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Addison's Disease in Dogs: A Comprehensive Guide

It's hard to not go into full throttle panic mode when something is wrong with your fur child. Trust us, we get it. Having your dog diagnosed with any disease can be extremely heart wrenching for any pet parent. With that being said, if your pup was recently diagnosed with Addison's disease, try to remain calm. While there certainly is an adjustment period, the disease is entirely manageable.

In this article, we hope to inform our readers of the disease as well as symptoms to look out for and the ways to manage it. Take a deep breath, you got this!

addison's disease in dogs

The Basics of Addison's Disease

You may also hear Addisons disease in dogs referred to as canine hypoadrenocorticism. While it is a fairly uncommon disease, when hypoadrenocorticism does occur in dogs, it may be seen more in does develop is it typically seen in young to middle-aged female canines (with an average age of four years old). With that being said, it is entirely possible for Addison's disease to develop at any age and affect both male and female dogs.

Furthermore, while the disease is relatively uncommon, it is still important to know the signs and potential causes for its development. While it is completely manageable with the appropriate treatment plan and medication, if left untreated, Addison's disease can be fatal. Therefore, if you suspect that your dog may have the disease, a timely diagnosis is absolutely imperative.

What is Addison's Disease in Dogs

The adrenal gland is a small organ located just in front of the kidney, which is how it got its name.  It consists of the medulla in the center and outer area called the cortex. The function of the adrenal gland is to produce hormones. Addison’s disease is concerned with the hormones called corticosteroids, which are produced in the cortex.  Addison's disease develops as a result of damage to the dog's adrenal glands. Adrenal glands are much more important than many people may realize. Cortisol and aldosterone are among two of the most important hormones that the glands produce.

adrenal gland in dogs

What is Cortisol 

Cortisol is the hormone that manages sugar, fat, and protein metabolism. Cortisol is also responsible for the dog’s response to stress.

What is Aldosterone 

Aldosterone is the hormone responsible for balancing the sodium and potassium in the dog’s body. Additionally, aldosterone plays a large role balancing sodium and potassium levels in situations when the dog's body is under stress.

As you can imagine, when these hormones aren’t functioning properly or aren't balanced, a slew of issues can quickly arise. These corticosteroid hormones are very important in helping our pets adapt to stressful situations, so even the smallest stresses can lead to a disaster.

What is Cushing's Disease 

The condition that is considered to be the opposite of Addison's disease is called Cushing’s disease. Cushing's disease is an overproduction of cortisol in the dog's body.

Potential Causes of Addison's Disease

Despite substantial research, not all causes of Addison's disease are known. Most commonly, the underlying cause is genetically based. In many of these cases, an autoimmune disorder causes the body to wrongfully see its own organs as a threat and attack them (this is also known as immune-mediated destruction).

Experts believe that other cases of Addison's disease are the result of trauma or diseases affecting the adrenal glands. For instance, different conditions such as infections of the adrenal glands like histoplasmosis or blastomycosis have been directly linked to the Addison's disease in dogs.

Other instances of Addison's disease are believed to occur from a problem in the dog’s pituitary gland. The issue results in the gland not producing the hormone ACTH which plays an important role in the production of cortisol in the body.

Types of Addison's Disease

Of the varying types of Addison's disease, primary, secondary, and treatment-induced are the three that pet owners should be aware of.

Primary Addison's Disease

Primary adrenocortical insufficiency is the most common type of Addison's disease in dogs. This type of Addison's disease occurs when the dog’s immune system destroys parts of the adrenal glands and they don’t function appropriately. Other causes for primary hypoadrenocorticism include medications, toxins, cancer or other concurrent diseases.

Secondary Addison's Disease

Secondary hypoadrenocorticism affects the pituitary glands (as opposed to the adrenal gland). The pituitary gland produces ACTH. ACTH is an important hormone that is responsible for sending signals to the adrenal glands. These signals alert the adrenal glands to make their own specific hormone.

If the pituitary gland stops producing ACTH, the adrenal glands, therefore, stop producing cortisol.  

If Fido is diagnosed with secondary Addison's disease, the treatment plan will involve medication that helps the produce the cortisol that it is not naturally making. This type of Addison's disease isn't accompanied by symptoms of an Addisonian crisis (symptoms of a bad sodium / potassium balance... more on that in a minute).

