Read Alex's story
Read Kayla's story
Read Sassy's story
Read Sassy's update (January 2002)
Read Sassy's Breeders story
Read Ginger's story

The following article was originally printed in "Toller Talk", the newsletter of the NSDTR Club of Canada.  It was written by club member Dr. Janice Madjanovich DVM and is reprinted here with permission.

Hypoadrenocorticism (Addison’s Disease)
By Janice Madjanovich

Hypoadrenocoricism is a condition which results when the outer layer, or cortex, of the adrenal glands fails in its secretion of the mineralocorticoid and glucocorticoid hormones. It is often called Addison’s Disease after the man who first described this syndrome in humans in 1855. It is not a very common disease in dogs, but unfortunately Tollers have an increased incidence of this condition. Middle-aged animals and particularly females are most commonly affected.

The adrenal glands which lie near the kidneys, have several important functions. Different areas secrete different hormones, with several different actions. The mineralocorticoids of which the main one is called aldosterone, are important in the regulation of electrolytes in the body. Their main action is to conserve sodium, chiefly by promoting reabsorption by the kidney. Water follows the sodium, so they indirectly affect the water balance of the body. They are also responsible for excreting potassium.

The main glucocorticoid hormone is cortisol. Cortisol is essential in an animal’s response to physical and mental stress. Cortisol levels rise when an animal is stressed. This hormone has many metabolic effects.

Primary adrenal insufficiency results from destruction of the adrenal cortex. The most common cause of this is immune-mediated destruction of the adrenal gland. Since Tollers are more susceptible to immune-mediated diseases, this is probably why they have an increased incidence of Addison’s disease. Like other immune-mediated diseases, Addison’s is thought to have a familial pattern. Other rarer conditions (e.g. tumor) resulting in destruction of the adrenal gland can also cause primary hypoadrenocorticism.

Hypoadrenocorticism can also be induced. If an animal is being given corticosteroid drugs such as Prednisone, its body stops producing its own corticosteroids. If the drug administration is abruptly stopped, the dog can’t start making it again fast enough and can go into an Addisonian crisis. For this reason, dosages of corticosteroids must always be tapered off. Lack of cortisol affects most tissues in the body. Tolerance to stress is reduced. The animal develops vomiting, diarrhea, loss of appetite, and weight loss. The mental state may be abnormal: lethargic or depressed.  Glucose production is decreased.

Without aldosterone a dog cannot conserve sodium and is unable to get rid of potassium. Water and chloride are lost along with the sodium. The animal may become dehydrated or weak. The increased potassium results in a slow heart rate and muscle weakness.

Not surprisingly, the signs of Addison’s disease tend to be a combination of the results of both lack of cortisol and lack of aldosterone (although occasionally only cortisol is deficient). In a study of 100 dogs with hypoadrenocorticism, the following were the most common findings:

Loss of appetite 77%
Vomiting 68%
Lethargy/depression 64%
Weakness 38%
Weight loss 23%
Diarrhea 22%
Shaking/shivering 21%
Increased urination 15%
Waxing/waning signs 10%
Abdominal pain 9%

Owners may only notice progressive, intermittent, vague problems, or the dog may go into acute adrenal crisis and have severely slowed heart rate, shock, dehydration, and weak pulses.

Since the signs of Addison’s disease are not very specific, the diagnosis must be confirmed with laboratory tests. Blood tests will usually reveal low levels of sodium and high 1evels of potassium. The definitive test is the ACTH stimulation test. Administration of ACTH stimulates the release of cortisol in normal animals.  If the cortisol level is low before the animal is given ATCH, and stays low afterwards, this confirms that the dog is Addisonian.

Fortunately, most dogs with hypoadrenocorticism respond very well to treatment with mineralocorticoid drugs. If they are severely ill, they may need therapy such as intravenous fluids to stabilize their condition. The blood sodium and potassium levels are monitored and the drug dosage adjusted accordingly over 3 to 4 weeks, and then checked every 3-4 months. As well as mineralocorticoid replacement, about 50% of dogs will also need glucocorticoids, particularly in times of stress. Usually Prednisone is used, and the dose can be increased when the dog is stressed.

