Addison’s Disease In Dogs
When dogs are stressed, their bodies produce cortisol. But if your dog has Addison’s, that production is inhibited. This can have some serious impacts on your dog’s body.
Addison’s disease in dogs is less common than its opposite condition, Cushing’s disease (the overproduction of cortisol), but it’s just as important to recognize and manage.
So, do you know what it is or how to spot it?
What Is Addison’s Disease In Dogs?
Addison’s disease is an endocrine disease caused by an inadequate production of hormones by the adrenal glands. The two most important hormones are cortisol and aldosterone. Cortisol is vitally important for healthy responses to stress, and it’s also important in regulating many body functions. Aldosterone regulates potassium and sodium levels.
Addison’s is hard to diagnose – the symptoms tend to come and go and vary in frequency and severity. An acute Addisonian crisis is a life-threatening emergency.
If your dog has a history of unexplained intermittent symptoms such as the following, then Addison’s may be the cause:
- Gastroenteritis (vomiting, diarrhea, no appetite)
- Blood in vomit or diarrhea
- Weight loss or difficulty putting weight on
- Poor ability to cope with stress (symptoms worse after stressful events)
- Drinking/urinating too much (polydipsia/polyuria)
Other signs that your vet will look out for are weakness, depression, low body temperature, dehydration, black poos (melena), a weak pulse, hair loss, slow heart rate, or even a history of collapsing in an acute crisis.
How Does Addison’s Develop?
Addison’s occurs when the tissue in the adrenal glands that makes cortisol and aldosterone is destroyed.
The most likely primary cause of this damage is autoimmune disease, but the tissue can also be destroyed by tumors (primary or metastatic), granulomatous disease (this is an inherited primary immunodeficiency disease), or after an overdose with mitotane, a drug used to treat Cushing’s disease in dogs.
Secondary hypoadrenocorticism can happen following withdrawal of prolonged treatment with cortisone, an isolated ACTH deficiency, an underactive pituitary gland, or a non-functional pituitary tumor.
Addison’s is most common in middle aged female dogs. Several breeds have a genetic predisposition to Addison’s:
- Standard Poodles
- West Highland White Terriers
- Great Danes
- Bearded Collies
- Portuguese Water Dogs
- Nova Scotia Duck Tolling Retrievers
- Soft Coated Wheaten Terriers
BUT this disease can affect any breed or sex of dog.
How Is Addison’s Diagnosed?
As I mentioned, it can be hard to diagnose, even for an experienced vet! Many of the signs are non-specific or are seen in other common dog diseases so can be mistaken for other issues.
In my opinion, if you have a dog that has trouble coping with stress, or who’s symptoms get worse after stress, this is a huge red flag. Also, if your dog has been treated with cortisone for these sorts of symptoms in the past and responded well, this may be an important clue (though I know most people reading here on DNM wouldn’t be likely to use cortisone!).
Blood tests can be of value. In a dog with Addison’s disease, you’ll likely see anemia (reduced red blood cells) and increased numbers of two kinds of white blood cells – eosinophils and lymphocytes.
The biochemistry of your dog will be out of whack too, with increased potassium levels, decreased sodium and chlorine levels, increased calcium levels, increased liver enzymes, decreased glucose levels, and azotemia. (Azotemia is an increase in nitrogen containing compounds in the blood – in particular urea and creatinine.)
A urine test will often show that your dog cannot concentrate the urine properly, and there may be other electrolyte abnormalities found.
Definitive diagnosis is going to require a day in the veterinary hospital for your dog, where they will have an ACTH stimulation test done. Your dog will be injected with a dose of ACTH (adrenocorticotropic hormone, a natural hormone produced by all healthy dogs), and this should cause the adrenals to produce cortisol and pump it into the bloodstream. If the serum cortisol doesn’t increase, you know for sure that your dog has Addison’s disease.
