Addison Disease
Hypoadrenocorticism
Znana też jako: Hypoadrenocorticism, Addison's disease, Adrenal insufficiency
W skrócie
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. Poważne, ale dobrze leczalne zaburzenie hormonalne przy niedoczynności nadnerczy; leki dożywotnio, potem często dobra jakość życia.
Nadnercza leżą tuż przed nerkami i są kluczowe.
Co to jest?
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.
Przyczyny i czynniki ryzyka
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).
Objawy
- Lethargy, anorexia, weakness, vomiting/diarrhea, dehydration (common)
- Bradycardia, hypothermia, hematemesis, melena, PU/PD (occasional)
- Collapse / hypovolemic shock: Addisonian crisis (emergency)
- Seizures (rare)
Letargia i osłabienie to częste wczesne objawy u ras predysponowanych, np. pudel standardowy.
Jak diagnozują weterynarze
Chemistry (low Na:K ratio), ECG if hyperkalemia. Gold standard: ACTH stimulation test (flat cortisol). Ultrasound (small adrenals), radiographs (microcardia).
EKG wykrywa groźne zaburzenia rytmu przy wysokim potasie.
Leczenie
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.
Rokowanie
Long-term excellent with consistent therapy and stress-dose adjustments.
Zapobieganie
Primary form not preventable. Never stop steroids abruptly. Responsible breeding in affected lines.
Kiedy dzwonić do weterynarza
Emergency: collapse, extreme weakness, continuous vomiting or bloody diarrhea, very slow pulse, pale gums.
Źródła
- Textbook of Veterinary Internal Medicine, 5th Edition, page 884, 888.
- Small Animal Critical Care Medicine, 2nd Edition, pages 425, 427.
My highlights & notes
Objawy i znaki
Rasy o wyższym ryzyku
Jak się diagnozuje
- ACTH Stimulation TestZłoty 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)
Podejścia do leczenia
Leczenie musi przepisać weterynarz. Konkretne dawki celowo nie są pokazywane.
Częste pytania
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?
Leczenie musi przepisać weterynarz. Konkretne dawki celowo nie są pokazywane.
Źródła
- 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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