We had two extremely active days in a row. Alex, our three and a half year old ToIler, had run with us on a trail through the woods. Tom my husband was jogging and I was riding my bike. Alex had a grand time. We were out for forty minutes and Alex was very tired. The next day, we three hiked along the sea-shore for over two hours. Alex, who always covered three times the beach area that we did, was understandably tired by the end of the day. However, we had been noticing in the past few months, that Alex tired easily. We planned to travel to visit relatives that weekend so we figured Alex could just rest up as we drove. He was used to the trip and slept most of the way as usual. That evening, however, he was still tired and was up during the night vomiting. By morning, he didn’t want to go for a walk or eat. As we drove home, we noticed that Alex was trembling. At home and still not eating our boy was definitely not well.

We visited the vet that evening. Alex did not have a fever so we were told to keep an eye on him and if he wasn’t better in the morning (or if he got worse during the night) we were to bring him right into the clinic. It wasn’t until the following day when Alex was in very dire straits, shaking, disoriented, and weak, that his blood was tested. We waited a day for the results. The vet then suggested a further test, an ACTH stimulation test. As soon as Alex was tested, he was put on intravenous fluids. Alex began feeling better. He spent the night at the clinic. The following day, the results came back confirming our vet’s suspicions.  Our Alex, now 5 pounds lighter and experiencing bradycardia had suffered an Acute Addisonian Crisis. He was then put on medication for Addison’s. Four days was a fairly quick diagnosis. Because our vet had recently treated another dog with Addison’s Disease (a lab cross), she was on the right track immediately and Alex was expertly treated.

Addison’s is an endocrine disorder that is also known as hypoadrenocorticism. It occurs when the adrenal gland fails to produce sufficient hormones. With this condition, the body lacks aldosterone and cortisol. Aldosterone deficiency causes the inability to excrete potassium and to retain sodium. Cortisol deficiency contributes to many other complicating health problems. Addison’s is a very serious disease involving multiple organ systems.

People can have the condition called Addison’s Disease (I’ve been told that John F. Kennedy had it) and so can dogs and cats. It is uncommon to rare in dogs and extremely rare in cats. Unfortunately, it does occur in ToIlers. Tollers have a higher incidence of Addison’s Disease than some dogs. Other dogs with a predisposition are: Great Dane, Rottweiler, Portuguese Water Dog, Standard Poodle, West Highland White Terrier, and Wheaten Terrier.

The best news is that Addison’s can be treated effectively and a dog with this disease can lead a good life, once he is stabilized on medications. In order to keep Alex’s salt and potassium levels balanced, Alex requires a slow releasing fludrocortisone shot every six weeks. Some dog owners prefer to administer this drug daily in pill form. In order to replace glucocorticoids, Alex also requires a daily dose of Prednisone. Addison’s dogs are very sensitive to stress so when we sense stress in Alex (i.e. when we have extra company in our home or when we’re leaving him for an extended period of time) we administer extra Prednisone. Addison’s dogs require increased medication when travelling, left in a kennel, or hospitalized.

During the same week that Alex became ill, another Toller, a half hour drive from our home was also in crisis. Unknown to us Wylie, an eight month old pup was at his vet’s. Unfortunately Wiley’s vet hadn’t seen an Addison’s dog for many years so just wasn’t on that track. Addison’s is often called ‘the pretender’ because its symptoms, even in crisis can be mistaken. Symptoms range from lethargy, vomiting, weight loss, diarrhea, frequent urination, and shaking, to weakness, dehydration, bradvcardia and more. Poor Wylie barely survived after initially being treated for antifreeze poisoning and later undergoing surgery for biopsies. Finally, after seven days of illness, an ACTH response test was administered to Wylie, a definitive test for Addison’s. Thankfully, Wylie did survive and is once again his bouncing puppy self.

I didn’t know Wylie and his owners before his illness. I had heard that a Toller had been diag-nosed with Addison’s and phoned the clinic where he was being treated. I asked if my name and phone number could be given to the Toller owner. Anne Miller, a two Toller owner, phoned me and we’ve been Toller friends ever since.

I felt the need to write this article for several reasons:

First, I feel that being informed is a very important part of being a good dog owner. Knowing Addison’s is in our breed, although rare in occurrence, may help someone. I hope you never do, but if you find yourself in that dreadful situation at the vet’s where everyone including the vet is wondering. “What’s wrong?” suggesting an ACTH test could be a lifesaver.

Second, if you do have an Addison’s Toller, be reassured. You’re not alone. There are others. We’re managing, and you can too, with lots of help from your vet.

