Canine Addison’s Disease: Treatment Options

Posted: July 24, 2009 | Author: kenrose | Filed under: Treatment |Leave a comment »

Treatment  for Addison’s disease in dogs consist of two stages. If your dog is in Addisonian Crisis,  your vet will want to, at a minimum, start your pet in IV fluids to get the electrolyte levels back to normal. You can read about Addisonian crisis and therapy in this article. The second step of treatment is maintenance therapy, which involves supplementing the missing hormones for the rest of your pet’s life. There is no one universal “fix” for Addison’s disease: dogs will need to be closely monitored to reach optimal health levels.

Treatment will depend on whether your dog has primary or secondary Addison’s disease (for an explanation of the difference between the two, see “What is Addison’s Disease?”) .

Treatment for Primary Addison’s Disease

Your pet will need lifelong cortisol and aldosterone replacements. You have two options: either fludrocortisone or Percorten-V and prednisone.

Fludrocortisone–marketed under the brand name Florinef®, replaces both cortisol (a glucocorticoid) and aldosterone (a mineralocorticoid).  The single medication may be all that your dog needs. Dosage recommendations are 0.02 mg/kg/ day (approximately one pill per ten pounds of body weight).

Cost: A drawback with fludrocortisone is that it is very expensive–treatment can cost hundreds of dollars a month for a large dog.

Side effects: if your dog stops eating, vomits, has diarrhea, weakness or depression, contact your vet as this may be a sign of too little fludrocortisone. Too much of this medicine and your dog may show increased thirst and urination, have a poor coat quality and may lose hair.

Percorten-V replaces aldosterone and is administered once a month. In addition to a once-monthly shot, dogs on Percorten-V will need to take daily doses of prednisone.

Cost: Varies wildly depending on where you obtain your Percorten-V from. For our 40lb border collie, local veterinarians charge from $50-78 for one 1.33 ml dose (1 1/3 vials) of Percorten-V and 30 5mg tablets of prednisone, including the office visit.

Side effects: depression,excessive urination and drinking, skin and coat changes, not eating, diarrhea, weakness, vomiting,  weight loss, and incontinence. These may be reduced by tapering the dose of the medicine with your vet’s assistance.

Treatment for Secondary Addison’s Disease

An atypical Addisonian dog with normal electrolyte levels only requires glucocorticoids replacement, i.e. prednisone, hydrocortisone, dexamethasone or similar replacement. Veterinarians used to recommend that owners salt their pets food, but it appears that has fallen out of practice.

Cost: generic glucocorticoids are typically cheap, and run a few dollars per month.

Side effects:  increased drinking and urination, ravenous appetite, infections, panting, restlessness and behavioral changes. Blood work might show elevated liver enzymes. These side effects may be relieved by tapering the dose with your vet’s assistance.

Dosages for all medications are approximate: your pet may vary in the amount of medication it needs and your veterinarian may want to tinker with the dosage, monitoring electrolytes and other functions until your dog’s health is at an optimal level.

Reference:  Tilley L, Goodwin J. Manual of Canine and Feline Cardiology. Philadelphia, Pennsylvania: Saunders. 3 edition (January 15, 2001)

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