# Secondary hypoadrenocorticism (Addisons disease)



## El Bueno Habanero (Oct 20, 2009)

Hello,

I have promised to keep you all updated on how Fedja is doing on his meds for hypothyroidism. 
(If interested how it all started, see: http://www.havaneseforum.com/showthread.php?t=13719 and then http://www.havaneseforum.com/showthread.php?t=14321.

After 3 months of taking his meds (Forthyron) twice daily we went again to the University Clinic to check if the things have changed and if the prescribed dosage is working good for Fedja. 
His T4 and TSH are ok, but he is still slightly anemic (his value is 39, normal ranging 42 to 60 according to the specialist, but I have found some website that claims normal is between 39 and 60? http://www.medicinenet.com/pets/dog-health/anemia_in_dogs.htm). 
Again, according to the specialist this is a big indication that his hypothyroidism could be secondary, meaning that there´s something else going on what´s causing thyroid problems. Or coexisting with hypothyroidism.

3 months prior to this visit I took Fedja to the same clinic, but because of the mistakes made by my vet (long story) they could´t do anything else then to retest his t4 and TSH values to be sure about the outcome (they didn´t trust the vets results for 100%, ´cause as I have been told not all the vets have an absolutely accurate laboratories equipment). Their test however has shown the same results which along with Fedja´s symptoms all were pointing at hypothyroidism. Since Fedja was doing great on his meds, we agreed that I would come 3 months later to see if everything is ok, and if not we will then look further.

Now she thinks that there is a possibility him having a secondary Addison disease (hypoadrenocorticism) where only the cortisol is affected. They did some additional test today, looking at the values of sodium and potassium in Fedja's blood. 
And just as I was typing this message I got a call from a specialist. Sodium/potassium values are fine. At first instance I was happy, but then...Addison's disease is often, but not always, indicated by high potassium, low sodium or a low ratio between the two in a standard chemistry panel. She wants to look further and check his urine, 'cause there still is a chance that he has Addison disease. If this test indicates that something is not right, then she will finally do a so called ACTH Stimulation (or Response) blood test.

If they diagnose Addison it does not mean that Fedja doesn't have a hypothyroidism too. Often this things go hand in hand. This is known as Schmidt's syndrome.

I then asked what's next if nothing shows wrong? She then briefly mentioned something about B12 and B6 vitamins deficiencies, but I didn't found this a very satisfactory answer (judging by the tone of her voice I got the idea that she wouldn't know where to look further ).

The results of Fedja's urine will be known next week Thursday...they only perform this tests on Tuesdays :frusty:.

I feel totally frustrated at this moment, arrrggggg. It looks like nobody can figure out what's wrong with Fedja. (As you may know his hind legs problem stayed also undiagnosed in the end.)

But I have a question for you all...same I asked endocrinologist, but she couldn't answer this one. Because Fedja is in her opinion very mildly anemic is it possible that standard range of blood cell values in a havanese is different then in other breeds (just as in standard thyroid values ranges, where it is known that Grayhounds eg. have very low values of T4 etc.) ? She did say that this could be possible. In that case Fedja is not anemic at all. I really don't know where to look further.

If someone has any idea (no matter how small) I would be glad to hear it. Thank you.


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## davetgabby (Dec 29, 2007)

Hi, Sena , hope you get to the bottom of this , Must be frustrating. Try giving Jean Dodds a letter. If you want the scoop on hypothyroidism she's the best. http://www.hemopet.org/services.html


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