Next, I have a helpful suggestion for owners of dogs with any health problems. An identification tag stating NEEDS DAILY MEDICATION and your pet clinic’s name and phone number may not only as-sure a faster return of your lost pet, but also save your pet’s life - a kind of pet medic alert. Having Alex dependent on medication has certainly made me very aware of this need

Finally, I’d like to remind you that if you have any Toller health problems, its good to share your infor-mation first with your breeder and then with our Health and Genetics Committee. It is believed that Addison’s IS genetic in Tollers but there isn’t enough information compiled to work out a mode of inheritance. If we all share, we may soon better understand this and other problems.

Since his crisis this past November, Alex has regained his lost five pounds. His coat is back to its usual silkiness and his energy level is better than it’s been in months. We regularly go to the beach where he swims enthusiastically and to the forest where he eagerly searches and retrieves. We keep in close touch with our vet and are forever diligent in our awareness of how Alex is feeling. He has everything going for him and should have an excellent and active life.

Judy Burgess and Alex

My Toller Kayla (Blue Sac’s Falls River Kelpie CGC) was diagnosed at 15 weeks of age with congenital Addison’s disease (AD).  Her initial diagnoses came after a near death crash and symptoms presenting themselves as poisoning.  Thanks to some helpful suggestions on the Toller email list she was tested for Addison’s disease, using the ATCH Stim. Test, which was positive.  At first she was not responding to her medication, Florinef and her health was in constant flux, which is common in the initial treatment phase of AD.  Her problems were so sever that we did another ATCH Stim test, which was also positive.  In Kayla’s case instead of the stim test showing a low functioning adrenal gland it showed a non-functioning adrenal gland, to the point she was in the margin of error for the test.

I had gotten Kayla to participate in obedience, agility, and therapy work.  We were not about to let a diagnoses of AD slow us down.  She continued to have problems with her medication until we switched vets to Dr. Sherry Seibel, who had much more experience treating AD and Tollers.  Kayla was eventually stable on .75 cc of DOCP, a monthly injectable drug, and 2.5 mgs of Prednisone daily.  When we went to a therapy visit or obedience class she got another 2.5 mgs of Prednisone.  She earned her first and only title, her CGC, at 5 ½ months of age with ease.  It was not until she was spayed that we noticed more problems with her.

Dr. Seibel performed her spay at about 7 months of age, and she had been stable for about 2 months.  We knew she had an umbilical hernia that needed to be repaired, which was thought to be routine.  As always nothing with Kayla was routine.  Her hernia ended up being huge, and when Dr. Seibel went to remove her uterus it was not in the correct spot.  The uterus ended up being behind and wrapped around her bladder.  Luckily, being Kayla, she bounced back in the standard two-week time, and we graduated into a Novice level obedience class.

The start of her problems began in early July, when our dogs contacted pink eye.  Our other two dog’s cases cleared within the normal round of eye drops.  Kayla’s did not leave and she had developed diarrhea.  She was put on medication for the diarrhea and stayed on the eye drops for three rounds.  Once that was cleared up we had to start on her yearly vacancies.  It was decided that each vaccine was to being given separately and at least one week apart.  She did have a negative reaction to her rabies and bordatella shots, which for her was diarrhea.  It was also during this time we noticed that she was starting to lose her hair on her belly (some never grew back from her spay) and her neck.  She was no longer able to wear a collar except when she was on leash.  Her thyroid was tested and the results were normal but low and the doctors at University of Michigan did not feel she should be on more medication.

By October she was having constant loose stools, but her blood work was wonderful and she had a great Sodium Potassium ratio, so it seemed that her AD was under control.  She was put on different medications for the loose stools but nothing seemed to help.  Then we tried different vet prescribed foods, without any luck.  Her blood work continued to show no signs of problems with her AD.  Dr. Seibel contacted the drug maker and the staff at University of Pennsylvania everyone was in agreement that according to her blood work her AD was under control but according to her symptoms it was not.  No one had any suggestions on how to help.

