Addison’s Disease – General Comments from the Addison’s List
These musings are not listed in any particular order, nor are they posted in relevance to any one member's posts.
1) There is absolutely no reason what so ever that a properly medicated Addisonian cannot and will not live a full and active life.
2) There is not any one particular food and/or feeding method recommended for Addisonian dogs. The dogs on our list do well on a wide variety of diets including but not limited to commercial kibbles, canned foods, commercial or home prepared prescription diets, balanced raw or BARF plans, properly balanced home cooked diets and/or a mixture of all of the aforementioned.
3) Glucocorticoids (e.g., prednisone, prednisolone, Medrol and hydrocortisone) do NOT and will NOT influence the electrolytes (sodium and potassium readings).
4) The glucocorticoids administered to Addisonian dogs are simply meant to replace their missing cortisol and as such we seek to administer the lowest amount (mg) possible. Therefore is not advisable to administer immunosuppressive or therapeutic dosages.
5) The abbreviation for sodium is Na and the abbreviation for potassium is K.
6) Only Percorten (DOCP) and/or Florinef will medicate electrolyte imbalances so naturally only the amounts of Percorten and/or Florinef administered will affect the electrolytes.
7) Prednisone and Prednisolone have a biological half-life of 18 to 36 hours.Medrol (Methylprednisolone ) has a biological half-life of 18 to 36 hours.Hydrocortisone has a biological half-life of 8 to 12 hours. Dexamethasone has a biological half-life of 36 to 54 hours.Florinef (fludrocortisone acetate) has a biological half-life of 18 to 36 hours.
8) Addisonians with normal electrolytes prior to their ACTH Stimulation Test are Primary/Atypcial and as such they do not require Florinef or Percorten unless they transition to Primary/Typical Addison's.
9) Dexamethasone is the only glucocorticoid that will not skew an ACTH.
10) Once a dog with Primary Addison's has been correctly diagnosed with Addison's meaning if the test was not skewed and/or influenced by other medications (e.g., oral, topical, otic and/or injectable glucocorticoids other than Dexamethasone) it is a waste of time and money to rerun another ACTH Stimulation Test.
11) The ratio is derived by dividing the big number (sodium) by the little number (potassium). The majority of Primary/Typical Addisonians feel their best when their ratios are in the low to mid 30's.
12) Only the starting dosages of Percorten and/or Florinef are determined by a dog's weight. The following dosages required are determined according to the dog's most recent electrolytes (sodium and potassium levels).
13) There is not a maximum amount of Florinef but there is a minimum recommended starting dose (O.1 mg per every 10 pounds.)The following Florinef or compounded fludrocortisone acetate dosages are determined according to the individual dog's most recent electrolytes (sodium and potassium levels).
14) There is not a minimum dosage of Percorten-V. Only the starting dose is administered according to the dog's weight. The subsequent injection amounts are determined according to EACH dog's most recent electrolytes (sodium and potassium levels).
15) While the ratio is important we do like to see the individual numbers especially the potassium (K) readings.
16) Various labs/testing facilities (e.g., varying vet's in-house equipment, Antech, Idexx) have different reference ranges.
17) Prednisone and/or Florinef should always be administered either with food or directly after eating as opposed to on an empty tummy.
18) Do not limit access to water.
19) Keep copious records and notes on your dog's behavior, symptoms and medications as well as copies of all blood work and/or tests.
20) Thanks to Bobbie and SusanL's expertise I have enclosed a link to the DOCP calculator (http://www.addisondogs.com/addisons/helpers/small/docp.html).
21) Not every symptom and/or behavior is related to Addison's.