Addison's Disease in dogs and cats treatment options, recommended remedies and helpful information has been provided by certified Master Herbalist Philip Reich and certified Canine Nutritionist Maria Reich. Philip and Maria specialize in medical herbalism and nutrition for animals with conditions like Addison's Disease. They approach this situation in a holistic manner with the main priority being the health and safety of your animal.
We deal with problems like Addison's Disease frequently with numerous clients from all over the country. Our experience with issues like this has helped us become one of the few places people can go for answers to help solve tough issues with their dogs and cats. We have helped hundreds of animals just like yours - it is what we do! See what others have to say about us by reading some of The Pet Health and Nutrition Center Testimonials. Feel free to contact us by email if you have any questions or just use our toll free number 888-683-3339 during normal business hours. We provide free telephone consultations and are here to help!
Addison's disease, also called hypoadrenocorticism, occurs when there is a decreased output of steroid and stress hormones by the adrenal glands. The adrenal glands are often called the stress glands as they are responsible for the production of epinephrine (adrenalin) and norepinephrine by the adrenal medulla that help regulate the nervous system, heart rate, respiration as well as the "fight or flight" response. The adrenal cortex portion of the adrenal glands produces glucocorticoids and mineralocorticoids that help to control blood sugar levels and regulate the amount of sodium and potassium in the blood. You can see how the loss of adrenal function can be life threatening and, as a result, proper medical attention as well as a thorough wellness program is necessary for long term success in treating Addison's Disease in dogs and cats.
What are the symptoms?
The symptoms of Addison's disease can be very unclear and many animals may have symptoms for a long time before the disease is diagnosed. In addition, symptoms may wax and wane, further complicating the diagnosis. An extreme presentation of Addison's Disease is an episode called an 'Addisonian Crisis.' In this scenario, an animal can experience extreme weakness, confusion, vomiting, and a big drop in blood pressure due to an extremely low level of cortisol. If left untreated this episode can lead to shock, seizure or coma. Unfortunately, due to the lack of a previous diagnosis an Addisonian Crisis may be the first time the pet owner becomes aware their animal has this condition. The more common symptoms of Addison's Disease are:
Other symptoms of Addisons include:
When does it typically occur?
Addison's Disease is primarily a disease of young to middle-aged female dogs and it is rare in cats. However, since this condition has been linked to the use of vaccinations and corticosteroids, an animal of any age and either sex can develop the disease.
In What breeds/sex is it most common?
Some feel That Addison's Disease does not appear to be more common in any one particular breed. However, taking the link with vaccinations into account, those breeds or families of dogs susceptible to or effected with immune dysfunction, immune-mediated disease, immune-reactions associated with vaccinations, or autoimmune endocrine disease (e.g., thyroiditis, Addison's or Cushing's Disease, diabetes, etc.) should take great care with the vaccinations they get their animals. These dogs include: Dachshund, Akita, Weimaraners, Standard Poodles, American Eskimo, Old English Sheepdogs, Pit Bulls, Irish Setters, Kerry Blue Terriers, and Cavalier King Charles Spaniels.
There are a number of different possible causes for the failure of the adrenal glands. It is believed the most common is destruction of the glands in a process in which the body attacks and kills its own tissue known as 'immune mediated destruction'. This is why many animals are diagnosed shortly after a vaccination or application of a topical flea and tick product, both of which can cause an exaggerated immune reaction. Other causes can be infections, tumors, or interruption in blood flow to the gland.
Another cause of Addisons can occur if the hypothalamus stops producing proper levels of CRH (Corticotropin-releasing hormone), which is a hormone that controls the pituitary gland's secretion of hormones that influence the adrenal glands. Or, it can be the failure of the pituitary gland to secrete ACTH (Adrenocorticotropic hormone), which is a hormone that stimulates the adrenal glands to work properly. Failure of the hypothalamus or pituitary gland is usually a result of a tumor, inflammation or injury.
