A watercolor painting of a man and his dog experiencing adrenal gland problems, such as Addison's Disease, resulting in low cortisol levels.

What is Hypoadrenocorticism (Addison’s Disease) in Dogs?

ByPhil Good, DVM Pet Health Plus

What is it?

Addison’s disease, also known as Hypoadrenocorticism, is a condition in dogs that occurs when the adrenal glands do not produce enough hormones such as cortisol and aldosterone. The condition can be caused by an autoimmune disorder, infection, or other factors. Diagnosis typically involves blood tests, urine tests, and imaging studies.

How is it Treated?

Treatment for Addison’s disease in dogs involves replacing the deficient hormones with medication such as fludrocortisone and prednisone. In some cases, dogs may require hospitalization and intravenous fluids to correct electrolyte imbalances and manage other symptoms. Regular monitoring and follow-up with a veterinarian are important for managing the condition.

Breed Predispositions

Standard Poodles Portuguese Water Dogs West Highland White Terriers Great Danes Bearded Collies Leonbergers Nova Scotia Duck Tolling Retrievers Wheaten Terriers

Introduction

When Tom’s usually energetic and playful Rottweiler, Duke, began displaying signs of lethargy, loss of appetite, and occasional vomiting, he knew something wasn’t right. Concerned about Duke’s well-being, Tom scheduled an appointment with their trusted veterinarian. After conducting a thorough examination and running several tests, the vet informed Tom that Duke was suffering from Addison’s Disease, a diagnosis Tom had never heard of before.

Addison’s Disease, also known as hypoadrenocorticism, is a rare but serious condition in dogs that occurs when the adrenal glands, small glands located near the kidneys, fail to produce adequate amounts of corticosteroids. These corticosteroids are essential for the body to function properly, as they help regulate the body’s use of proteins, carbohydrates, and fats, maintain cardiovascular function, suppress inflammation, and aid in the balance of salt and water. A dog’s body not producing enough of these hormones can lead to various symptoms and complications. This disease can affect dogs of all ages and breeds, but it is most commonly seen in young to middle-aged female dogs.

Causes of Hypoadrenocorticism in Dogs

Addison’s disease, also known as hypoadrenocorticism, in dogs results from a deficiency in the hormones cortisol and aldosterone produced by the adrenal glands. This deficiency can be caused by various factors, both common and less common, and the disease can be seen in dogs of all breeds and ages.

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Common Causes:

  1. Autoimmune disease: Addison’s disease often occurs when the body’s immune system mistakenly targets the adrenal glands, reducing hormone production. This form of Addison’s disease, a type of immune-mediated disease, is particularly common.
  2. Iatrogenic Addison’s disease can also be caused when a dog is abruptly discontinued under long-term corticosteroid treatment for a particular condition. As a result, the dog’s adrenal glands may have become reliant on the external steroid supply and may temporarily cease their hormone production, leading to an Addisonian crisis.

Less Common Causes:

  1. Infections and Diseases: Certain infectious diseases, including granulomatous disease, can damage the adrenal glands, resulting in Addison’s disease. However, these are less common causes.
  2. Adrenal gland damage: Physical trauma, bleeding, or tumors affecting the adrenal glands can result in Addison’s disease, although these causes are not frequently seen.
  3. Surgical removal of the adrenal glands: This is a very rare cause. If both adrenal glands need to be surgically removed, the dog’s body will no longer be able to produce the required adrenal hormones, resulting in Addison’s disease.

Addison’s disease can also be caused by a secondary form of Addison’s where the pituitary gland fails to stimulate the adrenals with adrenocorticotropic hormone (ACTH). Both male and female dogs are affected by this condition.

Regardless of the cause, Addison’s disease is a serious condition that can be life-threatening if not diagnosed and treated appropriately. However, with proper medical management, most dogs with Addison’s disease can lead a normal, healthy life. Always consult your veterinarian promptly if you suspect your dog may have Addison’s disease.

