When Bella, a gentle-natured four-and-a-half-year-old Cavoodle with a history of good health, suddenly became weak, cold and unable to stand, her family knew something was very wrong. What followed was a race against time and a textbook example of how Addison’s disease can quickly become life-threatening if left undiagnosed.
A sudden decline
Bella had been off-colour for a couple of days which originally presented as pain, but things took a sharp turn on a Saturday morning. Her regular vet had already carried out an impressive suite of tests, including comprehensive blood panel, x-rays and an abdominal ultrasound to rule out pyometra – a concern for any un-desexed female. Thankfully, there was no infection in the uterus, but Bella’s condition was still deteriorating.
When she arrived at AREC, she was flat, cold (her body temperature was just 33.5°C), hadn’t eaten or toileted, and was too weak to stand. Her gums were bright red and dry – signs that pointed to dehydration and shock. Her mental state was also concerning. She was ‘obtunded’, a term used in veterinary medicine to describe reduced awareness and responsiveness to surroundings.
Investigating the cause
Our team, led by Dr Natsuko, moved quickly. With stabilisation and work up already underway from her referring vet, we continued Bella’s emergency care while trying to narrow down the possible causes.
Based on her physical exam and initial blood work, we had two main concerns: sepsis (a widespread infection) or Addison’s disease, formally known as hypoadrenocorticism.
To help confirm the diagnosis and rule out other possibilities, we ran:
- In-house baseline cortisol testing which was imperative in her diagnosis as her blood work performed at her regular vet that morning was not yet showing clear changes consistent with Addison’s disease
- ACTH stimulation test which was sent to an external laboratory for further confirmation
- Electrolyte blood panel
- Repeat radiographs and ultrasound for full internal assessment
- Serial blood glucose
What is Addison’s disease?
Addison’s disease is a condition where the adrenal glands (tiny organs sitting just above the kidneys) stop producing enough of two essential hormones:
- Cortisol, which helps the body respond to stress and inflammation
- Aldosterone, which regulates sodium, potassium and water balance.
Without these hormones, a dog can develop dangerously low blood sugar, imbalanced electrolytes, and be unable to cope with physical or emotional stress. Elevated potassium, for instance, can stop the heart. A drop in sodium can cause brain swelling. This is why Addison’s is considered a medical emergency when symptoms flare.
For Bella, her baseline cortisol level returned at less than 14 nmol/L – inappropriately low for a dog as unwell as Bella. She was also hypoglycaemic, and her sodium-to-potassium ratio was 24:1 – lower than the safe cut-off of 27:1. Classic signs of an Addisonian crisis.
Treatment and recovery
Bella’s first 24 hours in hospital were critical. She needed round-the-clock care, intensive monitoring, and careful fluid and steroid therapy. Our nurses and vets worked closely to stabilise her, transitioning her to oral medication once her condition improved.
By Monday morning – just two days after admission – she was back on her feet, eating well and wagging her tail. Her recovery was remarkable.
Living with Addison’s
While Addison’s is a serious diagnosis, the long-term outlook is good with the right treatment. Dogs like Bella can lead full, happy lives on daily medication and with regular veterinary check-ups.
It’s a condition that requires vigilance, but with a committed owner and veterinary team, outcomes are very positive.
Trust your instincts
Bella is now home, soaking up cuddles with her family, and we already miss her sweet face in the hospital.
For vets, this case was a powerful reminder of how subtle signs can precede a major crisis. For pet owners, it’s a prompt to trust your instincts when something doesn’t seem right.
Emergency work can be intense, but seeing a patient like Bella bounce back is why we do it.