Treatment-Induced Addison’s Disease

Finally, the third type of Addison's disease is referred to as treatment-induced Addison's disease or iatrogenic Addison’s disease. It is the type of disease that is a result of prescription drugs.

Luckily, there are ways to prevent this form of Addison's disease from developing, but the trick is knowing the risks involved.

Iatrogenic Addison’s disease typically develops when a dog is taking a steroid medication for a long period of time and then comes off the medication too quickly. This is due to the fact that when dogs are taking steroids, their hormones levels increase in the body so the adrenal glands stop producing them.

For this reason (among others), it is so incredibly important to always discuss the proper way to use medications with your veterinarian and always follow the instructions accurately. Pet owners may believe that their beloved four-legged friend no longer needs to be on the steroid medication because they are feeling better. However, many dog parents do not realize that abruptly ending medication can quickly (and fairly easily) lead to a slew of additional problems to arise.

Furthermore, stopping steroids without slowly weaning the dog off of the medication can lead to issues that are irreversible. It is entirely possible for the adrenal glands to not be able to start up again. Again, consult with your vet and develop a proper, monitored treatment plan for your dog's individual needs.

pituitary gland in dogs

Addison's Disease Symptoms

The following are symptoms of Addison's disease and can range from mild to severe. It is incredibly important for pet parents not to ignore mild symptoms as they can quickly worsen and prove to be much more difficult to manage in many cases.  Additionally, Addison's disease symptoms may appear suddenly and be severe or may appear intermittently and vary in severity with each occurrence.

Stomach Issues

Gastrointestinal issues are a common sign of Addison's disease. Symptoms may include: painful stomach cramping, vomiting and diarrhea, anorexia or weight loss. 

Of course, general stomach issues are also referred to as non-specific symptoms. In other words, they are symptoms of many different conditions. For instance, diarrhea is a symptom of Addison's disease but can also be a sign that Fido may have gone through the trash while you were at work. The same goes for other non-specific symptoms such as a loss of appetite. That's why it's so important to know your dog's "normal" behavior in order to recognize when something is off and be able to act accordingly.

addison's disease in dogs causes stomach issues

Weakness

An increased amount of muscular weakness and overall tiredness are classical signs of Addison's disease. Many pet parents may not know that increased lethargy is directly tied to dehydration and hormone imbalance. Another telling symptom of Addison’s disease in dogs is increased thirst (polydipsia) and urination (polyuria). If Fido takes in more fluid or has any of the other aforementioned symptoms, a timely diagnosis is imperative in order to begin treatment and ensure the condition doesn't worsen.

Additional Symptoms of Addison's Disease

Symptoms of Addison's disease include:

  • Lethargy
  • Weakness
  • Poor appetite
  • Vomiting
  • Weight loss
  • Depression
  • Dehydration
  • Diarrhea
  • Excessive thirst or fluid intake
  • Cool to touch
  • Excessive shaking
  • Slow heart rate
  • Change in blood pressure

Addison's Disease & Stress

When a dog is stressed their adrenal glands naturally produce higher levels of cortisol. This helps them deal with the stress. A dog with Addison's disease is unable to make enough cortisol and therefore is unable to properly deal with whatever stress they are currently facing. Therefore, the symptoms of Addison's disease will often be much more severe when the dog is stressed.

We likely don't have to tell you that dogs are highly sensitive creatures. What stresses one dog may not stress the next, but you can assume that if something is bothering you, your dog is picking up on it. Additionally, any changes in your dog's day to day routine, traveling, having guests over, etc. can cause them to experience an amount of stress that will cause the symptoms of Addison's disease to worsen.

This brings us back to the beginning of this article when we encouraged our readers not to panic. We know this is easier said than done, but a dog with Addison's disease should avoid stress at all costs and if something is stressing you out, you can be sure it's stressing Fido out.

Addisonian Crisis

Unfortunately, because of the fact that early symptoms are typically mild, many dogs aren't diagnosed with Addison's disease until they experience an Addisonian crisis. About 30% of dogs are diagnosed with Addison’s disease during a crisis. An Addisonian crisis is a medical emergency that results in your dog going into shock from a sodium and potassium imbalance and the collapse of their circulation system. The increase in potassium can cause heart arrhythmias. The blood glucose level can also drop dangerously low during the crisis. If Fido has any of the aforementioned symptoms, a timely diagnosis is imperative in order to begin timely treatment and ensure the condition doesn't worsen or result in death.  

