The adrenal glands are two tiny glands located just above your dog's kidneys. The glands synthesize cortisol and aldosterone and regulate various body functions. Cortisol is a steroid that helps your dog deal with stress, and aldosterone regulates their body's water and electrolytes. Hypoadrenocorticism, or Addison's disease, is a deficit of these two hormones.

Addison's disease, also known as hypoadrenocorticism, is a condition that occurs due to a deficiency in hormones produced by the adrenal glands. These glands produce cortisol and aldosterone, which regulate various bodily functions.

In Addison's disease, the adrenal glands fail to produce an adequate amount of these hormones, leading to an imbalance in the body's electrolytes and affecting its ability to manage stress, regulate metabolism, and maintain overall health.

Addison's disease can present in three different forms. Although primary Addison’s disease is the most common form seen, the secondary and atypical forms can be equally damaging to your dog. 

Primary Addison's disease is the most common in dogs and occurs due to damage or dysfunction of the adrenal cortex, specifically the outer layer of the adrenal glands. In primary Addison's disease, the adrenal glands fail to produce enough cortisol and aldosterone, leading to hormonal deficiencies.

Secondary Addison's disease is when the pituitary gland fails to produce enough adrenocorticotropic hormone (ACTH). ACTH stimulates the adrenal glands to produce cortisol and aldosterone. Without sufficient ACTH, the adrenal glands don't receive the necessary signal to produce these hormones adequately.

The atypical or partial Addison's disease is less common and can present with milder or intermittent clinical signs. In atypical Addison's disease, there might be a partial deficiency of cortisol and aldosterone, leading to varying degrees of signs. 

Each type of Addison's disease involves deficiencies in cortisol and aldosterone, but the underlying cause and the specific site of dysfunction differ. Diagnosis often involves distinguishing between these types through hormone testing and evaluating the adrenal and pituitary function to determine the appropriate treatment approach. Treatment typically requires hormone replacement therapy to supplement the deficient hormones and manage the condition.

The Role of Stress in Addison’s Disease

Stress can have a significant impact on dogs with Addison's disease. Addison's disease is caused by a deficiency in adrenal hormones like cortisol and aldosterone. Stressful situations can exacerbate this condition in several ways.

Stress prompts the body to release higher levels of stress hormones, including cortisol, to manage the stress response. Dogs with Addison's disease already have reduced cortisol production, so increased stress levels can further strain their already compromised adrenal function. Types of stress include illness, injury, emotional distress, or sudden changes in routine.

Stress can exacerbate the clinical signs of Addison's disease in dogs, leading to increased lethargy, weakness, gastrointestinal issues like vomiting and diarrhea, and potential electrolyte imbalances. Dogs that experience repeated episodes of collapsing when exposed to everyday stimuli are overwhelmed, and their body cannot regulate the stress hormones in the body. 

If your dog has been diagnosed with Addison’s disease, you must be very observant of her reaction in all situations. Managing stress is integral to managing Addison’s disease in your dog. An Addisonian crisis (an acute episode of adrenal insufficiency) can occur if your dog’s demand for cortisol and aldosterone suddenly surpasses the compromised production capacity of the adrenal glands, leading to severe signs and potentially life-threatening complications.

Ways to reduce stress for your dog include maintaining a consistent daily routine and minimizing sudden changes, creating a calm and comfortable environment using calming aids like pheromone diffusers or calming music, and providing a safe space to self-regulate when feeling stressed. Schedule routine veterinary visits to monitor your dog’s disease and make any necessary adjustments to her treatment plan.

Many stressors in dogs can be overlooked. Thunderstorms, fireworks, construction noise, or loud household appliances can cause anxiety and stress in dogs. New experiences are stressful for some dogs, including meeting new people or going to new places. 

Other stressors include separation anxiety, pain or discomfort due to an injury, illness, or underlying health conditions, social conflict with other dogs or animals in the household, feeling dominated by a family member, travel, lack of exercise or mental stimulation, and harsh training methods. Positive experiences, such as overstimulation of too much exercise or the return of a favorite person, can also be stressful.

Recognizing signs of stress in dogs, such as excessive panting, pacing, drooling, hiding, shaking, yawning, or changes in behavior, is crucial. Providing a safe and calm environment, establishing routines, offering mental and physical stimulation, and addressing potential stressors can help alleviate stress and promote your dog's well-being. 

Addison's disease in dogs can manifest through various clinical signs. The signs can be very subtle or appear suddenly. These signs may come and go, making diagnosis challenging. Some common clinical signs include:

Lethargy: Dogs may appear extremely tired or lethargic, lacking their usual energy levels.

Low heart rate: Elevated potassium levels (hyperkalemia) can affect the heart's electrical conduction system, leading to a decreased heart rate (bradycardia).

Pale mucous membranes: Electrolyte imbalances caused by Addison's disease can affect the heart's muscle function and the overall efficiency of the cardiovascular system.

When blood circulation is compromised, mucous membranes, such as the gums, can appear paler than usual due to reduced blood flow and oxygenation.

Decreased Appetite: Loss of interest in eating or a significant decrease in appetite is often observed. Weight loss can also occur.

Vomiting and Diarrhea: Dogs with Addison's disease may experience recurrent episodes of vomiting and diarrhea.

Shaking or Trembling: Tremors or shivering might occur, especially during episodes of stress.

Dehydration: Increased thirst and urination can lead to dehydration, which may present as sunken eyes, dry gums, or lethargy.

