Don’t Worry, It’s NOT Acute Renal Failure…It’s Just Addison’s

Duke actually had Addison's disease

My dog Duke hadn’t been eating too well for about a week and I could tell something wasn’t right with him. His fur wasn’t as shiny and fluffy and his eyes didn’t look happy. All indications pointed towards him having some sort of stomach or intestinal illness that hopefully would resolve in a day or two. Well it didn’t. Another few days went by and Duke stopped eating altogether and started becoming very weak, so we did what anyone would have done and took him to the veterinarian. After several blood tests and an overnight stay, Duke was diagnosed with gastrointestinal inflammation and was sent home on a special diet. I was extremely happy to have Duke back and was also happy that basically he just had a stomach ache.

He nibbled on food for one day, the next day he didn’t eat at all, by the third day he had stopped drinking and eating. He became so weak that he was no longer able to walk without being wobbly. We put Duke in the car and went back to the veterinarian. I figured he was going to stay there for a few days until he gained his strength back with fluids and special food, and we’d have him back home in no time. A few hours later we got a phone call that was unexpected and extremely upsetting: “Duke has acute renal failure and most likely he will have to be put down so he doesn’t continue suffering.” My teenaged children who were in the car became so upset about this news, they cried and cried some more and they told us that they wanted to come and be with Duke during his last few moments.

We all loved Duke. He is gentle, kind, intelligent, and loyal. He was the best dog we ever had. The car was full of adults and children crying and we started heading back to the vet for Duke’s final appointment scheduled for 4pm that afternoon. On the way in, the cell phone rang. It was the veterinarian saying that Duke’s potassium was unexpectedly high and as a result wanted to rule out a disease called Addison’s. If in fact it was Addison’s, then Duke might have a chance after all. Is this even possible? I didn’t have much hope because Duke was a male and this disease was more common in females; additionally, Duke wasn’t one of the breeds predisposed to getting Addison’s.

The best way to diagnose Addison’s is with something called ACTH which Duke’s veterinarian said he would perform the next morning. When ACTH is given in a healthy dog, there is an elevation in cortisol levels. In animals with Addison’s disease there will be no such elevation. When cortisol levels do not go up after the ACTH is given then most likely the animal has Addison’s disease. At this point all we could do is go back home and wait until the next day when the results were in.

Nobody slept well that night. We all stayed up and discussed the things that Duke has done over the years such as the amount of kindness and love he showed a recent 2 year old house guest who would have driven anyone and certainly any pet crazy. Duke used to love swimming in the lake, and he loved chasing after his toy duck and bringing it to us as if saying “look what I got for you!” Duke was truly an exceptional dog.

The next morning I called the office for an update and was told to call back later. Later came and I called back and couldn’t have received better news: Duke’s ACTH stimulation test came up positive for Addison’s. I can’t remember ever being so happy about my pet getting diagnosed with a life-long disease that will require daily care and medication. I wasn’t thrilled that Duke had Addison’s but I was thrilled that Duke did not have terminal kidney failure and did not have to be put down that afternoon.Duke could and will still have many happy years with Addison’s as long as it is treated properly. To us that was great news!

Addison’s Disease–what is it? Hormones regulate certain body functions and the correct level of these hormones circulating in the blood is essential for the health and well-being of the pet. The gland called the adrenal gland is above the kidney and is responsible for making these essential hormones. There are times when the adrenal gland does not function properly or not at all and stops making those hormones. When that happens a diagnosis of Addison’s disease is made. In humans, Addison’s disease is relatively rare but it is a bit more prevalent in dogs.

As a point of interest, a famous person that suffered from Addison’s disease was President John F. Kennedy. It is possible to lead a normal life as long as the medications are taken the way they should be. Medication compliance is a very important factor on whether this disease is controlled or not controlled. With Addison’s the adrenal gland does not make enough of a hormone called cortisol. For that reason this condition is also sometimes call ”chronic adrenal insufficiency,” or hypocortisolism.

Cortisol has the very important function of helping the body deal with stress. Cortisol also helps the body regulate many essential things like protein and fat metabolism. Aldosterone, which may also be effected with this disease, has a major role in helping the regulation of salt and water. Regulating the sodium is extremely important in helping the pet keep his blood pressure under control. When aldosterone levels go below a certain level, the kidneys lose their ability to keep your salt and water levels in balance. This could make the blood pressure drop significantly.

