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96760
Addisons disease/ crisis
Descrição
Hons Addisons disease Mapa Mental sobre Addisons disease/ crisis, criado por becky.rawlinson em 18-05-2013.
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addisons disease
addisons disease
hons
Mapa Mental por
becky.rawlinson
, atualizado more than 1 year ago
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Criado por
becky.rawlinson
mais de 11 anos atrás
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Addisons disease/ crisis
"Pathophysiology"
Brought about by the destruction of the Adrenal gland - usually via an auto-immune pathway
Destruction leads to marked decreases in Aldosterone and Cortisol (adrenocortical hormones released natually from the adrenal gland)
ALDOSTERONE
Acts on the Kidneys to improve blood pressure
Increases blood volume by increasing water retention - caused by heightened sodium and chloride re-absorption & increased potassium excretion
CORTISOL
Acts in response to stress
Reduces sodium loss, aids in metabolism, increases blood sugar level (via insulin) & suppresses the immune system
Reductions in these hormones cause dramatically lowered blood pressure and volume due to water loss and less sodium/chloride retention
"Clinical signs"
Non -specific = mimics other diseases therefore making it difficult to diagnose
Loss of body condition
Anorexia
Emesis
Diarrhoea
Increased water loss
Dehydration
Gastroenteritis
Hypotension
Circulatory collapse
Shock
Increased potassium levels
Bradycardia
Irregular heart beat
Hypoxia due to lessened perfusion
RENAL FAILURE
Increased ACTH release from pituitary
Hyperpigmentation of the skin
"Diagnosis"
ACTH stimulation test
Adrenocorticotrophic hormone is usually released from the anterior pituitary in order to stimulate the adrenal gland to produce Cortisol
A healthy animal will have heightened cortisol levels following injection whereas an Addison's sufferer will have no change
Blood test prior to injection. 1ml synthetic ACTH injected (Synactin). Blood test 1 hour post injection.
"Aims of treatment"
Acute medical emergency
Stabilise patient ASAP
FLUIDS
Support vascular systems & reduces shock
NO HARTMANS- contains K +
Sodium chloride (Saline) administered to reduce hyperkalaemia and improve sodium and chloride levels
STEROIDS
Synthetic glucocorticoid (Prednisolone sodium succinate)
Short-course Preds once stable - not long term as animal cna usually cope with glucocorticoid insufficiency (Cortisol)
Once stable maintained on a synthetic minercorticoid (Florinef) in order to compensate for Aldosterone reduction
HYPERKALAEMIA
Dangerous in an emergency situation - capable of causing serious cardiac dysfunction
Small dose of insulin causes cellular uptake of Potassium - therefotre lowering blood concentration
Ahee and Crowe, 2000
NO steroids in this situation until insulin has stopped being effective as they can promote insulin resistance
NURSING TREATMENT
MONITORING
Regular electrolyte measurements
Temp
Fluids
Regular trips outside to toilet if capable
Potentially incontinent - INKA pad
Check hygiene constantly
Not weeing = need diruetics
Offer renal diet when stable
Home ASAP to prevent stress
Recumbent patient - comfy bed & regular turning
Recommend home visits & zylkene to reduce stress
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