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Canine Addison’s a letter to owners of any breed that is known to carry Addison’s

As I hear about illnesses (there are very few) in the Australian Labradoodle and Labradoodle I go back and forth with the idea of telling everyone and risking worry or not passing on the information and risk a possible (even if a miniscule chance) health issue.  Obvious we all hear about health symptoms online or on TV, even in humans, and think that sounds like me or my mom, or my daughter and run off worried to the doctor.   So that said I don’t want to cause panic, everyone please relax, I do not believe your dog is not at risk, we have NOT found any illness in our parent dogs, puppies or pedigree lines. I am just passing the word as I think a good breeder should do.

Most health concerns in the Poodle, Labrador or even Cocker spaniel can be removed from lines or greatly reduced incidence thru health testing.  As you all know we do extensive health testing of our parent dogs and continue contact with you all in hopes of hearing about the long term health of your puppies, thus helping us be better breeders.  Currently we are happy to say all are happy and healthy.  In 10 years of breeding (about 2-3 litters a year on average) we have only lost one offspring to cancer and one wonderful breeding dog was lost to an obstruction in his bowel (not health related but environmental).  I would have to assume I have not heard of all losses, aches or pains but I would also have to assume those were environmental (accident related).  So health testing is the main line of defense; however some illnesses have yet to have DNA or testing available to predetermine a condition and direct our breeding strategies.  Currently I am aware of some labradoodles (again NOT in our program) with seizure disorders (I have written an article on seizures available online) and some dogs with Addison’s (again NOT in our program).  But I would have to say never say never these issues cannot be predetermined so it is always possible in any breed whereas some (poodles and Labradors) are predisposed to these conditions.

So I have determined to send out this update from Rainmaker Ranch Labradoodles this year on canine Addison’s.

Canine Addison’s a letter to owners of any breed that is known to carry Addison’s

Where is Addison’s centered?

Addison’s is an imbalance in the adrenal glands; it is an imbalance in hormone levels.  Addison’s is believed to be primarily genetic with environmental triggers.  The adrenal glands are located in front of the canine kidneys and produce hormones.  These hormones are important in a body’s ability to cope with stress (physical and psycholocigal) plus balance minerals critical to life.  Of the two adrenal glands, the Adrenal cortex produces hormones essential to life, including mineralocorticoid, glucocorticoid.  Addison’s is basically hyposecretion of the hormones or the lack of mineralocorticoids whereas the result is a loss of sodium, and the ability of the body to retain potassium and water.  All of the various adrenal produced hormones (there are more than just mineralocorticoid) need to be balanced, the increase in one or decrease in one hormone causes illness.  Commercial drugs (corticosteroids or steroids) are available to substitute for the lack of mineralocorticoids produced naturally.  However, while low levels of mineralocorticoid causes illness (Addison’s), high levels of these steroids (given for other reasons) has a profound effect in the opposite direction and can actually trigger Addison’s or bring on an Addison’s crisis in dogs that carry the genetics for Addison’s.   Simply put Addison’s is believed to be genetic, even requiring two or more specific genes; however environmental factors are believed to trigger these genes.  Without the trigger even those with Addison’s genetics may never have or even know they carry Addison’s.

When would you see the signs?

Usually after a stressful situation (psychically or psychological) in dogs between the age of 18 months to 7 years of age Addison’s symptoms may arrive.  The younger age in that range occurs if, for other reasons, steroids have been given to the dog.

The problem with Addison’s is that many times it goes undiagnosed until it is too late.  What to look for are the commonly reported symptoms, which can vary from dog to dog, and include loss of appetite, weight loss, depression, listlessness, vomiting, diarrhea, hind-end pain, muscle weakness, tremors, shivering, increased thirst, dehydration, excessive urination, a painful or sensitive abdomen, muscle or joint pain, and changes in coat, which may become thicker, thinner, longer, or even curly and about 15 to 20 percent of Addisonian dogs will have dark, tarry stools or blood in their vomit, mental depression, patches of darkened skin, a slow and weak pulse, low body temperature, low blood pressure, and pale mucous membranes. These symptoms usually come in waves; the dog is sick and then seems to get over it for no apparent reason multiple times over a year or longer.   Many owners miss these bouts as they can be short in time. This temporary illness is when the adrenal functions are fluctuating but not yet at a critical stage.  As the illness progresses a lack mineralocorticoid results in marked changes in blood serum levels (potassium, sodium and chloride).  Excess potassium causes a decrease in heart rate leaving the dog predisposed to circulatory collapse and renal failure (acute renal failure is a common misdiagnosis).  An adrenal crisis is an acute medical emergency. The dog will need fluids, emergency doses of glucose and perhaps glucocorticoid.  This is sometimes given even if the ATCH (Addison’s test) is not back yet but blood levels indicate changes in levels of potassium, sodium and chloride (specifically elevated potassium, low sodium, elevated BUN and creatinine, elevated liver enzymes, low glucose, high calcium, low protein (albumin and globulin), anemia, low cholesterol, and metabolic acidosis. A sodium/potassium ratio of less than 27 is strongly indicator of Addison’s) indicating Addison’s.  Once these drugs are given the dog will be over the crisis and seem back to normal.  This of course is a preliminary indication that the problem is indeed Addison’s.  Note, only an ACTH stimulation test can determine positive Addison’s.   Currently there is NO test to determine if your dog carries the necessary genetics for Addison’s.  UCDavis is working on this test but it may be years before one is available.  Currently, prior to any illness the best you can do is follow the recommendations:

