Don't Wait Until Your Pet Collapses, Learn These 5 Signs Now - Addison's Disease in Cats
By Dr. Becker
Story at-a-glance
Addison’s disease — hypoadrenocorticism — is the result of overworked adrenal glands that produce fewer corticosteroid hormones than the body requires; it occurs much less often in cats than dogs
Feline hypoadrenocorticism is usually caused by atrophy of the adrenal glands due to an autoimmune disease
Symptoms of Addison’s in cats include weakness, lethargy, loss of appetite, increased thirst and urination, vomiting, and oftentimes, sudden collapse
Cats who survive the initial Addisonian crisis can often be well-managed going forward with proper care and veterinary follow-up
One thing you can do to help prevent Addison’s disease in your cat is to reduce or preferably eliminate all forms of physiologic stress
By Dr. Karen Shaw Becker
Addison’s disease, also known as hypoadrenocorticism, is a condition involving the adrenal glands. The disease is much more common in dogs than cats, but it does sometimes occur in kitties, and can happen at any age, in any breed, and affects both males and females.
Causes of Feline Hypoadrenocorticism
In Addison’s disease, the adrenal glands produce fewer corticosteroid hormones than the body requires. These are the hormones responsible for the fight-or-flight response, which is how an animal’s body copes with potential danger or stressful events.
These potent stress hormones are normally produced in small amounts and only when the body is being threatened. But sometimes the adrenal glands become overworked and can no longer produce the amount of hormones the body requires. If the adrenals consistently under-produce stress hormones, adrenal insufficiency (scientific name, hypoadrenocorticism), otherwise known as Addison's disease, can be the result. Potential causes of Addison’s in cats include:
However, the most common cause of Addison’s disease in kitties is atrophy of the adrenal glands due to an autoimmune disease in which the immune system attacks the tissues of the adrenals.
Signs to Watch For
Cats with Addison’s may not show any obvious signs of illness. When they do, the symptoms can be fairly nonspecific and are often also intermittent, coming and going for no apparent reason. Symptoms can include:
Another much more pronounced symptom is sudden collapse, which is unfortunately fairly common with feline hypoadrenocorticism. If you have a kitty showing one or more of the listed symptoms, you should suspect Addison’s and make an appointment right away with your veterinarian.
In addition, Addison’s causes an imbalance in the levels of circulating electrolytes (e.g., potassium, sodium and chloride) in your cat’s body, which can lead to dehydration and other serious problems.
The signs of hypoadrenocorticism are seen in many other feline diseases, and since Addison’s is relatively uncommon in cats, it can go undetected while your veterinarian searches for other more common underlying causes. The average time cats experience symptoms before Addison’s is diagnosed is about two weeks, but some poor kitties have gone months before receiving an accurate diagnosis.
Obviously, distinguishing hypoadrenocorticism from acute or chronic kidney disease is crucial in establishing an appropriate treatment protocol and prognosis.
How Feline Hypoadrenocorticism Is Diagnosed
After taking a history and completing a physical exam to look for clinical signs like dehydration, a weak or slow pulse rate, irregular heartbeat, generalized weakness or depression, your veterinarian will perform a complete blood count and serum chemistry profile, along with a urinalysis.
These tests help determine how well your cat’s organs are functioning, but they don’t confirm a diagnosis of Addison’s disease. Based on test results, your vet may also recommend chest X-rays, an abdominal ultrasound or other procedures to try to determine the cause of your kitty’s illness.
The confirming test for Addison's is an adrenocorticotropic hormone (ACTH) stimulation test. In this test, blood samples are taken before and after the cat is injected with an adrenal-stimulating hormone. If your cat does not have Addison’s, the blood cortisol levels will increase. If she has Addison's, there will be no increase in blood cortisol, which is the confirming diagnosis.
Treatment Options and Long-Term Care of Kitties With Addison’s Disease
How aggressively your cat’s illness is treated will depend on her clinical status. Acute cases of hypoadrenocorticism are true emergencies that require immediate veterinary intervention — sometimes even before a diagnosis is confirmed.
If your kitty is very sick, she’ll be hospitalized to receive intravenous (IV) fluids and cortisol replacement agents. While dogs often show good improvement within the first 24 hours after initiating treatment, sometimes cats don’t respond that quickly. It can be three to five days or even longer after treatment begins before improvement is seen in a feline Addison’s patient.
Once your pet’s fluid levels are normalized and hormone levels are stabilized, she has received initial fluids and medications (sometimes including IV glucose), and she has recovered from any other adverse effects of the Addisonian crisis, you’ll be able to take her home.
Long-term management of Addison’s disease usually involves oral adrenal corticosteroid hormone replacement therapy for the remainder of the cat’s life. These kitties should also have regular urine and blood tests to monitor the level of adrenal hormones and other substances, such as electrolytes, circulating in the blood. If elevated potassium levels persist, additional drug therapy may be required.
How You Can Help Prevent Addison’s Disease in Your Cat
Preventing all forms of physiologic stress can help prevent adrenal gland disorders like Addison’s disease.
Don’t allow your cat to be over-vaccinated, as this is tremendously stressful to the immune system and can set the stage for an autoimmune reaction
Don’t allow oral or injectable steroids (dexamethasone, prednisone, etc.) to be prescribed to your cat consistently without pursuing safer alternatives through a functional medicine veterinarian
Keep a consistent daily routine with your cat, including set times for meals, litterbox scooping, exercise, playtime, petting, grooming, etc.
I also recommend talking to your integrative veterinarian about glandulars to nourish your kitty’s adrenal glands, as well as adaptogenic herbs and nutritional support that might be beneficial. I’ve had success using whole food supplements and adrenal glandulars to help reduce the amount of drugs needed to manage Addison’s patients, as well as a homeopathic preparation of cell salts called Bioplasma, which helps regulate electrolytes.
