Westside Animal Hospital
4550 Illinois Rd.
Fort Wayne, IN 46804
The online blog of Westside Animal Hospital — important healthcare information to help you take the best care of your pet!
Sophie, normally a very active little Papillon, presented to us a few weeks ago because she wasn't feeling well. Her owner said that Sophie seemed to have been fighting a "bug" for the last few weeks. She had been having diarrhea on and off and had vomited the day before she came to see us.
Sophie's owner was becoming increasingly concerned about her due to the duration of her on-and-off symptoms. She was worried that there might be a more serious issue with Sophie (beyond just a simple virus). Her symptoms were not very specific: primarily lethargy and the intermittent gastrointestinal issues. In addition to the recurring diarrhea and occasional vomiting, her appetite had also fallen off. In fact, Sophie had lost a little over one pound in the preceding five months — a lot for such a small dog.
On physical exam, Sophie was much more quiet and subdued than her usual perky self. She clearly did not feel well. Her temperature was low-normal. Palpation of her abdomen felt normal. Sophie didn't look too bad, but she just didn't look "right."
We performed bloodwork on Sophie, and the results are summarized below:
|Glucose||107||74 - 143||Blood sugar|
|Blood Urea Nitrogen (BUN)||50 ↑||7 - 27||Kidney function|
|Creatinine||1.8||0.5 - 1.8||Kidney function|
|Phosphorus||8.8 ↑||2.5 - 6.8||Kidney function|
|Calcium||9.6||7.9 - 12.0|
|Sodium (Na)||143 ↓||144 - 160|
|Potassium (K)||6.7 ↑||3.5 - 5.8|
|Sodium:Potassium Ratio (Na:K)||21 ↓||27 - 40|
|Chloride||106 ↓||109 - 122|
|Total Protein||5.5||5.2 - 8.2|
|Albumin||2.4||2.3 - 4.0|
|Globulin||3.1||2.5 - 4.5|
|ALT||55||10 - 100||Liver|
|Alkaline Phosphatase||44||23 - 212||Liver|
|GGT||0||0 - 7||Liver|
|Total Bilirubin||0.1||0 - 0.9||Liver|
|Cholesterol||151||110 - 320|
|Amylase||1415||500 - 1500||Pancreas|
|Lipase||878||200 - 1800||Pancreas|
|Packed Cell Volume (PCV)||60% ↑||35 - 55||Red Blood Cell count|
The abnormalities in her electrolyte profile (sodium, potassium, and chloride) were the most noteworthy finding. Specifically, the ratio of sodium:potassium was very low. The elevation of some of her kidney values along with the increased PCV were supportive of dehydration. These bloodwork findings along with her symptoms and history were very suggestive of a disease called Addison's Disease. Addison's Disease is a relatively uncommon disease where the body's adrenal glands fail to produce cortisone, which is essential for life. Affected patients are often lethargic, dehydrated, and have chronic gastrointestinal symptoms such as vomiting and diarrhea. Symptoms can sometimes wax and wane over a period of months prior to diagnosis since the symptoms are not specific. For a more detailed summary of Addison's Disease, click here to read a past blog post. If undiagnosed and untreated, Addison's Disease is often fatal.
A more specific blood test (called an ACTH Stimulation Test) was then performed, which was diagnostic for Addison's Disease. Sophie was treated with fluids, a cortisone injection, and a special oral cortisone medication called fludrocortisone acetate. A once-monthly injection is also available as a treatment.
A couple of days later, Sophie was doing much better! She was eating normally, and her energy had returned. Her electrolytes were rechecked two additional times over the next week, and all of her levels were normal. Sophie will need to stay on this medication and will be closely monitored for life, but her long-term prognosis is excellent. Below is a picture of Sophie at her last recheck:
Sophie's owners are very committed to her, and they (along with all of us at Westside) are excited to see that she's feeling like her old self again!