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Have you heard of Addison's disease? Addison's disease, also called hypoadrenocorticism or adrenal insufficiency, is caused by failure of the adrenal gland to produce specific hormones. It occurs primarily in humans and dogs and is named for an 18th century British physician, Thomas Addison, who first described the syndrome. We'll be sharing more information about Addison's disease in dogs in an upcoming series of posts to help you learn more about the disease including the clinical signs, diagnosis, and treatment.

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Addison's disease is caused by the failure of the adrenal gland to produce certain hormones, but just what are adrenal glands? These glands are located next to the kidneys on both sides of the body. They are vital for your pet's health because they secrete hormones responsible for maintaining many body functions. Two of these important hormones are mineralocorticoids: primarily aldosterone, responsible for controlling the body's water balance and blood pressure and glucocorticoids, and primarily cortisol, responsible for helping the body manage stress. The most common form of Addison's disease involves failure of the adrenal gland to produce both these hormones.

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Though any dog can develop Addison's disease, it is most commonly seen in young to middle-aged dogs. Breeds particularly affected include Portuguese Water Dogs, Standard Poodles, Nova Scotia Duck Tolling Retrievers, Leonbergers, Great Danes, Bearded Collies and Labrador Retrievers.

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Addison's disease is often called "The Great Pretender" since it can mimic other diseases and present itself differently from dog-to-dog. The clinical signs can also be "off and on" or an acute (sudden), life-threatening disease. Gastrointestinal signs such as lack of appetite, vomiting, diarrhea, bloody stool, bloody vomit, and weight loss occur from lack of the cortisol hormone. Stressful situations, such as travel or changes in the home environment, can initiate or worsen these signs. The hormone deficiencies from Addison's disease cause increased drinking and urination, electrolyte disturbances, dehydration, and low blood pressure. In severe cases, the dog may have sudden onset cardiovascular failure and shock. If your dog is exhibiting any of these signs, contact the clinic at [INSERT CLINIC PHONE NUMBER] right away for an exam.

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If the veterinarian suspects Addison's disease based on the combination of clinical signs, the age/breed of the dog, and preliminary blood test results, he or she will perform a diagnostic test called ACTH-stimulation test. This test measures serum cortisol levels before and after administering adrenocortical stimulating hormone (ACTH).

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While Addison's disease can't be cured, it can be treated successfully by replacing the hormones that the adrenal gland can't make. In acute cases, very sick dogs may be stabilized with intravenous fluids, and supportive hospitalized care. Ongoing therapy includes hormone replacement that must be continued for life.

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Dogs with Addison's disease usually have an excellent response to treatment and go on to live normal lives. However, due to the heritability of the disease, dogs with Addison's disease should not be bred.

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We've talked about full-blown Addison's disease, but let's talk about atypical Addison's disease. Atypical Addison's disease is a more unusual form of the disease characterized by a deficiency of cortisol (glucocorticoid), while aldosterone (mineralocorticoid) activity remains intact. The clinical signs are centered around gastrointestinal abnormalities including vomiting, diarrhea, and inappetence. In some dogs, atypical Addison's disease will progress to full-blown Addison's disease with aldosterone-deficiency, while others will have no disease progression. Dogs with atypical Addison's disease are treated with daily glucocorticoids, but do not require aldosterone supplementation.

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Feline hyperthyroidism is a common disease affecting middle to older-aged cats, affecting an estimated 6% of cats over the age of 15. The disease occurs from hyperactive thyroid glands that overproduce thyroid hormone. The thyroid glands are often enlarged because of a benign tumor. The cause of the disease is unknown, although environmental and food-related factors have been implicated in its development.

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Cats display clinical signs related to an increase in their metabolism caused by excess thyroid hormone. Their drinking and urination may be increased, they may be hungrier, and they may lose weight. Sometimes cats will have vomiting and diarrhea because of increased gastrointestinal tract motility. They may have increased blood pressure, abnormal heart beats, and behavioral abnormalities such as hyperactivity and increased vocalization.

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Hyperthyroidism can be diagnosed early from screening blood work done as part of wellness exams for cats over the age of 10. A simple blood test measuring the level of thyroid hormone, T4, can identify hyperthyroidism in more than 90% of cases. Occasionally, your veterinarian may recommend further testing in difficult-to-diagnose hyperthyroid cases. To schedule an appointment for your senior cat's annual exam, contact us at [INSERT CLINIC PHONE NUMBER].

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Treatment for feline hyperthyroidism should begin when diagnosed. Early treatment will prevent long-term problems from chronic hyperthyroidism including hypertension and heart failure. There are 4 ways to treat hyperthyroidism in cats that include radioactive iodine (131I), medication, prescription diets, and surgery.