Collapse or Weakness: In severe cases or during an Addisonian crisis (an acute episode of adrenal insufficiency), dogs may collapse, appear disoriented, or have difficulty standing. Suppose your dog has repeated collapsing episodes when placed in the same situation, such as visiting a dog park. In that case, that activity is causing an overload of stress and cortisol production.

These signs can be nonspecific and mimic other health conditions, making it challenging to diagnose Addison's disease based solely on clinical signs. 

An Addisonian crisis, also known as an adrenal crisis, is a severe and life-threatening condition that occurs in dogs with Addison's disease. When the adrenal glands suddenly stop functioning, hormone levels, particularly cortisol and aldosterone, drastically drop. 

An Addisonian crisis is often triggered by stress, illness, trauma, or sometimes even a sudden withdrawal of corticosteroid medications used to manage Addison's disease. During an Addisonian crisis, a dog’s body is unable to cope with stress or maintain its normal functions due to the lack of essential hormones.

Signs of an Addisonian crisis in dogs may include severe lethargy, vomiting, diarrhea, shaking, trembling, collapse, and severe dehydration. An Addisonian crisis requires immediate emergency veterinary care. 

Diagnosing Addison's disease in dogs involves a combination of clinical signs, urinalysis, blood tests, and sometimes additional diagnostic procedures. Observing worsening clinical signs when your dog is stressed indicates Addison’s disease. 

You can start the diagnostic process with a non-invasive urine test measuring the cortisol to creatinine ratio in the urine. Low cortisol levels in the urine might support the diagnosis of Addison's disease, indicating insufficient cortisol production by the adrenal glands.

The blood tests for Addison’s disease include checking electrolyte levels - looking for specific electrolyte imbalances, especially low sodium (hyponatremia) and high potassium (hyperkalemia). The blood cells may be impacted, resulting in a decrease in red blood cells and an increase in two types of white blood cells: lymphocytes and neutrophils. 

Measurement of adrenal hormone levels, particularly cortisol and aldosterone, can aid in confirming the diagnosis. A blood test called an ACTH stimulation test or an adrenal function panel can assess these hormone levels.

If the blood tests are inconclusive, additional diagnostic testing could include an abdominal ultrasound to help evaluate the adrenal glands for abnormalities.

In some cases, a diagnosis of Addison's disease is confirmed by the dog's positive response to treatment. The diagnosis is supported if a dog’s clinical signs significantly improve after hormone replacement therapy.

Addison's disease can take on a far more dangerous form known as the Addisonian crisis. 

Addison’s is most common in middle-aged female dogs. Several breeds that are prone to Addison’s include:

While these breeds are more likely to develop Addison's disease, it can occur in any breed or mixed-breed dog. Additionally, the exact causes of breed predispositions are poorly understood and may involve genetic factors or environmental influences.

Your veterinarian will assess the most suitable supplementation for your dog based on her condition and your lifestyle. The primary goal is to monitor your dog’s clinical signs, electrolytes, and response to medication. Subsequently, your veterinarian will gradually reduce the medication dosage and frequency to the minimum adequate levels.

Standard treatment approaches for Addison’s disease entail lifelong supplementation of cortisol and aldosterone. Cortisol is typically supplemented with daily oral steroids like prednisone. 

Mineralocorticoids, particularly aldosterone, are provided to regulate the balance of minerals, particularly sodium and potassium, in your dog’s body. 

Aldosterone acts on the kidneys, specifically in the renal tubules, to increase the reabsorption of sodium and water while enhancing the excretion of potassium in urine. This process helps maintain proper fluid balance, electrolyte levels, and blood pressure. Mineralocorticoids are injectable medications given every 3–4 weeks, depending on your dog’s progress.

Treatment during an acute Addisonian crisis may include intravenous (IV) fluids and other IV medications such as glucose, medications to protect the GI tract, and glucocorticoids after performing diagnostic tests. 

Addison’s disease is an autoimmune disease. Feeding your dog to reduce inflammation and promote a balanced gut microbiome will enhance her overall health and well-being. Providing dogs with Addison's disease with fresh food, raw food, or a gently cooked diet has resulted in the recovery of the adrenal glands.

Foods with low-quality components can lead to nutritional inadequacies and gut microbiome imbalances, a significant stress source. Most commercial dry or canned dog foods are loaded with carbohydrates from corn, rice, soy, and other starchy foods, which cause chronic inflammation throughout your dog’s body.

Feeding your dog a species-appropriate diet is crucial to support her overall health and well-being. Homemade fresh food meals are optimal because you completely control the ingredients. A Real 6x Ancestral diet™ for dogs contains:

Fresh food is more easily digested than ultra-processed kibble. High-quality proteins found in the muscle meat of organically pasture-raised animals will help your dog maintain muscle mass. Raw, meaty bones supply mental stimulation and jaw exercises that can help reduce stress. 

The adrenal glands are two tiny glands located just above your dog's kidneys. The glands synthesize <a href="https://feedreal.com/glossary/cortisol">cortisol</a> and aldosterone and regulate various body functions. Cortisol is a steroid that helps your dog deal with stress, and aldosterone regulates their body's <a href="https://feedreal.com/glossary/adenosine-triphosphate">water</a> and electrolytes. Hypoadrenocorticism, or <a href="https://feedreal.com/glossary/addisons-disease">Addison's disease</a>, is a deficit of these two hormones.

What to Feed a Dog with Addison's Disease

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