Symptoms of Canine Addison’s Disease

The symptoms of Addison’s disease in dogs can be vague and non-specific, which often makes diagnosis challenging. However, some of the more common symptoms may include:

  • Lethargy or Fatigue
  • Decreased Appetite
  • Vomiting and Diarrhea
  • Increased Thirst and Urination
  • Depression or Lack of Interest
  • Muscle Weakness or Tremors
  • Low Heart Rate
  • Hyperpigmentation
  • Collapse or Sudden Weakness

Addison’s disease can present with various symptoms, and the severity can vary greatly from dog to dog. Therefore, if you notice any of these symptoms in your dog, it’s important to consult with a veterinarian as soon as possible.

Diagnosis of Addison’s Disease in Dogs

Diagnosing Addison’s disease in dogs, also known as hypoadrenocorticism, involves a multi-step process due to the nonspecific nature of the disease’s symptoms. However, here are the steps a veterinarian usually follows:

  1. Physical Examination: Initially, the veterinarian will conduct a comprehensive physical examination. This is critical in identifying signs or symptoms aligning with Addison’s disease. Often, dogs receiving their initial diagnosis may show signs such as loss of body condition.
  2. Clinical History and Blood Work: An extensive review of the dog’s clinical history will be undertaken. Simultaneously, routine blood tests like a complete blood count (CBC) and biochemical profile are performed. These blood work results can show potential indicators of Addison’s, such as hyponatremia (low sodium levels) and hyperkalemia (high potassium levels), as well as signs of kidney dysfunction.
  3. ACTH Stimulation Test: This test is the gold standard for the diagnosis of hypoadrenocorticism. It involves injecting a small amount of synthetic adrenocorticotropic hormone (ACTH), then the dog’s response is measured. A healthy dog should stimulate the adrenal glands to produce cortisol. However, some dogs with addison’s disease will typically have a weak or non-existent response.
  4. Electrolyte Measurements: Checking the levels of electrolytes in the blood, especially sodium and potassium, can aid in confirming the diagnosis. An imbalance in these electrolytes, namely increased potassium and decreased sodium levels, is a common sign of Addison’s disease.
  5. Imaging: Although not the first go-to method, imaging techniques like ultrasound can be utilized to examine the adrenal glands. That said, significant changes may not always be visible in dogs diagnosed with Addison’s.

A thorough diagnostic process is crucial to rule out the diagnosis of other diseases with similar symptoms. With a confirmed diagnosis and suitable treatment, dogs with Addison’s disease can continue to lead normal and healthy lives. Open communication with your veterinarian or a veterinary internal medicine specialist is essential if you suspect your dog might have Addison’s disease.

Treatments of Addison’s Disease in Dogs

Treatment of Addison’s disease in dogs is a key focus of veterinary medicine and primarily involves hormone replacement therapy. This therapy is designed to compensate for the inadequate hormone production by the dog’s adrenal glands, a problem that dogs with Addison’s disease require treatment for.

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  1. Glucocorticoid replacement:  The first step in proper treatment is glucocorticoid replacement. This involves supplementing cortisol, a type of glucocorticoid that the dog’s body can’t sufficiently produce due to Addison’s disease. Prednisone or prednisolone is commonly prescribed for this purpose. These drugs support various body functions, including the formation of red blood cells, and help the body respond quickly to stress, maintain blood sugar levels, and aid in proper metabolism.
  2. Mineralocorticoid replacement:  Mineralocorticoid replacement is another significant aspect of Addison’s treatment. Dogs with primary Addison’s disease need replacement of the mineralocorticoid aldosterone, which regulates sodium and potassium levels in the body. The synthetic hormone fludrocortisone (Florinef) is typically used, or a monthly desoxycorticosterone pivalate (DOCP, brand name Percorten-V) may be administered.

Both of these therapies are generally ongoing and lifelong. Therefore, it’s essential to adhere to the prescribed regimen and not suddenly discontinue the medications to rule out Addison’s disease triggering an Addisonian crisis, a potentially life-threatening condition.

  1. Adjusting doses: Dosage adjustments are often necessary based on the individual dog’s response to treatment. Regular blood tests may be required to monitor electrolyte levels and overall health. During times of stress or severe GI blood loss, a significant increase in cortisol may be needed.
  2. Treating an Addisonian crisis: Emergency treatment, including intravenous fluids and high doses of corticosteroids, is required if a dog is suffering from an Addisonian crisis. This treatment ensures the dog is out of immediate danger by addressing dehydration and shock symptoms.

