Poppy & Addisons Disease

POPPY’S STORY – LIVING WITH ADDISONS DISEASE

Poppy was 10 months old when she came to us – a beautiful orange belton English Setter, she wasn’t ‘suitable’ for showing, but we fell in love with her, and as a pet she became ‘perfection personified’. A gentle, elegant and feminine bitch, she had a litter at two and a half and produced 6 healthy puppies. At five she was in her prime, well bodied and with a good coat. She looked a picture, and we did show her, and she won several ‘Best in Show’s’ at Companion Dog Shows – ‘A Local Dog for Local People’ my partner, Steve, called her.

At about this time, I was able to stop watching her weight as she seemed to start regulating it herself, and even had to supplement her food to maintain it. I wasn’t worried, she still looked good. Coupled with this was the occasional bout of colitis which seemed related to times of stress and soon cleared up. Likewise, when she had her second litter in July 2003 at age six and a half, we were disappointed that she only had two puppies and had to have a caesarean. We put it down to her age and poorer fertility, and the caesarean because the puppies could have been quite big as there were only two. However, the puppies were normal sized and healthy and we thought no more about it.

George from this litter stayed with us for a few months waiting for his new home and when he left, there was major disruption in the household. Our youngest bitch, Delyth had suddenly lost her playmate and them promptly came into season for the first time. This caused quite a bit of conflict with her mother – Thalice who would like to think she is top dog and they both became rather a nuisance really. All this upset poor Poppy and she had a very serious bout of haemorrhagic colitis and I found her in a state of collapse when I got home after a night shift. After intensive treatment she started to recover, but never seemed particularly well again. She then unexpectedly came into season a few days later, far too early to be normal, but during this season she did not attract the attentions of her two sons, Fleet and Flash which was again rather strange.

Poppy at 10 months

At the same time all this was happening, she was suffering from a persistent ear infection which was extremely difficult to treat, but we eventually managed to resolve this. She then had a second bout of haemorrhagic colitis 3 months later, in February 2004, not quite as bad this time but even with careful feeding, she never seemed to recover.

She had more blood tests and her tummy shaved for x-rays and scans, but nothing untoward showed up. She had good days and bad days, but was never truly well. Each morning I would check her colour and her mouth would be grey/white and then pick up during the day. Her stomach would sometimes be very tender and ‘burbly’ and then otherwise OK. She seemed depressed and lost her ‘verve’. She became a picky eater and lost weight and muscle tone. Taking her for a walk with the other dogs, she would linger behind and we would get fed up waiting for her. She also started to have that cloying smell of a very old dog in its last days.

Poppy with George

Blood tests were repeated several times only and they came back as slightly abnormal – raised calcium and low protein, but not so far outside normal parameters as to indicate anything seriously wrong. In the mean time, her reluctance to walk, exercise and get into and out of the car was brought home to me when she fell down stairs – not all of them, but enough to frighten us both. Although she has a very low hip score, these symptoms suggested arthritis – so she was treated for that. This showed marginal improvement, but she was gradually losing weight and condition and being lethargic and depressed. Very soon she started to vomit back whatever she ate, her colour was deathly pale and her ear infection returned.

I returned to the vet and awaited a referral to the Royal Edinburgh (Dicks) Veterinary School. In the mean time Poppy was going downhill fast. I was feeding her a chicken ‘slurry’ in an attempt to keep it down, her weigh was down to 19.2 kilos from her normal 25-26 kilos. She appeared very tired and depressed. She was like a ghost, so thin you could see right through her. My wonderful vet got us an emergency appointment at Edinburgh on Thursday 23^rd September and I prayed that Poppy would live that long. Two nights before the appointment, Poppy was asleep next to me on the bed and in the middle of the night I reached out and touched her. She was icy cold and had stopped breathing. I didn’t know whether to be upset or grateful, that she had died in her sleep right next to her mum.

However, her chest rose ever so slightly – she was still alive !

Thursday saw the long drive to Edinburgh, and we saw vet Nick Bommer. He thoroughly examined her and asked many questions. I had to sign forms agreeing to euthanasia and post mortem. He told me the problem could be one of three things:

Firstly : Lots of tiny deposits of cancer throughout the digestive system – too small to show up on x-rays or even blood tests – she would have to have an operation to take samples for analysis.

Secondly: A major auto-immune problem

Thirdly: Addisons Disease – not curable, but treatable.

We kissed her goodbye and didn’t really think we would ever see her again – she was so weak she couldn’t even stand up. The vet promised to ring us each evening between 5pm and 6pm each evening to let us know how she was. They duly rang to say she had settled in that evening whilst we were still on our way home.

The next day I was work at lunchtime when my mobile rang. I was horrified – I thought they were going to tell me she had died. They had repeated the original blood tests and the results were worse than previous ones, and just before operating on her they decided to do the Addisons tests, and miraculously these show positive – she had Addisons Disease. I was so relieved – it was the best I could have hoped for.

