I know it has been a while since I wrote, but unfortunately, I have been ill. I am finally feeling better and everything is under control, thanks to my Mom, so now I can fill you in on all the details of the past several weeks.
You may remember that I broke my toe on August 30 and was placed in a splint with strict instructions for 6 weeks of rest. Well, my six weeks was up October 12, so I had a repeat radiograph to assess the progress of my healing. I had hoped to have the splint removed of course, but wouldn’t it figure, my toe fracture wasn’t healed! So, you guessed it, it was another 2 weeks in the splint for me. That brought us up to October 26, at which time we repeated the radiographs again and, yep, you guessed it, still not healed! Another 2 weeks in the splint for me, which will bring me to November 9, at which time I will hopefully (everyone keep your fingers crossed for me) be able to FINALLY get this gosh darn splint off after being stuck in it for the past 10 weeks!
I mean, don’t get me wrong, my life hasn’t been terrible or anything in this splint, but I’m just looking forward to getting it off. The splint doesn’t slow me down at all, I treat it as an extension of my body, and because it’s been so long, at this point I am pretty much assuming that it will be a part of me forever. The big downside though has been the inability to do anything fun! I can’t play in the yard, I can’t go for walks, I can’t go to my obedience or agility classes, I can’t do anything, except rest. I am a pretty lazy guy by nature, so it hasn’t been too bad to catch up on my rest, but I am still a puppy and would like to frolic and play. I do miss my walks with Mom at Chestnut Ridge though, we have been inside throughout this entire gorgeous fall because of this darn splint!
As if the broken toe and splint thing wasn’t enough, I took ill the weekend of October 8-9. I woke up on Saturday and decided not to eat my breakfast. Initially, Mom didn’t think too much of this because from time to time, I have been known to not eat my meals. What can I say, I am a finicky guy and have always seemed to have a sensitive stomach. So, we went about our business during the day, Mom got me to eat a few treats throughout the day, but when dinnertime rolled around again, I still wouldn’t eat. Mom tried so hard to get me to eat, she even hand fed me my favorite canned food, of which I only ate about 1/2 can total. When Sunday came, it was the same story, I wouldn’t eat, but this time, I wouldn’t even take my favorite treats. I refused my treats, peanut butter, and even string cheese! Mom was starting to get worried because this was unlike me. She said that if I didn’t eat by Monday morning that she would draw my blood to check a blood panel on me just in case something was wrong with me and I wasn’t just being “finicky.” After only eating a few bites of canned food that Mom again had to hand feed me, she woke up early Monday morning to draw my blood and send it off to the lab just to be sure everything was OK.
Dad was home with me on Monday, October 10 because it was Columbus Day and he didn’t have to go to work. Mom called to check in on me in the afternoon and Dad told her that I was pretty lethargic all day, that I didn’t eat anything, and that I wouldn’t even get up to greet him. He told her that I would just lay on the floor and wag my tail if he came over to say hi, but that’s it. This worried my Mom because it was very unusual behavior for me. She got my blood work results back and saw something very concerning to her, my electrolytes (sodium, potassium, and chloride) were all out of whack! They had a typical pattern of something called Addison’s disease, or hypoadrenocorticism. Mom said that this disease is manageable, but in a crisis, it could be life threatening. She immediately left work to go home to get me and bring me into work for emergency treatment.
Addison’s disease is an endocrine disorder in which the adrenal glands are not making enough hormones, specifically, cortisol and aldosterone. These hormones are important in the stress response and regulate a variety of body functions, including fluid and electrolyte balance. The adrenal glands are two small organs located near each kidney. Typical symptoms of Addison’s disease are lethargy, anorexia, vomiting, diarrhea, and muscle weakness. These signs may wax and wane making diagnosis difficult. Fun fact, former President John F. Kennedy also suffered from Addison’s disease.
Once I got to my Mom’s work, everyone was waiting for me and started to get going on helping my Mom treat me. The first thing that happened was more blood was collected and an intravenous (IV) catheter was placed to start an immediate bolus of fluids. Mom said she had to confirm her suspicions and test me for Addison’s. The test just involved a pre-blood sample to measure my resting cortisol level, followed by an injection designed to stimulate my body to produce cortisol, and then a post-blood sample taken 1 hour after the injection to measure my body’s response to the injection. In a normal dog, with appropriately functioning adrenal glands, there should be an increase in the cortisol level from pre and post readings. It would take another 2 days before this test came back to confirm my Mom’s suspicions, so in the meantime, because I was experiencing what you would call an Addisonian Crisis, Mom started treatment on me right away while awaiting the confirmatory test results.
My immediate treatment included intravenous fluid support to normalize my electrolytes and stabilize my blood pressure. Mom started me on the medication that treats Addison’s disease, called DOCP (Desoxycorticosterone Pivalate more commonly known by the trade name, Percorten) and of course a heavy dose of steroids. I was on intravenous fluids for three days and was getting a ton of additional medications to help support me through the crisis. Slowly but surely I was improving each and every day. I finally ate something on Monday night, which made my Mom super happy! It was a super special and tasty food for critically ill patients, but still, it was something!
Over the following three days, I continued my intensive treatment both in the hospital and at home. Mom was able to transition me onto oral medications in that time and did get me to eat a special gastrointestinal diet that I ate happily for the following few weeks. The confirmatory test results came back on that Wednesday, October 12 (same day as my repeat toe radiographs), which showed that I did in fact have Addison’s disease. Mom was happy that we had an answer and that I was getting better. She said this is the best of the worst news because Addison’s disease is treatable and I can go onto live a completely normal life. Although it would require me to take medications for the rest of my life to manage the disease, at least it would not affect my lifespan.
Since the initial crisis, I have been doing well. Mom has been gradually transitioning me back onto my regular food and weaning me off many of my medications. Long term, I will just need to stay on the prednisone every day and get an injection every 25 days or so. The injection of the DOCP (Percorten) helps to regulate my electrolytes since my body can’t and the prednisone replaces my normal, physiologic cortisol that my body isn’t able to produce on its own anymore. Mom has been checking my blood work on a regular basis to monitor my body’s response to the medications and make sure I am getting the appropriate dose and frequency of each. So far, so good! My electrolytes are normalized and I have been doing great! I feel good as new again! Now, the only thing that is missing is to get this darn splint off! Here’s hoping that by my next blog entry, I will finally back to a normal life with a healed toe and a case of well managed Addison’s disease.