited by John Dunn MA, MvetSc, BVM&S, DSAM, DipECVIM, MRCVS, Published by Saunders, 1999)
(2) Source 'Textbook of Small Animal Medicine' ,Edited by John Dunn MA, MvetSc, BVM&S, DSAM, DipECVIM, MRCVS, Published by Saunders, 1999)
(3) (Source Natural Healthcare for pets, by Richard Allport, Published by Element 2001)
Dogs - This article has been reproduced courtesy of Burns Pet Nutrition

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