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Addison's disease?

Species: Dog
Breed: Affenpinscher
Age: 5-8 years
I've seen a few questions where people ask about what could have happened to their pet and I thought I'd give it a try.

Yesterday I lost my dog and it was so sudden that I think I'm still in shock.

Around 2-3am she was quite restless in bed, just moving around a lot and it happens quite frequently so I thought nothing of it. Then around 4am she began throwing up and had really runny diarrhea. I noticed the color was more a muddy brownish red and was worried she had eaten something bad. I let her keep going to the bathroom and cleaning up the mess. Her vomit was quite sticky white and a little foamy. I decided to give her a bath because she was getting quite messy.

Around 6:30 I realized it was getting worst and her diarrhea had blood in it. At 8am I called the vet for an appointment that day. She was calming down and appeared tired so I put a sweater on her, wrapped her in a blanket and stayed with her on the couch. She was still a little diarrhea but it was mostly gone. I went to lie down and she popped up and looked at me so I decided to take her to bed with me. She looked quite tired and fell asleep, as did I. Around 11 I woke up and she took a turn for the worse. She was now throwing up blood and was extremely limp. I picked her up and she was like a little rag doll. I wrapped her in a towel and went to the vet. They took her immediately and put her on an IV. They said her heart and lungs appeared OK but she had a really low temp (98-96 I think)and was too weak to take blood. They said they needed to stabilize her for a few hours. They decided to run xrays in the mean time. They also said she was quite unresponsive. I went to see her for a few mins and rubbed her head and tried to see if she would respond. They told me about 15-20 mins after I walked out she had one last violent attack of diarrhea and then passed. It's heartbreaking that I don't know what happened. The xray came back and said there was a small mass on her adrenal gland and a small blockage in her intestines that may have caused the vomiting. They guessed it could have been either distemper or cancer that caused a rupture. They did an initial provo test when she first arrived and it was negative so that part is good.

I know of course it would be hard to diagnose from the web but have you heard of anything like this before? To get sick at 4am and gone by noon is just too much to process right now. I think talking to someone that knows more about this might just make me feel a little better. Thank you Dr. Marie.

Online vet, Dr. Marie

Dr. Marie replied:

Oh wow...this sounds like such a traumatic event. I'm so sorry that you had to go through this.

As you know, ultimately we will never know what caused this. I am wondering if perhaps this was an Addisonian Crisis. Addisons is a disease where the adrenal glands do not make enough cortisol. The symptoms can come on slowly and be really vague, but some dogs do not show any signs until suddenly they are in crisis. The symptoms of an addisonian crisis are usually shock, collapse, severe diarrhea and vomiting.

Addison's needs a blood test to be diagnosed. Most veterinary hospitals don't have the capability to run a cortisol test but sometimes there can be hints on in house blood tests that can help a vet make the diagnosis. While Addison's can be caused by an adrenal tumor, it is not normally the cause. Still, if the vets felt there was an adrenal tumor then this is possible. As a side note though, an Adrenal tumor is not something we would normally see on an xray but rather with an ultrasound. It is usually very hard to see.

There are other possibilities, but I think that Addison's sounds most likely. Exposure to rat poison could be a cause. A tumor on the pancreas causing low blood sugar could do this as well. The fact that there was possibly an intestinal blockage is concerning as well. It's possible that there was an intestinal rupture and she went into shock which caused her death.

I can't see how you could have done anything differently in Bella's case. This must have been so difficult for you. Please know that this was not your fault.

Dr. Marie.

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Disclaimer: Although Dr. Marie is a qualified veterinarian, the information found on this site is not meant to replace the advice of your own veterinarian. and Dr. Marie do not accept any responsibility for any loss, damage, injury, death, or disease which may arise from reliance on information contained on this site. Do not use information found on this site for diagnosing or treating your pet. Anything you read here is for information only.

Customer reply:

Hi Dr. Marie,

Thank you very much for responding and providing your insight. I just wanted to add some notes from the xray results. I know this won't change anything but I feel better just trying to understand what happened in any way that I can.

No abnormalities of the colon are identified. Abdominal serosal detail is appropriate. No abnormalities of the liver, kidneys or urinary bladder are detected.

An irregularly shaped, small focus of mineralization is identified cranial to the right kidney within the retropertioneal space, and most likely represents mineralization of the right adrenal gland. The cardiovascular and pulmonary structures are unremarkable.

Equivocal evidence of small intestinal mechanical obstruction. The area suspicious for an intraluminal foreign body cannot be differentiated from the cecum or proximal colon. No other cause for the reporting vomiting and diarrhea are seen, however severe enterocolitis would also be considered.

Suspected right adrenal gland mineralization may represent the presence of an adrenal mass such as an adenoma or adenocarcinoma.

They recommended an adominal ultrasound but unfortunately there wasn't time.

I don't understand all of the lingo but it appears the two areas were the adrenal gland and the small intestines.

They said her heart and lungs had no murmur and auscultated but labored breathing. Pink mucous membranes but dry and tachy.

Does any of this support your initial thoughts?

Online vet, Dr. Marie

Dr. Marie replied:

Thanks for that additional information. I still think my answer would be the same though. It is possible that there was a tumor on the adrenal gland that triggered an Addisonian crisis.

The part about the intestines is saying some really vague things. It sounds like there was a gas pocket in the intestines which usually means that there is just gas in the cecum (like an appendix) or colon, but occasionally this can mean there was an obstruction. I am doubtful that an obstruction is the culprit.

Customer reply:

Thank you for following up with me Dr. Marie. It has truly been helpful in processing what happened. I loved that little girl and hate that she had to go out that way, but glad to have had the time I did with her. I wish you all the best and thank you for having this website.

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Dr. MarieDr. Marie is a veterinarian who practices in a busy animal hospital in Ottawa, Ontario. She created Ask A Vet Question as a resource for good, accurate veterinary advice online. Dr. Marie treats dogs, cats, hamsters, guinea pigs, and rats. She has been a vet since 1999.

Is an online vet visit just as good as a trip to your veterinarian? No! But, many times, asking an online veterinarian a question can help save you money. While Dr. Marie can't officially diagnose your pet or prescribe medications, she can often advise you on whether a vet visit is necessary. You can also ask Dr. Marie for a second opinion on your pet's condition.