Since Addison's Disease has such a wide variety of symptoms, the actual diagnosis often comes after several other tests are used to rule out more common diseases. For instance, if a dog or cat presents with a history of weight loss, lethargy, or muscle weakness, which are the symptoms of many diseases, a chemistry profile and blood count are usually performed first to look at a number of body systems. Animals with Addisons often have elevated blood urea nitrogen (BUN) and creatinine (which could result in a renal failure diagnosis), lower levels of sodium (hyponatremia) and chloride (hypochloremia), increased levels of calcium (hypercalcemia), increased liver enzymes, including ALT and AST, decreased blood glucose and a blood count may show chronic anemia.
If these other diagnostic tests point to the possibility of Addison's Disease, a veterinarian will then usually use a blood test called the ACTH stimulation test. In an ACTH challenge test, the dog is given an injection of the adrenal stimulating hormone ACTH. A normal dog will respond by having an increase in blood cortisol. If a dog with Addison's Disease is given ACTH, the dog will not have an increase in blood cortisol and the diagnosis of Addisons can be made.
The standard treatment for Addison's Disease involves replacing the mineralocorticoids and glucocorticoids in the body that are not being properly supplied by the adrenal glands. This treatment will require constant monitoring and adjustment as situations change in your animal's life and your animal ages. The drug most commonly used to accomplish this are Florinef (fludrocortisone). Florinef is usually given twice a day. Initially, the blood sodium and potassium levels are monitored to help obtain the correct dose. After the animal is regulated, then the levels are rechecked at least 2 to 3 times a year and adjustments in dosing are made as needed.
A newer option in the treatment of Addison's disease is a drug called DOCP (desoxycorticosterone pivalate aka Percorten-V™). The injection is long acting and only needs to be given once every 25 days. Some feel that this drug has been shown to provide better electrolyte regulation than Florinef.
In an Addisonian Crisis extremely low levels of cortisol can cause sudden dizziness, vomiting and even loss of consciousness. This can be extremely dangerous if cortisol levels aren’t replenished. It’s a life-threatening condition that requires immediate medical treatment. Animals that are experiencing an Addisonian Crisis typically get an immediate injection of hydrocortisone in a muscle or vein. If you have an animal diagnosed with Addisons it would be a good idea to have an emergency kit that includes a hydrocortisone injection. Your veterinarian can show you how to give your animal an emergency injection of hydrocortisone. It may also be a good idea to teach a family member or friend how to give an injection properly. You may want to keep a spare kit in the car if you’re a frequent traveler.
Electrolyte levels can also cause an 'Addison's Crash' in animals with the primary form of the disease. This occurs because potassium levels elevate and disrupt normal functions of the heart that can result in arrhythmia and blood pressure drops to dangerously low levels.
Primary Addison's Disease - The cortex of both adrenal glands are usually destroyed, disrupting the production of cortisol and aldosterone requiring Florinef or DOCP and prednisone, prednisolone, hydrocortisone or methylprednisolone (Medrol).
Secondary Addison's Disease - Results from failure of the pituitary to stimulate the adrenals with adrenocorticotropic hormone (ACTH). There are no changes in electrolyte levels as with Primary Addisons so only glucocorticoids (cortisol) needs to be replaced with prednisone, prednisolone, hydrocortisone or methylprednisolone (Medrol).
Atypical Addison's Disease - Similar to Primary Addisons in that the adrenals are not functioning properly, but in this case the adrenals only fail to provide the glucocorticoid hormones, so the electrolytes are usually normal. Only glucocorticoids (cortisol) needs to be replaced with prednisone, prednisolone, hydrocortisone or methylprednisolone (Medrol).
It is important to note that Atypical Addisonians can become Primary Addisonians. This bears watching via regularly scheduled blood testing to evaluate their electrolytes. This would require the addition of the mineralocorticoid replacement properties of Florinef or DOCP. Blood work every 3-4 months is usually recommended.
We are not permitted to diagnose or treat specific diseases. All of our protocols are designed to use supplementation and diet to promote the health and rebalancing of organ systems that may be contributing to your animal's condition.