Remember, any treatment plan must be discussed and implemented under the guidance of a licensed veterinarian. Although Addison’s disease can’t be cured, dogs with this condition can lead a normal, active life with appropriate lifelong therapy.

Prevention of Canine Addison’s Disease

Unfortunately, Addison’s disease in dogs can’t be directly prevented as the exact cause of the disease is usually unknown, and it’s often due to an autoimmune response, which is difficult to predict or control. However, some general practices may help maintain your dog’s overall health and reduce the risk of developing Addison’s disease.

  • Regular Vet Check-ups: Routine veterinary care is crucial. Regular check-ups can often detect health issues before they become serious. Early detection can result in a better prognosis and can often prevent complications.
  • Healthy Diet and Regular Exercise: A balanced diet and regular exercise are important for overall health. Keeping your dog at a healthy weight can reduce the risk of many health issues, including endocrine disorders.
  • Proper Medication Management: Follow your vet’s instructions carefully if your dog is on any medication, especially steroids. Suddenly stopping certain medications can trigger Addison’s disease.
  • Reducing Stress: As stress can trigger an Addisonian crisis in dogs with the disease, maintaining a calm and stable environment can be beneficial.
  • Care with Vaccinations and Medications: Some evidence suggests a link between certain vaccinations or medications and autoimmune diseases. Though more research is needed, discussing any concerns with your vet can help you make informed decisions about your pet’s healthcare.

Remember, while these steps can support your dog’s overall health, they don’t guarantee preventing Addison’s disease. Therefore, important to consult your vet about any health concerns or changes in your dog’s behavior.

Frequently Asked Questions

With appropriate management and treatment, dogs with Addison’s disease (hypoadrenocorticism) can have a good prognosis and live a normal lifespan. The key to managing Addison’s disease is lifelong hormone replacement therapy with medications such as glucocorticoids (e.g., prednisone) and mineralocorticoids (e.g., fludrocortisone).

Regularly monitoring electrolyte levels and medication adjustments are important to maintain hormonal balance. In addition, compliance with medication administration and regular veterinary check-ups are crucial for ensuring the well-being of dogs with Addison’s disease.

There are no specific dietary restrictions for dogs with Addison’s disease. However, a balanced and nutritious diet that supports overall health and well-being is generally recommended. Therefore, it is important to consult with your veterinarian for personalized dietary recommendations based on your dog’s specific needs.

In some cases, dogs with Addison’s disease may require dietary modifications to manage concurrent health conditions or medication side effects, such as sodium or potassium adjustments. Your veterinarian can guide you on the most appropriate diet for your dog’s situation.

The cost of treating a dog with Addison’s disease can vary depending on several factors, including the severity of the condition, the required diagnostic tests, ongoing medication needs, and any additional treatments or hospitalization that may be necessary. Generally, the cost of managing Addison’s disease in dogs can range from a few hundred to several thousand dollars annually. This includes the cost of regular check-ups, blood tests, hormone replacement medications (such as fludrocortisone and prednisone), and potentially emergency care if an Addisonian crisis occurs.

Therefore, discussing the estimated costs with your veterinarian is important to understand the financial commitment to treating and managing the disease effectively.

Addison’s disease itself does not typically cause pain in dogs. However, the symptoms and complications associated with the disease, such as dehydration, electrolyte imbalances, weakness, and gastrointestinal issues, can cause discomfort and discomfort for the dog. Addisonian crisis, a severe disease, can be life-threatening and cause abdominal pain, vomiting, and collapse.

Prompt veterinary treatment is necessary to manage Addison’s disease and alleviate any associated discomfort or pain. If you suspect your dog has Addison’s disease or is experiencing any signs of pain, it is important to consult with a veterinarian for proper diagnosis and appropriate treatment.

Prednisone, a corticosteroid medication, is commonly used to treat Addison’s disease in dogs. It works by replacing or supplementing the deficient cortisol hormone in dogs with Addison’s disease. Cortisol regulates various bodily functions, including metabolism, immune response, and stress management. Providing synthetic cortisol through prednisone helps balance the hormonal levels and manage the symptoms of Addison’s disease.