An ultrasound can also give a lot of useful information about the size of the adrenal glands. They’re usually smaller in cases of adrenal insufficiency.
How Is Addison’s Treated?
Unfortunately, once the adrenal tissue is gone, the only way to keep your dog healthy is replacement hormone therapy with cortisone and fludrocortisone acetate. (If you have a dog with confirmed secondary hypoadrenocorticism, they will only need cortisone.) It will likely take some time and a series of blood tests to make sure that all the electrolyte levels have settled into the normal range.
Also, Addisonian dogs usually benefit from an increased dose of cortisone in times of stress.
Please note that some dogs will only need cortisone supplementation at times of stress. The side effects of cortisone are much worse than of fludrocortisone acetate, so the less you need to use it, the better!
Prevention And Holistic Care
Right then – let’s step out of the box and consider how we can help dogs with Addison’s disease as naturally as is possible.
Prevention is a big one here, and a super healthy, complete, raw, whole food diet is the best place to start.
Remember, the prescription hormone replacement therapy may be life-saving, even though I always like to try everything else first. And please be aware that this illness can become a life-threatening emergency, so it may be in your dog’s best interest to start off on the prescription hormone replacement and then integrate the other treatments in while adjusting dose rates, with regular electrolyte tests to assess response.
If your dog is not severely affected, then you may wish to try a completely holistic health plan and see how that goes. If you take this route, I do encourage you to do so in partnership with a vet, so you can have regular blood tests to see how your dog is responding to treatment, and be ready to seek veterinary attention if symptoms worsen.
Prevention is a big one here, and a super healthy, complete, raw, whole food diet is the best place to start.
Avoid all processed food like the plague. Also, if you have a breed that’s pre-disposed, be very sensitive to any of the symptoms and take extra care!
Over-Vaccination is likely to be a contributing factor. Avoiding all but the most necessary vaccines is super important, and if you’re forced to vaccinate your dogs, be sure to treat them homeopathically before and after to minimize any damage.
Be alert to the subtle symptoms and insist on an ACTH test if you have had multiple bouts of the symptoms with no definitive reason why. The earlier you catch this, the more likely it will be that a holistic intervention will be helpful.
I believe it is possible for the adrenals to regenerate to at least some extent in some cases. The more holistic treatments you integrate into your dog’s health plan, the better the chances are of this happening.
Here are a range of holistic interventions for you to consider.
High-quality supplements: liver support, omegas, mineral supplements, pre- and probiotics and multivitamins are all going to make a big difference.
Also consider intensive antioxidant supplementation. Even 6-12 blueberries a couple of times a day can make all the difference.
You can trial your dog on natural hormone replacement with extracts of adrenal glands (and other organs) that contain non-synthetic hormone replacement. The Canine Adrenal Support supplement from Standard Process is a great one.
Herbal medicines may be of value: There are many herbs that support overall well-being and help the body return to health. Licorice herbal tincture is one of my favorites. Work with a herbalist to find the ultimate list and for the correct dose rates!
Make sure your dog’s spine is healthy and supple, especially around the 3 rd lumbar vertebrae. The energy flow from the spine to the adrenals is here. Bodywork and chiropractic care may be helpful if there’s a problem in this region of the spine.
Acupuncture/Acupressure: Assessment and treatment by a skilled acupuncture or acupressure practitioner will also help, sometimes a lot! This approach helps reset the health and well being of your dog’s body at a very deep level, and sometimes leads to almost miraculous responses.
Minimize stress and treat any PTSD: Stress is poison for dogs who have Addison’s, so make sure that your dog is happy and relaxed. If they have a traumatic history, consider a hands-on therapy such as the Whole Energy Body Balance or any other bodywork modality from a skilled practitioner.
Cannabis extracts/CBD: This is so good for supporting vital well-being, but its main benefit is as a natural calming supplement. Research shows that CBD Oil is very valuable when it comes to reducing anxiety and stress, which can cause Addison’s symptoms to increase. Be sure to source a whole plant extract.
