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Addison's Disease (common symptoms (hyperkalemia (high K, due to…
Addison's Disease
common symptoms
hyperkalemia
high K
due to aldosterone deficiency
hyponatremia
low Na
due to aldosterone deficiency
hypovolemia
too little fluid in the blood
due to aldosterone deficiency
metabolic acidosis
due to aldosterone deficiency
hypoglycemia
low blood sugar
due to cortisol deficiency
breeds commonly affected
Poodles
Portuguese Water Dog
Bearded Collie
Cairn Terrier
Cocker Spaniel
overview
primary (99% of cases)
disease of adrenal cortex
inflammatory cells invade and destroy the cortex
secondary (rare)
due to hypothalamic issues
cortisol
stimulates gluconeogenesis
counteracts insulin
anti-inflammatory
regulation of vascular smooth muscle tone
aldosterone
activates transcription factors that allow Na/K transports to be implanted
signals Na to be absorbed
signals K to be secreted
treatment
steroids
cortisol replacement
start with dexamethasone until ACTH stim results are back
(0.5 mg/kg IV)
aldosterone replacement
DOCP
fluids
gastroprotectants
atypical Addison's
absence of cortisol
only
zona glomerulosa affected
harder to diagnose
can progress to become typical Addison's
typical Addison's
absence of aldosterone and cortisol
zona fasiculata and zona glomerulosa affected
severe clinical presentation
requires treatment with both hormones
diagnosis
baseline cortisol
amount of cortisol in the blood at any one time
>
or = to 2: normal
<2: abnormal, follow with ACTH stim test
ACTH stim
give ACTH (stimulate cortisol production) and measure the cortisol level