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This fundraiser ended on 01/13/11

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Help Jude! Jude, a 2 year old Great Dane, was diagnosed with Addison's Disease. After being in the ICU for days, his costs were astronomical. Addison's requires lifelong medications, including a pricey injection.

Addison's Disease requires lifelong medication -- daily steroids, and a monthly (pricey) injection.  Please help Jude overcome his medical costs.  It is now suspected that Jude has futher gastrointenstinal/thyroid disease, and needs help paying his vet costs!

This fundraiser is for my 2 year old male Great Dane, named Jude. Jude was presented to the Port City Veterinary Referral Hospital in Portsmouth, NH in an Addisonian Crisis. It was a scary day. I had been referred to a cardiologist because my primary veterinarian couldn't figure out what was wrong with Jude. He was extremely underweight, and not quite right. By the time we got to the ER, Jude needed a stretcher and couldn't walk at all. My baby is only 2! The cardiologist told me that my primary vet misdiagnosed him but that Jude was experiencing some sort of crisis, but not heart-related... so they got the internal medicine specialist to come see Jude, they rushed him to intensive care, and I spent about 7 hours in the waiting room thinking my dog was dead. They couldn't find a pulse, he had a dangerously high level of potassium, an electrolyte deficiency and more... they ended up pumping him full of fluids and within hours, he was full of life, bright, and the dog I used to know -- I felt like I had watched my dog die and come back to life infront of me. In just 2 more hours he would have died, the specialist told me.

This visit left me with an astronomical balance that I am trying to pay off -- and having difficulties doing so. His monthly medications include (the expensive) desoxycorticosterone pivalate (Percorten-V) and prednisone. I am a student of animal science at the University of New Hampshire. I am obviously not made of money. So while I am trying to balance the costs of this disease, the doctors now suspect possible thyroid disease.

The following is an essay that I wrote, about Addison's Disease, that follows along with Jude's case study if you are interested in learning more:

Canine hypoadrenocorticism is a disease that has a number of inconsistent and vague symptoms making it hard for veterinarians to diagnose. Most often, the dog is diagnosed when an Addisonian crisis occurs and without seeking immediate veterinary attention, the crisis is fatal. Once the disease is properly diagnosed, however, with proper medication and treatment, he or she can live a happy, healthy, and normal life. This paper will discuss the pathology and treatment of the disease, alongside a case study of a 2-year-old Great Dane, named Jude.
Hypoadrenocorticism, better known as Addison’s Disease is a condition that occurs within the endocrine system. The body, working properly, would allow the pituitary gland to make the adrenocorticotropic hormone which sends a signal to the adrenal glands. There is an adrenal gland on each kidney and is made up of a cortex and medulla. After the signal is received, the adrenal glands produce the glucocorticoid steroid, which is also called Cortisol or Cortison. The adrenal cortex then also produces the mineralocorticoid hormone which aids the metabolism of sodium and potassium—regulating the body’s water and electrolytes. The importance of Cortisol is to allow the body to convert protein and fat into glucose and allows the dog to react appropriately to stress. Addison’s disease comes in three forms. The primary and atypical forms of Addison’s result from damage to the glands which is usually immune-mediated. The secondary form occurs when the pituitary gland fails to stimulate the adrenal glands with the adrencorticotropic hormone. Depending on which form of Addison’s the dog has will affect the treatment plan.
Addison’s disease is idiopathic meaning the primary cause of adrenocortical failure is not known, although it can commonly be a result from an autoimmune process. It can also be caused by fungal infections, heredity, and trauma. While Addison’s is considered a rare disease there is some conflict in whether it is really uncommon or if it is just under diagnosed. Because the disease carries so many symptoms that mimic other diseases, and the difficulty of diagnosis, it is often called “The Great Pretender.” While Addison’s can occur in any breed of dog, studies conducted by Dr. Oberbauer suggest that West Highland White Terriers are six times more likely to be diagnosed with Addison’s disease than other dogs, and Great Danes are seven times more likely, than other dogs, to be diagnosed. She also suggests that Addison’s can be hereditary and has data that suggests a “polygenic mode of inheritance” but has no major gene yet confirmed.
The affects and symptoms of canine hypoadrenocorticism are large in number, and are often misdiagnosed due to the similarity of other diseases. Addison, in 1855, first described hypoadrenocorticism or chronic adrenocortical insufficiency a “syndrome of weakness, anorexia, abdominal pain, nausea, emesis, weight loss, hyperpigmentation of skin and mucus membranes” (Ettinger, 1411). Today, the symptoms do not differ much, symptoms that are often observed include: depression, lethargy, weakness, lack of appetite, weight loss, vomiting and diarrhea, pain in hind quarters, muscle weakness, tremors or shaking, drinking more, urinating more, dehydration, and a fast heart rate in some patients. The most extreme clinical sign is when the disease results in an Addisonian crisis. During crisis, the dog will collapse in shock because of his or her inability to maintain the caloric and circulatory requirements in stress. Without immediate medical attention, the dog will not survive through the crisis. The crisis includes soaring levels of potassium which disrupt the heart rhythm because there is not enough sodium to exchange the potassium; blood sugar levels become dangerously low; and the heart rate slows. Unfortunately, 30% of dogs are not yet diagnosed with Addison’s disease until they have reached Addisonian crisis (Veterinary Partner).

