Addison's disease

Welcome back to Navly Nuggets, the review series from Scrubbed In, The DVM Journey.

I'm your host, Grace Gaynor, and today we're talking about two endocrine diseases that are basically opposites, hyperadrenocorticism, or Cushing's disease, and hypoadrenocorticism, or Addison's disease.

We'll go through two cases, the clinical signs, diagnosis, treatment, and the most important part for the NAVLE, which is when do you use an LDDS test versus an ACTH stimulation test.

So let's go ahead and get started.

Blood work reveals hyponatremia and hyperkalemia.

The dog is also hypotensive.

What is your top differential? The answer is hypoadrenocorticism or Addison's disease.

Instead of having too much adrenal hormone, these dogs have too little.

Yeah.

Now, this is going to be kind of a trick question, but why don't medical doctors acknowledge adrenal fatigue? I mean, typically, though, when I think of like flatline cortisol, you know, they're concerned with Addison's disease, something like that, but they don't really acknowledge, well, HP axis dysregulation, we need to support.

Why do you think that is?

I think they don't acknowledge it because they don't have a treatment for it, right? There's no drug that treats that.

I'm like, well, actually in my

experience, it is definitely a real thing.

And I think between Cushing's and Addison's, which are the two extreme states of Cushing's is way too much cortisol production.

And Addison's is not at all.

Oh.

And so there was a big surge of Addisons there at that time.

And Addison can...

That's sort of gender neutral.

I feel like we could actually do this and break this into what would feel like a mini thyroid crash course, and I'd kinda like to do that, because you talked about Graves'.

There's also Hashimoto's, there's Addison's.

And I, I wanna ask for a listener who may be saying, "I wish she would ask this," is, is every thyroid issue one of those? Or is that there's also kind of a benign label of just a thyroid issue, it's not functioning well? And could you break down what are the- What is the actual hyper or hypo of either of those, and what are signs or symptoms early on that somebody might have?

Sure, we could talk about that.

...

Graves', Hashimoto's are two autoimmune conditions, but you could have other thyroid conditions that are not autoimmune.

Uh, you mentioned Addison's, so it's actually more adrenal.

Addison's and Cushing's are more adrenal-

this is where we aim to bring you up to date with all the latest news and products from the UK for the last few weeks.

We hope you enjoyed our extra bonus episode covering Addisons at the end of August.

Fingers crossed you've taken away a few little nuggets of advice and the next case you see will feel a little bit easier.

Yeah, fingers crossed.

It's going to be the inconsistency that Killian doesn't get it right.

Anywhere from the Marvs, the QJs, the Godwins, the Pittmans, the Downs, the Tates, the Pierce, the BTJs, the Wandels, the Addisons, the Cokers, the Oh, my goodness.

What else do you have with this game?

Oh, my goodness.

Addison adjacent, but a lot of people are going with it to kind of differentiate, I think.

Don't need anymore Addisons.

Addison versus Madison.

It's like a blue-gray versus a blue.

We are moving from the mechanical structure of the body into pure chemical signaling.

We're going to explore everything from the foundational biology of how a single hormone is synthesized to the intense clinical realities of managing complex conditions like Addison's disease, Graves' disease, and diabetes.

Okay, let's unpack this.

To understand how doctors treat these conditions today, we first have to understand how we even figured out these invisible signals existed.

We step on the gas.

Okay, so give us an example from the text.

So if a patient might have Addison's disease, where the adrenal cortex is failing to produce cortisol, we perform an ACTH stimulation test.

We inject synthetic ACTH, which is the brain's natural gas pedal signal telling the adrenal gland to work.