Holly recently diagnosed with Addison's

[HollyPolly]

Hi All,

I have a 6 year old Staffie Cross called Holly who was diagnosed with Addison's disease just under 4 weeks ago. She had a full blown Addison's crisis initially and was in hospital for just under a week because she was so unwell. Since being home she had a a further two small episodes where she has been kept in overnight for fluids and to stabilise her levels. Currently she is on 3 tablets of Florinef. This dose has gradually been increased from 1.5, then to 2 and now we are on 3, given in the morning. She is also taking Predinale tablets twice a day, morning and evening, although in the long term the vet's would like to decrease this.

We seem to yoyo back and forth from her being ok for a while then back to the vets. She is having weekly blood test for her sodium and potassium levels. Seem to have got the potassium levels ok, but sodium remains a problem. Also having problems with frequency of going for a wee, day and night. We were advised to add a pinch of salt into her food twice a day also.

Is getting sodium and potassium levels balanced always difficult in the early days following diagnosis? 

[patp]

Hello
Sorry to hear that Holly has been unwell.

My Whippet has Addisons and the early days are the worst. Trying to find the right balance of drugs is always difficult and Willow went through just what Holly is doing. She was in the vets on a regular basis to have drip and bloods tested. Her details are on here but I must stress that she is an unusual case (so I am told) All you can do is persevere and trust that one day she will be balanced and happy.

I am sure one of the moderators will be along shortly and they will probably ask for Holly's blood results. This will mean the Potassium and Sodium and Chloride reading together with the "normal range" figure that is in brackets on the test results. I always ask for a copy of the results in case I am not able to get to my normal vet for any reason.

Stress is not good for dogs with Addisons so it will help Holly if you keep her routine as normal as possible during these troubling times.

Best Wishes on your journey with an addisonian dog

[HollyPolly]

Thank you for your kind reply. Both my husband and myself have had a fairly fraught couple of weeks( not to mention poor Holly) and really can't see the bright light at the end of the tunnel yet!

Thanks for the info re: Potassium, sodium and chloride levels, never thought about asking for those before.

Whilst on this post, has anyone ever taken their dog away since being diagnosed with  Addison's? We love taking her away with us and would hate for that to stop

[HollyPolly]

Hi Holly's owner here again. Holly is 41/2 weeks into diagnosis and we still seem to be at the vet's every couple of days. Her Florinef has been increased to 4 tablets a day, 2 morning and evening, in addition, she is also having 1 predinale morning and evening. Last week she had a bout of vomiting, attributed to the Addison's. She was kept in again, put on a drip and sent home in the evening the next day. The meds she was sent home with included 1/2 tab Zantac twice a day and a stomach liner which we gave 1-2 after the other tabs. These have now finished. My question is should she have an antacid prescribed anyway, as we are going back again this evening due to vomiting. Any answers gratefully received.

[Jo CIMDA]

Hi

I'm sorry for the delay in replying to your post.  I hope Holly is feeling better today.

It does take some weeks for an Addisionan dog to stabilise and to establish the correct dose of Florinef. Measuring sodium and potassium levels and monitoring clinical signs every 1-2 weeks is usual to start with.  The Sod:Pot ratio should be above 27 but most dogs seem to do better when their ratio is 30+ this means that they no longer show clinical signs of Addison's disease and they are they are back to normal (or near normal).  When the dog has reached this stage it is usual to wean the dog off of prednisolone or  withdraw it,  and only give it at times of stress.  This is because they can no longer produce the 'flight/fight' hormone (glucorticoid hormone).  When stable there should be enough glucocorticoid hormone within the dose of Florinef to cope with the stresses of every day life. 

I don't know how much Holly weighs or the dose of pred you are giving to her but if she is having excess to her needs then it might be causing an upset stomach and also causing her to wee more.   Hopefully she will soon be stable and the pred can be reduced or stopped. It is not usual to have tablets to protect the stomach but Holly might need it at this time.

To give you some idea of how the medication is given, I have quoted the following from the BSAVA Small Animal Formulary, 6th Edition:

Florinef:
Start at 0.01mg/kg/24 hr depending on the size of animal.  Monitor sodium and potassium levels every 1-2 weeks and adjust dose by 0.05-0.1mg accordingly.  Most patients once stabilised will require approximately 0.1mg/5kg 24hr.

Prednisolone:
0.2-0.3mg/kg with Florinef.  The use of prednisolone may be discontinued in most cases once the animal is stable.

