Chapter 53 The historical findings, clinical signs, and laboratory abnormalities associated with spontaneous hypoadrenocorticism are well described (Tables 53-1 and 53-2). The severity and duration of clinical signs vary greatly among cases, from the acute life-threatening addisonian crisis to the chronic intermittent or waxing and waning signs seen in some dogs with chronic hypoadrenocorticism. Many of the historical and clinical findings are nonspecific and also occur in many more common diseases, particularly gastrointestinal and renal disorders. No set of findings is pathognomonic for canine hypoadrenocorticism. A high index of suspicion is needed to recognize some cases, particularly those with normal serum electrolyte concentrations. Findings that should heighten this suspicion include a waxing/waning course, previous response to fluid or glucocorticoid therapy, and exacerbation of clinical signs in stressful situations. TABLE 53-1 Clinical Findings in Dogs with Hypoadrenocorticism TABLE 53-2 Laboratory Findings* in Canine Hypoadrenocorticism ALT, Alanine aminotransferase; AST, aspartate aminotransferase. *Hypoalbuminemia and hypocholesterolemia are also sometimes observed.
Canine Hypoadrenocorticism
Diagnosis
Finding
Percent
Lethargy/depression
95
Anorexia
90
Vomiting
75
Weakness
75
Weight loss
50
Dehydration
45
Diarrhea
40
Waxing/waning course
40
Collapse
35
Previous response to therapy
35
Hypothermia
35
Slow capillary refill (perfusion) time
30
Shaking
25
Polydipsia/polyuria
25
Melena
20
Weak pulse
20
Bradycardia
18
Painful abdomen
8
Hair loss
5
Finding
Percent
Hyperkalemia
90
Hyponatremia
80
Na/K ratio <27
95
Hypochloremia
40
Hypercalcemia
30
Azotemia
85
Acidosis
40
Elevated ALT or AST
30
Hyperbilirubinemia
20
Hypoglycemia
15
Anemia
25
Eosinophilia
20
Lymphocytosis
10
Urine specific gravity <1.030
60
Canine Hypoadrenocorticism
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