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  • Title: [Hypoadrenocorticism without classic electrolyte abnormalities in seven dogs].
    Author: Richartz J, Neiger R.
    Journal: Tierarztl Prax Ausg K Kleintiere Heimtiere; 2011; 39(3):163-9. PubMed ID: 22143625.
    Abstract:
    OBJECTIVE: Evaluation of all dogs with hypoadrenocorticism (hAC) without classic electrolyte abnormalities that had been admitted during the previous 3.75 years. MATERIAL AND METHODS: Criteria for inclusion in this study were a confirmed diagnosis of hypoadrenocorticism (cortisol concentration before and after ACTH application <2 µg/dl) accompanied by a normal sodium:potassium ratio (≥ 27). Hyperkalaemic animals or those with a history of glucocorticoid, trilostane or mitotane administration were excluded. Information including signalement, history, physical examination, results of complete blood count, serum biochemical analysis, ACTH stimulation test, other laboratory tests and diagnostic imaging findings as well as information on the therapy were evaluated. Outcome, management and development of electrolyte shifts were assessed by owner telephone contact. RESULTS: Seven dogs (among those two poodles) fulfilled the inclusion criteria. The median age was 3.6 years. The most common clinical signs observed were diarrhoea, vomiting, inappetence and lethargy. The median sodium-potassium ratio was 38 (27-41). One dog developed electrolyte abnormalities after 5 months. Prednisolone was given to five dogs while one dog received fludrocortisone. In one dog repeating of the ACTH stimulation test was recommended before the initiation of therapy. One dog was euthanized because of other problems 21 months after diagnosis. The other patients responded well to therapy and are in a good general condition at present. Two of them occasionally have diarrhoea. CONCLUSION AND CLINICAL RELEVANCE: Atypical hAC is an important disease in dogs with recurrent chronic gastrointestinal signs seen mainly in young animals with non-specific historical and physical findings. Therefore, an ACTH stimulation test should be considered before invasive diagnostic tests like endoscopy are performed in these patients. Since some dogs with primary hAC eventually develop classical electrolyte abnormalities serum electrolyte concentrations should be monitored regularly.
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