Addisonian Crisis Management: Emergency Welfare Guide

Key Welfare Considerations

• Addisonian crisis occurs when cortisol and aldosterone deficiency causes cardiovascular collapse and electrolyte emergency.
• Bradycardia from hyperkalaemia is a hallmark — ECG changes include tall peaked T waves and widened QRS.
• Profound weakness, collapse, vomiting, and hypothermia characterise the welfare emergency presentation.
• Hyponatraemia and hyperkalaemia cause the classic sodium:potassium ratio below 27 seen in crisis.
• IV fluid resuscitation with 0.9% saline corrects hypotension and dilutes dangerous potassium welfare immediately.
• Dexamethasone provides rapid glucocorticoid support without interfering with cortisol assays during crisis.
• Calcium gluconate provides cardiac membrane stabilisation when ECG changes indicate hyperkalaemia welfare risk.
• Glucose supplementation corrects hypoglycaemia welfare impairment during crisis management.
• Once stable, ACTH stimulation test confirms diagnosis before long-term welfare management begins.
• Transition to DOCP and prednisolone maintenance enables excellent long-term welfare recovery.
• Stress dosing protocols must be established before discharge — welfare depends on owner preparation.
• Injectable dexamethasone kept at home enables owner management of early crisis welfare emergencies.
• Medic alert identification ensures emergency treatment welfare if dog presents unconscious to unfamiliar vet.
• Crisis frequency reduces dramatically with appropriate maintenance medication welfare management.
• The welfare transformation from critical collapse to normal function is one of veterinary medicine's most rewarding interventions.