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Cause
Addison's disease is caused by the adrenal cortex not functioning properly. This results in a deficiency of mineralocorticosteroids and glucocorticosteroids. The mineralocorticosteroids (including aldosterone) ensure the mineral and water balance in the body and the maintenance of blood pressure. The glucocorticosteroids (cortisol) are important for the metabolism. During stressful situations, the adrenal glands normally produce glucocorticosteroids, which allow the body to cope with the situation. So a stressful situation can lead to a crisis where prompt treatment is necessary.
Autoimmune disease
Addison's disease is usually an autoimmune disease. In an autoimmune disease, the immune system targets parts of the body. In Addison's disease, the immune system targets the adrenal cortex. In animals treated for Cushing's disease with Lysodren, the destruction of the adrenal cortex also creates the picture of Addison's disease. These diseases mainly occur in dogs and are rarely seen in cats.
Symptoms
The symptoms of this disease are very vague. Due to the non-specific symptoms, it can resemble other more common conditions such as gastrointestinal complaints or kidney failure. Usually the process is gradual and the dog has occasional periods of vague symptoms. The dog is not presented to the clinic until an acute crisis occurs. The most commonly observed symptoms are poor appetite, sluggishness, weight loss, abdominal pain, vomiting, weakness, trembling and diarrhea. The examination at the clinic often shows that the dog is dehydrated and has a slow, weak pulse.
Making the diagnosis
The diagnosis is made by a blood test. This blood test shows that the sodium and potassium values are abnormal. Striking is a high potassium content. When there is a suspicion of Addison's disease, an ACTH stimulation test is done. In this test, blood is drawn twice with 90 minutes in between. After the first time, the dog is given an injection of a synthetic ACTH. Then the cortisol value is determined in the blood. If this value is lower than the reference values in both blood samples, Addison's disease is confirmed. Normally, the cortisol value should be higher in the second sample after the stimulation of the ACTH. ACTH is a hormone produced in the pituitary gland (located near the brain) and activates the adrenal cortex to produce cortisol.
Unfortunately incurable
Addison's disease has no cure. The treatment consists of giving certain hormones for life so that the shortage of cortisol and aldosterone is eliminated. So a deficiency is replenished so that the body can function normally and no overdose is given. As a result, there are no side effects that normally occur when giving corticosteroids, such as drinking a lot, urinating a lot and gaining weight.
Addison crisis
When a patient is in an acute 'Addison crisis', this is an emergency. This is a life-threatening situation. It is important that the dog receives an intravenous drip and medication through the drip until the dog is eating and drinking independently again. Then it is switched to oral medication. The oral medication consists of a glucocorticoid, mineralocorticoid, and salt. The first check is done after two to three weeks, during which the sodium and potassium determination is done. Then the medication can still be adjusted. After that, it will take place every six months.
Adapted medication for stress
The dosages of the medication should be adjusted in stressful situations for the dog such as fever, illness, surgery, grooming or change in daily routine. This increases the glucocorticosteroids.
Life expectancy
Expectations for the patient are positive and in most cases they respond well to treatment and can lead a normal life.
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