  • ·         Always keep your dog on high quality foods low in grains (no wheat, corn, and soy); I cannot say this enough; a good food is well worth the price in exchange for long term health.  Dogs are carnivores not omnivores, they are not able to digest grains and making a canine body to digest grain causes daily stress on the dogs complete system.
  • If you are worried, because a dog in your dog’s pedigree line has Addison’s, you can supplement with licorice root (pill or liquid) daily (consult a holistic vet) to help your dogs body deal with stress. Research has shown that licorice helps prolong the activity of natural (and synthetic) corticosteroids like hydrocortisone.
  • Digestive enzyme powders (probiotics or good bacteria) are a sensible addition for any dog with digestive problems and can be found at almost all pet stores.
  • Melatonin (consult a holistic vet) is recommended occasionally (one 3-mg tablet or capsule for a medium-sized dog) 20 to 30 minutes before stressful events such as fireworks, thunder, long distance moves, etc., if a dog has reactions.
  • ·         Be aware of Addison’s symptoms
  • ·         IF a crisis arrives along checking for other issues (obstructions, etc) request a blood test be preformed to check potassium, sodium and chloride levels.  If levels indicate possible Addison’s, run a ACTH test (this test is two blood draws one hour apart, after the first an injection is given to stimulate cortisol both blood tests check for cortisol levels) and IF the crisis is a critical situation treat for Addison’s with fluids and glucocorticoid.  The ACTH test is a blood test and can take up to 24 hours to get the results, the time some dogs do not have.

IF your dog has been diagnosed with Addison’s the recommendation is to move to a holistic veterinarians for long term treatment.   A dog on long term treatment can lead a normal happy life.  Treatments vary depending on a dog’s size and the extent of illness plus a negotiated price at your vet for blood work and finding the lowest cost treatments. But in general, long term treatment can be holistic or commercial drugs or usually best a combination of both to reduce dependence on synthetic drugs and lower costs, all and all about $30/month on average.  Addison’s groups on line can help find the lowest prices for long term treatments.  Each dog will vary on what is effective and what is not so obviously that cost varies as well.

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Canine Health, the Labradoodle blog

When is canine vomiting and diarrhea something serious?

My dog threw up, is he really sick, or is this just something minor?  It is always best to ask your veterinarian this question and let the doctor make the judgment as to if a visit is necessary.  Here are some simple at home tests. 

  1. Is the dog still interested in eating, will they eat their favorite treat, even a small one?
  2. Do they have diarrhea?
  3.  Is there any blood in their vomit or diarrhea?
  4. Do they have a temperature, always have a thermometer for your dog and know that a dog’s temperature should be 101.  A dog can be very sick and NOT have a fever, but it is a warning sign.
  5. Is the dog dehydrated? Grasp the skin between the shoulder blades; it should bounce back upon releasing the skin almost immediately. Skin that takes more than 2 seconds to bounce back or stands up in the position grasped is a sign of dehydration and in need of immediate veterinary attention.
  6. Does the dog have good blood circulation and oxygenation? Check the color of your pet’s gums. Lift your pet’s upper or lower lip and observe the color of the inner lip and gums. A healthy animal should have a pink color to the gums. Brick red or brown, pale light pink, white, yellow or blue colors of the mucous membranes are colors indicative of an emergency (shock, loss of blood, or anemia). Some breeds have dark pigmentation in their inner lips and gums making observations difficult and misleading, know the color of your dogs gums when healthy. For these dogs check for color by gently pulling down on the skin just below the eye with your thumb and observe the color in the inner eyelid.
  7. Will the dog play? Grab their favorite toy and see if they will play.
  8. Will the dog stand? Move them to their feet and see what their reactions are.
  9. Call your veterinarian and tell them the answers to these questions.  If you vet is closed and any of these questions are of concern, go immediately to an emergency room.

What is Hemorrhagic GastroEnteritis, HGE?

The onset of HGE is usually very quick/immediate, with no previous warning signs or health problems reported in the affected dog. Signs progress rapidly and can become severe within a few hours. First vomiting, then bloody diarrhea, followed quickly by dehydration, shock, collapse, and sudden death.

