Cause of Death
What/who killed Asproolee??
We have asked many professionals what REALLY happened!
Here’s what we got from the Alabama State Board investigating vet:
He called us to tell us that NONE of the vets in our complaint did anything wrong. “In fact”, he said, “I know two of them personally and they would do nothing wrong.” (Now we know why the board has about a 95% “no fault” decision rate.) Then we asked him what he thought was the cause of death. His answer was “Probably natural causes.”
We had just spent nearly $5,000 in the past few weeks and had all kinds of tests and exams and surgery performed, and Asproolee died of natural causes!! What an insult to our intelligence to try to tell us that!
Tina has been on a mission every since to try to determine the REAL cause of Asproolee’s death.
We could NOT get even one vet in the state of Alabama to provide us an opinion on his cause of death----they have formed a very tight circle among themselves!!
We were able to contact real professionals from other states via the internet and they were happy to review his records and provide a diagnosis. It is SIGNIFICANT that each of these vets independently all came to the same conclusion! Yet it never occurred to the vets we used in Alabama!
Vet from New Mexico:
My top suspicion is hypoadreanal or Addisons disease (the "great imitator"). The electrolyte results did not support, but atypical cases can have normal electrolytes. One big question not answered with Addisons is the histopath report from the liver tissue submission postop. It talked about changes caused by exposure to corticosteroids (from oral meds or from cushings). So, the test result I would like to have seen comes from an ACTH stimulation test. Abnormally high results indicate possible Cushings, while low results indicate possible Addisons.
An exploratory should always be preceded with discussion about what could happen. I always tell folks that we hope to find a problem that can be corrected, and do so! But sometimes we find problems that cannot be corrected; or no problem is found (this case), and the patient must then deal with the problems brought on by surgery..
I've learned to at least ask myself about Addisonian disease when planning an exploratory.
Vet from MEDHELP.ORG:
(read their whole story about Asproolee: http://www.medhelp.org/posts/show/505070)
Lethargy, anorexia, panting, hind leg weakness, gastrointestinal problems,
vomiting, and hair thinning, were the symptoms that forced you to take your dog
to the vet initially. These symptoms can be signs of endocrine disorders,
specifically Hypoadrenocorticism (Addison's Disease), Hyperadrenocorticism
(Cushing 's Syndrome), and hypothyroid.
I think that your dog may have had undiagnosed Addison’s disease
Hypoadrenocorticism). The cause of Hypoadrenocorticism is unknown, although
immune -mediated destruction of the adrenal gland is suspected in most cases.
Addison’s disease is a deficiency of hormones normally produced by the adrenal
glands. However, your dog’s the blood work was atypical for Addison‘s, so
Addison’s disease would have to have been diagnosed with additional tests such
as: ACTH stim test or Low dose dex. test, and unfortunately it is too late for
such tests so we must just speculate.
The enlarged heart and poor eye sight may have been congenital or developmental
and may not have been related to the endocrine disorder. Your dog had already
been on heart medications for 3 years prior to this episode. However,
electrolyte abnormalities secondary to Addison's disease can disrupt heart
function and cause arrhythmias, which could worsen an existing heart condition.
Addison’s disease can also cause seizure and coma due to hypoglycemia. Your
dog’s last listed glucose level was 29. A glucose level of 29 is extremely low
and is considered to be hypoglycemic. Hypoglycemia by itself can cause seizures
and coma. Addison’s disease is not the only cause of sudden hypoglycemia,
though. Other causes that could have occurred in your dog’s case include
Insulinoma (a tumor of the pancreas that produces excess insulin) and
overwhelming infection (possibly secondary to the surgery, in your dog‘s case).
There was a sign of possible infection in your dog: “SQ emphysema” in the
integument at the suture site, this can be indicative of infection.
Though there is no way to be definitive about the cause of death for your dog
the following are possible: Surgical complications secondary to Addison’s
disease, Surgical complications secondary to heart disease, Infection following
surgery, Adrenal carcinoma causing adrenal failure, or Pancreatic cancer (Insulinoma),
among other possibilities.
