Impact of Long-Term Management of Canine Hypoadrenocorticism

Zoe Belshaw, Vet MB, MA, PhD, Cert SAM, DECVIM-CA, MRCVS, AFHEA, EviVet Research Consultancy, Nottingham, United Kingdom

ArticleLast Updated June 20233 min read
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In the Literature 

Hupfeld J, Dölle M, Volk H, Rieder J. Effect of long-term management of hypoadrenocorticism on the quality of life of affected dogs and their owners. Vet Rec. 2022;191(10):e1977. doi:10.1002/vetr.1977 


The Research … 

Diagnosis and management of hypoadrenocorticism can be challenging, as glucocorticoid and mineralocorticoid deficiencies cause a diverse range of clinical signs and hematologic abnormalities. Long-term treatment and management are required but may not be straightforward.  

Owners of dogs with hypoadrenocorticism were given a survey regarding their dog’s health and how the condition affected their and their dog’s quality of life. The survey was distributed via social media in German, then in English. Respondents (n = 322) were predominantly German. Median age of dogs was 7 years; median age at diagnosis was 3 years. More than 70% of dogs were diagnosed following an acute adrenal crisis, with inappetence, lethargy, diarrhea, and vomiting being the most common signs. Most owners (94%) administered glucocorticoids as part of regular treatment, with 47% giving a booster dose for stressful situations (eg, veterinary visits, fireworks, thunderstorms). Most dogs (62%) received mineralocorticoid substitution as deoxycorticosterone pivalate; 48% of reporting owners administered the injections.  

Many owners (49%) feared their dog would have an acute adrenal crisis, and 27% worried they would not recognize a crisis. Social media forums were used for additional support by 58% of respondents. Although high veterinary costs, the challenge of taking a vacation, and concerns about leaving the dog unsupervised were additional reported negative impacts, most owners did not feel their dog’s condition regularly impacted their own quality of life, and 69% felt the bond with their dog had increased.  

Owner-reported impact of the disease on the dogs’ quality of life varied; time since diagnosis was not a significant influence.  

This study is the first to investigate the impact of canine hypoadrenocorticism on patient and owner quality of life and provides evidence of the commitment involved with owning a pet with a chronic condition. Owners of dogs with hypoadrenocorticism may need more support than previously recognized.  


… The Takeaways 

Key pearls to put into practice: 

  • Owning a chronically ill pet can be difficult and isolating. Discussing coping skills and providing support to these pet owners is important.  

  • Online support from other affected owners may be a substantial comfort. Owners should be supported if they choose to use these forums and advised to seek guidance from a clinician if they have questions. 

  • Fear of both adrenal crises and not recognizing a crisis is prevalent in owners of dogs with hypoadrenocorticism. Owners should be given clear, printed information about what to look for and what to do in the event of a crisis.  

  • Owners who have experience managing a dog with hypoadrenocorticism may be able to provide useful tips. Sharing what these owners wish they had known at diagnosis may be helpful to less experienced owners.