Everything You Need to Know about Addison’s Disease in Dogs

Here at My Pet Nutritionist, one of the topics we get asked about a lot is Addison’s Disease. This is something that can be heavily influenced by diet and lifestyle, so this blog post is a great read for those with a dog suffering from this awful and debilitating disease.

Worldwide, somewhere between 1in 500 and 1 in 1000 dogs is affected by Addison’s Disease. Closer to the home of My Pet Nutritionist, a study was carried out in 2016 to determine the estimated number of dogs with Addison’s Disease in the UK. It was estimated under 1% of the dog population have it, though this may have changed as time has passed. Most commonly, young female dogs tend to be most prone to Addison’s Disease.

Severe cases of Addison’s Disease lead to Addisonian Crisis, which is life threatening. Read on to find out more about this nasty disease!

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What is Addisons Disease?

The clinical name for Addison’s Disease is Hypoadrenocorticism. This is an endocrine disease; a disease affecting the hormone system. Addison’s specifically involves the Adrenal glands which are located near the kidneys. These glands produce lots of extremely important hormones controlling various health factors, including the control of metabolism, stabilisation of blood pressure, and keeping blood sugar levels steady. It is also involved in the immune system and part of the stress response.

The adrenal glands, of which there are two, are comprised of two parts each; the inner medulla and the outer cortex. The inner medulla produces adrenaline, and the outer cortex produces two hormones called cortisol and aldosterone. Addison’s Disease concerns the outer cortex. Those suffering with the disease do not produce sufficient amounts of cortisol or aldosterone.

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Symptoms and Causes

There are a range of symptoms seen in those with Addison’s Disease. Typically you will see the following symptoms in mild to moderate cases:

• Letharghy
• Vomiting
• Diarrhoea
• Weight loss
• Loss of appetite
• Low mood
• Muscle weakness
• Increased thirst
• Increased urination

In those entering Addisonian Crisis, a smaller range of more severe symptoms are possible, including:

• Severe dehydration (due to the inability for the body to control the salt and water balance in tissues)
• Irregular heart rate and blood pressure (due to the lack of aldosterone which is responsible for helping the kidneys retain sodium and excrete potassium; a crucial part of stable blood pressure)
• Collapse
• Cold extremities
• Persistent and severe vomiting and diarrhoea

The milder symptoms are often preventable and manageable with the right lifestyle, diet and medication regimes, however those experiencing one or more of the more severe symptoms must seek veterinary aid immediately as they may be entering Addisonian Crisis which is life threatening.

There are multiple potential causes for the onset of Addison’s Disease. Let’s start with autoimmunity. Autoimmune diseases happen when the body’s immune system attacks itself and other parts of the body. When a dog has an autoimmune disease affecting the adrenal glands, the body attacks the glands which damages them, causing a lack of the associated hormones.

There is a specific type of Addison’s Disease known as Latrogenic Addisons. This is caused by the overuse of pharmaceuticals when a dog is treated for Cushing’s Disease (which is due to overactive adrenal glands). The drug used to treat Cushing’s Disease suppresses adrenal gland activity to better control the amount of hormones it produces, however when this drug suppresses the glands too far, Addison’s Disease is a huge risk as the glands will go from overproducing to underproducing the necessary hormones.

Addison’s Disease can also be a secondary disease. The Pituitary Gland and the Adrenal Glands are part of the HPA Axis (Hypothalamic-Pituitary-Adrenal). The Adrenal Glands are largely controlled by the Pituitary Gland, so if there is a defect on the Pituitary such as a tumour or other issue, this can massively affect the functioning of the Adrenal Glands, causing partial or complete failure to produce Cortisol and Aldosterone.

Another form of secondary Addison’s Disease is due to the sudden stopping of long-term steroid treatment. The shock of this on the body can cause the Adrenal Glands to stop working properly.

Genetic predisposition also plays a role in the cause of Addison’s Disease. While any breed of dog can be affected, some breeds are more prone to Addison’s than others. Breeds that are genetically predisposed include Portuguese Water Dogs, Great Danes, West Highland White Terriers, Standard Poodles, Bearded Collies, Rottweilers, Leonbergers, Labradors, Soft Coated Wheaten Terriers and Nova Scotia Duck Tolling Retrievers.

