September 8, 2021

During routine lab work, Porter’s results displayed a low albumin level. There are multiple different causes of a low albumin level, including intestinal disease, kidney disease, and liver dysfunction. Porter was not displaying any other symptoms, so we continued to have his albumin level monitored over a course of a few months. Kidney disease was also ruled out based urine testing.

March 3, 2022

Porter’s Albumin decreased even further, so it was recommended that we see an Internal Medicine Specialist. On March 3, we saw Dr. Alan Klag at Blue Pearl Pet Hospital in Levittown, Pennsylvania.

Bloodwork was taken for a bile acids test and an extensive tick panel, as some tick-borne diseases can cause vasculitis (leaky vessels) and a low albumin level. However, both the bile acids test and the tick panel came back with no issues.

An abdominal ultrasound was also completed at this visit. Porter’s intestines appeared normal on his ultrasound and he did not have any supporting gastrointestinal signs, making a protein-losing intestinal disease less likely. His liver did appear subjectively small on the ultrasound, which may indicate liver dysfunction, but the bile acids test came back fine and indicated his liver function was normal.
His adrenal glands appeared small on the ultrasound, which indicates that he has a
cortisol deficiency (Atypical Addison’s Disease) causing his low albumin. A cortisol test was done, and low and behold, Porter’s cortisol was extremely low, and the diagnosis was confirmed. It was suggested that Porter immediately begin to take a low dose of Prednisone. Prednisone mimics cortisol, making it an effective tool for supporting dogs with Addison’s Disease. Porter immediately began taking Prednisone (2.5 mg once daily). Within just a very short time, what we had thought to be daily focal seizures had disappeared completely, and Porter became energized and agile. No more shaking…no more falling. Much of what was considered fall-out from his status epilepticus episode vanished!

Although Porter was diagnosed with Atypical Addison’s Disease, there is a risk that it could later develop into full-blown Addison’s Disease. It was explained that we should get Porter to an emergency room if he exhibits any of the following symptoms:

• vomiting
• collapse
• no appetite
• lethargy
• dehydration

The above symptoms indicate an Addisonian crisis, which is considered a medical emergency and requires immediate hospitalization and supportive treatment.

Porter will be on Prednisone for the remainder of his life. He will continue to have a full CBC lab work and his Albumin levels checked according to the schedule that Dr. Klag dictates.