Disease in the Great Dane –
2003 – We've been
discussing hypoadrenocorticism, or Addison's Disease, in the Great
Dane. (See last week.) Addison's is
not widely known to the general public and the condition is often
misdiagnosed by veterinarians due to the fact that symptoms often
mimic those of other diseases. In fact, Addison's
Disease is often referred to as "The Great Pretender." While
AD isn't exactly prevalent in our breed, it has a definite presence
and you should know something about it because, if left undiagnosed,
Addison's can kill your dog.
What exactly is Addison's?
If you have an Addison's Dane, you
and your dog may be able to help our breed!
contact JP Yousha, chair of the Great Dane Club of America's
Health & Welfare Committee
via email, or by phone
at (432) 684-8940.
Confidentiality is assured, as all
dogs will be assigned numbers for the study.
Simply put, Addison's Disease is a failure of the adrenal glands.
Dogs – and humans, too – have
two adrenal glands located midway up the back, just above the kidneys. The outer
layer (adrenal cortex) of each gland secretes corticosteroids, aldosterone and
cortisol. These hormones are essential to good health. When the adrenal glands
begin to fail, usually due to inherited immune problems, serious problems can
There are two basic types of AD: Primary
Addison's (which is perhaps the easiest to diagnose based
on symptoms) and Atypical Addison's. Each has its own
characteristics and treatment
protocol. To the lay-person, a discussion of the various clinical
manifestations of the disease can get pretty complicated, as can
Unless your dog actually has Addison's, I don't think you need to know all that
information, so I am not
going to spend time talking about it. What's more important are
the actual symptoms.
So, what are the symptoms?
Before we talk about the symptoms, you need to know that Addison's occurs
in our breed and it is often misdiagnosed – or under diagnosed– by
veterinarians. For that reason, Addison's may be more common than current estimates
While AD may be difficult to diagnose based on observable symptoms, the
ACTH (adrenocorticotropin) Stimulation Test can be administered to determine
once and for all whether a dog has AD. This is a fairly expensive test, but
it is the only test available that can provide a definitive diagnosis. If Addison's
is identified as the source of your dog's problems, the disease is manageable,
and he or she can be treated. However, for some families, the ongoing cost
of treatment could be an issue.
You also need to learn to recognize the
signs and symptoms of Addison's. Last week we read about Tank,
who has Primary Addison's Disease. Tank experienced an acute Addisonian
Crisis and nearly died. Prompt and knowledgeable medical attention
pulled him through. He now receives regular treatment for
AD and he is a happy, healthy dog. This week we'll read about Catherine,
Dane (pictured above)
with Primary Addison's
for 4 years. Like many AD-affected dogs, Catherine's symptoms were
– at the onset – a bit confusing:
of a "Near Miss"
Bobbie Marie Palsa
a sudden, dramatic "crash," or Addisonian Crisis
is not uncommon, many dogs experience a more insidious slide
into Addison’s Disease. As the adrenal glands begin to
fail, there is a waxing and waning of vague symptoms, often
easy to miss or misdiagnose.
initial symptoms consisted of nothing more than a slight
limp in her right hind leg and some generalized weakness in
rear end. She was originally diagnosed as having early arthritis
from a sports injury, the result of rough-housing with our
black lab. She was put on Rimadyl. At that time, Catherine
had no other symptoms, but in retrospect, her unusually long
hair-coat and her less than
enthusiastic appetite hadn't been normal for
her first day on Rimadyl, Catherine's limping was resolved;
however, her appetite rapidly declined over the next few
days. This was worrisome. After four days
Catherine was taken off the Rimadyl and our vet began running
additional tests (blood, urine, you name it) to determine
her problem. At that point her only 'clinical' indications
were slightly elevated potassium and liver enzyme levels.
By then Catherine's appetite was non-existent, although she
never did go through the vomiting that so many AD dogs seem
to experience. None-the-less, her weight
had dropped 27 pounds and she had bloody stools. After consulting
with Dr. Deborah Greco, one of the country's
leading canine endocrinologists, our veterinarian ran the
ACTH Stimulation Test. BINGO!! Catherine tested positive
for Canine Addison's Disease. We got the results of the test
on Saturday morning and she received her first injection
of Percorten-v (DOCP)
the following Monday. In the meanwhile, we were told to start
giving her 30 mg of Prednisone a day to "prop her up" until
she got her shot and the DOCP started doing its job.