AltheaVet
at http://www.marvistavet.com/html/addison_s_disease.html
I can say that the liver biopsy supports an underlying Cushing's disease but
beyond that I'm not sure. The hypoglycemia could explain the seizure but and
could fit w/Addison's but Addison's doesn't fit w/the steroid hepatopathy in the
liver. The rest really does sound like Addison's though: ultrasound that looked
like intestinal obstruction, hypoglycemia, shock and death. What did the
adrenals look like on the ultrasound? Big or small?
Not sure what you mean by the internist failed to perform ultrasound on the
adrenal glands. They were too small to be seen. That pretty much rules Cushing's
disease out and puts more evidence under the Addison's disease category. Normal
adrenal glands are easy to see and Cushing's adrenals are larger than normal. It
is highly significant that they were not seen.
From http://www.poodlehealthregistry.org
Registered Standard Poodles with Addison's Disease
(Hypoadrenocorticism)
mode of inheritance: uncertain
Addison's disease (Hypoadrenocorticism)
Addison's Disease is a disease of the adrenal glands, usually caused by the immune mediated destruction of the adrenal glands. It affects dogs of all breeds and mixed breeds. Unfortunately, there is a very high incidence of this disease in Standard Poodles, although Miniature and Toy Poodles can also be affected.
As of January 2008, it has been announced that researchers have found that Addison’s in Standard Poodles is most probably polygenic, involving the combinations of several genes. It is not, as was thought earlier, a simple recessive. Until more information is known, the mode of inheritance remains uncertain. In a related study on Portugese Water Dogs, researchers have found a number of genes, some of which work to cause Addison’s and some of which work to suppress the destruction of the adrenal glands. Work is underway with tissue samples and DNA to see if the same genetic process and location is the same for Standard Poodles. To read the entire write-up click here!
There is no line or color of Standard Poodles that is not affected by Addison's and no dogs that can be certified as "clear" of the disease. Breeders who test for Addison's are only confirming that their dogs do not have the disease at the time of the testing. Addison's can strike at any age, so testing for Addison's does not guarantee that the dog will not develop Addison's later in life, nor does it guarantee that any puppies will not develop Addison's. That is why it is so important for breeders to know in great detail about the health of the dogs in the pedigrees of those they intend to breed to ensure low risk breedings and also to avoid perpetuating this genetic disease..
Addison's Disease affects males and females equally in Standard Poodles, and is frequently diagnosed in dogs less than a year old. This is important for Poodle owners to remember. Many vets fail to consider it for males or puppies, since the literature suggests that 75% of all affected dogs are middle aged females.
Untreated Addison's is a true medical emergency since death can come swiftly. However, with a timely diagnosis and lifelong medication coupled with careful management of stress, an Addisonian can lead a good life with normal life expectancy.
Symptoms of Addison's frequently begin with vague gastrointestinal problems. The most common symptoms of Addison's are a loss of appetite, vomiting, diarrhea, weakness, depression and lethargy. Other common signs include a painful abdomen, excessive thirst and/or urination, shaking, low body temperature, signs of dehydration or shock. Most dogs don't exhibit all these symptoms and another hallmark of Addison's is that in the early days the symptoms can come and go.
The only definitive test for Addison's is the ACTH stimulation test. Sometimes a regular blood chemistry will show the characteristic low serum sodium and high serum potassium associated with Primary Addison's. However, this imbalance is not always present in the early days and will not be present at all in the case of Atypical Addison's, where only part of the adrenal glands fail.
Because Addison's Disease is known as the Great Imitator, with vague and nonspecific symptoms, getting a diagnosis can be elusive and expensive. Abnormalities in the bloodwork of an affected dog will frequently lead to a misdiagnosis of kidney failure. Many other dogs undergo barium x-rays or exploratory surgery looking for an impaction or foreign object in the digestive tract. Dogs may present with heart abnormalities or symptoms suggestive of cancer. Once treatment is started, most of these other vague symptoms usually disappear and the bloodwork will return to normal.
Whenever faced with one or more recurring symptoms mentioned above, it is wise to ask for an ACTH stimulation test before going for more expensive and invasive procedures. This is a relatively inexpensive test performed in a veterinarian's office.
Addison’s disease may present in more unusual ways. Inability to maintain normal sugar levels (ultimately manifesting as a seizure disorder) may be strongly suggestive of an insulin-secreting pancreatic tumor but before a major abdominal surgery is planned, it is important to test for Addison’s disease.