Addison's Disease: The Stealth Killer That Mimics Everything

Learning Objectives

• 1Recognize the classic and atypical presentations of canine hypoadrenocorticism including the absent stress leukogram, Na:K ratio screening threshold, and the waxing/waning GI history that distinguishes Addison's from primary gastrointestinal disease
• 2Explain the pathophysiologic consequences of aldosterone and cortisol deficiency and connect each clinical abnormality in an Addisonian crisis — hyperkalemia, hyponatremia, hypoglycemia, bradycardia, and absent stress response — to its mechanism
• 3Execute the Addisonian crisis treatment protocol in correct sequence: 0.9% NaCl at shock rate, calcium gluconate for cardioprotection, dexamethasone (not prednisolone) to preserve ACTH stimulation test validity, and cosyntropin 5 mcg/kg for definitive diagnosis
• 4Prescribe chronic mineralocorticoid and glucocorticoid replacement using DOCP at 2.2 mg/kg IM q25 days or fludrocortisone at 0.01-0.02 mg/kg PO q12h, and apply the correct stress dosing protocol for mild, moderate, and severe stressors
• 5Screen for atypical Addison's using resting cortisol as a low-cost, high-sensitivity tool and design an appropriate monitoring schedule for DOCP dose titration using electrolyte rechecks at 2 weeks and before each subsequent injection

Course Syllabus

1. 1
   Meet Willow: The Dog Everyone MissedPreview

   module-1-meet-willow

   8 min
2. 2
   Pathophysiology: When the Adrenals Fail

   module-2-pathophysiology

   9 min
3. 3
   Emergency Treatment: The Addisonian Crisis

   module-3-emergency-treatment

   10 min