Effect of long‐term management of hypoadrenocorticism on the quality of life of affected dogs and their owners

Abstract

Background The treatment of canine adrenal insufficiency consists of hormone substitution and requires high owner compliance and intense human–dog interaction. This might affect the quality of life (QoL) of owners and their pets. The aim of the study was to evaluate the impact of hypoadrenocorticism and its treatment on the QoL of dogs and their owners. Methods Owners completed a web‐based survey that contained items concerning signalment, owner QoL, dog QoL and long‐term therapy. Results Three hundred and twenty‐two owners participated. Most owners feared an adrenal crisis. Approximately half of the participants reported that the bond between them and their pet increased after diagnosis. Although many participants felt that their own QoL was not affected by their dog's disease, worries about costs and leaving their dog unsupervised were frequently reported. Half of the study participants increased their dog's glucocorticoid doses when a stressful situation was foreseeable (‘boosting’ of therapy). Some administered hydrocortisone, mostly switched from prednisolone, resulting in a reduction in side effects. Conclusions Special attention should be given to glucocorticoid therapy and owner's QoL. The overall worry of an adrenal crisis might increase caregivers’ burden, reducing their overall QoL. Hydrocortisone might be a safe alternative to prednisolone, but further research is necessary to evaluate its long‐term efficacy and safety in dogs.

Optimising the long‐term management of dogs with hypoadrenocorticism

“…A total of 322 owners of dogs with hypoadrenocorticism completed the survey, of which 255 were German-speaking and 67 were English-speaking. 11 Unlike some older reports, 3,8 dogs of both sexes were almost equally represented in the study cohort, but signalment and clinical signs were otherwise consistent with previous reports. 1,3,8 Although most owners indicated that their dog's disease did not affect their own quality of life, they reported multiple potential sources of quality of life impairment.…”

“…To help address this knowledge gap, a study by Hupfeld and colleagues, summarised on p 417 of this issue of Vet Record, used an anonymous online survey to gather information regarding the effect of long-term management of hypoadrenocorticism on the quality of life of affected dogs and their owners. 11 Data collected included the affected dogs' signalment, clinical signs, time to diagnosis and details of the therapy administered and its adjustments. In addition, quality of life tools previously validated for diabetes mellitus 12 and hyperadrenocorticism 13 were used to assess the quality of life of both the owners and their dogs.…”

“…The leading concerns included the fear of their dog having an adrenal crisis (49 per cent) and being afraid to leave their dog unsupervised (37 power cent). 11 These concerns underscore the importance of counselling owners about measures to prevent an adrenal crisis (eg, prednisolone dose adjustments during illness or stressful events) and ensure early recognition if one occurs. Furthermore, 58 per cent of owners reported being concerned about high veterinary costs, emphasising the need for vets to provide a long-term cost estimate during initial consultations for companion animals with chronic diseases.…”

“…More positively, approximately one-third of the owners felt their dog's quality of life was not at all affected by the disease, and around two-thirds believed the bond between them and their dog had become stronger since the animal's diagnosis. 11 In addition to the quality of life data obtained, Hupfeld and colleagues' study also provides information on long-term treatment of hypoadrenocorticism from the owner's perspective, with some dogs included in the study cohort having lived with the disease for five years or longer. Almost 50 per cent of owners reported…”

“…However, almost two-thirds of dogs experienced adverse side effects of prednisolone, and in a small proportion of dogs, prednisolone was replaced by hydrocortisone, which almost invariably led to improvement. 11 Indeed, hydrocortisone is the mainstay of treatment in people with hypoadrenocorticism. 14 However, while the study provides valuable information about owners' perceptions of the long-term management of hypoadrenocorticism in dogs, it is not without limitations.…”