Jude, a 2-year old, male, Great Dane, like most dogs that end up with an Addison’s diagnosis, showed signs of not feeling well too infrequently to have any real concern of a serious problem but he did experience lethargy, lack of appetite, pain in his hind quarters, cold extremities, and an increased heart rate. That all changed on March 2, 2010, however. Jude was first referred to a cardiologist for his increased heart rate that was observed by his primary veterinarian. It was quickly determined that it was not a cardiac issue and was transferred to Dr. Tonya Boyle DVM, with practice limited to internal medicine, for further diagnostics and treatment. Jude was presented to the Internal Medicine Service at the Port City Veterinary Referral Hospital for evaluation of his history with intermittent diarrhea, weakness, lethargy, increased heart rate, and cold extremities. Jude was severely dehydrated, his blood pressure was too low to register, had a body-condition score of 2/9 with severe amounts of muscle wasted; he had a dangerously high level of potassium, and low blood sugars. Dr. Boyle quickly pumped him full of fluids, and waited to make his diagnosis; he was expected to be in Addisonian Crisis with possible gastro-intestinal malabsorption or maldigestion disease.
Similar to Jude, dogs with one or more of the before-mentioned symptoms and that have a history of reoccurring gastrointestinal disturbances that do not have intestinal parasites nor dietary indiscretions should be considered for a possible Addison’s diagnosis. Normally, when making the diagnosis, the veterinarian treats the dog for shock and administers fluids which usually include glucocorticoids, a low level of potassium, and a reasonable amount of sodium. While this treatment is also sufficient for Addison’s, the veterinarian may not suspect it yet. Once the blood panel comes back, it will show high levels of potassium suggesting possible renal failure. However, dogs with renal failure do not respond well to fluid treatments, and therefore this must not be the diagnosis. Addison's is diagnosed by a series of blood tests. A chemistry panel will show a low sodium level, a high potassium level, the resulting Na:K ratio will be low. The kidney enzymes will be high, but the only test that will definitively test for Addison’s is the adrenocorticotropic hormone stiumulation test. Dogs with Addison’s will have a low cortisol concentration, and will remain low even after giving a synthetic adrenocorticotropic hormone, called Cortrosyn, by injection.
Replacing the missing mineralocorticoid hormones is the most important part of treatment for hypoadrenocorticism. “DOCP”, or brand-name, Percorten-V, can be injected approximately every 25 days. When the dog is first diagnosed, electrolytes should be measured routinely, but if tests prove normal, and the treatment is working, the electrolytes can be measured once or twice a year instead. When using Percorten-V, dogs require a glucocorticoid supplementation, in which case, a low dose of prednisone will be prescribed. An alternative is with oral fludrocortisone, or brand-name, Florinef, which is given twice a day. The dog’s sodium and potassium blood tests will determine the amount of each dose. Florinef contains both glucorticoid and mineralocorticoid supplementation so no other medications are necessary. However, the dose of Florinef needed for Addison’s may increase over time which not only makes regular blood tests important, but can get extremely expensive, resulting in some additional decision-making on which treatment is right for the owner and the dog.
Percorten-V (desoxycorticosterone pivalate) is the only medication that is approved by the FDA for the treatment of Canine Addison’s disease. It is an injectable suspension and is well-tolerated by most dogs. There is a low incidence of any kind of side effects, however side effects may include: depression, excessive thirst and urination, digestive, skin, and coat changes,
weakness, and pain in the injection site. If any side effects are noted, it is important to make adjustments to either the dose, interval of medication, or both. It is important to not use Percorten-V with dogs that suffer from congestive heart disease, edema, severe renal disease, or dogs that may be pregnant. The glucocorticoid supplementation is provided by administering Prednisone. Prednisone works to break down stored fats, sugars, and proteins, so that the dog can use this energy as fuel in stressful situations.
