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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 24385
Experience:  University of California at Davis graduate veterinarian with 44 years of experience
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My barely 3 year old Peke just suddenly died. We think she

Customer Question

Hi, My young barely 3 year old Peke just suddenly died. We think she was having an addison crisis. She was not diagnosed before that. She was acting so strange not eating and throwing so we brought her to vet and they wanted to put her down immediately. Her vitals were all over the place. They gave her IV and some paid med...told us to leave her there over night -when we came back in the AM she was gone. That is when they said she had addison disease... why how we never saw signs...a month ago she got sick but we thought she may have eaten something. That was the first and only time she was ever sick and then again when we rushed her to drs she died...please help feeling so lost
Submitted: 1 year ago.
Category: Dog Veterinary
Expert:  Dr. Michael Salkin replied 1 year ago.

My condolences for your loss of Minnie. Clinical signs of Addison's disease (hypoadrenocortisolism) are notoriously vague and often wax and wane over weeks or months (sometimes only apprarent to owners in retrospect). The signs may worsen in stressful situations such as travel or boarding. The severity of signs ranges from a mild, progressive, intermittent course to an acute, life-threatening crisis - as appeared to be the case in Minnie.

I know that you're wondering if Minnie could have been saved...

Her best chance would have been prompt diagnosis of her Addison's which is done by acknowledging her history of collapse and seeing that serum sodium level was decreased and her serum potassium level was increased. These electrolytes (sodium, potassium) are measured by electrolyte analyzers which many veterinary hospitals have in addition to complete blood count and serum biochemistry analyzers. Once confirmed, a crisis is then treated with IV fluids in an attempt to correct hypovolemia (dehydration), electrolyte imbalance, and hypoglycemia (low blood glucose) if present. Mineralocorticoid administration (DOCP) is initiated immediately after correction of electrolyte imbalances with fluid therapy. Addison's disease patients lack the ability to produce mineralocorticoids.

The above treatment might not have been successful if Minnie had suffered multiple organ failure prior to initiation of therapy which, unfortuantely, I'm unable to ascertain from here. Please respond with further questions or concerns if you wish.

Customer: replied 1 year ago.
I am just wondering if it could have been anything else. The vet closest wasn't an all night hospital...but they stayed late till 10pm. I know they said her kidney was failing at the time we brought her in, they gave her IV she started to feel better...wondering if leaving her overnight was best choice without anyone or if we should have brought her home..again we were not told she addison disease until after she had passed..they had planned on doing a test in the AM but she passed before they could. Based on what happened the vet said -Addison disease /crisis...just wondering if anything else could have been.. if she had eaten anything the only other time she was like this would it take 4 weeks to kill her? I know the first time she was like this we thought she at something, which was 3-4 weeks before another "episode" the vet says that's similar to addisons...just looking for another opinon thank you in advance.
Expert:  Dr. Michael Salkin replied 1 year ago.

I would have insisted that Minnie be attended to at a 24-hour facility if such a facility were available to you. Kidney failure is a common cause of death in Addisonians but kidney failure can be due to primary kidney disease as well. There are toxins that cause hepatic failure which could conceivably take a month to kill my patient but these dogs would be progressively worsening over the month's time. Can you upload a copy of Minnie's test results to our conversation? I understand that you might not have a copy of the results at home but her vet should be able to give you one which you could scan into your computer and give me the link or you can photograph the page(s) and upload the images by using the paperclip icon in the toolbar above your message box (if you can see such an icon) or by using an external app such as imgur.com or dropbox.com. I can be more accurate for you if I can review any testing that had been performed.