The goal of our Holistic Natural Addison’s Disease Protocol is to strengthen the glands (hypothalamus, pituitary and adrenal) that play a role in proper adrenal hormone secretion so the body can grow stronger and potentially be able to maintain or contribute to this balance on its own. When medications are used to accomplish this alone, the end result will be two very small, shriveled adrenal glands and a lower quality of life for the animal, so our protocol can play an important supportive role. If medications can be reduced when using our protocol this must be done in conjunction with your veterinarian so your animal can be properly monitored.
We use diet; organic, whole food supplementation; and organic herbs to support and strengthen the challenged organs and glands, which in this case are primarily the hypothalamus, pituitary, adrenals and even the liver, with the goal of making your dog or cat stronger and healthier down the road. Following our suggestions will help to alleviate the often debilitating symptoms of Addison’s Disease and return a quality of life to your animal for as long as possible. With Addison’s Disease a “cure” may not be attainable depending on the root cause of your animal's condition, but a better quality of life can be achieved and maintained for as long as possible. However, if Addisons is caused by the withdrawal of corticosteroid drugs very often a “return to normal” can be accomplished and the adrenal glands returned to a healthier state with the right support.
Core Recommendations Suggested products are included in the Core Addison's Disease Package found below.Our "Core Recommendations" form the backbone of our Natural Addison's Disease Protocol. They consist of the supplement recommendations we feel are the most important to provide to your animal companion for this condition. They are displayed individually or as a package at the bottom of this page along with other helpful products from which you may make additional selections. Pet foods can be purchased at your finer, local pet stores. As always, we are here to help and you may contact us by phone or email if you need more individualized attention.
Core Recommendation #1 - Daily Multi PlusOur Daily Multi Plus is formulated with organic, whole foods that are extremely important to an animal's nutritional needs but are often missing from the majority of canine and feline diets. This special formula provides the enzymes, probiotics, prebiotics, glandulars, vitamins, minerals, antioxidants and phytonutrients that are so beneficial to the body's daily maintenance and repair needs for healthy aging. In this formula you will find the vitamins, minerals and antioxidants recommended by the veterinarian community for this condition - only in an organic, whole food form!
Core Recommendation #2 - Adrenal Tonic
This is an organic herbal preparation formulated by a certified Master Herbalist specifically for those dogs and cats suffering with Addison's Disease. It features potent herbs that support the hypothalamus, pituitary and adrenal glands that together are so important for balancing the levels of glucocorticoids like cortisol in the body. This formula will help to strengthen your animal and their resistance to stress and illness while reducing the uncomfortable symptoms of Addisons.
Core Recommendation #3 - BioPreparation Microalgae Formula
This special blend of four unique algae was developed by a Russian Scientist, Dr. Michael Kiriac after decades of research. It is grown in controlled hydroponic conditions so it is the purest microalgae supplement on the planet. Its thousand of nutrients are so bioavailable they do not have to be digested, they easily pass through the digestive tract and feed cells on a cellular level. BioPreparation can cross the blood brain barrier to feed the brain, support the hypothalamus (so important for Addison's Disease) to help balance the entire endocrine system and even cross the blood retinal barrier to nurture the eyes. We have had outstanding success with this product so it is a Core Recommendation. Select the F3+ Forte for this condition.
Core Recommendation #4 - Adrenal Glandular
We have used glandulars successfully for numerous conditions ranging from those of the adrenal glands to the thyroid, kidneys and liver. Glandulars work by providing similar tissue to that of the corresponding gland or organ. This benefits that gland or organ by providing similar vitamins, minerals, enzymes, coenzymes and many other nutrients that feed and strengthen that part of the body. Again simple, but glandular therapy can be very effective to support and tonify struggling glands and organs.
Whole Food Nutrition
With a serious condition like Addison's Disease, in which the body needs the highest value nutrition possible so it has the energy necessary to rebalance itself, we highly recommend a raw food diet. Raw food is how carnivores, like canines and felines, have evolved to eat and they do best on a high protein, low carbohydrate diet. This is, unfortunately, the opposite of how most pets are fed since the majority of commercial diets are low protein with 50% or more carbohydrates.
