This is Cleo. She is a 4 year old rottweiler. We all love her because she is very sweet. We were all upset the day she showed up having visited the emergency clinic the night before she was on intravenous fluids and weighted in about 15 pounds less than her normal weight. She had quickly deteriorated at home and by the time she went to the E.C. she was extremely dehydrated and was completely off food and was vomiting on a regular basis. The Doctors at the E.C. acted quickly by placing Cleo on fluids and running the basic bloodwork. The blood tests revealed a variety of problems. Cleo's kidneys were malfunctioning and the enzymes that are normally excreted by the kidneys were sky high. There were significant changes in the white blood cell count as well. Finally the electrolytes namely potassium and sodium were well out of the normal ranges. The most immediate danger here was the high potassium. If it got high enough it could cause problems with the beating of the heart.
Cleo arrived to us the next morning with only a little improvement from a night of fluids. The picture painted by the tests that were run left us with a few main possibilities to look at. First the apparent rapid onset of disease and the sign of kidney failure in such a young dog puts a possible ingestion of a toxic substance on our list. There are also a number of infectious organisms that can affect the kidneys( Leptospirosis and other bacteria) these were possibilities. And finally, a fairly rare disease in which the animals own immune system attacks and destroys the adrenal glands. This disease ,which after stabilizing her and running a few more test, Cleo was found to have, is called Hypoadrenocorticism (or Addison's disease).
The reason Cleo was so sick is the lack of hormonal products of the adrenal glands. Their affects are important across the entire body. There are two basic products from the adrenal glands, mineralocorticoids and corticosteroids.
The mineralocortcoids, most importantly Aldosterone, function by helping the body conserve sodium and chloride, and promoting the excretion of potassium. When this is deficient the body looses excessive amounts of salt. When the body looses salt it also looses water. As the body looses water the blood volume drops the body receives less blood and many organs begin to fail. This is one way that this disease causes the rapid collapse of the patient.
The corticosteroids literally affect every part of the body. They serve the body by stimulating the metabolism of fat and protein, reducing the uptake of glucose, and suppressing the inflammatory response. When these are deficient an animal experiences low blood glucose and impaired metabolism of energy, this leads to weakness. Also a variety of exaggerated inflammatory reactions are allowed to flourish, adding to the problems in an already sick patient.
In Cleo's case all of these things were happening to their maximum level making her a very sick girl. Once we stabilized here and found out what was happening we were able to start treating her. This treatment involves replacing her glucocoticoid deficits with a drug called prednisone and replacing her mineralocorticoid with a fairly new drug know as DOCP. This therapy is working for Cleo and after 12 days these photos were taken of a happy 95 pound girl.
-Geoff Wisbrock DVM
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