How to Treat Addison's Disease in Poodles

Three Parts:Identifying Addison's DiseaseGetting a Veterinary DiagnosisTreating Addison's Disease

Addison's disease is a potentially serious condition that affects a dog's ability to produce important hormones in its own body. The condition occurs in a variety of dog breeds and poodles are one that it shows up in more often than others. It has subtle signs at first, but these become progressively more dangerous over time. Once recognized and diagnosed, Addison's Disease can be treated, but the key is to be able to identify it quickly so that treatment can begin as quickly as possible. [1]

Part 1
Identifying Addison's Disease

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    Be able to spot the initial signs of Addison's disease. [2] At first the signs are vague. They include lethargy, intermittent diarrhea and vomiting, shaking, and muscular weakness, which makes it difficult to jump up on a favorite spot.
    • These symptoms often wax and wane, which can make it hard to diagnose.[3]
    • It most cases, the adrenal glands gradually fail, as a result of attack from the poodle's own immune system.
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    Look for the signs of a crisis. The initial symptoms can persist in a mild form for a few months.[4] However, if the problem is not identified, eventually the levels of hormones are so low that the dog collapses, in what is known as an Addisonian crisis.
    • These are potentially fatal and need emergency medical treatment if the dog is to live.
    • During an Addisonian crisis, the dog collapses, repeatedly vomits, and goes into circulatory shock with a slow heartbeat. The paws are likely to feel cold, the animal is extremely weak and this is likely to be fatal unless treated promptly.
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    Keep an eye out for symptoms in dogs with risk factors. Addison's disease is more common in female than male dogs, with the ratio being 2:1. Age also seems to be a risk factor, with young to middle-aged female dogs seeming the most likely to suffer from Addison's.[5]
    • Several dogs breeds seem to be more likely to suffer from Addison's disease than others. This includes the poodle, rottweiler, bearded collie, and the west highland white terrier.[6]
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    Understand what Addison's disease is. Addison's disease is also known as hypoadrenocorticism. It is a condition where the adrenal glands (two small glands that sit just in front of each kidney in the abdomen) fail to produce enough of the natural steroids, called corticosteroids and mineralocorticoids.
    • These are crucial chemicals for the normal functioning of the body as they help the dog to cope with stress, and also regulate the levels of certain crucial minerals and salts in the body.

Part 2
Getting a Veterinary Diagnosis

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    Take your dog to a veterinarian. The symptoms of weakness, poor appetite and frequent tummy upsets are quite nonspecific and can be confused with infections, pancreatitis, or even a foreign body. The vet may run a screening blood test and identify changes in the balance of minerals and salts in the blood that are suggestive of Addison's disease.
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    Talk to your veterinarian about the need for additional testing. This can increase the cost of the visit, but may be necessary. To pin down the diagnosis requires a blood test called an ACTH stimulation test.[7]
    • This test consists of an injection of a substance that stimulates the adrenal glands and a repeat blood sample taken one hour later. If the adrenal gland does not respond by producing more hormone, than Addison's is confirmed.
    • In some cases, it is also necessary to eliminate other problems, such as ruling out back pain as a cause of weakness, an ECG for heart disease, or imaging the abdomen to rule out a foreign body.
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    Discuss the need for immediate treatment due to crisis. Addison's is treated by supplementing the missing hormones. However, if the dog is in an Addisonian crisis, then it needs emergency stabilization. This includes intravenous fluids, along with intravenous corticosteroids.
    • Treatment may also include an injection of a new drug called DOCP (Percorten V), which is a synthetic mineralocorticoid.[8]
    • In addition the dog will need to be kept warm, and turned regularly so that she doesn't get bed sores.

Part 3
Treating Addison's Disease

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    Administer mineralocorticoids. The aim of treatment is to replace the missing hormones, which help the dog to cope with stress and regulate its blood salt and mineral levels. All cases of Addison's disease need to take mineralocorticoids in the long term. Traditionally, there was only one treatment available, which is a tablet fludrocortisone (Florinef), which is given daily.[9] However, a new synthetic mineralocorticoid, called DOCP (Percorten V), is given by long-acting injection is now available.
    • The salt levels in the blood are checked every week to two weeks and the dose increased incrementally until sodium and chloride levels are within normal. After that the blood levels need to be monitored regularly, such as every 2 - 3 months.
    • Florinef has mixed activity, which means it supports both mineralocorticoid and corticosteroid levels, which means in some cases additional corticosteroid tablets are not necessary.
    • The vet gives DOCP by subcutaneous or intramuscular injection once every 25 - 30 days.[10][11] It should be noted that DOCP has no corticosteroid action and so supplementation with corticosteroids, such as prednisolone, is essential. At the start of treatment the patient's kidney and salt levels should be monitored every 2 weeks, and adjustments to the dose of DOCP made. Once stable, these can be checked every 3 - 6 months.
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    Give your dog corticosteroids if it is also taking DOCP. Dogs taking the mineralocorticoid DOCP, it will also need to take a corticosteroid. However, once stabilized, some dogs that are taking Florinef can stop taking corticosteroids regularly.
    • However, the owner needs to keep a supply on hand to give at times of stress (such as going to the dog grooming parlor or the kennel).[12]
    • Other dogs need to stay on corticosteroids in the long term. The vet will make a judgement call based on the dog's demeanor at home (a good appetite, energetic, lack of shaking) and the results of blood tests.
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    Supplement your dog's salt intake. Some dogs with Addison's disease do struggle to maintain the salt levels in their blood. For these patients, the vet may suggest sprinkling table salt over the dog's food to supplement their salt levels.
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    Give ongoing care. Once diagnosed and stabilized, the long-term outlook for Addison's patients is excellent.[13] However, stressful situations always increase the dog's need for steroids, so the owner should be aware and keep extra tablets on hand.
    • Give your dog steroids if it shows signs of trembling or weakness, or it vomits. This could indicate destabilization.

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