If your dog is struggling with Addison’s disease, I wish you luck and courage. If you do need to use prescription hormone replacement therapy, be sure to integrate all the holistic options into your treatment plan. At the very least, you may be able to reduce the amounts of prescription drugs required.
What is Addison’s Disease in Dogs?
Addison’s disease is an endocrine or hormonal disorder in dogs that affects their adrenal glands. These glands are responsible for the release of important hormones like cortisol, a stress hormone, and aldosterone, a hormone that helps regulate levels of potassium and sodium in the body.
Addison’s disease is also known as hypoadrenocorticism because the adrenals release too-low levels of these hormones. Too-high levels of cortisol and aldosterone are caused by the opposite condition – hyperadrenocorticism or Cushing’s disease.
Addison’s commonly affects young to middle-aged dogs, more females than males, and the average age of onset is four years old. Breeds like Labrador Retrievers, Standard Poodles, Bearded Collies, and Portuguese Water Dogs have a higher genetic predisposition for the disease.
What causes Addison’s Disease in Dogs?
Addison’s is mostly caused by an autoimmune response, which means that your dog’s immune system can attack the adrenal glands and cause disease. In some cases, infection and trauma can result in Addison’s, and adrenal gland tumors can significantly affect the way that the adrenal glands function.
Pet owners should be wary of Addison’s when it comes to certain medications. If your dog has Cushing’s disease, your vet may prescribe an oral medication known as trilostane or Vetoryl. Careful monitoring is necessary to ensure that your dog does not overdose.
If he takes too much trilostane, his adrenal glands may become suppressed which results in clinical signs for Addison’s disease. Abrupt cessation of an oral steroid like prednisone can also cause signs of Addison’s, although this condition is only temporary.
Symptoms of Addison’s Disease in dogs
Addison’s can be tricky to diagnose because there are a wide variety of symptoms, and these signs can wax and wane over time. Lethargy, vomiting, diarrhea, increased thirst, and increased urination are the most common signs. Because of his gastrointestinal upset, your dog may have a poor appetite.
He will slowly lose weight and his muscles will start to atrophy or shrivel, resulting in an underweight body condition score. He may have a slow heart rate and a weak pulse. Addison’s patients tend to have very dry, brittle hair coats and develop moderate to severe dehydration.
How is it diagnosed?
If your dog has any of the above clinical signs, make sure to schedule an appointment with your veterinarian right away. She may recommend several different tests in order to rule out other underlying causes for your dog’s illness.
Routine blood work might show low amounts of sodium and high amounts of potassium because there is not enough aldosterone to prevent sodium from being excreted from the body. Blood values associated with the kidneys tend to be elevated, and white blood cells will be elevated if there is an infection. Anemia is also common, which means that the red blood cell count will be low.
With your dog’s clinical history and lab findings, your vet will recommend a special blood test known as the ACTH stimulation test. A blood sample is taken from your dog before a synthetic hormone known as adrenocorticotropic hormone (ACTH) is administered.
About an hour later, another blood sample is taken. In a healthy dog, the administration of ACTH will cause the adrenal glands to release cortisol into the bloodstream. Dogs with Addison’s disease will have little to no response to the ACTH, and so their cortisol levels will remain low.
Imaging can also help diagnose Addison’s disease. The adrenal glands may be difficult to evaluate with x-rays because the glands are very small. Ultrasound is useful because it can locate the adrenal glands and look for the presence of tumors or overall size changes. Advanced imaging like CT and MRI can help rule out tumors in the pituitary gland at the base of the brain.
Treating Addison’s Disease in dogs
Dogs who are acutely ill may require hospital care such as intravenous fluids, antibiotics, and steroid therapy. Once confirmatory test results are received, your vet will go over long-term treatment.