In addition, kibble diets are harder for an animal to digest and this is the last thing your pet needs at this point. Since lean muscle can be lost as part of the Addison's Disease process without the right nutrition that is easily digested, absorbed and metabolized your animal will have a more difficult time getting better. If a raw food diet is not your cup of tea, the next best thing would be a cooked, whole food diet. There are now many quality premixes to choose from to which you can add your own raw or cooked meat. For a quick and easy way to add high-quality protein to your pet's diet take a look at our Whey Protein Isolate. For more information read our articles How to Feed Your Dog or How to Feed Your Cat that can be found in our Education section.
This formula contains organic herbs recognized for their ability to support a healthy immune response. The majority of Addison's cases are believed to be the result of an autoimmune condition that destroys adrenal gland tissue. If your animal's condition is believed to be related to an overactive immune response this would make a good addition to your pet's holistic protocol.
Colostrum is the "first milk" produced by the mammary glands of mammals. It contains numerous beneficial compounds, but the one we will focus on for Addison's Disease is the proline-rich polypeptides. This constituent has been shown in studies to inhibit the over-production of T-cells and other immune cells that play a role in aggressive immune reactions.
By exercising your dog you will help to maintain or potentially increase lean muscle mass and naturally help to balance levels of stress hormones in the body. Exercise also acts to benefit the lymphatic system helping the body to eliminate metabolic waste. It is important not to overdo exercise sessions by taking the age and fitness level of your animal into account. Smaller more frequent sessions may be better than one longer, more demanding one.
Stress can aggravate the symptoms of Addison's Disease or even bring on an Addisonian Crisis. It is very important to create the least stressful lifestyle for your animal with Addisons. Try to maintain a uniform schedule as animals like this. Also, try to provide good leadership which makes your animal feel secure and protect them from situations that may cause them stress such as encounters with scary dogs. Maintain a low stress environment in the house as much as possible and this will benefit your animal tremendously.
Vaccinations and Toxins
Vaccinations and/or toxins from topical flea and tick products, household cleaners or lawn chemicals may have caused or contributed to your animal's Addison's Disease. Vaccinations should be avoided for those with Addison's and you should be able to get an exemption for the rabies vaccination with a letter from your vet (read our article: Are You Over Vaccinating Your Dog or Cat). Topical pesticide products would be a big 'no' for your animal and you should eliminate their exposure to household and lawn chemicals for the good of their long term health.
So Your Dog Has Addison's Disease. Retrieved from http://www.addisondogs.com/addisons/
Canine Addison's Disease FAQ. Retrieved from http://www.k9addisons.com/faqs/atypical.html
Hoffman, D. (2003). Medical herbalism: The science and practice of herbal medicine. Rochester, VT: Healing Arts Press.
Messonnier, S. (2001). Natural health bible for dogs & cats: You’re a-z guide to over 200 conditions, herbs, vitamins and supplements. New York, NY: Three Rivers Press.
Murray, M. T., & Pizzorno, J. E. (1998). Encyclopedia of natural medicine (2nd ed.). New York, NY: Three Rivers Press.
Pitcairn R. H., & Hubble-Pitcairn S. (1995). Dr. Pitcairn’s complete guide to natural health for dogs & cats. Emmaus, PA: Rodale Press, Inc.
Pitchford, P. (2002). Healing with whole foods: Asian traditions and modern nutrition (3rd ed.). Berkeley, CA: North Atlantic Books.
Puotinen, CJ. (2000). The encyclopedia of natural pet care (2nd ed.). Los Angeles, CA: Keats Publishing.
Tilford, G. L., & Wulff, M. L. (2009). Herbs for pets: The natural way to enhance your pet’s life. (2nd ed.). Irvine, CA: BowTie Press.
Thibodeau, G.A., & Patton, K.T. (2008). Structure & function of the body. St. Louis, MO: Mosby.