At the end of November she was hospitalized for IV fluids, hoping to break the cycle of loose stools and weight loss.  After 3 days of the IV treatment and injectable Predisone she was doing great.  Once she came home she was so healthy that I thought I could even take her back to her obedience and agility classes, which we had to stop attending mid-October.  Her rebound only lasted 5 days.  At this point I avoided calling Dr. Seibel to tell her of the relapse because I knew that we had finally played all of our cards in choices of medical care.  One week from the day she was release from the hospital I saw Dr. Seibel at a holiday gathering of a few Toller friends.  She was hoping I had not contacted her because Kayla was doing good, and was upset to hear otherwise.  The next day I called the office to talk to her about our choices.  It was decided that Kayla was going to be euthanised on December 13th, 2000, just 19 months after she entered this world.  She had put in a full life and had suffered long enough.  Kayla had her energy and life up to the end even wildly retrieving her tennis ball up to the last hours.

Dr. Seibel performed the necropsy the evening Kayla was euthanised.  What she found amazed us that Kayla had even made it as long as she did.  Her right kidney was attached to her diaphragm, she had a heart defect, her esophagus was not normal (it is not uncommon that megaesophagus accompanies AD) and she had no adrenal tissue present.  Dr. Seibel has since found that although AD is not common in a congenital form it is common to have organ abnormalities with it.  Also with all of Dr. Seibel’s and I research it seems that Tollers are the only breed that congenital AD is not uncommon.

Kayla lived a wonderful and full life for a dog that had so many strikes against her, from the start.  She touched so many lives in such a short time.  I think this quote from a friend after we lost her sums up Kayla “I will always remember her bight eyes, her zest for life and my picture of her will always be her looking up at you or the bumper with her eyes just sparkling.”   My darling girl will sparkle forever.
“Endings always come to fast – but pass too slow…”

Sara Berry McLoudrey

I became interested in the 'Toller' breed in 1996 when I read an article about them, we at that time had 3 Golden Retrievers, the Grandfather, Daughter and Grandson which were our breeding and we had brought them from Kenya to Atlanta with us when we did our last corporate move in 1992.  My husband and I are English by birth and have been brought up with all types of animals so we have experience, added to which I am an RN by training and we had persuaded 2 different friends to purchase Tollers during the last 3 years so knew what they were like. May 1999 and we only had the youngest Golden Retriever, his Mother had died in the March and he was depressed, the decision was made to get a Toller puppy and I was lucky to hear about a litter of 8 puppies when only 4 had been expected, yes we could have a little girl. We live in Atlanta but also have a house in Florida, Sassy was born in Florida so we decided I would keep her at our house down there for her first 2 weeks, she would see the vet we used there and the journey to Atlanta would be easier for her when she knew us, was 10 weeks old and more confident.

Sassy had ticks and fleas so the vet began her on frontline, checked her over, thought she was very lovely and advised us to keep a watch on her right eye which seemed to weep slightly.  We began the housetraining, learning our name, cuddling up to Tembo (Golden Retriever) and getting used to the parrot who quickly learnt to call Sassy and generally adjusting to a new life.  Feeding was never that easy with her, she would eat but very slowly and preferred multiple small meals to 3 main ones, not a problem except the Golden Retriever got a bit heavy.  First visit to our vet up here and 'shock, horror' the ticks which I then learnt were 'seed ticks' were still fully in situ so she was dipped and combed at the vets until clear.  The eye was still a little weepy but nothing. At 12 weeks this right eye was 'sticky' in the mornings so thinking infection we trotted to the vets, oh yes she had a slight infection and we were prescribed ointment for the right eye only.  3 days later and it was definitely in both so I asked over the telephone "shall I apply it to both eyes now?", the answer was of course yes and this was Wednesday.  By the Friday her right eye looked like an Opal, it was opaque and we went for our appointment with more than a touch of panick.....2  hours later we are 20 miles away at the specialist who asked if anything could have been sprayed in her eye accidentally.  Not as far as we are aware I replied and $270 and 3 bottles of drops later we began the great trek home.  We are to this day still on 2 different drops twice a day and every 8 weeks we visit the eye doctor but who knows this may finally get better now we are treating her whole system.

July 4th approaches and I decide to go down to Florida for 3 weeks, my husband will commute at weekends but during the first week Sassy seems lethargic, tired and not at all interested in food, we also have quite a few wetting accidents especially at night so I think 'bladder infection' and off we trot to the vet.  Half way through the antibiotics she is getting worse and suddenly collapses at night so off we dash to the emergency vet where they take blood and give her steroids and antibiotics by injection.  Next morning at our usual vets office he is scratching his head, she has the most peculiar blood results, the white count is not that high but the red count is very, very low...most strange, he thinks tick disease, lyme disease and although nothing will confirm any of these diagnosis it is decided to put her on a high dose, for a prolonged time of tetracycline...sort of hit everything theory.