Two kinds of steroids are necessary for dogs with Addison’s disease: mineralocorticoids and glucocorticoids. Aldosterone is a mineralocorticoid, and this is supplemented in the form of a long-acting injection known as desoxycorticosterone pivalate or DOCP. It is injected by your veterinarian every three to four weeks depending on your dog’s overall response to it.
Cortisol, which is a glucocorticoid, is supplemented by administering oral prednisone once a day. Because it is a low dose, your dog won’t have any of the side effects commonly associated with steroid administration such as increased thirst and urination and increased appetite.
Once treatment is initiated, your dog will need to be rechecked after the first ten days and then again one month later. His blood values will need to be checked to make sure that his sodium and potassium go back to normal. As his hormone values stabilize, your dog will gain weight, have a healthier coat, and his other clinical signs will resolve.
There is no cure for Addison’s disease, but with regular monitoring and treatment, your dog can live a normal life. Dogs who undergo treatment for Addison’s disease usually have a good to excellent prognosis. If the underlying cause is related to a tumor, your dog will require further care and may need to see a specialist for further treatment options.
Addison’s Disease In Dogs
It always takes you by surprise to hear that your pup has been diagnosed with a disease. It’s even worse when you have never heard about the disease before. Addison’s Disease in dogs is an uncommon disease that is unheard of to most pet owners, but it has a habit targeting a certain subsect of dogs. Addison’s disease can be quite dangerous and even fatal, but with early diagnosis and treatment, dogs with Addison’s disease can live a long and normal life.
What is Addison’s Disease In Dogs
Addison’s disease, hypoadrenocorticism – is a medical condition where a dog’s adrenal glands have difficulty producing hormones – notably cortisol and aldosterone. Adrenal hormones are vital to controlling the balance between the trifecta of water, sugar, and salt in the body.
Canine Hypoadrenocorticism can affect any dog at any age. However, it’s most commonly seen in young to middle aged female dogs around age four. Addison’s disease is rare in cats of all types.
Your dog can only develop Addison’s disease if its adrenal glands are damaged. The symptoms of Addison’s disease vary in severity and can come on rather quickly. They are often confused for other less severe medical issues playing into the danger of the disease.
It’s hard to describe Addison’s disease in the same way we can with say allergies — which have very distinctive symptoms and causes. This is simply due to the nature of hormones and how they balance health. When a hormone becomes unbalanced itself it can affect health in a number of ways — both in big and microscopic ways.
Better known as the stress hormone, cortisol is vital to the management and metabolizing of sugar, protein, and fat in the body. It of course plays a significant role in stress but plays minor roles in tissue repair, memory formulation, and reducing inflammation.
Aldosterone has many roles, but mainly it’s found in the kidneys where it aids in the conversation of sodium, production of potassium, stabilizes blood pressure and retains water. It has a small role, but not fully understood role in stress and the adrenal glands — anxiety increases aldosterone.
Cushing’s disease is more common in dogs than Addison’s, and it’s caused by an overproduction of cortisol unlike Addison’s which is a paucity of cortisol. Symptoms include increased thirst, appetite, and urination, along with elasticity and thin skin.
What Causes Addison’s Disease?
Autoimmune disease is the culprit in the vast majority of cases. Autoimmune disease happens when the body’s immune system attacks the body. In Addison’s disease, this assault happens on the adrenal glands — destroying the outer layer of the glands.
Cancer is another — a bit less common — culprit along with long-term infections like histoplasmosis or blastomycosis. These infections have been directly linked to cases Addison’s disease.
Another less common culprit is a pituitary gland disease which causes it to not produce the hormone ACTH. This hormone is directly linked to cortisol production, and this gives you more insight into how an unbalanced hormone can mess up so many tiny things.
Types of Addison’s Disease
There are three main types of Addison’s disease: primary, secondary, and treatment-induced which a few other lesser known forms.
Primary Addison’s Disease
Primary Addison’s disease is characterized by the adrenal glands completely shutting down and no longer working. This is the most common form of Addison’s disease in dogs as it’s basically the destruction of the adrenal gland system.
