NOTE: All information included herein regarding Addison’s Disease is shared with the kind consent of the Addison’s Disease in Dogs FaceBook community.
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Your dog has just been diagnosed with Addison’s Disease which you may not have even heard of. Addison’s is a disease which humans as well dogs get. At the start it can be quite daunting. This introductory guide takes you through the initial things you need to know about in order to get your dog feeling good again and hopefully take away some of the worries you may have. The first thing to do, is breathe! Getting the diagnosis is usually the hardest part. Dogs with Addison’s live happy lives doing anything a dog without Addison’s can do. It is not a life limiting condition.
If your dog has been very poorly prior to diagnosis, he / she may need to stay at the vets for a few days having IV (Intravenous Fluids) fluids to stabilise them and make sure their electrolytes are well balanced - this is normal. The fluids will help to make sure your dog is well hydrated which is important for their medications to work efficiently.
Your dog may not want to eat for a while at first. This is also normal. Try feeding smaller bits of food more often. Some dogs respond better to having a different bowl to eat from. Some dogs prefer slightly saltier food at first.
If your dog has been having IV fluids and / or is on a high dose of prednisolone* you may see unwanted side effects of excessive urination and thirst at first. This is normal and will stop once the meds are optimised. Access to fresh water at all times is essential.
If your dog has been quite poorly leading up to diagnosis, the recovery period can take a couple of weeks, so exercise should be restricted until your dog is clearly feeling good again.
Try to keep a record of the meds your dog is having, along with their doses. Setting up a file can be helpful. Logging any changes in your dog’s behaviour or side effects will be useful information to share with your vet when your dog has its first checkup which should be in a week to 14 days depending upon the type of Addison’s your dog has. Ask your vet for a copy of all the blood test results – you are entitled to have these.
Make sure you know what type of Addison’s your dog has – it is most likely to be Typical or Atypical Addison’s. Dogs with Typical Addison’s will be given either a monthly injection of DOCP (Zycortal or Percorten) plus a daily dose of steroid (Prednisolone, Prednisone, Hydrocortisone or Cortisone Acetate) or daily Florinef/Fludrocortisone. Dogs with Atypical Addison’s need only a daily dose of steroids.
It is not uncommon for a newly diagnosed dog to tremble in the first day or so whilst the meds kick in fully and the dog starts to feel much better, but if this continues beyond a couple days and your dog is not eating at all or drinking, then a visit to the vet is needed. It is possible more fluids are needed.
Watch out for times of extra stress for your dog. Stress comes in many different forms - ‘bad’ stress – e.g. your dog being left on its own, kennelled, workmen in the house – or ‘good’ stress – having friends to your house, other dogs to play with or simply going for a longer walk than usual. The regular dose of Prednisolone* may not be enough at those times, so be ready to give a small boost of it. Take some Prednisolone* with you when you take your dog out for longer periods so that you have some at hand at all times.
Make sure you have a follow up appointment made with your vet.
N.B. Prednisolone* may be replaced with Prednisone, Hydrocortisone, or Cortisone Acetate
Welcome to the World of Addison’s Disease in Dogs: www.facebook.com/groups/addisonsdiseaseindogs/
***Caution ! Dogs with Addison’s Disease should NOT be given NSAIDs as these are contraindicated for the glucocorticoids (steroids such as Prednisolone / Prednisone) given to our dogs. Giving NSAIDs alongside Steroids can be deadly.***
***Please note: OUR DOGS NEED A DAILY DOSE of GLUCOCORTICOID***
Cortisol affects many important functions in your dog’s body such as regulating certain white blood cells, decreasing inflammation, keeping glucose levels stable, and monitoring fat production, it is therefore essential that dogs with both Typical, and Atypical Addison’s get a small daily dose of cortisol replacement. Without it, things start to fail, not dramatically as in Typical Addison’s, but slowly with things gradually deteriorating, often so slowly that you don’t notice, until your dog gets really sick.
