What are corticosteroids?
Corticosteroids are hormones produced naturally by the adrenal glands which have many important functions on every organ system...Corticoste
roids affect the strength of heart muscle and its response to natural chemicals affecting heart rate. They affect the water and salt balance in the body and also enable the body to cope with stress. Stress includes changes in temperature, pain, fear, anxiety and illness and can be hazardous if the body is not equipped to cope, due to low levels of corticosteroids. Corticosteroids allow us to respond to stress by increasing the rate and force of the heartbeat, increasing blood supply to essential tissues (muscle, heart, brain), increasing the body's supply of energy by raising blood sugar and by several other effects on body systems.

What are the signs of too much or too little prednisone, Florinef or DOCP?
The signs of too much pred can include excessive thirst, excessive urination, ravenous appetite, panting, nervousness or restlessness, thinning skin, hair loss, elevated liver enzymes. Signs of too little pred include loss of appetite, vomiting, diarrhea, loose stools, lethargy, weakness. Signs of too much Florinef would show up mainly in the bloodwork as high sodium and low potassium. It can also result in edema and excessive urination. Signs of too little Florinef also show up in the bloodwork as low sodium and high potassium. The low sodium can sometimes be seen as signs of dehydration in the dog (tacky gums, skin on the shoulder that doesn't snap back when pinched). The high potassium will frequently cause a slow heartbeat. Some people have also noticed twitching or shivering when the potassium starts to rise.

What is "Atypical" Addison's?
Deficient in cortisol only. The zones of the adrenal glands that manufacture cortisol are no longer functioning. (treated with a low daily dose of prednisone only)

What is "Primary/Typical" Addison's?
Deficient in cortisol AND aldosterone. The zones of the adrenal glands that manufacture cortisol AND aldosterone are no longer functioning. (treated with prednisone and either Percorten or Florinef)

What is "Secondary" Addison's?
Adrenal glands are normal, but the pituitary does not signal a need for cortisol. "Secondary adrenal insufficiency is due to a decrease in the production of the pituitary hormone ACTH (adrenocorticotropi
c hormone). ACTH is a pituitary messenger -- it tells the adrenal cortex to produce cortisol. If there is insufficient ACTH -- due to pituitary damage, a pituitary tumor, or some other cause -- then cortisol production is not stimulated. Secondary adrenal insufficiency can also arise when corticosteroid therapy (such as prednisone...) is abruptly halted. These treatments suppress natural cortisol production and it can take several weeks or months for normal production to resume. With secondary adrenal insufficiency aldosterone production is usually not affected."

What is "compounded" Florinef?
For efficient and cost-effective treatment of Primary Canine Addison's Disease, a "compounding pharmacist" can prepare an entire day's dose of generic fludrocortisone acetate in one (or two) capsules.

What's the difference between Primary and Secondary Addison's?
"Addison's disease can be characterized as being either primary or secondary. As the name implies, primary reflects an insufficiency due to a defect or atrophy in the adrenal gland itself. Secondary Addison's disease reflects the condition where the impaired adrenal cortex function is the consequence of some other identifiable cause; for example, a deficiency in adrenocorticotropin hormone (ACTH), the hormone that stimulates the adrenal gland to function."  Dr. Anita Oberbauer -in her presentation to the Tufts Genetics and Breeding Conference (10/05)  http://www.vin.com/

What happens if the potassium level goes TOO low?
Hypokalemia (low potassium) causes muscle weakness, increased thirst and urination, fatigue, loss of appetite, muscle cramps, cardiac irregularities, and puts a strain on the kidneys. Administering more Percorten-v or Florinef than is necessary to "normalize" or balance the electrolytes, can cause hypokalemia.

More on the effects of low potassium (hypokalemia)
"Overmedicating" with Percorten-v or Florinef can cause hypokalemia, which can be as damaging to the heart and body as the opposite condition (hyperkalemia: elevated potassium). The most lethal consequence of hypokalemia is cardiac arrhythmias. The initial manifestation of potassium depletion is muscle weakness which can lead to paralysis. In severe cases, respiratory muscle paralysis may occur.

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