Secondary Addison’s Disease
Above we discuss how hormones balance one another and when one goes it can unleash a domino effect. Secondary Addison’s disease happens when the hormone ACTH — produced in the pituitary gland — ceases which will cause a scarcity in cortisol production. This happens because ACTH signals the adrenal gland and tells it to produce cortisol.
Treatment-Induced Addison’s Disease
The rarest form of Addison’s disease is treatment-induced. Iatrogenic Addison’s disease is usually a result of poor steroid usage. When used for extended periods, steroids need to be slowly reduced as a rapid cut-off can produce negative side effects such as Addison’s disease. Steroids will boost hormone levels allowing the adrenal glands to become “lazy” and not produce hormones themselves.
When we see a drug causes side effects, it’s our instinct to immediately withdraw all use of the said drug. But as you can see above this can be very dangerous, much more so than the side effect that causes you to discontinue use. As always talk to your veterinarian before making changes in your dog’s drug dosage.
Breeds Prone To Addison’s Disease
We don’t currently know why, but a few dog breeds appear to be more prone to developing Addison’s disease:
- Airedale Terrier
- Bearded Collies
- Nova Scotia Duck Tolling Retrievers
- Standard Poodles
- Springer Spaniels: English Springer Spaniel and Welsh Springer Spaniel
It’s important to remember that any dog can develop Addison’s disease, however certain breeds and females around age four are more at risk.
Symptoms and Clinical signs of Addison’s Disease In Dogs
Diagnosing Addison’s disease can be very tricky, but a dead giveaway is muscle weakness. This weakness is a direct result of dehydration due to a hormone imbalance so be on the lookout for that to help confirm the diagnosis. However, an increase of thirst and urination is also possible — though it’s more common to see these symptoms in Cushing’s disease.
Imagine having all the gastrointestinal issues at one: stomach pain, no appetite, weight loss, vomiting, diarrhea. It isn’t fun and that’s what can all happen at once to dogs with Addison’s disease.
In all cases, it’s important to know what’s normal behavior for your dog. Some dogs will hide their symptoms, and Addison’s disease symptoms are already tricky enough as is to diagnose.
How Stress Affects Addison’s Disease
One of the biggest clinical signs of Addison’s disease is stress. Both pet owners and their dogs produce cortisol to help regulate and quell stress, so what happens when the body can’t produce cortisol? It can exacerbate all the other symptoms of Addison’s.
Even on a good day, a healthy dog is probably going to stress out or get anxious about something in some way. It feels like everything freaks out dogs: traveling, leaving the house, loud noises, celebrations, other dogs and people, and let’s stop there.
As you can imagine this makes life very difficult and stressful for a dog who no longer can produce the hormone that regulates stress. But don’t get your hopes up yet.
Treating Stress With CBD
Because treatment for Addison’s will likely include prescription medication, we wanted to offer an anti-anxiety solution that you can get over-the-counter. As well, it’s all-natural and has a very safe side-effect profile.
You’ve likely heard about lately as both people and pets are finding out that it’s having a startling effect on their anxiety levels. CBD supports and extends a vital regulatory system that helps balance the perception of anxiety. Since Addison’s disease severely hinders a major component of stress regulation, it’s a good idea to reinforce and boost other stress regulators that will now be working overtime to compensate.
CBD treats for dogs that are already taking pills or other medications as it breaks up the monotony. As well, who doesn’t want to spoil their dog with a tasty treat that may improve their health?
In most cases, Addison’s disease will slowly sneak up on your dog. However, there is a rare chance it can rapidly appear with dangerous results. Acute adrenal failure, also known as an Addisonian crisis is the rapid onset of Addison’s. It can send your dog into shock and can be life-threatening. If you notice several of the following symptoms appear closely together — seemingly out of nowhere — immediately see emergency medical attention.
