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Basel the <\/span>three-year-old <\/span>Bernese Mountain Dog just <\/span>wasn\u2019t<\/span> feeling like himself. <\/span>He\u2019d<\/span> pooped in the kitchen \u2013 a definite no-no. <\/span>The stool was loose and became looser as the day wore on, and oddly, Basel bega<\/span>n to favor his hindlimbs. <\/span>Then Basel\u2019s back legs began to give out on him, so Monday morning, straight to his veterinarian he went. <\/span>Inexplicably, <\/span>Basel had lost 4 pounds, but his examina<\/span>tion was normal, as were x-rays of his hindlimbs and belly. <\/span>Basel was put on pain medications and an antibiotic, <\/span>in the event that<\/span> he was suffering from<\/span>\u00a0a tick-borne illness.<\/span> <\/span>\u00a0<\/span><\/p>\n As Monday evening arrived, Basel stopped walking entirely and seemed uncomfortable. He\u2019d also vomited several times. His owner decided it was time to visit the ER. <\/span>\u00a0<\/span><\/p>\n During the exam, Dr. Tabor noted that Basel\u2019s belly was tender, and he was somewhat dehydrated, unable to walk, and his heartrate was slower than normal. She ordered bloodwork to try to get to the bottom of Basel\u2019s mysterious illness.\u00a0<\/span>\u00a0<\/span><\/p>\n Basel had low blood pressure, and his baseline blood work confirmed mild dehydration, low-normal glucose, elevated kidney values, elevated phosphorus, low cortisol, low cholesterol, low sodium and significantly elevated potassium. His potassium was so high, in fact, that it was having a negative effect on Basel\u2019s heart and cardiovascular system in the form of a cardiac arrhythmia. Basel\u2019s potassium would need to be addressed, or it could lead to life-threatening cardiovascular problems.<\/span>\u00a0<\/span><\/p>\n Basel was also positive for anaplasma and Lyme, but the test looks for antibodies to these two tickborne illnesses, and antibodies can indicate either a previous exposure or current infection. <\/span>\u00a0<\/span><\/p>\n Dr. Tabor did not believe that Basel\u2019s current state was caused by a tickborne disease. But what was going on? She reviewed the bloodwork\u2019s major findings: low sodium, high potassium, <\/span>azotemia<\/span><\/i> (a buildup of waste products in the blood, including urea and creatinine) and low cortisol. Additionally, Basel\u2019s bloodwork showed that he lacked a <\/span>stress leukogram<\/span><\/i>, a specific pattern of changes in white blood cell counts that occur in response to stress. Basel\u2019s low cortisol was likely responsible for this. <\/span>\u00a0<\/span><\/p>\n Dr. Tabor was suspicious that Basel might have Addison\u2019s Disease. Addison\u2019s Disease, also known as hypoadrenocorticism, is a condition where the adrenal glands fail to produce sufficient corticosteroid hormones, primarily cortisol and aldosterone. This deficiency affects various bodily functions, including stress response, electrolyte balance, and metabolism. Basel\u2019s low cortisol, lack of a stress response as shown in his bloodwork, high potassium, and loss of four pounds in body weight could all be signs of Addison\u2019s. A special test called an ACTH Stim test was performed to see if Basel had Addison\u2019s Disease.<\/span>\u00a0<\/span><\/p>\n In the meantime, Basel\u2019s electrolyte and hormone imbalances needed to be treated. <\/span>A dose of calcium gluconate was given to protect <\/span>Basel\u2019s <\/span>heart <\/span>from his high potassium<\/span> level<\/span>,<\/span>\u00a0<\/span>and it<\/span>\u00a0<\/span>resolved <\/span>his <\/span>arrhythmia. <\/span>Fluids and<\/span> insulin w<\/span>ere<\/span> given to help bring down<\/span> his<\/span> potassium <\/span>level, <\/span>a<\/span>nd\u00a0<\/span>Basel<\/span>\u00a0was\u00a0<\/span>given<\/span>\u00a0an anti-inflammatory dose of steroids <\/span>to <\/span>supplement the steroids not being produced<\/span> in his own body.\u00a0He was also given a drug called<\/span>\u00a0<\/span>Zycortal<\/span> which helps replace mineralocorticoids<\/span>, a class of corticosteroids including aldosterone<\/span>. <\/span><\/span>\u00a0<\/span><\/p>\n Over the next day and a half, Basel\u2019s potassium, sodium and kidney values returned to normal. He also began eating and was able to walk again. And guess what? The ACTH Stim test confirmed that the source of Basel\u2019s illness was Addison’s disease. <\/span>\u00a0<\/span><\/p>\n Basel was sent home on oral steroids which were tapered down to a maintenance dose over time. Basel will be on steroids daily and Zycortal monthly for the rest of his life.<\/span>\u00a0<\/span><\/p>\n Addison’s disease (hypoadrenocorticism) is a hormonal disease characterized by a deficiency of cortisol and aldosterone which is produced by the adrenal glands. The hormones are crucial for regulating stress response, blood pressure and fluid balance. Addison\u2019s disease is fairly rare and can be tricky to diagnose. In fact, it is known as \u201cThe Great Pretender\u201d because its clinical signs can mimic those of many other diseases.\u00a0 \u00a0Breeds like Standard Poodles, Portuguese Water Dogs, Bearded Collies, West Highland White Terriers, Great Danes, and Nova Scotia Duck Tolling Retrievers are believed to show a genetic predisposition to Addison\u2019s Disease. <\/span>\u00a0<\/span><\/p>\n Unfortunately for Basel, he experienced what is called an Addisonian Crisis. Fortunately, however, his family acted quickly and got him help when they noticed things going south. Addisonian Crisis is\u00a0characterized by a sudden and drastic drop in hormone levels, leading to a range of symptoms \u2013 all of which Basel experienced – including lethargy, vomiting, diarrhea, weakness, and even collapse. Without prompt veterinary treatment, an Addisonian crisis can be fatal. <\/span>\u00a0<\/span><\/p>\n As long as Basel\u2019s disease is properly managed, he has a great chance at a healthy and long future!<\/span>\u00a0<\/span><\/p>\n Our \u201cFur-tunately: Stories of Animal Survival\u201d series features real pets treated by our team at Animal Emergency & Referral Center of Minnesota. All images and information have been shared with the owner\u2019s permission.\u202f<\/span><\/i>\u202f\u202f\u00a0<\/span>\u00a0<\/span><\/p>\n Case content provided by Kylie Tabor, DVM.<\/span><\/i>\u00a0<\/span><\/p>\n More Reading:\u00a0<\/strong><\/em><\/p>\n![\"picture](\"https:\/\/www.aercmn.com\/blog\/wp-content\/uploads\/2025\/05\/Basel.png\")
<\/p>\nArriving at The ER<\/h4>\n
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<\/p>\nPutting Together the Puzzle <\/span><\/h4>\n
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<\/p>\nTreatment<\/span><\/span><\/h3>\n
Basel Begins to Feel Better<\/h3>\n
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<\/p>\nAddison\u2019s Disease and Addisonian Crisis <\/span><\/b>\u00a0<\/span><\/h3>\n
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