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"Ginny" - Yorkshire Terrier with Addinsons Disease

photo: GinnyGinny

I was recently asked by a local group to give a talk on my life as a vet. I told them about the best and worst points about my job.

Without a doubt, one of the worst things, I told them, was the out of hours work. However dedicated you are, and however much you enjoy your job, it is never pleasant to be woken from your sleep at 3am to the sound of the ringing phone.

Most of the cases we see out of hours turn out not to be true emergencies, but in the case of "Ginny", a 10 year old Yorkshire Terrier, there was no doubt when I saw her at 3am on a Sunday morning that she was a genuine emergency, and I certainly couldn't resent getting out of bed to see such a case.

Ginny had collapsed, and when I saw her she was rigid and unable to stand. Her heart rate was extremely slow, and I soon realised that if I didn't act quickly, Ginny would die. I called in the on-call nurse, and we ran some blood tests and an ECG, and realised that Ginny was having an "Addisonian Crisis".

Addisons disease is an uncommon condition where the adrenal glands (small glands near to the kidneys) stops producing certain vital hormones. The most serious consequence of this is that the body cannot regulate the levels of sodium and potassium in the blood. When the potassium levels rise, the heart muscle cannot function normally, and eventually the heart will stop altogether.

We had to take rapid action to reduce the levels of potassium in Ginny's blood (which was twice normal levels). We did this by putting her on a drip, to dilute the potassium down, and also by giving her drugs which cause the potassium to move out of the blood and into cells in the body, where it is less harmful.

Ginny required intensive treatment over the next few hours, but gradually started to respond to treatment. She remained in hospital for a further five days before she was stable enough to return home - her £800 bill all fortunately paid for by her pet insurance. She will need lifelong "hormone replacement therapy", but the outlook for her now she is over the crisis is excellent.

With hindsight, I should probably qualify my statement about out of hours work: it can be one of the worst points of my job, but in life-or-death situations like this, it can also be one of the most rewarding parts! I'm sure Ginny and her owners would agree.

Geraldine Young BVSc CertSAM MRCVS

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