Addisons Disease
Here we explore what Addisons Disease is, the symptoms, tests for your dog, and management of the condition.
Addisons Disease
If you have a Poodle one of the issues you need to be aware of is they can be prone to Addison’s Disease. In a survey a number of years since on the USA Addisons Facebook Group 17% of dogs with Addisons were Standard Poodles. It can also affect miniature and toys, they made up 7% at the time.
If you added in Poodle crosses, it increased to over 40%. We believe the numbers/percentages to be higher now. Latest studies have shown there to be a genetic propensity to Addisons but it can just happen to any, and a stressful or traumatic incident can trigger the immune system to overreact and attack the adrenal glands which is the usual cause.
What is Addisons Disease?
Addison’s is the failure of the adrenal glands which sit on top of the kidneys. The Adrenal Glands control the production of Aldosterone (Mineralocorticoids) and Cortisol (Glucocorticoids). A reduction in Aldosterone production leads to changes in levels of sodium, chloride, and potassium, which affects the kidneys. This in turn can lead to problems with the heart and circulatory system.
Cortisol regulates the production of glucose, regulates metabolism, influences the breakdown of fat and proteins, regulates blood pressure, suppresses inflammation, stimulates the formation of red blood cells, and counteracts stress. Stresses can be good stress aswell as bad and your dog just can't cope with any.
Addisons Disease Symptoms:
Addisons Disease is also called the great pretender, if you have a set of random symptoms which you can't get to the bottom of, testing for Addisons Disease in a Poodle and Poodle crosses may give you the answer, if you have a Standard Poodle you should know the symptoms.
The symptoms are wide-ranging:
Dehydration, Lethargy, Muscle wasting, Low temperature including cold in leg joints and under ears, Pale gums, Sunken eyes with bottom lids rolling in, it can show as Kidney and/or Liver failure (these usually recover once on medication), Depression, Anorexia (lack of appetite), Weight loss, Vomiting, Diarrhoea, Bloody stools, recurrent bouts of Gastroenteritis, Alopecia (hair loss), Increased urination, Increased thirst, Shaking/tremors, Weak pulse, Irregular heart rate, Painful abdomen, Hypoglycaemia, Hyperpigmentation of the skin, slow loss of body condition, hind end weakness and an inability to respond appropriately to stress.
It’s important to note that the symptoms of Addison’s disease may wax and wane; some go into 'crisis' almost overnight others may have symptoms for years. Some dogs may show one symptom, some all, but most show a few.
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Dehydration,
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Lethargy,
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Muscle wasting,
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Low temperature including cold in leg joints and under ears,
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Pale gums,
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Sunken eyes with bottom lids rolling in,
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it can show as Kidney and/or Liver failure (these usually recover once on medication),
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Depression,
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Anorexia (lack of appetite),
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Weight loss,
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Vomiting,
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Diarrhoea,
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Bloody stools and / or recurrent bouts of Gastroenteritis,
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Alopecia (hair loss),
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Increased urination, Increased thirst, Shaking/tremors,
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Weak pulse,
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Irregular heart rate,
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Painful abdomen,
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Hypoglycaemia,
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Hyperpigmentation of the skin,
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slow loss of body condition,
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hind end weakness,
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and an inability to respond appropriately to stress.
It’s important to note that the symptoms of Addison’s disease may wax and wane; some go into 'crisis' almost overnight others may have symptoms for years. Some dogs may show one symptom, some all, but most show a few.
Testing for Addisons Disease:
The definitive test for Addison’s is the ACTH stimulation test. A blood test is done to measure the cortisol levels, they are given an injection of synthetic hormone ACTH and the blood test is repeated. If there is no increase in the cortisol results then the dog has Addisons. It is important that for a correct result dogs should not have been given steroids for 4 to 6 weeks before the test. The adrenals need to be 90% failed to fail the ACTH test and it is something they can test negative today and positive tomorrow for. There currently is no genetic test for Poodles although we are hoping there maybe soon.
Treatment for Addisons Disease:
If a dog fails the ACTH test and has problems with the potassium and sodium levels (potassium high, sodium low) then it has Typical Addisons and needs an injection of Zycortal or Percorten V in some countries usually every 28days and a DAILY low dose of steroids.
If the sodium and potassium are normal then the dog has ATypical Addisons, needing just low dose DAILY steroid supplementation. Dogs with ATypical do often switch to Typical, particularly during the first year and electrolytes (Sodium and Potassium) should be checked weekly for the first few weeks then regularly and if your Poodle suddenly seems unwell they should be checked immediately.
Dogs usually need fluids via a drip at the start if they have gone into an Addisons crisis to safely adjust the sodium and potassium levels but once the ACTH test has been done they can be given medication as you wait for the results. (the only other medication for Typical Addisons is fludrocortisone twice daily tablets, but this is not usually used now in the UK as this is a human medication).
Higher doses of steroids are given at the start to help the dogs recover but these can usually be tapered down and many dogs do well on doses of about 0.05mg/kg/day of prednisolone. Occasionally prednisone, Hydrocortisone or Cortisone Acetate may be used instead. In times of additional stress and if lethargy and shaking are seen a half dose boost of steroids can be given which usually works within 30 minutes.
For Zycortal doses the Michigan State University Study can be used, which shows the dogs can be started on half the manufacturers dose. It is better to give a lower dose every 28 days than increase the dosing period length as this helps to reduce the swing in the highs and lows of the sodium and potassium.
Support and Resources for Addisons Disease:
The good news is properly medicated on low doses of both medicines Addisons dogs go on to lead a normal life doing everything they could before and should have a normal lifespan. Poodle Network currently have a number of standard and miniature poodles and a labradoodle with Addisons and the numbers are increasing.
Our Chair, Julie Aldcroft, is one of the admins on the Addison’s Disease in Dogs Facebook Group, having had 2 of her own Standards with Addisons and a number of fosters with it. She also oversees others in their foster homes and adoptive homes.
Pam Johnson, who runs the group has Standard Poodles and together with the other admins, many from the UK, hundreds are receiving help each week on the group. Addisons is something that vets see few cases in a lifetime of practice so it isn’t high on their RADAR and is often missed which is why it needs to be high on yours, and if one of your Poodles has it you need to know everything you can about it.
We practice a low dose protocol for the medications on the group and with Poodle Networks Addison’s dogs, medicating them with the lowest EFFECTIVE dose rather than the manufacturers doses and the dogs feel a lot better because of it. This method has been used effectively for far longer in the USA as the DOCP injection of Percorten V was available there before our DOCP injection of Zycortal became available in the UK for our dogs. We all research Addisons constantly and keep up to date with the latest studies and our files and guides on the group have all the supporting documents you need to take to your vet.
If you have a Standard Poodle with Addisons Disease then the Standard Poodle Club in the UK have a health database to register it on your Standards record, you just need your Pedigree and a copy of the ACTH test from your vet. Latest studies have shown there to be a genetic propensity, (despite what breeders may tell you) and dogs with a history of it should really be removed from breeding lines. This is why it is important to update your Standards records on the database. If you have a Standard with Addisons please follow the link on the Standard Poodle Club article below to register your Poodle.
Fostering and Adopting a Poodle with Addisons Disease:
We are always in need of foster homes for Addisons Poodles if they are handed in who can care for them while we get their medications correct and we do need homes who are willing to adopt them. If you think you can help please get in touch