Management of hypoadrenocorticism (Addison’s disease) in dogs

Management of hypoadrenocorticism (Addison’s disease) in dogs

Patty Lathan,1 Ann L Thompson2 1College of Veterinary Medicine, Mississippi State University, Starkville, MS, USA; 2School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia Abstract: Hypoadrenocorticism (HOAC; Addison’s disease) is an endocrine condition se...

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Autores principales: Lathan P, Thompson AL
Formato: article
Lenguaje:EN
Publicado: Dove Medical Press 2018
Materias:
Hypoadrenocorticism
Addison's
Adrenal
Veterinary medicine
SF600-1100
Acceso en línea:https://doaj.org/article/8e6c3322ad10486cb4e4412d3210a238
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spelling oai:doaj.org-article:8e6c3322ad10486cb4e4412d3210a2382021-12-02T05:34:48ZManagement of hypoadrenocorticism (Addison’s disease) in dogs2230-2034https://doaj.org/article/8e6c3322ad10486cb4e4412d3210a2382018-02-01T00:00:00Zhttps://www.dovepress.com/management-of-hypoadrenocorticism-addisons-disease-in-dogs-peer-reviewed-article-VMRRhttps://doaj.org/toc/2230-2034Patty Lathan,1 Ann L Thompson2 1College of Veterinary Medicine, Mississippi State University, Starkville, MS, USA; 2School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia Abstract: Hypoadrenocorticism (HOAC; Addison’s disease) is an endocrine condition seen in small animal practice. Dogs with this disease can present in a variety of ways from acute hypovolemic collapse to vague, chronic, waxing, and waning clinical signs. In the most common form of this disease, animals have both mineralocorticoid and glucocorticoid deficiency, resulting in hyponatremia and hyperkalemia, and signs of cortisol deficiency. The etiology may be immune-mediated destruction of the adrenal cortex, drug-induced adrenocortical necrosis (mitotane), enzyme inhibition (trilostane), or infiltrative processes such as neoplastic or fungal disease. Much less commonly, dogs have signs of cortisol deficiency, but no electrolyte changes. This is referred to as atypical HOAC. The veterinarian needs to have a clinical suspicion for HOAC to make a diagnosis in a timely manner. Treatment of dogs with an acute presentation prioritizes correcting the hypovolemia, hyperkalemia, acidosis, and hypoglycemia. Fluid therapy addresses most of these issues, but other directed therapies may be required in the most severe cases. For chronic management, all patients with Addison’s disease will require replacement of glucocorticoids (usually prednisone), and most patients require replacement of mineralocorticoids with either desoxycorticosterone pivalate or fludrocortisone. Atypical Addisonians do not require mineralocorticoid supplementation, but electrolytes should be monitored in case the need arises in the future. The prognosis for dogs treated for HOAC promptly and appropriately is excellent; most patients die from other diseases. However, if the diagnosis is missed, patients may die as a consequence of HOAC. Thus, knowledge of the hallmarks of Addison’s disease is imperative. Keywords: hypoadrenocorticism, Addison’s disease, adrenalLathan PThompson ALDove Medical PressarticleHypoadrenocorticismAddison'sAdrenalVeterinary medicineSF600-1100ENVeterinary Medicine: Research and Reports, Vol Volume 9, Pp 1-10 (2018)
institution DOAJ
collection DOAJ
language EN
topic Hypoadrenocorticism
Addison's
Adrenal
Veterinary medicine
SF600-1100
spellingShingle Hypoadrenocorticism
Addison's
Adrenal
Veterinary medicine
SF600-1100
Lathan P
Thompson AL
Management of hypoadrenocorticism (Addison’s disease) in dogs
description Patty Lathan,1 Ann L Thompson2 1College of Veterinary Medicine, Mississippi State University, Starkville, MS, USA; 2School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia Abstract: Hypoadrenocorticism (HOAC; Addison’s disease) is an endocrine condition seen in small animal practice. Dogs with this disease can present in a variety of ways from acute hypovolemic collapse to vague, chronic, waxing, and waning clinical signs. In the most common form of this disease, animals have both mineralocorticoid and glucocorticoid deficiency, resulting in hyponatremia and hyperkalemia, and signs of cortisol deficiency. The etiology may be immune-mediated destruction of the adrenal cortex, drug-induced adrenocortical necrosis (mitotane), enzyme inhibition (trilostane), or infiltrative processes such as neoplastic or fungal disease. Much less commonly, dogs have signs of cortisol deficiency, but no electrolyte changes. This is referred to as atypical HOAC. The veterinarian needs to have a clinical suspicion for HOAC to make a diagnosis in a timely manner. Treatment of dogs with an acute presentation prioritizes correcting the hypovolemia, hyperkalemia, acidosis, and hypoglycemia. Fluid therapy addresses most of these issues, but other directed therapies may be required in the most severe cases. For chronic management, all patients with Addison’s disease will require replacement of glucocorticoids (usually prednisone), and most patients require replacement of mineralocorticoids with either desoxycorticosterone pivalate or fludrocortisone. Atypical Addisonians do not require mineralocorticoid supplementation, but electrolytes should be monitored in case the need arises in the future. The prognosis for dogs treated for HOAC promptly and appropriately is excellent; most patients die from other diseases. However, if the diagnosis is missed, patients may die as a consequence of HOAC. Thus, knowledge of the hallmarks of Addison’s disease is imperative. Keywords: hypoadrenocorticism, Addison’s disease, adrenal
format article
author Lathan P
Thompson AL
author_facet Lathan P
Thompson AL
author_sort Lathan P
title Management of hypoadrenocorticism (Addison’s disease) in dogs
title_short Management of hypoadrenocorticism (Addison’s disease) in dogs
title_full Management of hypoadrenocorticism (Addison’s disease) in dogs
title_fullStr Management of hypoadrenocorticism (Addison’s disease) in dogs
title_full_unstemmed Management of hypoadrenocorticism (Addison’s disease) in dogs
title_sort management of hypoadrenocorticism (addison’s disease) in dogs
publisher Dove Medical Press
publishDate 2018
url https://doaj.org/article/8e6c3322ad10486cb4e4412d3210a238
work_keys_str_mv AT lathanp managementofhypoadrenocorticismaddisonrsquosdiseaseindogs
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