In Dukes case the electrolytes and blood pressure were all so out of range that the immediate impression was that of acute kidney failure. Addison’s disease is classified into three different categories. Primary and atypical Addison’s are when the adrenal gland’s function is damaged due to an attack by the pet’s immune system. Secondary Addison’s occurs due to the failure of the pituitary to stimulate the adrenals. Knowing which type the pet has could be important in the method used for treatment. As I found out the hard way, diagnosing this disease can be difficult because the symptoms may seem similar to many other different conditions.

The dog might lack its usual luster, look depressed, lose its appetite, and just as in Duke’s case, the dog may seem a bit off and not his usual playful self. Other symptoms may include vomiting and diarrhea and could be mistaken for gastrointestinal upset. The back legs may become weak and the dog may have a difficult time walking. This is common and generally makes the dog appear unstable on his hind quarters.

Nobody knows your dog better than you; if something does not seem right, it probably isn’t and it’s time for a full checkup. The symptoms of Addison’s come and go over a period of a month or two and if nothing is done, the condition might progress to something called an Addisonian Crisis. Blood pressure drops to a dangerously low level, the kidneys are not able to function properly (hence the potential for an incorrect diagnosis of Kidney Failure). Potassium levels start getting elevated and cardiac function could get disrupted. This crisis is life threatening and veterinary intervention is essential. The veterinarian may give IV hydration and support along with the proper treatment which hopefully allows all the levels to return to their normal values.

The electrolyte levels that are of most concern are the sodium and potassium. The ratio between these two is usually assessed to determine what is going on. A dog in Addisonian crisis usually has low sodium levels and a high potassium level. Electrolyte levels are very important to make a diagnosis but the only way to confirm a diagnosis for Addison’s involves a test called the ACTH stimulation test. During this test, the dog is given something to stimulate the adrenals to produce cortisol. If the levels don’t go up after the hormone ACTH is given then that is a strong indicator that the pet has Addison’s. Giving a dog a corticosteroid such as prednisone or prednisolone prior to the test may create a false positive so it is important to tell your veterinarian about all the medication you may have given your pet over the past several days.

Percorten-V can be used to treat canine Addison's disease

There are several medications used to treat Addison’s. Some are oral and some require regular visits to the veterinarian for injections. Oral forms for prednisone or fludrocortisone are sometimes given, and many dogs are also treated with a regular injection of a product called Percorten V. It is very important to remember that a dog with Addison’s disease will require life-long medication and frequent visits to the veterinarian for blood tests. Most dogs that have this condition who are treated properly by responsible owners return to normal function and live a full, happy life. In many cases since the disease was present long before it was actually diagnosed, you may notice that after getting treatment your dog will look better than it has in a very long time. Eventually as you take care of your dog with this condition you will most likely become somewhat of an expert in picking up on clues that your dog is being stressed and you will be able to help reduce the stress and monitor the daily medication so your dog leads a full happy life. Sometimes if a stressful event is coming up such as a long travel, the veterinarian may suggest the dose of the medication be increased to help the pet handle the event.

The good news about Addison’s is that the condition can be treated and your pet can live a full enjoyable life. One of the most important things to remember is that if something feels off with your pet, it probably is. Taking your dog in for regular veterinary checkups is one of the best things that you can do to keep him healthy. Also don’t forget that a 1800PetMeds pharmacist is available to answer any medication related question that you may have.

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  1. I felt like I was reading my story in the first few paragraphs. I was going to have to put my dog down on a Friday due to kidney failure. He wasn’t improving but his blood work was so the vet let me take him home and had me sub Q hydrate through the weekend and try to get him to eat. My dog did started eating. More blood test on Tuesday and he was diagnosed with Addison’s disease.

    I was never so happy he was diagnosed with Addison’s disease. It is not curable but it is manageable. Sounds weird that I was happy he had a non-curable disease because he will need to be treated for the rest of his life but he can live a normal long life. Remember the first diagnosis was fatal.

  2. Unfortunately that’s not always the case… a happy ending. My female dog had addisons. She responded well to treatment, for nearly a year. Then she had renal kidney failure, not due to her addisons, and had to be put to sleep. As both of the 2 conditions don’t go well hand in hand. Being treated for her renal kidney failure would help her for a while but then relapse. Too much for a little dog.

  3. This is exactly what happened to my dog. Just got the diagnosis yesterday. He’s still hospitalized but doing better.

  4. Michelle HarrisonMarch 3, 2023 at 6:20 pm

    My dog was recently diagnosed with kidney disease. She’s a 6 year old Duck Toller. She was shaking uncontrollably last night, which made me think it’s Addison’s disease.

    The vet just performed the test. I told his assistant I was praying for a positive test. She said my dog may have both Addison’s and kidney disease…😞

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