Practical Matters: Rule out Addison's disease in patients with possible renal failure

Jörg M. Steiner
Hypoadrenocorticism, or Addison's disease, in dogs is not a common disease but may be overlooked as a diagnosis. Dogs with classic Addison's disease (moderately to severely elevated serum potassium concentrations, decreased serum sodium concentrations, and mild to moderate azotemia) are often misdiagnosed as having primary renal failure. When the azotemia quickly resolves after fluid therapy, an ACTH stimulation test may be indicated, adding little to the overall cost of veterinary care in such a patient.

An ACTH stimulation test in a dog with true renal failure does no harm. A missed diagnosis of Addison's disease, however, may lead to an addisonian crisis and, possibly, death.

Jörg M. Steiner,,, PhD, DACVIM, DECVIM-CA
Department of Small Animal Medicine & Surgery
College of Veterinary Medicine
Texas A&M University
College Station, TX 77843