Our vet later
told us that Catherine's initial symptoms –
limping and generalized weakness of the rear quarters, depressed
appetite, and unusual coat – were due to underlying
Addison's Disease. Upper gastrointestinal irritation, ulceration
and bleeding is consistent with Addison's. In Catherine's
case, the Rimadyl and high doses of Prednisone administered
prior to her first
DOCP injection resulted in extensive damage to her stomach.
So even though her electrolytes were stabilized within hours
of her first DOCP injection, Catherine's stomach was still
bad shape. Four days after her first treatment, Catherine
collapsed and was admitted to the ER in shock. At least by
they had to focus on was controlling the upper GI bleeding
by "spackling" her
stomach with Carafate, then transfusing a unit of blood and
rehydrating her. For about a month after that, Catherine took
Carafate and Pepcid on a regular basis. Once she got over
the hump and her stomach began healing, Catherine's appetite
returned to normal. After two months of treatment she was
BETTER than her "old
self" and started regaining the weight she had lost.
can use an oral medication in a compounded dosage (an entire day's
in one capsule) for about
$30-$40 a month. The generic name is "fludrocortisone acetate" and
it is generally prescribed at 0.1mg per 10 pounds of body weight – so
a dog weighing 150 pounds would require 1.5 mg a day.
Since the majority of the cost of compounded
meds is the labor of putting the powder into the capsules, the
price of this pretty much the same whether you're treating a 50
pound dog or a 150 pound dog!
other words, a month's supply of the compounded version of the
brand name "Florinef" (which,
btw, sells for about $1.25 a pill) would cost about a dollar a
day to treat a 150 pound Dane with an entire day's dosage in one
capsule – versus $15 a day for 15 individual "brand
name" Florinef tablets.
the first few months after Catherine's initial diagnosis,
we ran blood work once a month. Now we check her electrolytes
once every three or four months. Catherine has remained rock-solid
and stable for almost four years! The only time her limping
and hind-end weakness returned was four months after her
of Percorten-v (DOCP). That's because her original DOCP dosage,
which was calculated based on her initial body
weight, was no longer adequate. Once the dosage was adjusted
to compensate for her weight gain, Catherine was fine again.
timing from Catherine's first exam (for limping) to her
final diagnosis of Addison's Disease was less than three
but it seemed like forever! When the results of the ACTH
test came in, the vet told us: "The
good news is that it's completely treatable. The bad news
is that it's extremely expensive." We focused on the
GOOD news. And we've since discovered that there ARE some
less expensive treatment options – if
you know where to look.
Today our girl is a happy, goofy, active, squirrel-chasing
seven- year-old with a healthy appetite for food – and
life in general! Nobody'd better ever tell HER she's got
a *disease!* She's got at least another seven years to go.
After all, there are a lot more squirrels in them thar trees!
a wealth of information on Canine Addison’s Disease at www.canineaddisonsinfo.com.
We were lucky that Catherine didn’t go into a full-blown
Addisonian Crisis or "crash" before she was diagnosed,
but many dogs aren't as lucky, and many don’t survive.
Having your dog diagnosed early and correctly is half the battle,
the other half is finding a vet who – if he’s not
already familiar with AD – is at least willing to learn
about it along with you. Maintaining a stable Addisonian is basically
simple: you replace the hormones their failing adrenals can no
longer produce. When you first hear your dog's been diagnosed
with Canine Addison's, it's a lot easier to wade through
the "information overload" with the help
and support of over 1100 members at K9
Addisons, a Yahoo mail list forum.
