Berry Haven Veterinary Group Medical Case
Max was presented as a very ill dog, ever since he visited the groomers. His owner was away on holidays at the time, and Max was missing her very much. Unbeknown to anyone, Max had a condition where his body did not produce enough cortisone to keep his body finely tuned. This was ok as long as he was not under any major stress. And he was under plenty of stress at the time of presentation.
Initially, he was seen for weakness, lethargy and occasional vomiting. He was suspected to have a mild upset stomach brought on by the stress. He made a slight short lived recovery to an intravenous drip but soon re-presented in a collapsed state of shock. His temperature was low, he was dehydrated and had been vomiting. His heart rate was slow.
Blood tests showed he had high blood potassium and calcium levels, kidney problems, and dehydration- all of which are suggestive of Addison's disease or kidney failure. We tested some urine to see how strong it was and it was too concentrated for kidney failure- in other words, it appeared the kidneys were still able to concentre the urine. If he had been in kidney failure, we would have expected his urine to be very dilute.
An ECG showed a slow heart rate and the absence of P waves (see photos). P waves occur when the two smaller heart chambers (the atria) contract. The fact they were absent meant the two atria had stopped contracting. The cause of this was the high blood potassium levels. Left untreated, this would progress until he died from shock and heart failure.
We placed Max on a drip with added intravenous Glucose in it. He was given a cortisone injection. We repeated the ECG every 2 hours during the day and by 8 hours, the P waves had re-appeared and his blood potassium levels had dropped down to nearly normal levels.
The next day, he was much better. We started Max on oral cortisone tablets and he has made a full recovery. He will need to stay on medication for some time and every time we anticipate a stressful event e.g. grooming, fireworks, we will step up the dose of cortisone so his body can handle the stress.