Prednisone is typically used with other medications, such as fludrocortisone, to achieve proper hormone replacement therapy and maintain the dog’s health. However, it is important to follow the veterinarian’s instructions regarding the dosage and administration of prednisone, as it should be carefully monitored and adjusted to meet the individual needs of each dog with Addison’s disease.

Atypical Addison’s disease, also known as atypical hypoadrenocorticism, is a less common condition where the cortisol levels may be within the normal range, but the aldosterone hormone is deficient. Treating atypical Addison’s disease in dogs involves replacing the deficient aldosterone hormone.

The standard treatment for atypical Addison’s disease includes supplementation with oral fludrocortisone acetate, a synthetic form of aldosterone. Fludrocortisone helps regulate electrolyte balance and fluid retention in the body, which is typically disrupted in dogs with atypical Addison’s disease.

As with any medical condition, working closely with a veterinarian to establish the proper diagnosis and develop an individualized treatment plan for a dog with atypical Addison’s disease is important. In addition, regular monitoring and medication adjustments may be necessary to ensure the dog’s hormone levels are appropriately managed, and their overall health is maintained.

The recovery time for a dog after an Addisonian crisis, a life-threatening emergency caused by acute adrenal insufficiency can vary depending on the severity of the crisis and the promptness of treatment. However, with appropriate and timely treatment, most dogs respond positively and show improvement within 24 to 48 hours.

Yes, stress can trigger an Addisonian crisis in dogs with underlying Addison’s disease. Addison’s disease is characterized by the adrenal glands’ insufficient production of cortisol and aldosterone hormones. In times of stress, such as during an illness, injury, or other stressful events, the demand for these hormones increases. However, dogs with Addison’s disease cannot produce an adequate stress response due to the dysfunction of their adrenal glands.

Dogs of all breeds are prone to Addison’s disease, but some species are more commonly affected than others. Some typical dog breeds that are particularly prone to developing Addison’s disease include retrievers, boxers, golden retriever puppies, German shepherds, and Doberman pinschers.

The stages of Addison’s disease are: primary, secondary, and tertiary. The preliminary phase is when the dog experiences symptoms such as muscle weakness or fatigue; this may progress to a second stage, where more severe symptoms develop, such as weight loss or anemia. A third and final stage, known as the tertiary stage, can involve death if untreated.

Addison’s disease can be mistaken for other conditions, including adrenal gland failure, Cushing’s syndrome (a disorder caused by the overproduction of cortisol), and primary ovarian insufficiency.

If Addison’s disease in canines, also known as hypoadrenocorticism or adrenal insufficiency, is left untreated, it can have serious consequences for the dog’s health and well-being. Addison’s disease occurs when the adrenal glands fail to produce sufficient hormones, such as cortisol and aldosterone, which are important for regulating various bodily functions.

Without treatment, the lack of these hormones can lead to a range of symptoms and potential complications, including:

  1. Weakness and lethargy: Dogs with untreated Addison’s disease often experience fatigue and a general lack of energy.
  2. Gastrointestinal issues: Vomiting, diarrhea, and poor appetite can occur, leading to weight loss and dehydration.
  3. Electrolyte imbalances: Insufficient aldosterone can disrupt the balance of electrolytes in the body, particularly sodium and potassium. This can lead to abnormalities in heart function, muscle weakness, and potentially life-threatening cardiac arrhythmias.
  4. Collapse and shock: In severe cases, untreated Addison’s disease can result in an adrenal crisis, characterized by sudden weakness, collapse, low blood pressure, and shock. This is a medical emergency requiring immediate veterinary intervention.

Yes, Addison’s disease in dogs can have a genetic component, specifically primary or hereditary Addison’s disease. It is believed to be an autosomal recessive genetic disorder, meaning both parents must carry the gene for it to be passed on to their offspring. Breeds such as Standard Poodles, Portuguese Water Dogs, West Highland White Terriers, Bearded Collies, and Nova Scotia Duck Tolling Retrievers have an increased risk.

However, Addison’s disease can occur in any breed or mixed breed dog, and it can also develop sporadically without a clear genetic predisposition. Responsible breeders can perform genetic testing to identify carriers and make informed breeding decisions to minimize the risk of passing on the disease. Regular veterinary check-ups are important for detecting and managing Addison’s disease in dogs.