Radioactive iodine (131I) is the treatment of choice in cats without severe kidney disease and is typically safe and effective with virtually no side effects. Medication therapy is another treatment option that is given to control elevated T4 levels and clinical signs. A prescription diet is another treatment option for the management of feline hyperthyroidism and is severely limited in iodine content and results in limiting the ability of hyperthyroid cats to make active thyroid hormone. Finally, another option for hyperthyroid treatment is surgery to remove the thyroid glands. Some veterinarians will offer this option for cats that cannot be medicated or will not eat the Y/D food.

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Hyperadrenocorticism (HAC)--also referred to as Cushing's syndrome--is one of the most common endocrine disorders in middle to older aged dogs and is defined by a chronic overproduction of the cortisol hormone caused by either pituitary or adrenal tumors. Unmanaged Cushing's can lead to harmful effects on the dog's organs and metabolism.

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Dogs with hyperadrenocorticism (Cushing's syndrome) can exhibit a variety of clinical signs including excessive appetite, urination, and thirst, and bacterial skin infections, a pot-bellied appearance, panting, hair loss, and persistent urinary tract infections. If you've recently noticed any of these signs in your dog, contact our clinic at [INSERT CLINIC PHONE NUMBER] to schedule an exam.

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If your veterinarian suspects your dog may have hyperadrenocorticism (Cushing's syndrome), he/she may recommend blood testing to diagnose the disease. There is no single test that will absolutely identify Cushing's disease. Screening tests for the disease include the urine cortisol:creatinine ratio, the ACTH-stimulation test, and the low dose dexamethasone suppression test.

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If your dog is diagnosed with hyperadrenocorticism, there are several treatment options available that your veterinarian may recommend. Surgery may be performed if an adrenal tumor is detected or medical therapy may be started.

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Diabetes mellitus is a common endocrine disorder in both dogs and cats. An estimated 1 in 300 dogs and 1 in 230 cats develop the disease in their lifetime. Dogs typically get the insulin-dependent (Type 1) form while cats usually are affected by non-insulin dependent (Type 2) diabetes. Type 1 diabetes occurs from a loss of pancreatic beta cells that keeps the pancreas from producing an adequate amount of insulin. Type 2 diabetes occurs from insulin-resistance when the insulin receptors in the cells do not recognize insulin and are unable to transport glucose into the cell.

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Risk factors for Type 2 diabetes mellitus in cats are similar to those in people and include obesity and lack of exercise. Cats can go into diabetic remission in which insulin requirements diminish or even cease to be necessary after initial treatment.

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If you've recently noticed your dog or cat has been urinating excessively or drinking more than usual, it could be a sign that your pet has diabetes mellitus. Other clinical signs include unexplained weight loss, persistent or recurrent urinary tract infections, weakness and muscle wasting, cataracts (usually in dogs), and peripheral neuropathies (usually in cats.) If your pet is exhibiting any of these signs, contact our clinic right away at [INSERT CLINIC PHONE NUMBER] to schedule an examination.

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Diabetes mellitus is diagnosed by recognition of appropriate clinical signs and demonstration of hyperglycemia (high blood glucose levels) and glucosuria (high urine glucose levels). Initial evaluation of the diabetic pet should include a complete physical examination along with diagnostic bloodwork and urinalysis.

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If your cat is diagnosed with diabetes mellitus, the goals of therapy will be to treat the clinical signs, control any concurrent diseases, and avoid emergency situations like hypoglycemia (low blood sugar), ketosis, or hyperosmolality. Depending on blood glucose level, stable cats might be treated initially with a diet change and treatment of any concurrent disease. If diet changes do not work, insulin therapy is recommended, and there are several products approved for veterinary use.

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Treatment for dogs diagnosed with diabetes mellitus is different than what is recommended for cats. The optimal diet for diabetic dogs is one high in insoluble fiber which slows glucose absorption from the gut. Since diet change alone is not usually enough to keep dogs' glycemic levels stable, insulin therapy should be started. Pets should be fed twice a day when insulin is given even if it is only given once per day. Care should be taken to ensure that your dog is not receiving more than their caloric needs to avoid unnecessary weight gain.

For both diabetic dogs and cats, exercise is beneficial to lowering insulin requirements and providing better glycemic control. Daily walking for dogs and cat play can be effective ancillary treatments for diabetes mellitus. Average time for initial diabetic control is 4-6 weeks.

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It's important for you and your veterinarian to monitor your diabetic pet's response to insulin therapy. It takes at least 6 weeks for an animal to fully adjust to insulin therapy, so although small changes to insulin may be made during this time, full insulin effects should not be determined until after the pet has been treated continually for 6 weeks.

A portable glucometer can be used to measure blood glucose directly, and there are several affordable models that require only a minimal amount of blood. Periodic veterinary examinations are also needed to evaluate the clinical response to insulin and can be used to assess administration concerns with your veterinarian.