ADDISON'S DISEASE

ADDISON'S DISEASE:

I decided to write about Addison's disease because my dog, our office mascot, Dr. Papidies has this disease. Addison's disease is seen in humans and in animals. There are skin changes in humans that can act as a clue to a dermatologist helping he or she correctly diagnosis the problem. Many times dermatologists must be detectives looking at the patient's entire skin surface for clues that occasionally will lead them to an underlying disease. A well trained dermatologist will take his time with patients; do the appropriate exam and testing that will eventually lead to the correct diagnosis and appropriate treatment.

ADDISONS DISEASE IN HUMANS:

DEFINITION: Addison's disease (AD) is a disease of adrenal insufficiency which is a condition characterized by inadequate production of adrenal hormones cortisol and aldosterone. The adrenal glands are small organs located on top of each kidney. The adrenal gland produces different hormones that control many of our body systems. Hormone production is complex and regulated by the hypothalamus, pituitary gland, and the adrenal gland. If any part of the signaling and feedback system isn't working, it can cause illness within the body. Addison's disease of primary adrenal insufficiency affects levels of cortisol and aldosterone in the body caused by underactive or damaged adrenal glands. Cortisol is a glucorticoid hormone produced by the adrenal gland. Cortisol affects the metabolism of sugars, proteins, fats, sugar levels in our blood, acts as an anti-inflammatory agent, and helps our bodies react to stress. Aldosterone is a mineralcorticoid that manages salt and potassium balance in the blood. If we don't have enough of these two hormones, the body becomes weak and dehydrated, unable to maintain adequate blood pressure and respond properly to stress. AD affects 1 to 4 people per 100,000 in the US, men and women equally, and all age groups.

SYMPTOMS: CAN BE VAGUE AND NONSPECIFIC. They can appear slowly during times of stress. Symptoms can include abdominal pain, dehydration, constipation or diarrhea, dizziness and fainting, fatigue, joint and muscle weakness, low blood pressure, low blood sugar, salt craving, weight loss, and vomiting. SKIN SIGNS: DECREASED BODY HAIR and HYPERPIGMENTATION. We can see dark patches of skin, especially in the folds of the skin; black freckles on the forehead and face, discoloration around nipples, lips, and rectum. ADDISONIAN CRISIS can appear suddenly and can be caused by stress, trauma, surgery, and infection. This crisis can be fatal if left untreated. One should look for kidney failure, loss of consciousness, low blood pressure, severe pain in the legs, back, abdomen, dehydration; and shock.

TESTS: There are tests the physician can perform to help diagnose this disease. Some of these tests include checking cortisol levels, ACTH, electrolytes, aldosterone, kidney function, and glucose levels. These are but a few of the tests available to us in our armamentarium to detect AD.


TREATMENT: There is adequate treatment but no cure!


ADDISONS DISEASE IN DOGS:

AD in dogs is more common than one would think and is very similar to the human variety.

SIGNS AND SYMPTOMS include weakness, vomiting, hypothermia, painful tummy, bloody stools, depression, heart irregularities, low blood pressure, and hair loss. The frightening condition of AD in a dog is life threatening and requires immediate treatment.

TREATMENT is with intravenous injection of saline and cortisol. This is a must or the dog will die. Once the dog is stable, he can be maintained with prednisolone. When the dog is under any stress his prednisolone must be increased. The dog's potassium must be closely monitored. Prognosis is excellent when properly treated with hydrocortisone and aldosterone. As it is difficult for our furry friends to tell us what is going on, sometimes the diagnosis is a difficult one. The owner of a dog with Addison's disease must be extremely vigilant as the dog can go into crisis at any time and die.

My dog, Papidies, is watched very closely. He is never left alone, takes daily medications to keep him alive which must be adjusted in times of stress. He must see the vet monthly to monitor his blood pressure and potassium and have intramuscular medication administered. Within 24 hours after Papidies left the kennel and arrived at my home, he became lethargic and listless, wouldn't eat or drink fluids, and wouldn't go to the bathroom. He became so lethargic that we rushed him to Columbine Animal Hospital where he was placed on IV fluids and eventually AD was diagnosed. He now leads a happy, healthy life as my pet at home and our office mascot.


Leslie Capin MD

Hello everyone,

Thanks for opening my blog and taking time to read.

My three passions have always been my patients, friends and family, and animals. With the down turn of the economy, I have become increasingly concerned with the displacement of animals. The animal shelters are underfunded and there are many cats and dogs with no homes. There are two wonderful shelters in Denver where one can adopt an animal, but they are expensive to operate. The Denver Dumb Friends League (http://www.DDFL.org) and The Max Fund (http://www.maxfund.org/). The Max Fund is a no kill shelter. If you haven't heard of these two shelters, go on line and see all of the wonderful things they do for animals.

I have a dog named Papidies with Addison's disease and am blessed that I am able to afford his vet care and expensive medicines. Not all dogs are this lucky. Papidies has become our office mascot and we now call him "Dr. Papidies." Dr. Papidies was a gift to me three years ago from an employee named Carol. Prior to the gift, I had lost my black Labrador of almost fifteen years. Carol realized that I was sad, walked into my office one day and asked me if I liked little dogs like Chi... Before I knew it I received a new dog from Carol as a gift! Unfortunately Carol purchased Dr. Papidies from a puppy mill that Carol thought was a reputable kennel. Within 24 hours of the gift, Dr. Papidies ended up in Columbine vet emergency room on IV fluids and medications fighting for his life. He was found to have Addison's disease. Knowing I had the option of exchanging Dr. Papidies for another dog, the kennel was visited and it was clear from our visit and what we experienced that exchanging Papidies was not an option. Dr. Papidies would have been put to sleep or left in the back room where he was found in his own feces. Since then, the kennel has been investigated and shut down. I know Carol's intentions were honorable in purchasing Dr. Papidies, but this is a great example of why the public needs to be educated on not buying animals from stores that get their stock inexpensively from puppy mills. Dr. Papidies came with papers, but these kennels masquerading as puppy mills sell dogs with papers. Carol had no idea when the dog was purchased that it was purchased from a true puppy mill rather than a reputable kennel.

If it hadn't been for Carol giving me Dr. Papidies, I would never have become educated in puppy mills, Addison's disease, or how many animals are without good homes or shelters. Nor would Carol or I have known about the present plight of the shelters in Denver with the down turn of the economy.

With this in mind, I have nominated my dog Papidies for the cutest dog competition. The grand prize is one million dollars with smaller amounts leading up to the grand prize. Any proceeds Papidies wins will be donated to the Denver Dumb Friends League and The Max Fund. If he were to get really lucky and win, this means half a million dollars to each organization which would help them is these lean times.

Please help us fund these two wonderful organizations by voting for Papidies!

Go to cutestdogcompetition.com, click on vote, then type in Dr. Papidies under Search for a dog, then register to vote with your e-mail. You will then be sent an e-mail stating you are registered. You must click on the link and vote for Dr.. Papidies. Let me know if you have any trouble voting. You may vote daily for one week.

I know this alot to ask of all of you, but feel it is a worthy cause and it will only take you a few minutes a day. Should Dr. Papidies be so lucky as to win this competition, we have Carol to thank for blessing me with Dr. Papidies to begin with. He has changed my life, for the better. I am now on a quest to educate people about puppy mills and the worthy shelters in Colorado.

Dr. Papidies thanks you in advance for his support as do all of his furry friends at the Dumb Friends League and The Max Fund. Let's all help get them one million dollars!!

Leslie Capin

STAY TUNED FOR MY NEXT BLOG ON ADDISON'S DISEASE!