Most owners feel their dog does better splitting the dose of Florinef (as you are doing) and giving it every 12 hours rather than giving one dose very 24 hours, and also it seems better absorbed on empty stomach, but if you are still giving prednisolone with the Florinef then perhaps it would be better with food, or to give the pred with food at least, because pred can upset the stomach.

The good news is the prognosis for Holly is excellent.  Now you have a diagnosis and she is on medication she should stabilise and go on to have a happy life.  Of course she will have to be monitored about every 6 months when stable,  and it is best to try to anticipate stressful events so that you can give her a pred tablet beforehand.  It is a good idea to keep a few preds in your pocket in the event of a stress situation happening out of the house.
Jo

[patp]

To answer your question about whether Holly can go away with you then the answer is yes. If she is used to going with you it will be less stressful than leaving her. It is generally considered that kennels is too stressful for an Addison dog. It might be good though, for emergencies to get her used to being cared for by another person such as a family member or dog sitter.
We travel in our camper van and Willow comes too.

[HollyPolly]

 Hi all,

Many thanks for your messages, I am pleased to report that Holly has now gone a week without going to the vet's. Before, we used to go every 3-4 days, the last visit was for a minor problem, so if I don't count this it will be about 9-10 days, so relieved!

Holly is due a visit tomorrow to check levels, but already we are seeing signs of our old dog back! We thought we had a changeling!

Slowly, but surely, she is adapting to the medication and the view of the vet is that once stabilised will come off Predinale, except for emergency use and just be on Florinef.

I am so glad I found this wonderful site as we both thought Holly would not make it through and you have been able to answer from a personal viewpoint rather than the vet's.

I have to say our vet's have been wonderful, admitting that they did not know much about Addison's as they don't see it that often, but being very supportive. They ran an article in our local newspaper about Addison's featuring Holly.

Once again thank you for all your support, will keep in touch.

[patp]

Glad to hear Holly is improving. Such a relief for you. Well done on getting the article in the paper. You will probably meet more people who own dogs with Addisons. I know two already!

[Jo CIMDA]

Great news about Holly.  she should continue to thrive on the correct mediation.

Jo

[HollyPolly]

Hlolly has has been to the vet's again! Another  out of diarrhea and vomitting! Holly's Addiso 's seems to ha e stabilised so vet's looking at other things! Poor Holly, will she ever be out of the woods? We both feel she has been through so much. Just want our old Holly back.

[Jo CIMDA]

Hi

There seems to be a lots of tummy upsets about at the moment and it can be difficult in a dog with Addison's to differentiate between an Addisonian problem and a tummy bug.

I do hope she improves soon.  Don't forget she may need a replacement dose of pred if she is anxious about being unwell or going to see the vet.

Jo

[Jo CIMDA]

Hi

There seems to be a lots of tummy upsets about at the moment and it can be difficult in a dog with Addison's to differentiate between an Addisonian problem and a tummy bug.

I do hope she improves soon.  Don't forget she may need a replacement dose of pred if she is anxious about being unwell or going to see the vet.

Jo

[patp]

Are you absolutely sure she is stabilised? Sometimes, for whatever reason, they go "off" and their meds need tweaking. Don't be afraid to ask for an extra electrolytes test.

[HollyPolly]

Hi all,

Just an update on Holly.

She was kept in overnight again, but by the next day she was her normal perky self, so much so that in view of the fact the she was spending more time in the garden with staff than in a kennel, it was time to go home!

Vet's did some more blood tests as they were not convinced that the D and V was due to the Addison's. They tested for Pancreatic insufficiency and a parasitic infection. Her bloods showed no evidence of Pancreatic insufficiency and the Addison's seemed stable, however she did have a higher white cell count indicating some kind of inflammation so she was put on antibiotics for a week. Just finished the course of antibiotics and Panacur and Holly is much improved. She seems much more stable with regards to the Addison's and this week we all went out and left her for a couple hours and she was fine.

The vet has said that as long as she is having all her meds and she has no D and V it is unlikely that she would have a crisis in such a short space of time.

It is possible that Holly did have something else in conjunction with the Addison's(Holly is one of those dogs who eat absolutely ANYTHING!) as she does appear so much better, however we always remain vigilant and the next couple of days will tell if she did have a bug of some sort as she is not now on antibiotics and the symptoms may well return, but I really hope they do not.

Many thanks for your messages as I find all information very helpful.

[Penel CIMDA moderator]

Fingers crossed it was nothing to do with the Addison's then, and that she stays well for a long while.