Addison’s disease in dogs is a chronic condition that typically requires lifelong management. It does not typically go away on its own. Addison’s disease occurs when the adrenal glands fail to produce sufficient hormones, and it is generally caused by an autoimmune reaction or damage to the adrenal glands. Treatment for Addison’s disease involves hormone replacement therapy, typically with medications such as corticosteroids and mineralocorticoids, to compensate for the deficient hormone production.

With proper treatment and ongoing management, dogs with Addison’s disease can lead healthy and normal lives. However, stopping treatment or inadequate management can lead to a recurrence of symptoms and potentially life-threatening adrenal crises. Therefore, lifelong treatment and close monitoring are necessary to effectively manage the condition.

Addison’s disease in dogs can be a serious condition, but with proper diagnosis, treatment, and ongoing management, it is typically not fatal. Addison’s disease, or hypoadrenocorticism, is a chronic condition where the adrenal glands fail to produce sufficient hormones. Without treatment, it can lead to significant health complications, including electrolyte imbalances, weakness, gastrointestinal issues, and potentially life-threatening adrenal crises.

However, with appropriate hormone replacement therapy and close veterinary supervision, dogs with Addison’s disease can lead healthy and fulfilling lives. Regular monitoring, adherence to medication protocols, and immediate attention to any changes or symptoms are essential to ensure the well-being of dogs with Addison’s disease and minimize the risk of life-threatening situations.

There is currently no scientific evidence to suggest that vaccines cause Addison’s disease in dogs. Addison’s disease is generally considered to have an autoimmune or idiopathic origin, meaning its cause is not fully understood. It is thought to involve a combination of genetic predisposition and environmental factors.

Vaccinations play a crucial role in preventing infectious diseases and are generally considered safe for dogs. Vaccines are designed to stimulate an immune response, but they do not typically trigger an autoimmune reaction leading to Addison’s disease.

It’s important to note that adverse reactions to vaccines, although rare, can occur. These reactions are usually mild and temporary, such as soreness at the injection site or mild flu-like symptoms. Serious adverse events are extremely rare and often outweighed by the benefits of vaccination in preventing potentially life-threatening diseases.

No, Addison’s disease in dogs is not contagious. Addison’s disease, also known as hypoadrenocorticism, is an endocrine disorder caused by a dysfunction of the adrenal glands. It is not caused by an infectious agent and cannot be transmitted from one dog to another. Addison’s disease is typically considered to have an autoimmune or idiopathic origin, meaning its cause is not fully understood and is not related to contagious factors.

If a dog is diagnosed with Addison’s disease, there is no need to worry about it spreading to other dogs. However, it is essential to provide appropriate veterinary care and management for the affected dog to ensure their well-being.

Yes, diarrhea can be a symptom of Addison’s disease in dogs. Addison’s disease, or hypoadrenocorticism, is a condition characterized by insufficient production of adrenal hormones. The inadequate levels of hormones can disrupt the normal functioning of the gastrointestinal tract, leading to symptoms such as diarrhea, vomiting, and poor appetite.

However, it’s important to note that diarrhea can have various causes, and Addison’s disease is not the only condition that can result in this symptom. If you suspect your dog has Addison’s disease or is experiencing persistent or severe diarrhea, it’s crucial to seek veterinary attention for proper diagnosis and treatment.

Addison’s disease in dogs does not directly cause kidney failure. Addison’s disease, or hypoadrenocorticism, primarily affects the adrenal glands and leads to insufficient production of adrenal hormones. While untreated or poorly managed Addison’s disease can result in electrolyte imbalances and dehydration, which may indirectly impact kidney function, it is not a direct cause of kidney failure.

However, if a dog with Addison’s disease experiences an adrenal crisis or severe complications, it can put additional stress on the body and potentially lead to organ damage, including the kidneys. Early diagnosis, appropriate treatment, and regular veterinary care are important to prevent complications and maintain overall health.

Addison’s disease in dogs is not typically associated with causing seizures. Seizures are abnormal electrical activities in the brain and are usually caused by factors unrelated to adrenal insufficiency. However, in rare cases, severe electrolyte imbalances resulting from untreated or uncontrolled Addison’s disease could potentially lead to neurological symptoms, including seizures.