Addison’s Disease in Dogs FAQs 1: Prednisolone
Pred doses for dogs with Addison’s
Addison’s Disease in Dogs – Five Factors for Successful Treatment
Canine Hypoadrenocorticism: An Overview, Diagnosis and Treatment: https://todaysveterinarypractice.com/endocrinology/canine-hypoadrenocorticism-overview-diagnosis-treatment/
Lower initial dose of DOCP for treatment of Canine Hypoadrenocorticism
A guide to understanding blood tests for dogs with Addison’s Disease Part 1: The Electrolytes
A guide to understanding blood tests for dogs with Addison’s Disease Part 2: Haemolysis and Lipaemia
A guide to understanding blood tests for dogs with Addison’s Disease Part 3: Indicators of Addison’s in a Full Blood / Chemistry Panel
Low-dose desoxycorticosterone pivalate treatment of hypoadrenocorticism in dogs: A randomized controlled clinical trial
Failure of the cortisol producing part of the adrenal glands only
Symptoms: lethargy, vomiting, diarrhoea, anaemia, high lymphocytes, high eosinophils, weight loss.
Treatment: Initially, a higher dose of Prednisolone*, approximately 5 mg may be given for the first 7-10 days and then a smaller dose of between 0.05 and 0.1 mg/kg given once a day, in the mornings as a maintenance/replacement dose. If your dog has been having a specific dose for more than 10 days, you need to reduce the dose slowly to avoid any rebound symptoms. Your dog may unwanted side effects at first of excessive urination, thirst and hunger, so be prepared for the odd accident or two. Let your vet know this so that the dose can be reduced.You are aiming for a dose of 0.04 to 0.05 mg/kg per day.
Some dogs with Atypical Addison’s, go on to transition to Typical Addison’s at some point, usually within the first few months, so it is essential to check electrolytes weekly at first, then monthly, checking regularly thereafter.
In times of stress, for instance things that either upset or excite your dog, you may need to give a boost of Prednisolone, usually about half the dose you give daily.
Keep a Record of all the blood test results including those from diagnosis, ask your vet for a copy of them.
N.B. Prednisolone* may be replaced by Prednisone, Hydrocortisone or Cortisone Acetate
Failure of the adrenal gland to produce aldosterone and cortisol hormones.
Symptoms: : Lethargy, weight loss/anorexia, Vomiting, Diarrhoea, Muscle Weakness and/or Cramps often in the rear end, Increased Thirst and Urination, Abdominal Pain, Lowered Heart Rate, Seizures and others.
Treatment: EITHER a monthly injection of DOCP (Zycortal or Percorten) to replace the aldosterone as well as a daily dose of steroid to replace the cortisol. OR daily tablets of Florinef or Fludrocortisone (usually accompanied by a daily steroid such as Prednisolone* for the initial recovery period though most dogs do not end up needing the steroid long term as Florinef and Fludrocortisone replaces both aldosterone and cortisol).
DOCP:
The starting dose is stated as 2.2 mg/kg in the Zycortal and Percorten Product Inserts, however, research studies as well as anecdotal evidence shows a starting dose of 1 mg/kg works well for most dogs. Check the files for up to date information on research studies on the lower dose protocol.
The electrolytes should be checked after 10 days for Zycortal or 14 days for Percorten to see how well it is working and then again at around day 28, the results of which should be used to determine the next dose. Checking the electrolytes (Sodium - Na and Potassium - K) mid-cycle is only necessary for the very first cycle unless a reduction larger than 15% has been made in the dose of DOCP.
Giving a daily dose of Prednisolone* is essential and clearly stated in the Product Inserts for Zycortal and Percorten. Failure to do so will make your dog very poorly.
The starting dose of Prednisolone will be higher at the start whilst your dog recovers – this is normal. However, you may soon see unwanted side effects of excessive urination, thirst and hunger; your dog cannot help it if he/she has ‘accidents’, this is due to the doses of medication, with either/or both DOCP and Prednisolone* potentially being the cause.
Florinef / Fludrocortisone:
should be started at a dose of 0.1 mg/10 lb or 0.02 mg/kg and given every day. Most people split the dose evenly 12 hours apart from each other.
Most vets will also prescribe Prednisolone alongside the Florinef, which is often needed at the very start to aid with the recovery period, however most dogs on Florinef do not need Prednisolone in addition once they are fully stabilised.
The electrolytes should be checked weekly for the first few weeks, aiming to keep the electrolytes well balanced. The time between checks can gradually be extended.
In times of greater stress, a small boost of Prednisolone* may be needed.
IDEXX-understand diagnostic-test
Why is a GLUCOCORTICOID (Cortisol) Needed Every Day for Dogs
Addison’s Disease in Dogs- are you Addison’s aware
