"Tilly" a five year old female Maltese cross, was brought in to Vetwest Beaumaris for a check up. She had been lethargic for several days and her owners had noticed her drinking more than normal. Our veterinarian performed a full physical examination and found Tilly to be in good general health. However we were very concerned about her history of excessive thirst. This is an 'alarm bell' for numerous diseases such as diabetes, Cushings, Addisons, renal diseases and liver problems.
The first step in Tilly's diagnostic work-up was a full general health profile (blood test). This revealed multiple abnormalities in Tilly's blood with the main concerns being elevated potassium and decreased sodium levels. Sodium and potassium are electrolytes in the body, that play an important role in cell function.
The presence of these abnormal levels in her electrolytes allowed us to narrow down our diagnosis, with hypoadrenocorticism, commonly known as Addison's Disease at the top of the list. Hypoadrenocorticism is caused by a decrease in production of hormones normally produced in the adrenal glands (located near the kidneys). These hormones are the steroid hormones; mineralocorticoids and glucocorticoids. Mineralocorticoids play a major role in regulating sodium, potassium and water balance, and glucocorticoids are involved in cell metabolism. Hypoadrenocorticism occurs more in female dogs, aged four to five years at onset, so Tilly fitted all criteria.
To confirm the presence of this disease, an ACTH stimulation test was performed. This involves a blood sample being taken before and after an injection of a synthetic adrenal hormone. This test stimulates adrenal gland function and a response is measured. Tilly's adrenal glands responded marginally, indicating they were not functioning adequately. A diagnosis of Hypoadrenocorticism was confirmed.
Treatment for hypoadrenocorticism initially involves intravenous fluid therapy (a drip) and the supplementation of mineralocorticoids and glucocorticoids to correct the electrolyte imbalances. Tilly stayed in hospital for several days on her drip until we were happy with her progress. Once her electrolytes were at an acceptable level she was discharged for lots of TLC and oral medication at home.
After a week Tilly visited us again for a check-up. Tests revealed she was 100% back to normal. Tilly will need to continue her medication for the rest of her life. She will require regular veterinary check-ups and will be monitored with blood tests to ensure she continues to respond well to the medicaitons.
Luckily for Tilly her owners had been very perceptive and quick to act in bringing her to the veterinarian for a check-up before other symptoms of the disease had time to develop. Early intervention means Tilly's prognosis is excellent.
