Addison’s disease and tricky endocrine cases

Iloved being at vet school and learning so many new facts, but one topic I just did not seem able to get my head around was called endocrinology.

After all this time in the profession, I have acquired an even better understanding of so many diseases. There is nothing like personal experience to illuminate one’s education. I now have a good understanding of those tricky endocrine cases, but there was a time when my brain just refused to compute.

One of my favourite endocrine disorders now is Addison’s disease, because it is very rare, has fairly recognisable symptoms, is relatively simple and inexpensive to treat, and is not life-shortening once treated, despite being fatal if undiagnosed.

So what is endocrine disease? Your endocrine system refers to all the ways in which your body’s organs can communicate with each other not via the nerves. It consists of glands that make hormones. These are our body’s chemical messengers, circulating in our blood stream, and they control everything going on in our body, from growth and metabolism to reproduction. Our endocrine organs include the ovaries/testes, adrenal glands, thyroid and pituitary, among others.

Addison’s disease occurs when the adrenal glands are unable to produce sufficient amounts of the natural hormones called glucocorticoids, or the mineralocorticoids, sometimes both. It is thought the problem is caused by an auto-immune disease, and is so rare I might only diagnose a case once every few years.

Sick dogs show vague symptoms, such as repeated stomach upsets, unexplained weight loss and weakness together with a slow heart rate. If undiagnosed the pet will eventually collapse and go into kidney failure.

Luckily the process can be diagnosed with a blood test and confirmed with a relatively simple additional test. Treatment is available and even on collapse we can often pull them round with emergency intensive care.

It was really only after I saw my first case of Addison’s disease in an actual patient that the penny finally dropped in my brain about how important these chemical messengers and the study of endocrinopathy could be.