Symptoms of Primary AD
with Primary Addison's Disease often exhibit gastrointestinal problems,
such as loss of appetite, vomiting or
diarrhea. They can
appear weak, easily fatigued, and depressed. They may
also exhibit a generalized weakness in their hind quarters and/or
they may limp. Their fur can be affected in
a variety of ways, too. Some dogs may
a thicker coat, while others may lose fur. Some dogs might even develop
a curly coat – or lose the curl they've always had.
and there is no "absolute" set
of symptoms. Still, as you read first-hand accounts of the disease,
a pattern begins to emerge.
Cynthia had this to say about her
Dane, Lily, another Primary AD patient:
The first thing I noticed about the onset
of Lily's AD was that she had difficulty supporting herself with
her front legs in a sitting position. I didn't really think much
about that until she started to really get sick. She stopped eating-totally.
I went nuts doing things like cooking a big pan of chicken for her
and she just turned away when I offered it to her. Of course, we
were back and forth with the vet and he kept zeroing in on Wobbler's
but that really didn't make sense, either.
As her disease progressed,
she bled from her mouth and her gums were very red instead of the
normal blackish color. She also wasn't able to lift herself from
a lying position. Within a few weeks of her initial symptoms, Lily
had lost a total of 40 pounds. At this point the vet sent us to the University of Georgia vet
school. They were wonderful. What had seemingly been an undiagnosable
situation here in Charlotte, NC, the people at vet school in Georgia nailed
in a matter of hours. Once Lily began medication she immediately improved and in a short time she was completely
Merrell writes about OP:
OP, our harle,
was diagnosed with Addison's Disease earlier this year. His first
that he would just stop
and lay down on our daily
walks. Then he had trouble getting off the couch. (Yeah, I know,
tough life, eh?) We were treating him for a bad back. His coat,
which is abnormally thick and curly to start, got even more weird,
spotty and shaggy with unbelievable shedding. He looked like a
Shetland pony with a bad hairdresser. He was tired and depressed
and thirsty. We were traipsing from veterinary specialist to veterinary
specialist, both holistic and allopathic. I kept telling them that "something
is just off." To me, the most frightening thing about Addison's
disease is that the symptoms are so nebulous. I strongly feel that
Addison's is under-diagnosed.
Marilu writes about Cissie:
My Dane Cissie was
diagnosed with Addison's 5 years ago at the age of 4. Prior to
finally being correctly
diagnosed, she had had many bouts with pimples on her chin and
neck area and had several biopsies of that area. She also went
thru a period of horrendous shedding. I thought she might
actually go bald. Her
has never been what I consider Dane-like, and throwing up was
the norm for her.
Since being diagnosed
and stable on her DOCP injection
and daily Prednisone, Cissie has no more pimples, no excessive
shedding and she is a much better eater. Had I not found the right
would have died years ago and I would have missed out on a lot
of the joy that just living with her brings me.
Sarah writes about Summer:
Thanks for bringing up the Addison's issue.
Summer, my 3-year-old harle, was diagnosed when she was one and
a half. My husband and I had gone on a short trip and left her
at a boarding
kennel (which had been highly recommended). When we picked her up
5 days later, she looked horrible. The worst part was that she didn't
seem to recognize us, or care that we were back. We knew something
was wrong and took her to our vet. She had several episodes of diarrhea
and her fur was dull and shedding. When we got to the vet, Summer
wouldn't get out of the car and growled
when we tried lift
her. (Summer loves the vet!) Luckily, our vet decided we should
University Vet School after she was started
on fluids. They recognized the signs of Addison's Disease. They
told us how close we were to losing her. She had lost 16 lbs during
the 5 days we were gone! She is doing great now on her Prednisone
and monthly injection.
These dogs were all lucky because
their AD was diagnosed and treated before they went into a full-blown
Addisonian Crisis. During an Addisonian Crisis, a dog may collapse,
go into shock, have a slow or irregular heart rate, low blood pressure,
and show signs of what appears to be (but is not) acute renal failure.
If inappropriately treated, it is likely the dog will die.
The next installment...
Next week we'll wind things up by taking
a look at Atypical Addison's. This condition can be even trickier to
alone. We'll also talk about how you or someone you know might
be able to participate in a research project to explore the
of Addison's Disease
Dane. And in conclusion, I'll provide a comprehensive set of links
to Canine Addison's Disease resources. (See next
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