Addison Disease
Hypoadrenocorticism
Také známé jako: Hypoadrenocorticism, Addison's disease, Adrenal insufficiency
Stručně
Addison's disease is an uncommon endocrine disorder where the adrenal glands fail to produce vital hormones. This leads to severe gastrointestinal issues, weakness, and life-threatening electrolyte imbalances. While an Addisonian crisis is a veterinary emergency, the long-term prognosis is excellent with lifelong daily or monthly hormone replacement therapy.
TL;DR. Závažná, ale dobře léčitelná hormonální porucha při nedostatečné funkci nadledvin; celoživotní léčba a po stabilizaci často výborná kvalita života.
Nadledviny leží těsně před ledvinami a jsou životně důležité.
Co to je?
Hypoadrenocorticism: deficient adrenal cortex hormones (glucocorticoids/cortisol and mineralocorticoids/aldosterone). Without aldosterone, potassium rises and sodium/volume fall, causing dehydration, bradycardia, and shock. Common in dogs; rare in cats.
Příčiny a rizikové faktory
Usually immune-mediated (idiopathic); >90% of cortex destroyed at clinical onset. Also iatrogenic (abrupt steroid withdrawal; overtreatment of Cushing). Breed predisposition in several dogs (e.g. Standard Poodle, Portuguese Water Dog, NSDTR).
Známky, na které dávat pozor
- Lethargy, anorexia, weakness, vomiting/diarrhea, dehydration (common)
- Bradycardia, hypothermia, hematemesis, melena, PU/PD (occasional)
- Collapse / hypovolemic shock: Addisonian crisis (emergency)
- Seizures (rare)
Letargie a slabost jsou časté časné známky u predisponovaných plemen, např. standardní pudl.
Jak veterináři diagnostikují
Chemistry (low Na:K ratio), ECG if hyperkalemia. Gold standard: ACTH stimulation test (flat cortisol). Ultrasound (small adrenals), radiographs (microcardia).
EKG odhalí nebezpečné arytmie při vysokém draslíku.
Možnosti léčby
Crisis: aggressive IV fluids, rapid glucocorticoids (dexamethasone), insulin/glucose if critical K⁺.
Maintenance: mineralocorticoid (DOCP every ~25–30 days or daily fludrocortisone) plus often prednisone/prednisolone. Close electrolyte monitoring; increase glucocorticoid at stress.
Prognóza
Long-term excellent with consistent therapy and stress-dose adjustments.
Prevence
Primary form not preventable. Never stop steroids abruptly. Responsible breeding in affected lines.
Kdy volat veterináře
Emergency: collapse, extreme weakness, continuous vomiting or bloody diarrhea, very slow pulse, pale gums.
Zdroje
- Textbook of Veterinary Internal Medicine, 5th Edition, page 884, 888.
- Small Animal Critical Care Medicine, 2nd Edition, pages 425, 427.
My highlights & notes
Příznaky a projevy
Plemena s vyšším rizikem
Jak se diagnostikuje
- ACTH Stimulation TestZlatý standard
- Abdominal Ultrasonography
- Baseline endogenous ACTH concentration
- Electrocardiogram (ECG)
- Low-dose ACTH stimulation test
- Plasma aldosterone concentrations during ACTH stimulation test
- Radiography
- Serum electrolyte concentrations (Na:K ratio)
Přístupy k léčbě
Léčbu musí předepsat licencovaný veterinář. Konkrétní dávky záměrně neuvažujeme.
Časté otázky
What is Addison Disease?
Addison's disease is an uncommon endocrine disorder where the adrenal glands fail to produce vital hormones. This leads to severe gastrointestinal issues, weakness, and life-threatening electrolyte imbalances. While an Addisonian crisis is a veterinary emergency, the long-term prognosis is excellent with lifelong daily or monthly hormone replacement therapy.
What are the symptoms of Addison Disease?
Loss of appetite、Dehydration、Diarrhoea、Lethargy、Vomiting (throwing up)、Weakness (low energy, no strength)、Weight loss (getting thinner)、Hematemesis
How is Addison Disease diagnosed?
ACTH Stimulation Test、Abdominal Ultrasonography、Baseline endogenous ACTH concentration、Electrocardiogram (ECG)、Low-dose ACTH stimulation test、Plasma aldosterone concentrations during ACTH stimulation test
How is Addison Disease treated?
Léčbu musí předepsat licencovaný veterinář. Konkrétní dávky záměrně neuvažujeme.
Zdroje
- Internal Medicine 5th · p. 884
- Small Animal Critical Care Medicine, 2nd Edition (VetBooks.ir) · p. 425
- Internal Medicine 5th · p. 884
- Small Animal Critical Care Medicine, 2nd Edition (VetBooks.ir) · p. 427
- Internal Medicine 5th · p. 888
- Internal Medicine 5th · p. 888
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