Addisons disease is a failure of the Adrenal glands which secrete the ‘fight or flight’ hormones. Lack of these hormones mean the body cannot cope with stress – both physical (ie illness) and emotional, plus it allows gains in potassium levels and reductions in sodium levels. The prognosis is good – she will have to take tablets for the rest of her life – I liken it to myself – having to take Thyroxin for the rest of my life – easy peasy !

She is already much better. She hasn’t got arthritis – that was just a red herring, she is bright and lively (and yes – naughty) and putting on weight.

Nick Bommer says that the disease does appear in certain breeds, but English Setters were not known to be one of them, and therefore there is likely to be an inheritance factor. Fortunately Poppy is not the foundation of a great dynasty and her lines will progress no further than her immediate progency.

Poppy was so lucky to get a diagnosis when she did, she would have died that week without treatment. I wonder how many other dogs have had this disease and not been diagnosed ? I hope Poppy’s Story will make other dog owners more aware of this disease and perhaps save another precious life..

THE STORY CONTINUES

Poppy has progressed well and stabilised on her medication. Her shaved patches from the scans and canulas have regrown and she has become bright and cheerful again, put her weight back on and she has started a gentle exercise regime.

I was anxious to avoid what is called an Addisonian Crisis as dogs with this disease are not physically able to cope with stress – either mental or physical and can collapse and die.

So the main worry for an unneutered older bitch would be a Pyometra. For those who don’t already know, this is a serious infection of the uterus and can in itself be fatal. Bitches are very poorly with this and usually need an emergency hysterectomy. It was unlikely that Poppy would survive such an illness couple with emergency surgery. So in discussion with my vet, I decided it would be wise to spay her whilst she was in good health, stable and in a situation where stress could be properly managed.

She was booked in for the operation, which went well except, because she was given extra steroids to manage her condition, she was unable to have painkillers. She was quite poorly at home that evening and her wound was continually bleeding, but not to excess. She was obviously in great pain so I returned her to the vets the next day and we were able to start painkillers whilst the bleeding was stemmed by a large pad and bandage.

Ten days later we returned to have the stitches out and she had healed reasonable well in spite of the high dose of steroids. She appeared well, bright and lively so I asked if she could have her booster. I had discussed this previously with my vet and she had contacted the drug company who had confirmed there were no contra-indications in using the vaccine in Addisonian dogs. Indeed the only other Addisonian dog at the practice has had no problems with the vaccine.

Poppy was a little unwell that evening – she threw back her dinner and appeared a bit subdued. The next morning she was obviously under the weather so I put her in the utility room with access to the outside to give her some peace and quiet. A short while later I could hear her crying. During all the horrendous things she has had to endure in the last two years, she has never cried, she was obviously very poorly. I asked if she wanted to ‘pop out’ and she struggled to her feet and followed me through the house. She stepped out of the patio doors and immediately collapsed. Her mouth was a strong colour and her extremities felt rather cold, and her tummy felt hard. It wasn’t what I expected a crisis would be like and didn’t know if she had eaten something which was causing an obstruction or if it was a case of bloat.

I rushed her to the vets. I had to carry her in and watched her deteriorate on the table. She had a low body temperature, shallow breathing and was drifting into unconsciousness. Her moth was now a vicious purple colour and the vet had great difficulty getting bloods from her. She was wrapped in towels and a space blanket whilst I blew a warm hairdryer inside them.

Her bloods came back well out of normal parameters – this was most likely an Addisonian crisis. She was put on a drip and given steroids and I had to leave her at the vets to go to work.

I later rang the vet from work to check on her, but they were non-commital. I was frantic all through my late shift and although I only got home at 3am the next day, I was up at 8.30 ringing the vets. Better news – she had been out in their garden for a ‘wee’ and was eyeing up the other patients breakfasts although she couldn’t have any herself until they had ruled out any sort of obstruction.. I was back at work later that day, so my partner Steve collected her.

She was put on a raised level of Prednicare and we planned to go back to the vet for more blood tests, but four days later I caught her licking her operation scar and when I checked it she had opened up about two thirds of it and I could see the internal stitches. It was too late to get to the vets that night, so I put a pad on the wound and an old T shirt on Poppy with her tail through the neck, back legs through the arms and the rest gathered up under her chin with a big safety pin !

Back to the vets the following day – they decided to staple the wound without anaesthetic as this was likely to cause the least stress and she lay down and exposed her tummy for them to do this. She was released to me with a collar and some antibiotics. Back to the vets four days later when further staples were required. Her bloods were still abnormal and her medication was adjusted accordingly.

I now know what an Addisonian crisis is like – quite different from the chronic disease I had experienced earlier. The difficulty is going to be recognising the difference between general doggie malaise and the actual collapse which may give me only a couple of hours in which to save her life.

The incident has been reported to the drug company and I am left with the problem of how to deal with an unvaccinated dog who is at as much at risk from the diseases it prevents as she is from the vaccination itself.

STOP PRESS

A year and one minor crisis on from the above, Poppy is fighting fit and so pleased with herself after qualifying for Crufts at the age of nine and a half that she is merrily playing ‘wall of death’ round my living room and wearing out the youngsters with her requests to play !!

Click HERE for the remainder of Poppy's story