Back to Atlanta now and packing Sassy's notes has become a task, she has a rather large, fat folder that has to travel with us from vet to vet so both know what the other is doing.  I said "It seems that everytime I take her to Florida she gets sick and yet she was born there so she should be used to it" - of course neither my vet or I put any meaning into it but with hindsight we should have heard the warning bells. My vet here is also puzzled by the reports and we repeat the blood test which shows she is borderline O.K., not brilliant but better than she was and on we plod with the eye treatments. Sassy is gaining weight during this time and she is growing but we still have good days and bad days, I meanwhile have been offered a free trip to the Olympics in Australia, without my husband so we decide Sassy can board at the vets during the week, have every test they deem necessary and she can come home at weekends. After 2 weeks of extensive tests, X-rays and observation there is still no diagnosis yet she is not 'right'.  I said if she was a child of mine I would describe her as a 'failure to thrive' and ask for tests for dwarfism since her
legs have not developed properly, she has a strange gait and this continually 'sick' just isn't normal.

We get through October, November and December with fairly regular visits to the vets because we are lame on this leg, or that leg, we throw up or we don't eat but nothing is ever found.  Our house is always a bit like a zoo because we have friends from all over the world so we have many visitors who come to stay for a week or more every month - a quiet house it isn't.  I also don't work so people 'drop in' during the day and sometimes I have someone else’s dog to help out for an afternoon.  Quiet and organized it isn't but I don't relate this to Sassy's episodes of ill health.

Christmas and New Year we are all down in Florida but 2 days before we travelled down Sassy and I were coming out of the eye specialists when we got sideswiped rather badly by an old lady and yes we were both rather shaken. This last acute attack came when we had 2 lots of visitors staying at the same time, our first appointment with the eye doctor since our accident and we had a puppy to stay for one day....probably all just too much for her.   She collapsed on the Friday morning when we got her up but by the time we reached the vets at 8 a.m. she was fine, no pain, no weakness, nothing, so I said I thought she had a very low pain threshold.  The next day she limped with her right front leg but it was the weekend so I thought it would wait until Monday.  She was fine on Monday, a bit quiet but not sick that I could see.  Tuesday evening she begins to vomit and even water comes straight back, I decide to sit up with her and try to wait for 7.30a.m. rather than use the emergency vet.

Wednesday our vet says "I think we have to look at a broader picture here, maybe some sort of immune disease", here we are not 3 days later with an 8 month old Addison Puppy.  If this helps someone else then Sassy and I will be thrilled because when you have a very precious puppy who just isn't 'right' it is the most worrying and frustrating feeling.

No one is guilty of anything in Sassy's story.  I had never seen a seed tick before, didn't know how common they were in Florida and because the old Golden Retriever is on Frontline he had never had them so Sassy was full of ticks.  The vet down there gave her Frontline, I will not touch a puppy that small with any chemical, and I presumed, wrongly as it turned out, that they were gone.

The first time she crashed we were in Florida, we went to an emergency room, they were very nice and the usual vet was lovely the following day but he didn't know what the results were telling him and he copied all her results for the vet up here.  I cannot 'fault' any treatment. Her eye not healing was a mystery, no one could understand it and we were seeing a specialist who was convinced her eye had been contaminated with chemicals and the cornea was just so badly scared.   I didn't contact Cathy (our breeder), no one thought it was anymore than bad luck, in fact a specialist vet who was contacted regarding her on going medical problems said he thought she would out grow them.

We bought one book on Tollers when we first had her, very good for the history and not much else.  Some friends who also have a Toller gave me a book for Christmas and I didn't even read the medical page until 2 weeks ago.  I wasn't looking for medical problems.   I would like to recommend that the Toller Club web sites provide more health information and that they look to publish a booklet, outlining health concerns in the breed, that they can provide to breeders to give to their new puppy buyers.  Had we known sooner of the early onset of Addisons in Tollers we may have been able to get a diagnosis quicker.  Yes now we know this site is here, we know to scream Addisons disease and that she will wear an identity disc with all her information on it but this is all with hindsight and I am just eternally grateful that I still have her.