While there is no replacement for these medications that replace the missing hormones, studies show that the quality of the dog’s life can be improved with complementary therapies (it may even be possible to reduce the medications). Successful complementary therapies include: improving the dog’s diet; Western herbs and non-herbal supplements (upset stomachs, stress, and other symptoms that dogs with Addison’s experience may be calmed with the use of these); traditional Chinese medicine (beliefs that the body’s organs are individually related to a season and natural element. Sickness is looked upon as a disharmony and the Chinese practitioner concentrates on fixing it with any treatment that may include herbal blends, dietary changes, or acupuncture); homeopathy (a type of holistic medicine that is used commonly in Europe and the United Kingdom); flower essences (dilute tincures made from flowers); aromatherapy (helps dogs relax or regain appetite if candles or potpourri are used properly. Two essential oils are lavender and eucalyptus. They work to stimulate the immune system and promote healing in addition to calming a dog); and Tellington TTouch (allows owners and dogs to have a deeper understanding of eachother and the environment. It proves helpful to the nervous system). These methods can benefit dogs with Addison’s disease and prevent them from feeling poorly, however, should never be used in substitute of pharmaceuticals.
Where the cause of Addison’s disease is uncertain, there is no specific preventative care from the disease, however, proper nutrition always goes hand-in-hand with optimal health of a dog. It is always important to offer a well-balanced, nutritious meal plan for a dog, but it is especially important for dogs with Addison’s disease. Choosing a commercial dog food can be suitable if the food is made with whole ingredients and sufficient amounts of nutrients. Home-cooked meals, and the raw food diet are also alternatives to finding a new feed for a dog, however careful consideration should be put in place based on the breed, age, and activity level. It is important that all nutritional requirements are supplied by whatever feed is chosen and what is most important is finding a food that is nutritious and that the dog enjoys eating. Even the best food is not the best food if the dog will not eat it!
In Jude’s specific case, I have found that there is a unique set of nutritional requirements for Great Danes. It is not possible to change the genetic makeup of the breed and Great Dane owners therefore should feed a food that contains nutrient sources that are “similar to those found in the native environment of the breed’s ancestors”—feeds that are not foreign to the digestive and glandular systems (Cusick). Great Danes are originally from Germany and this native environment suggests a diet of high fiber—oats and cabbage—and high protein foods. A high fiber, high protein diet results in a lessened chance of gastric torsion. Meats in their native environment included wild boar, deer, and beef. Notice: no chicken or turkey. It is actually suggested that Great Dane owners avoid feeding soy, white rice, or fish.
A proper balance of protein, carbohydrates, fatty acids, vitamins, and minerals based on breed specific nutritional requirements are also essential. It is proven that “different breeds will assimilate different sources of vitamins and minerals in different ways.” (Cusick) For example,
there are over 170 different molecular form of calcium. While one may do well, another may cause kidney stones. It is further suggested that, for a Great Dane, protein levels must be no greater than 24% and the percentage of lipids should be between 12% and 14%. By working with my veterinarian, we have confirmed that the most suitable diet for Jude is Solid Gold Wolf King. Solid Gold Wolf King is a bison formula geared toward Great Danes. All nutritional values are met, Jude loves to eat it, and it is more practical for me to buy a commercial dog food rather than prepare constant meals. Jude has thrived on this food, and since being diagnosed with Addison’s, has gained 21 pounds, and has the activity level of a puppy.
While canine hypoadrenocorticism has the role of being the “Great Pretender”, making it difficult to diagnose, with the proper life-long medication and treatment, the dog can live a happy and normal life. With no known cause, all the owner can offer is a clean living environment, free of environmental pollutants, and a healthy diet. Understanding how to give your dog a healthy and happy lifestyle will greatly increase his or her health either before or after being diagnosed with Addison’s disease. Complementary therapies may be considered to potentially increase their quality of life, health, and to alter doses of medication. Overall, it is scary to see an animal down from this disease, hours from death, the purpose of this paper is not to make the disease seem unimportant, but instead, to help future owners with Addison’s dogs to feel at ease knowing the disease is completely treatable, and the dog will be happier than ever, after being properly diagnosed and prescribed proper medication.
 

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