Oftentimes, a dog experiencing an Addisonian crisis will appear to be extremely ill. Typical symptoms include:

  • Extremely dehydrated
  • Lethargy
  • Physically weak
  • Excessive shivering
  • Heart failure (Relatively uncommon but possible)

Addison's Disease Diagnosis

You may hear your vet refer to Addison's disease as “the great imitator.” This goes back to the non-specific symptoms that we discussed. Due to the fact that the symptoms of Addison's disease are also those of a slew of other conditions, your veterinarian will likely have to run a series of tests on your dog in order to accurately diagnose the disorder. When other diagnoses are ruled out, the veterinarian will confirm an adrenal insufficiency and thus an Addison's disease diagnosis by using an ACTH stimulation test.

Initial diagnostics typically include standard blood tests such as a complete blood count and a chemistry profile to check for imbalances such as:

  • Blood urea nitrogen (BUN)
  • Elevated creatinine
  • Decreased blood sugar
  • Anemia
  • Electrolyte abnormalities (including sodium and potassium)

If all the results are pointing to Addison's disease, then the vet will perform an ACTH challenge test in order to make the final diagnosis.

addison's disease in dogs diagnosis

ACTH Stimulation Test

An ACTH stimulation test involves injecting the dog with (you guessed it) ACTH. This is the pituitary hormone that tells the adrenal glands to release corticosteroids during times of stress. The dog’s cortisol levels are measured before and several hours after the injection of ACTH.  A dog that does not have Addison's disease will respond by showing increased cortisol levels. The vet will confirm that it's Addison's disease if there is no increase in the dog's cortisol levels after being injected with ACTH.

A screening test called a resting cortisol level can also be performed prior to an ACTH stimulation test. If the resting cortisol is in the normal range than Addison’s disease is less likely. If the results come back low, then Addision’s disease cannot be ruled out and an ACTH stimulation test should be performed. The resting cortisol test is less expensive than the ACTH test, so it may be useful if it comes back normal.

Preventing Addison's Disease

As we previously mentioned, some cases of Addison's disease are caused by genetics. In these cases, unfortunately, there is no real way to prevent the disease from developing. However, in other cases of Addison's disease in dogs, there are a few ways that pet owners can make sure they are protecting their pup's adrenal gland and ultimately prevent the disease.

Avoid Drugs and Chemicals 

Consuming dangerous drugs and chemicals is one way that Addison's disease may develop. Keeping these substances out of reach is an easy way to prevent Fido from accidentally eating them. 

For dogs that are on medications to treat Cushing’s disease, make sure to follow the recommended dosing. An overdose of these medications can cause destruction of the adrenal gland and lead to Addison’s disease. 

It goes without saying that consuming any drugs or chemicals may not result in Addison's disease, but will likely result in a serious issue developing either immediately or in the future. If you believe your dog may have eaten something dangerous, it is extremely important to have them checked by a vet right way.

Protect the Kidneys

Avoiding any pressure or impact on the sensitive area surrounding the kidneys is also an important way to prevent Addison's disease from developing.

Steroid Usage

As we previously mentioned, one of the most common known reasons behind Addison's disease is discontinuing steroid use too quickly. We understand that there are times when steroids may be necessary to get your beloved four-legged friend back on the right track. It is impossibly hard seeing your pet in pain so it makes sense that owners may think that as soon as the medication works, they should stop giving it (especially if you're aware of the dangers of so many conventional drugs). However, this truly can harm your dog more than you can imagine. It is imperative to always follow your veterinarian's instructions when starting and ending medications, particularly steroids. It can make a world of difference in your dog's health and well-being.

Protect the Adrenal Glands

It's pretty safe to assume that anything that causes harm to the adrenal glands has the potential to cause Addison's disease. Therefore, by protecting the adrenal glands you are helping to prevent the disease from developing.

Treatment for Addison's Disease

We know that that was a fair amount of potentially troubling information. However, we originally said not to panic for a reason. That is because and the reason is that when diagnosed appropriately and in a timely manner, hypoadrenocorticism in dogs is entirely treatable. Addison’s disease is not curable but it can be managed with lifelong treatment.

