Bernie McSquare is a member of the McSquare Doodles; don’t you just love that name? Bernie is a sweet, happy-go-lucky mini Labradoodle whose ultimate goal is to become a certified therapy dog. He is working hard toward that goal.
In November of 2016, Bernie received a diagnosis of atypical Addison’s disease.
Addison’s disease is one of the most commonly misdiagnosed hormonal diseases;
its common symptoms can come with a whole laundry list of other conditions. There is a reason why Addison’s disease is dubbed the great pretender.
Bernie’s symptoms included nausea, fatigue, and anxiety. Hardly specific, wouldn’t you say?
If your dog woke you up vomiting in the middle of the night, what would be your first suspect?
I doubt Addison’s disease would cross your mind. Dogs vomit for a gazillion of reasons.
Later, Bernie threw up again. This time with specs of blood in it. That landed Bernie in an emergency vet. He was dehydrated but otherwise seemed normal. The veterinarian gave him some fluids and meds and Bernie was able to go back home. He seemed to be feeling much better, and hungry.
Time has passed, and all seemed well.
Until, after some stress, Bernie started throwing up blood again. The ER vet felt that nothing seemed out of the ordinary; his vitals were good. The question of whether anxiety could have caused the vomiting came up. Could Bernie have Addison’s disease?
Labradoodles are at a higher risk of this disease.
Big kudos to Bernie’s mom and the vet picking up on that so quickly.
The only way to accurately diagnose Addison’s disease is by ACTH stimulation test.
ACTH stimulation test measures the ability of adrenal glands to adequately respond to stress; release an appropriate amount of cortisol. Cortisol gets a bad reputation as a stress hormone. It is, however, vital for a body to be able to cope with stress. It stimulates the production of glucose and the breakdown of fats, proteins, and carbohydrates to provide fuel for the body. Without it, the system breaks down. Glucose, electrolyte, and water regulation is impaired. Which is what leads to the symptoms:
- weakness
- dehydration
- increased thirst
- tremors
- and GI disturbance
Without the ability to increase cortisol production (often combined with an equivalent drop in mineralocorticoids) during times of stress, dogs become physiologically unable to deal with even the most common of situations.
Bernie’s mom agreed to the test hoping to rule out this possibility.
Unfortunately, that did not happen. Bernie’s adrenal glands all but ignored the ACTH stimulation. His electrolytes were normal, though.
Typical versus atypical Addison’s disease.
The adrenal glands produce hormones. The outer part, adrenal cortex, produces cortisol and aldosterone; the inner part produces adrenaline. Cortisol, as discussed above, is essential for the body’s stress response. Aldosterone is responsible for regulating electrolyte levels and fluid balance.
Addison’s disease is adrenal insufficiency. The adrenal glands aren’t doing their job properly. Which, typically, means they lag on all their jobs.
When the adrenal glands produce aldosterone just fine but don’t keep up with cortisol production, it is referred to as atypical Addison’s disease.
So that’s what Bernie has.
In general, it is always easier to treat deficiency than excess; it is easier to add something into the body than to get rid of something. Where it gets tricky with adrenal deficiency is that the need is not consistent. A relaxed dog doesn’t need nearly as much cortisol as a stressed dog. And you don’t want to have too much cortisol in the blood because that brings about the opposite issue, Cushing’s.
Bernie’s adrenals still do make some cortisol so he can get away with a low dose of Prednisone which can be increased before or during stressful events.
To read more about Bernie McSquare’s journey with Addison’s disease, follow McSquare Doodles.
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