It is important to note that seizures can have various causes, and if a dog with Addison’s disease experiences seizures, it may be due to an underlying condition or a separate health issue. Consulting with a veterinarian is crucial for proper evaluation, diagnosis, and treatment of seizures in dogs.

Addison’s disease in dogs does not typically cause blindness. Addison’s disease, or hypoadrenocorticism, primarily affects the adrenal glands and hormone production. While untreated or poorly managed Addison’s disease can lead to various symptoms and complications, including electrolyte imbalances, weakness, and gastrointestinal issues, it does not directly affect vision.

However, it’s important to note that other underlying conditions or complications associated with Addison’s disease, such as immune-mediated disorders or medication side effects, could potentially impact vision. If you notice changes in your dog’s vision or have concerns about their eyes, it is recommended to consult with a veterinarian for proper evaluation and guidance.

Addison’s disease in dogs does not typically cause aggression as a direct symptom. Addison’s disease, or hypoadrenocorticism, primarily affects the adrenal glands and hormone production, leading to various symptoms such as weakness, gastrointestinal issues, and electrolyte imbalances. Aggression in dogs can stem from a variety of factors, including fear, anxiety, territoriality, or behavioral issues unrelated to Addison’s disease.

However, it’s important to note that dogs with untreated or poorly managed Addison’s disease may experience discomfort or irritability due to the associated symptoms, and this could potentially affect their behavior. Proper diagnosis, treatment, and ongoing management of Addison’s disease are essential for maintaining a dog’s overall well-being and behavioral health.

Shaking or trembling is not a typical symptom of Addison’s disease in dogs. Addison’s disease, or hypoadrenocorticism, primarily affects the adrenal glands and hormone production. The common symptoms of Addison’s disease include weakness, lethargy, poor appetite, weight loss, vomiting, and diarrhea. While dogs with Addison’s disease may exhibit general discomfort or weakness, trembling or shaking is more commonly associated with other conditions, such as pain, anxiety, fear, or neurological issues. If your dog is experiencing shaking or trembling, it is advisable to consult with a veterinarian for proper evaluation and diagnosis to determine the underlying cause.

Addison’s disease, or hypoadrenocorticism, can develop at any age in dogs, but it is most commonly diagnosed between the ages of 4 and 7 years. However, it can also occur in younger or older dogs. The onset of Addison’s disease can be gradual, with symptoms appearing over time, or it can occur suddenly during times of stress or illness.

It is important to note that Addison’s disease is a chronic condition that requires lifelong management once diagnosed. If you suspect your dog may have Addison’s disease or are concerned about their health, it is best to consult with a veterinarian for proper evaluation and diagnosis.

Adrenal hormones play a vital role in regulating various bodily functions in dogs. The adrenal glands, located near the kidneys, produce two main types of hormones: glucocorticoids and mineralocorticoids.

Glucocorticoids, such as cortisol, help regulate metabolism, manage stress responses, and modulate the immune system. They play a role in maintaining blood sugar levels, promoting anti-inflammatory actions, and aiding in the response to physical and emotional stressors.

Mineralocorticoids, particularly aldosterone, regulate the balance of electrolytes, including sodium and potassium, in the body. They help maintain proper fluid balance, blood pressure, and kidney function.

Both types of adrenal hormones are crucial for overall health and well-being in dogs. They help the body respond to stress, support normal metabolic processes, regulate fluid and electrolyte balance, and contribute to immune system function. In dogs with Addison’s disease (hypoadrenocorticism), there is insufficient production of these hormones, leading to a range of symptoms and potential health complications.

Disclaimer: The information provided on this veterinary website is intended for general educational purposes only and should not be considered as a substitute for professional veterinary advice, diagnosis, or treatment. Always consult a licensed veterinarian for any concerns or questions regarding the health and well-being of your pet. This website does not claim to cover every possible situation or provide exhaustive knowledge on the subjects presented. The owners and contributors of this website are not responsible for any harm or loss that may result from the use or misuse of the information provided herein.

Dr. Phil Good, owner of Beyond Pets Animal Hospital, received his Bachelor of Science with highest honors in Chemical Engineering from Georgia Tech in 2006. Phil finally came to his senses, realizing he’d much rather work with animals than in a chemical plant. Dr. Good obtained his doctorate in veterinary medicine from UGA in 2011.

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