Hydroelectrolytic disorders in acute primary hypoadrenocorticism in dogs: a review

Abstract

Canine hypoadrenocorticism is an endocrinopathy characterized, in its most common form, by glucocorticoid and mineralocorticoid deficiency, often resulting from immune-mediated destruction of the adrenal glands. Untreated patients may develop the acute form of the disease (Addisonian crisis), a severe presentation with a risk of death if appropriate interventions are not performed. Among the changes presented are: electrolyte disorders (such as hyponatremia, hyperkalemia, hyperphosphatemia and hypercalcemia), water imbalance (dehydration and hypovolemic shock) and acid-base disorder. Adequate intravenous fluid therapy is the basis for the initial management of Addisonian crisis, which will restore intravascular volume and hydration, reducing serum phosphorus and potassium concentrations, lactic acidosis, pre-renal azotemia and metabolic acidosis. Glucocorticoid replacement also contributes to the normalization of these changes. Among the possible complications of the treatment is pontine myelinolysis, resulting from a rapid increase in serum sodium concentration. In view of this, knowledge of the disorders associated with this endocrinopathy helps in the suspicion and adequate management of the disease.