Canine Addison’s disease
Canine Addison’s disease is a life-threatening condition that affects a dog’s adrenal glands. The adrenals produce aldosterone and cortisol, two key hormones critical to a dog’s bodily functions. The inadequate production of mineralocorticoids and/or glucocorticoids is known as canine Addison’s disease.
Breeds at increased risk
Canine Addison’s disease can affect dogs of any age, but primarily tends to occur in young to middle-aged and female dogs, with some breeds at higher risk.2
- Airedale terrier
- Basset hound
- Bearded collie
- Great Dane
- Nova Scotia duck tolling retriever
- Portuguese water dog
- Rottweiler
- Soft-coated wheaten terrier
- Springer spaniel
- Standard poodle
- St. Bernard
- West Highland white terrier
Changes caused by the aldosterone and cortisol deficiency of canine Addison’s disease include:
- Hyperkalemia K
- Hyponatremia Na
- Low sodium/potassium (Na/K) ratio
- Hyperphosphatemia
- Azotemia
- Increased liver enzymes
- Lack of stress leukogram
- Hypochloremia
- Non-regenerative anemia
- Lymphocytosis
- Hypoglycemia
- Hypophosphatemia
- Hypercalcemia
Not all dogs with hypoadrenocorticism
have the expected electrolyte changes.
- Adrenal glands produce mineralocorticoids (aldosterone), glucocorticoids (cortisol) and other hormones
- Mineralocorticoids regulate electrolyte balance, extracellular fluid volume and blood pressure
- Glucocorticoids play an important role in protein, fat and glucose metabolism
Early testing can save lives
It is estimated that there are approximately 100,000 dogs with canine Addison’s disease in the U.S. and that every veterinarian will see two cases of canine Addison’s disease per year.1 With patients showing signs of the disease, immediate treatment can make the difference between life and death.
Diagnosing canine Addison’s disease
Determining for certain whether a patient has canine Addison’s disease is difficult because the clinical signs are vague and mimic those of other diseases that can often be temporarily resolved with fluids and other supportive care. The on-again, off-again signs are so variable and similar to other diseases that canine Addison’s disease has come to be known as The Great Pretender.
The only definitive way to diagnose canine Addison’s disease is through the adrenocorticotropic hormone (ACTH) stimulation test.
When to consider the ACTH stimulation test2:
- To confirm the diagnosis of canine Addison’s disease when the resting (basal) cortisol is below 2 μg/dL and sodium-potassium ratios are less than 15:1
- When the clinician is highly suspicious of canine Addison’s disease based on clinical signs, even if the resting cortisol level is normal
- When the patient is presented with signs consistent with an Addisonian crisis
Clinical signs of canine Addison’s disease2,3
Anorexia
Vomiting
Lethargy, depression
Weakness
Weight loss
Diarrhea
Shaking, shivering
Polyuria, polydipsia
Bradycardia
Weak pulse
Collapse
Clinical signs may be acute or gradual in onset, and can wax and wane.
Conducting the ACTH stimulation test
Step 1
Obtain baseline blood sample
Step 2
Administer 5μg/kg synthetic ACTH via IV or IM
Step 3
Take a blood sample 1 hour later
Step 4
Centrifuge both blood samples and submit serum to laboratory
Interpreting the results
A dog with Addison’s disease
will show low baseline cortisol
with little to no response to
ACTH. A normal dog will have
a normal response to ACTH.
Treatment
Accepting a confirmed diagnosis of canine Addison’s disease may not be easy, but for many dog owners the diagnosis can be a blessing in disguise. Once your client knows what their dog is facing, it can help them regain control and take the appropriate action.
As the first FDA-approved treatment for canine Addison's disease*, Percorten-V has a long history of proven success. With careful monitoring and regular injections, Percorten-V can help your patients lead a normal life.2,4,5
Talk to your Elanco representative today about the solution that's saved nearly 70,000 dogs1 and counting.
Percorten-V is an injectable suspension of desoxycorticosterone pivalate (DOCP).
- DOCP replaces the mineralocorticoid hormones not produced by Addisonian dogs
- Administered via easy, intramuscular doses every 21 to 30 days**
- Animals suffering from hypovolemia, pre-renal azotemia, and inadequate tissue perfusion must be rehydrated with intravenous fluid (saline) therapy, and primary renal disease should be ruled out before starting Percorten-V therapy.
*For use as replacement therapy for the mineralocorticoid deficit in dogs with primary adrenocortical insufficiency.
**The initial starting dose of Percorten-V is 1 mg/lb intramuscular injection every 25 days. For most dogs, a dose range of 0.75 mg/lb to 1.0 mg/lb (1.65 mg/kg to 2.2 mg/kg) given every 21 to 30 days is effective. Glucocorticoid replacement must be supplied by small daily doses of glucocorticoid hormones (e.g., prednisone or prednisolone at 0.2 to 0.4 mg/kg). Dosage requirements are variable and must be individualized on the basis of the response of the patient to therapy.
Important Safety Information
Do not use in pregnant dogs or in dogs suffering from congestive heart failure, severe renal disease, or edema. Reduce dosage in dogs showing signs of hypernatremia or hypokalemia.
Like other adrenocortical hormones, Percorten-V may cause severe side effects if dosage is too high or prolonged.
The most common adverse reactions reported were depression/lethargy, vomiting, anorexia, polydipsia, and polyuria. Some of these effects may resolve with adjustments in dose or interval of Percorten-V or concomitant glucocorticoid administration. Please click here for full product information.
The following case studies provide examples of the variable clinical signs of canine hyperadrenocorticism and the value of early diagnosis and prompt initiation of treatment with Percorten-V.
For more information, talk to your Elanco representative today.