Addison's Disease - Frequently Asked Questions
The PWDCA Endocrine Committee continues to field questions by telephone and email several times a week. Here are some of the most frequently asked questions and the answers provided.
"Sorry to say I never bothered to read the Addison's stuff available because I never thought I'd need it. I was wrong! What are the major symptoms of Addison's disease?"
"When my dog vomited and seemed to be hanging off his backbone I thought he was about to collapse. What's the first thing to do?"
GET THE DOG TO A VET HOSPITAL AND GET HIM ON A SALINE IV DRIP as soon as possible. Your dog has probably had an Addisonian crisis and will die if you don't get help quickly. Ask the vet to use dexamethazone rather than prednisone.
"Why is it okay to treat a dog with dexamethazone and then do an ACTH test, but not with prednisone or prednisilone?"
Dexamethazone has no mineralocorticoids and no long lasting effects. There may be false elevations of cortisol concentrations if the dog is receiving prednisone, prednisolone, cortisone, or fludrocortisone. These drugs should be discontinued at least 48 hours prior to testing.
"What will the ACTH test tell me?"
The ACTH test involves measuring the level of cortisol in a dog's blood before and after an injection of synthetic ACTH. If the adrenal glands are functioning, cortisol levels will rise in response to the ACTH stimulation. If they are damaged, then their response to ACTH will be minimal. When Addison's disease is confirmed by an ACTH test and the dog has usually lost at least 70% of his adrenal gland function and needs medication immediately.
"What is "glucocorticoid definiency?"
These are decreases in normal glucose production in the dog's body.
"What is "mineralocorticoid deficiency?"
These are changes in normal sodium and potassium levels in the body. In Addison's disease sodium becomes lower than normal and potassium is higher than normal. If these levels are not corrected the dog will die.
"How is Addison's disease treated in Portuguese Water Dogs?"
Twenty five years ago only one therapy, Florinef, a pill taken once or twice daily was used to treat Addison's disease. It is still used successfully although far more owners of Addisonian dogs prefer using the once-a-month long acting injection of DOCP, from Novartis pharmaceuticals marketed as Percorten V.
DOCP (desoxycorticosterone) is a long-acting injection, (about a month depending upon the individual) which is recognized as having the same qualitative effects as the natural mineralocorticoid hormone aldosterone. It regulates the absorption of sodium and the excretion of potassium so they maintain normal levels and function in the body.
In some cases over the years dogs have been reported to be treated with prednisone, which is a short term glucocorticoid support drug. When those dogs have been switched to Percorten V, with or without continuing cortisone owners have reported far greater normalcy "I've got my dog back!" The use of cortisone depends completely on the individual but in most cases because stress is such a trigger for an Addisonian episode, the Addison's Committee (with the agreement and consent of the individual dog owner's vet) has recommended giving a small dose of prednisone prior to putting the dog in a known stress situation, such as grooming visit or "play dates" or other environmental changes. Any changes in medication or behavior should be discussed with the veterinarian to insure the dog's well being. Google ‘docp' and read the Novartis information provided.
"Are there other diseases or illnesses related to Addison's disease?"
There are other classic abnormalities associated with high potassium and low sodium. Some are related to heart function and should be discussed with the vet. The article "Three Awful A's" is available here at PWDCA.org. It discusses autopsy, Addison's disease and Autoimmune Polyglandular Syndrome.
"Is Addison's disease genetic in the Portuguese Water Dog?"
YES. Two different sets of scientists agree that Addison's disease is an inherited trait but they disagree on the mode of inheritance. To date (August 2012) there is no mode of inheritance for Addison's disease.
"As a breeder what should I know about Addison's disease when selecting a stud dog?"
Ask your breeder about the incidence of Addison's disease in your own bitch's line first. Get the information, it's out there somewhere. Ask the stud owner for the history of Addison's in their line. If you don't think you're getting the truth, find another dog and when asked, tell your reasons for not using him. This is serious business. Every known Addisonian should be reported to the Addison's Committee and the Health Registry. The Addison's committee has been answering questions since 1983 we will always be available to try to answer yours.