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Hipoadrenocorticismo or Enfermedad de Addison
It is a endócrina disease of little frequent presentation in the dog and still more in the cat characterized by a adrenocortical hypofunction (deficiency of the function of the crust of the suprarrenal gland).
The suprarrenal insufficiency, acute as as much chronic, pronounces with a sintomatología that this given by the absence or little glucocorticoid secretion or mineralocorticoids (hormones that must secretar the suprarrenal gland) have serious consequences, since these hormones are indispensable to conserve the arterial pressure, the volume, the homeostasis of the glucose and a great variety of vital functions for the life the basic characteristicses of the metabolic disorder are hipovolemia, arterial hypotension, lethargy and anorexy.
It mainly affects dogs (70-85%) adult, most of cases before the 7 years, do not know preferences by no race in individual.
It can be:
* Primary
Of primary due to a disease of the adrenal glands or secondary origin if there is a lack of adrenal stimulation of hipotalámico-hipofisario origin. The most frequent cause of spontaneous primary hipoadrenocorticismo is not known with exactitude but it seems to be that it is a inmunomediado upheaval affecting the adrenal ones and sometimes, simultaneously, other glands endócrinas. A secretion deficiency takes place in this case glucocorticoid and mineralocorticoid. Other causes you decipher are adrenal infections, infarcts, neoplasias, traumas and amiloidosis. Also cases of iatrogénico primary hipoadrenocorticismo as a result of the treatment of a hiperadrenocorticismo appear with or, p'- DDD.
* Secondary
The spontaneous secondary hipoadrenocorticismo must to diverse diseases that can affect to the hypothalamus or the hipófisis of inflammatory type, tumorlike or traumatic. The presentation of a iatrogénico secondary hipoadrenocorticismo is more frequent: one is generally in patients who have received glucocorticoids in high doses due to the administration of exogenous corticoesteroides when suppressing itself, although she is made with extreme caution, she can produce a suprarrenal hypofunction and to even exacerbar the underlying upheaval. In addition, if it adds conditions of estréss, the doses of steroid maintenance are sometimes insufficient.
Causes of Suprarrenal Insufficiency:
Primary: |
A. - |
Secondary: | A. - Hipopituitarismo (ej. secondary to neoplasias) B. - Sudden steroid suspension |
SYMPTOMS AND I DIAGNOSE:
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At gastrointestinal level, the anorexy, the loss of weight, nauseas and the vomits are practically constant in the patients and the diarrea is not infrequent, thus often it is confused with gastrointestinales and/or renales affections. We can find bradicardia and weak pulse. In rare occasions abdominal pain and hypotherm. The clinical signs can be intermittent, get worse before stress situations and to improve later. Also the acute presentation of a hipotensiva crisis and shock is possible (Adissoniana crisis).
One suspects to acute suprarrenal insufficiency in critically ill patients with inadequate answer to liquids and agents presisters, for an accurate diagnosis also recommend not only dosajes of adrenal hormones but a complete profile (blood analysis), finding following desbalances
Data of laboratory:
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TREATMENT:
The treatment will depend if it is an acute or chronic case, in the chronic cases without crisis restores generally suplementacion oral with corticoids (gluco and/or mineral), however once carried out the diagnosis of acute suprarrenal insufficiency, the treatment must begin in immediate form.
The treatment must be aggressive, so that the replacement begins after the therapeutic hidroelectrolitica and the administration of hidrocortisona. Once controlled the manifestations of serious character, the dose of steroids is reduced gradually and an oral dose of maintenance with hidrocortisona or an equivalent dose of prednisona is restored. Often it is used in canine a mineralocorticoid (fluorhidrocortisona 0.1 to 0.5 mg/día).
I FORETELL:
The prognosis is good if an early diagnosis exists, maintaining the treatment in permanent form.
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Hipoadrenocorticismo |
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