By Christie Long
A classic veterinary school case goes as follows: distraught owners rush a dog into your clinic. The dog is laterally recumbent, minimally responsive, and severely dehydrated.
The owners breathlessly tell you, as you fumble with your stethoscope, that the dog started vomiting earlier today and has vomited seven or eight times. You listen to the dog’s heart, and realize that it’s beating really slowly for a dog that appears so ill. The coldhearted professor points at you, grinning in an evil way, and asks you what disease this dog most likely has?
With any luck you’ll be able to find your voice and squeak out the words, “Addison’s disease." Although it’s a relatively rare condition, veterinarians must always remember to maintain a high degree of suspicion when they see a dog like the one above, because without the proper care, these dogs can crash and burn quickly.
Addison’s disease is a condition that usually affects relatively young dogs (four to five years of age), and the crux of the problem is that the adrenal glands, those tiny little bean-shaped glands that nestle up against the kidneys, can’t produce the cortisol, a hormone that helps dogs, and people, physiologically deal with stress. In addition, they don’t make the hormone that helps the kidneys maintain a proper balance of sodium and potassium. This is what causes the heart to beat too slowly, when it should be pumping like mad to help the body deal with dehydration.
John F. Kennedy was an Addisonian. During his administration he was taking hormones on a daily basis to make up for what his adrenal glands could not produce. Can you imagine being the President, and not being able to tolerate stress?
An interesting piece of the history that often accompanies these animals is that a stressful event has recently happened – relatives visiting from out of town, a new baby or puppy is in the house, or the house is being renovated. Stressful events are enough to push these patients into what’s known as an Addisonian crisis, which is described above.
Standard Poodles and Bearded Collies are breeds that seem overrepresented, but any breed of dog or mixed breed can have Addison’s disease. Cats can get Addison’s disease, but it’s extremely rare. Unfortunately, we don’t know what causes Addison’s, and there’s no cure.
Dogs that survive the initial crisis can go on to lead fairly normal lives, but they must be closely monitored and require medication for the rest of their lives. Typically this entails monthly injections by the veterinarian, plus a daily dose of medications at home by the owner. The owner must do their best to anticipate stressful situations, like when your sister’s family comes in from Milwaukee with three kids under the age of five. When these situations loom on the horizon, the owner should schedule a visit to the veterinarian, who might consider a temporary increase in the medication dosage.
Christie Long is a veterinarian at the VCA Animal Hospital in Fort Collins, CO. Long left her job in software sales in 2000 to travel for 13 months. Along the way, she was touched by the plight of the animals she saw and somewhere in the Nepalese Himalayas she vowed to return to school to become a veterinarian. While she often finds end-of-life situations heart-wrenching, she considers herself blessed to be called upon as a trusted advisor to families during difficult times. Dr. Long’s family includes her husband and travel partner, Wiley, their 5-year-old son, Wiley IV, their dogs Pancake and Gizmo and cats Sneaky and Sidh.