The long-term treatment of Addison’s in dogs involves replacing the essential hormones that the dog's body is no longer producing naturally. This is achieved with drugs such as Florinef (fludrocortisone), or a newer treatment option, Percorten-V (desoxycorticosterone pivalate | DOCP).

Percorten-V (DOCP) is a long-acting injectable mineralocorticoid medication and only has to be administered once every twenty-five day period. It’s been shown to offer much better results than Florinef. However, with that in mind, if your dog is prescribed Percorten-V (DOCP), they will typically also be prescribed a steroid called prednisone. Prednisone will have to be given daily to replace the corticosteroid in the body.

Once your dog's hormone levels are stabilized, it is important for them to be rechecked by a vet 2-3 times a year so that the dose of medication can be altered if necessary.

Treatment for an Addisonian Crisis 

If your dog is in an Addisonian crisis your veterinarian will likely recommend hospitalization with the administration of intravenous fluids and other medications such as dexamethasone, and potentially glucose (sugar). The fluid will help stabilize your dog.

Managing Addison’s Disease in Dogs

Here's the good news. With proper treatment and an understanding of how to manage the disease, Addison's disease in dogs has a good prognosis. With the appropriate care, the majority of Addison's dogs won’t have any disease-related problems that could lead to their lifespan being shortened.

As a pet owner, the most difficult aspect of managing Addison's disease is making sure that you are staying on top of necessary medications and always being on the lookout for signs of an Addisonian crisis. Pets undergoing stressful situations such as boarding, traveling and surgery may require an increase in the prednisone dosing to compensate for the additional stress and anxiety. In the beginning, it is important for your dog's blood to be tested weekly. However, once stabilized, you'll likely only need to have their blood checked 2-4 times a year.

Again, we cannot stress enough the importance of knowing your dog's "normal" behavior. We wish that our dogs could talk to us and tell us exactly how they are feeling. However, this just isn't the case. Dogs are notorious for hiding pain and playing it cool. Therefore, if anything seems off, chances are, something is very off. It is imperative to be able to quickly recognize these changes and act accordingly.

addison's disease in dogs treatment

Breeds at Risk of Addison's Disease

While any dog, at any age, any breed, and either sex can develop Addison's disease, studies have found that certain breeds seem to be at higher risk.

These breeds include:

  • Nova Scotia Duck Tolling Retriever
  • Portuguese Water Dogs
  • Standard Poodles
  • Airedale Terrier
  • Basset Hound
  • Bearded Collies
  • Great Dane
  • Rottweiler
  • Springer Spaniels: English Springer Spaniel and Welsh Springer Spaniel
  • Saint Bernard
  • Soft-Coated Wheaten Terrier
  • West Highland White Terrier

If your pup happens to be one of the aforementioned breeds, it's even more important to be on high alert when it comes to recognizing symptoms of canine Addison's disease.

Addison's Disease in Dog's: The Bottom Line

At the end of the day, we know that your dog means the entire world to you. Trust us, we get it. At Honest Paws, we are all dog owners. That's why we know firsthand just how difficult it can be when your four-legged family member is diagnosed with a lifelong disease.

We are here to tell you that thanks to modern medicine, Addison's disease in dogs is very manageable and no longer a death sentence. Furthermore, a dog diagnosed with  Addisons disease dog can live just as long as a dog that doesn't have the condition.

By knowing the ways that you can help protect the adrenal gland, the signs of the disease, and what to do if symptoms occur, you can ensure that you are doing everything you can to keep Fido happy and healthy. Again, Addison's disease is manageable, but the first step in doing so is through an accurate diagnosis. If for any reason you believe that your dog may have Addison's disease, don't delay in contacting your veterinarian.

Sources

 

Jennifer Dempsey, DVM

Dr. Jennifer Dempsey is a small animal veterinarian and freelance medical writer. She received her Bachelor of Science from the University of Central Florida and her Doctorate of Veterinary Medicine from the University of Florida (Go Gators!) 

She has resided in the Orlando area since graduation and has gained years of experience helping cats and dogs live happier and longer lives. As a general practitioner, she has found client education to be one of the most important aspects of day to day life in veterinary medicine.  

Medical writing has helped her to connect with a larger audience and make sure that pet owners are fully aware of their loved one’s medical condition.  She currently shares her home with two rescued mixed breed dogs named Primo and Morgan.

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