January 2002 Update

In December Sassy had one 'petti mall' epileptic episode, no problem I thought but on December 26th she had a 'grande mall' lasting 3 minutes so we came back to Georgia on the 27th, Vetinarian's office first thing on the 28th.  All examinations and blood test results were normal, she had a bladder infection and was a bit over weight so we came home with 'diet dry and wet' food and antibiotics.  I thought if these were only going to occur every 10 days then we could cope without extra medicaton since phenobarbitone is also metabolized through the liver.

This last Saturday she had one 'grande mall' lasting over 4minutes but on Sunday she had a fit at 12 midday, 4pm, 8pm, midnight and 4am which was dreadful so now we are on the medication and will undergo yet more tests.  There seems to be a link between the Addison's and the Epilepsy but it isn't supposed to happen if the dogs are properly medicated and balanced which Sassy is and was.  The Proffessor from the vetinarian college who is our 'telephone consultant' said this is the second dog she has heard of whereby the disease is progressing dispite medication.  The other little dog is a Jack Russell.

Moira Turner and Sassy

I am Sassy's breeder and really do wish to contribute a message from a breeders view point.

I feel knowing what dog has Addisons helps somewhat and certainly helps the owner vent frustrations.  However the true help for the breed is through the breeder.  This is why contact with the breeder is MOST important..the most important thing the owner of an Addison effected dog can do!  This is why it is important to post this..PLEASE PLEASE stay in contact with your breeder..If the breeder  refuses to help or take responsibility that too should be noted.  PLEASE PLEASE take your dog to a vet the minute something is wrong!  Too many people lose dogs because they forget this and would have taken their child to the Doctor faster then they do the dog!

I have learned a lot from the Sassy case..I now include in my contract that ..UNLESS you stay in touch with the breeder it is null and void! in hopes that everyone will let me know the very minute something is wrong with their dog.  You see I never knew Sassy was sick untill final diagnosis..everyone must co-operate to help our precious breed.. My Tollers if fact all my dogs are my passion.  I also will add my vet was terribly shocked to read about Sassy because she had given Sassy a clean bill of health the day before she went home and had seen all puppies many times.

Cathy

PS a health certificate is a requirement in Florida.
PPS Moira is getting a replacement puppy from me and we will remain in close contact now as much has been learned.

I noticed Ginger out eating grass which is a sure sign for her that her tummy is not well, she refused dinner which is another sign something is not well, I already knew the next morning she was going to the Docs. (We lived through this in March of 01 and did not get a diagnosis at that time) She vomited during the night. In the early morning my husband offer breakfast which she refused, vomited again so I gave her doggie pepto that I kept due to her episode in March, (we thought she either had an obstruction or ate a dead animal I had found in the pasture) She vomited the medicine up also.

The Doc took blood, gave her a shot to stop vomiting she was not dehydrated so he sent us home with a milder tummy med, no food or water for 24 hours.  Vomiting stopped but diarrhea started with blood. He was not in the next day but we were on the phone all day. She was very listless just not my Ginger. Back to the clinic the next day and she was put on IV's with medicine because she could not keep any medication on her tummy. She was kept 2 days on IV's with med to stop vomiting and diarrhea. Her blood work looked good, electrolyte levels good.

She was sent home Friday night, she was acting like my old Ginger. By Friday about 8:00 she seemed not right again, just laying around. Saturday AM (she at this point was still not on food or water) she started having diarrhea again also. Back into the clinic, her regular doc was off, the doc on call gave her fluids under the skin and another shot to stop diarrhea, changed the food from what I was going to feed her, told me to start food and water that evening if she seemed okay the rest of the day. We started food and water (small amounts).

She continued to have symptoms on Sunday.  Talked to my regular Doc who had me stop everything again and bring her in first thing Monday to run ACTH test and a urine test to test for Addisons. The reason we were testing for this was because when I got my second Toller from Gretchen she was a very low birthrate pup and she had suggested we test her when she was older due to that.  He had asked me if Addisons was running in the breed. I knew about Kayla and with Gretchen wanting me to test Taffy we thought what the heck lets rule it out.  Well the rest is history, the test came back positive for Addisons and meds were started.  She is doing well now and the Addisons support group has helped me so much.

Kathy Gaddis and Ginger