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Addison`s disease in a 4 year old MN dog

History

A 4-year-old MN dog, being boarded at the rDVM, began vomiting despite having a normal appetite. The dog was found to be pyrexic on physical examination. Initial blood work revealed hyperlipasemia, and hypochloremia. There was an elevated HCT, and an elevated HGB on the CBC. Symptomatic therapy was initiated for the vomiting and blood work was repeated a few days later. Serum biochemical profile revealed an elevated ALT enzyme activity, azotemia, hyperphosphatemia, hyperkalemia, and hypochloremia and hyperlipasemia.

A 4-year-old MN dog, being boarded at the rDVM, began vomiting despite having a normal appetite. The dog was found to be pyrexic on physical examination. Initial blood work revealed hyperlipasemia, and hypochloremia. There was an elevated HCT, and an elevated HGB on the CBC. Symptomatic therapy was initiated for the vomiting and blood work was repeated a few days later. Serum biochemical profile revealed an elevated ALT enzyme activity, azotemia, hyperphosphatemia, hyperkalemia, and hypochloremia and hyperlipasemia.

Clinical Differential Diagnosis

Hypoadrenocorticism is the most likely diagnosis based upon the dog’s signalment and history (i.e. the fact that the dog is stressed due to being boarded) and the blood work results. Gastroenteritis is also a possibility if the dog’s diet was suddenly changed (while boarding) and/or stress of being boarded, and could be due to an infectious etiology (bacterial, viral, parasitic). Leptospirosis causing acute renal failure and the elevated ALT enzyme activity is possible. Pancreatitis is also possible.

DX

Addison`s disease

Sampling

The ACTH stimulation test results were consistent with hypoadrenocorticism.

Sonographic Differential Diagnosis

Small adrenal glands.

Image Interpretation

The adrenal glands are small with echogenic parenchyma and flattened contour. These are most consistent with adrenal atrophy and may be normal for this patient.

Outcome

I.V. fluid therapy was initiated in conjunction with oral steroids. Follow-up blood chemistry drawn the day after the ultrasound showed only hypoamylasemia and hypokalemia. The CBC found a low L/M ratio. Leptosporosis titers were negative. The patient was discharged the day after the ultrasound on an increased dose of steroids with the recommendation to recheck blood work in a few days.

Video

Patient Information

Patient Name : Bailey K
Age : 4 Years
Gender : Male, Neutered
Species : Canine
Liz Wuz Here : Yes
Status : Complete
Code : 07_00030

Blood Chemistry

  • ALT (SGPT), High
  • Azotemia
  • Chloride, Low
  • Lipase, High
  • Phosphorus, High
  • Potassium, High

CBC

  • Hematocrit, High
  • Hemoglobin, High

Clinical Signs

  • Vomiting

Exam Finding

  • Fever

Images

AddisonsLeftAdrenal_01012011061437AddisonsRightadrenal_01012011061457

sonoadmin-KV 2018
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