How late can Addisons present?

RE: How late can Addisons present?

Anthony Dennison — Tue, 10 Oct 2017 12:59:09 GMT

Did an ACTH Stim in house last night, normal. Dog deteriorated overnight, became increasingly dyspnoeic due to a pleural effusion. I confirmed this this morning, on abdo scan the stomach was abnormally thickened and horrible. Was euthanased due to her condition and poor prognosis.

Possibly a gastrinoma causing the hypoglycaemia and hyperkalaemia?

RE: How late can Addisons present?

Clive Ansell — Tue, 10 Oct 2017 04:26:04 GMT

[quote user="Anthony Dennison"]

[quote user="Jill Butterworth"]

Insuminoma?

[/quote]

This is another thought, but I would have thought with an insulinoma there would be a hypokalaemia, not a hyperkalaemia?

[/quote]

The last insulinoma I dealt with, initial bloods including glucose and electrolytes were normal. Only when we repeated on a starved sample did we discover hypoglycaemia.

RE: How late can Addisons present?

Catherine Spence — Mon, 09 Oct 2017 22:10:16 GMT

My own dog, a 12year old collie, had an addisonian crisis 6 months ago, confirmed withan acth stim test. Very little warning beforehand, just a bit slower and stiffer than of old, so no, never too old in my view.

RE: How late can Addisons present?

Jill Butterworth — Mon, 09 Oct 2017 21:06:39 GMT

Sorry about the spelling!! Predictive text interfered, I think...

RE: How late can Addisons present?

Anthony Dennison — Mon, 09 Oct 2017 19:20:48 GMT

[quote user="Jill Butterworth"]

Insuminoma?

[/quote]

This is another thought, but I would have thought with an insulinoma there would be a hypokalaemia, not a hyperkalaemia?

RE: How late can Addisons present?

Jill Butterworth — Mon, 09 Oct 2017 19:15:41 GMT

Insulinoma?

RE: How late can Addisons present?

Anthony Dennison — Mon, 09 Oct 2017 18:13:45 GMT

No, dog isn't on steroids, and hasn't been. She's on a saline drip at the moment and electrolytes are being rechecked at 8pm to see if the insulin/glucose infusion helped correct the hyperkalaemia. According to the nurse soon after the insulin was given she did go bradycardic and pale, HR dropped to 40 but then rose back up again, dog recovered within 15mins.

RE: How late can Addisons present?

Richard Carter — Mon, 09 Oct 2017 18:06:14 GMT

or a WHWT that has finished a course of steroids for skin problems but they forgot to tell you?

saline, cortisone and see the response?