Hypoadrenocorticism Flashcards
What is the common name for Hypoadrenocorticism?
Addison’s Disease
What causes Addison’s Disease?
Inability of the adrenal glands to produce cortisol (glucocorticoids + mineralocorticoids)
- Autoimmune/idiopathic factors
- Granulomatous destruction of adrenal cortex
- Secondary via a disruption in the adrenal-pituitary axis
What dog 4 most common breeds to be affected by Addison’s?
- Standard Poodles
- Portuguese Water Dogs
- Rottweilers
- West Highland White Terriers
What are the 6 clinical signs of Addison’s?
- Weakness
- Vomiting
- Diarrhea (sometime vague GI symptoms)
- Finicky appetite
- Dehydration
- Bradycardia and low blood pressure
Addisonian crisis is a medical emergency
What are labatory signs of Addison’s Disease?
- Elevated potassium
- Low sodium and chloride (lack of aldosterone leads to impaired renal sodium retention and potassium excretion)
- Na:K ratio usually < 27:1
- Hypoglycemia
- Increased BUN and creatinine, due to decreased renal perfusion (hypovolemia & hypotension lead to decreased cardiac output)
What is the diagnositic of Addison’s Disease?
ACTH Stimulation Test
What are the 2 treatments for Addision’s when it is uncontrolled?
- Supportive care with fluids and steroids are the mainstays of therapy
- Fluid of choice: 0.9% sodium chloride
- The only steroid medication that can be given prior to the ACTH stim is dexamethasone.
- Should be started in a crisis situation, until the ACTH stim may be performed.
- Prednisone cannot be started until AFTER the ACTH stimulation test has been performed!
- Will interfere with test results.
What are the 3 treatment options for controlled Addison’s Disease?
Requires lifelong treatment
1. Mineralocorticoid: DOCP injections (mineralocorticoid only)
2. Oral fludrocortisone acetate (mineralocorticoid that also has some glucocorticoid activity)
3. Glucocorticoid: oral prednisone.