Symptoms of an Addisonian crisis dog:
- Low blood pressure
- High potassium (hyperkalemia) and low sodium (hyponatremia)
- Delirium or lack of consciousness
- Extreme weakness
- Pain in the backend
- Stomach pain — diarrhea and nausea
Diagnosing Addison’s Disease
Diagnosing dogs with Addison’s disease is not easy, and a series of tests are usually performed to narrow if Addison’s is the culprit. Addison’s symptoms mimic many other more common diseases. As such, the first series of tests your vet preforms will focus on ruling other more common diseases as Addison’s is tough to get a definitive diagnosis.
ACTH stimulation test
Once everything else has been checked off, an ACTH stimulation test is performed to confirm there is an issue with the adrenal glands. Above you read how the pituitary gland naturally produces adrenocorticotropic hormones (ACTH) to stimulate the adrenal glands to produce cortisol. An ACTH stimulation test is an injection of ACTH which measures the degree to which the adrenal gland reacts when this test is performed.
As well, your vet may perform a dehydration test and will likely perform a blood test which will test for a number of imbalances:
Preventing Addison’s Disease
In most cases, there is little you can do to prevent Addison’s disease due to its genetic nature. However, Addison’s disease can be a result of a physical injury or drug-induced so we put together some helpful tips so you can keep your fur nugget safe.
Slowly Reduce Steroid Dosage
There are many reasons your vet may prescribe your dog steroids: pain, allergies, appetite stimulation, muscle weakness, adrenal insufficiency, etc. In most cases, steroids are only used short-term as long-term use greatly increases the risk of side effects. However, there are times when the extended use of them is required.
It is strongly recommended that you gradually reduce the steroid’s dosage over time, instead of dropping it cold turkey. Doing so can cause the adrenal glands to not fire back up to produce hormones since they were relying on the steroids to stimulate hormones.
Treatment for Addison’s Disease
While difficult to diagnose and potentially life-threatening, Addison’s disease is fairly easy to treat. So what are the available medication for Addison’s disease in dogs?
Well, there are two main drugs to choose from. Florinef (fludrocortisone) is the older of the two, however it is very effective. Even more effective is Percorten-V (DOCP) — it will require a steroid to achieve such however. Prednisone is typically the steroid prescribed, and we have a great article that will tell you all about the positives and negatives of prednisone.
Both drugs will hopefully achieve the same result, and that’s balancing your dog’s hormone levels. Your dog should be rechecked by your veterinarian 2-3 times a year to see if a change in dosage is needed.
If your dog is experiencing acute adrenal failure (Addisonian crisis), the emergency treatment protocol is administering intravenous fluid therapy which is typically a mixture of glucose and dexamethasone.
Managing Addison’s Disease in Dogs
While it can come as a big surprise to hear your dog diagnosed with a rare and potentially life-treating disease, Addison’s disease is easily managed in most dogs. You’ll want to use the tips we given and be aware of the symptoms as early diagnosing will translate into your dog having the best chance at a happy and healthy life. All in all, if you notice that not all is well with your pup, trust your instincts, and don’t wait to call your vet.
Fortunately, the hardest part in managing Addison’s is sticking to a constant regimen which in the beginning will be weekly blood tests. However, after their hormones have stabilized, blood tests will only need to be done 2-4 times a year.
Thanks to modern medicine, managing and treating Addison’s is very effective — which is wonderful to see as once it spelled a death sentence. As well, by using an all-natural remedy like CBD for stress, we can potentially extend our hand in helping our pets have a healthier life. At Innovetpet this is what we love to see — harmony between modern convention medications and all-natural remedies. Where one picks up the slack of the other. In CBD’s case, that’s extending the conventional medication used for Addison’s disease to also help with stress and anxiety.
This can make an already manageable disease even easier to treat. Remember, your most important job is to know the signs of Addison’s disease in dogs and immediately contact your veterinarian if you see them.