Hemorrhagic gastroenteritis (HGE) is a fairly common disorder of dogs that is characterized by the sudden development of vomiting and/or diarrhea.  The vomitus and the diarrhea may contain variable amounts of bright, red blood or dark, digested blood.

Contributing Factors

There are no known contributing factors.  Most dogs appear healthy prior to the onset of clinical signs. Dogs with sensitive stomachs are believed to possibly be prone to HGE.

Affected Animals

Dogs of all ages and breeds can be affected by hemorrhagic gastroenteritis. Young adult dogs of toy and miniature breeds, may be affected more frequently.

Causes/Transmission

The exact cause of HGE remains unknown.

Clinical Signs

There is some variability in the both the severity and course of this disease but, generally, signs are very sudden in onset.  Vomiting is followed by the onset of bloody diarrhea.  The rapid onset of profound dehydration is one of the hallmarks of HGE.  The continuing loss of bodily fluids can progress so rapidly that hypotension (low blood pressure) and shock develop.   

There are many causes for bloody diarrhea and vomiting in dogs. Hemorrhagic gastroenteritis, or HGE, refers to a specific syndrome usually seen in young adult dogs. In HGE, fever is usually NOT present, and the main laboratory abnormality is a marked elevation of the hematocrit (concentration of blood cells) due to fluid shifts and intestinal fluid loss. There is no diagnostic test that confirms the presence of HGE. Its diagnosis is made mainly on clinical grounds.

Just as there is no unique diagnostic test for HGE, there is no established cause for the illness. Treatment is similar as that for other causes of vomiting and bloody diarrhea in dogs. However, relatively large amounts of fluid are usually needed to replace the fluid lost into the intestinal tract, and to reverse shock, if present. Antibiotics are also given because bacteria may play a role in causing HGE. Although the signs are sudden and severe, and some dogs do not survive, most animals with HGE recover fully with prompt treatment. Prompt veterinary attention is VITAL for any dog with severe gastrointestinal signs and depression, whether due to HGE or other causes.

Canine hemorrhagic gastroenteritis, or HGE, is a syndrome characterized by the sudden onset of vomiting, bloody diarrhea, depression, no fever, a normal white blood cell count, and an elevated hematocrit on bloodwork.

Changes in the mucosa, or lining tissue, of the intestine result in fluid shifts from the vascular system and changes in fluid secretion into the intestinal tract. These changes appear to cause the symptoms of HGE. Animals can become extremely ill in a very short period of time.

Treatment requires prompt and aggressive fluid administration, and shock-level doses are usually needed at first. Steroids are given to animals that are in shock, and dogs with severe blood loss may require blood transfusion. Antibiotics are also given as part of the supportive treatment for HGE. Most dogs recover with appropriate treatment, although some may have additional bouts of the same signs after the initial episode resolves.

Prevention

Because the cause is unknown, there is no recommended preventive therapy. A bacterium called Clostridium perfringens has been isolated from cultures of intestinal contents in dogs with HGE, but its exact role in the syndrome has not been identified.

There are many other diseases/disorders that can appear similar to HGE. These include:

  • Parvovirus is a contagious virus that can affect any age or breed of dog, although it is most common in the young, unvaccinated pup. The most common signs associated with parvo are vomiting, diarrhea (often with blood), and loss of appetite.
  • Bacterial enteritis, which is inflammation/infection of the intestinal tract with salmonella, clostridia, is commonly associated with signs that may mimic HGE.
  • Conditions resulting in endotoxic or hypovolemic shock, often associated with the movement of certain bacteria or toxins, or other overwhelming systemic infections, need to be ruled out.
  • Intestinal obstruction or intussusception, which is the telescoping of one part of the bowel into another, secondary to foreign bodies, tumors, or parasites can cause similar gastrointestinal signs.
  • Hypoadrenocorticism (Addison’s disease) is an endocrine disorder in which there is a hormonal deficiency, most often corticosteroids and mineralocorticoids, due to a problem with the adrenal glands. These individuals often present with signs extremely similar to HGE.
  • Uremia is when toxins or poisons are not excreted from the body associated with kidney failure. It is not uncommon for these patients to present with gastrointestinal ulceration, vomiting, and bloody diarrhea.
  • Pancreatitis, an inflammation of the pancreas, often presents for some combination of vomiting, inappetence, and/or bloody diarrhea.
  • Coagulopathies, or bleeding disorders, including thrombocytopenia (decreased platelets), warfarin ingestion, disseminated vascular coagulation (DIC), and bleeding secondary to liver disorders may present with bloody diarrhea.
  • Toxins including arsenic, thallium, Amanita mushrooms, and certain household cleaning products cause bloody diarrhea.

Written by Krista at Rainmaker Ranch Labradoodles www.labradoodle-breeder.com, editted by Dr. Sandy Fink VDM of West Orange Animal Hospital