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Diagnosis

If your dog displays any of the aforementioned symptoms, it is important you consult your vet who will run the appropriate diagnostic tests. Firstly, the vet will run a full blood panel, and also a urinalysis to detect any possible imbalances such as low sodium and/or high potassium which would pinpoint an issue with adrenal function. Dilute urine would also be a sign of potential adrenal function loss, but could also be a sign of diabetes insipidus.

The next test performed, which confirms Addison’s Disease, is called the ACTH Stimulation Test. During this test, a blood sample is taken, before the dog is given a synthetic ACTH-like drug, intravenously. Two hours after the injection is given, another blood sample is taken. Cortisol levels in both blood samples are compared with one another, to check how much cortisol the body has produced in the presence of the ATCH-like drug (which mimics the Adrenocorticotropic Hormone secreted by the Pituitary Gland). Your veterinarian will then interpret these results. This is the same test used to diagnose Cushing’s Disease.

It is important for both you and your veterinarian to note that if your dog has been on steroidal drugs before the ACTH test is performed, a false positive for Addison’s Disease is possible.

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Conventional Treatment

Treatment is absolutely necessary in those with Addison’s Disease; if it is not kept on top of, it can become life threatening! Initially, your vet may recommend your dog stays in the vet practice for a short time to be given intravenous fluids and steroids to stabilise before sending the dog home with lifelong prescription medication. Once home, your pet will likely be given daily steroids to replace cortisol, and a monthly injection of a mineralcorticoid such as desoxycorticosterone will be administered. These two medications are part of hormone replacement therapy, and will be needed for life.

Regular monitoring at the vet is important to check for signs of relapse or surplus cortisol. As stress can increase the severity of Addison’s Disease, during stressful times such as firework night, Christmas or house moves etc, dosages of these medications may be increased temporarily.

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A Natural Approach to Addison’s Disease

As always, our approach is often supported by veterinary care, so we tend to look at this as a complementary approach as opposed to alternative.

Here are some of our considerations:

• Feed Fresh: A fresh diet is paramount whether it’s raw, or lightly cooked food. fresh diet is the most gut-friendly option when it comes to feeding your dog, and a healthy gut can reduce the risk of Addison’s Disease, as the correct balance of gut flora in the microbiome means the bacteria capable of utilising cortisol is present in the correct amounts.
• Mineral Testing: Mineral tests to test for imbalances in sodium and potassium may be beneficial so you can be sure there is plenty of each in your dogs meals. Most fresh diets are naturally deficient in sodium, so it is something to keep a close eye on!
• Probiotics and Gut Healing Protocols: The gut is absolutely essential to keep healthy. It really is the main ‘hub’ of health in the body, and poor gut health, leads to other problems within the body – everything from hormone regulation to joint and skin health, brain health and calm behaviour, and so many more aspects of health. Our fantastic product, Gut Guardian is your all-in-one supplement for gut healing and microbiome boosting. Mucilage herbs are ideal for gut healing, while high quality soil based probiotics help the gut microbiome to flourish.

• Herbs that can help regulate cortisol levels, blood sugar balance and inflammation: you may wish to consider adding some beneficial supplements to your dog’s diet, including Cinnamon (helps to regulate blood sugar levels and reduce inflammation – aim for Ceylon Cinnamon!), Rhodiola (helps balance cortisol levels), Ginseng (anti-inflammatory properties), Liquorice Root (helps to regulate cortisol levels)
• Support to Detoxification: Detox, often best achieved using Milk Thistle, can help those with Addison’s Disease, particularly secondary disease as a result of pituitary tumours. The active compound in Milk Thistle, Silymarin, has properties which can help shrink these tumours!
• Add antioxidant rich foods: antioxidants reduce oxidative stress, which in turn aids relief from Addison’s Disease.
• Reduce Exposure to Toxins: environmental toxins, including flea products, household cleaning products, and gardening products can have an enormous impact on glands and organs in the body, which in turn plays havoc with hormones. Eliminating exposure to these toxins may help reduce the symptoms of Addison’s Disease.

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To conclude our guide to spotting, diagnosing and treating Addison’s Disease, and supporting the body with natural options, if your dog frequently shows any of the aforementioned signs and symptoms, book in with your veterinarian as soon as possible. If you feel you could benefit from some 1-2-1 support for your dog, consider booking in with one of our team!



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