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Addisonian crisis in a dog treated with phenobarbitone
V Simerdova1, I Hajek, P Schanilec
1Small Animal Clinic, Faculty of Veterinary Medicine, University of Veterinary and Pharmaceutical Sciences Brno, Palackeho tr. 1/3, 61242, Brno, Czech Republic. simerdovav@gmail.com.
Australian Veterinary Journal
|March 31, 2015
Summary
Phenobarbital may trigger Addisonian crisis in dogs, a serious condition affecting steroid metabolism. This case highlights the need for caution when using phenobarbital in canine patients, especially those with pre-existing adrenal issues.
Area of Science:
- Veterinary Medicine
- Endocrinology
- Pharmacology
Background:
- A 2-year-old Irish Setter presented with anorexia, lethargy, vomiting, and diarrhea.
- The dog had a recent 3-week history of phenobarbital treatment for suspected epilepsy.
- Phenobarbital is known to accelerate steroid metabolism in humans.
Observation:
- Clinical signs suggested Addisonian crisis, supported by abnormal mentation and laboratory findings (azotemia, hyponatremia, hyperkalemia).
- An adrenocorticotropic hormone stimulation test confirmed the diagnosis of hypoadrenocorticism.
- Treatment involved intravenous fluids, glucocorticoids, and mineralocorticoids.
Findings:
- The patient recovered within 3 days of treatment.
- This is the first reported case of Addisonian crisis potentially linked to phenobarbital administration in a dog.
- Phenobarbital's effect on steroid metabolism is implicated as the likely cause.
Implications:
- Clinicians should be aware of phenobarbital as a potential cause of Addisonian crisis in dogs.
- Cautious use of phenobarbital is recommended, particularly in dogs with borderline hypoadrenocorticism.
- Early recognition and treatment of Addisonian crisis are crucial due to its life-threatening nature.
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