Around this time last year, Zelda came to see me for her annual check up. Her mom reported that she had vomited a couple of times over the two to three days prior to her visit. Her examination at that time was routine and an intestinal parasite test later revealed the presence of a parasite called giardia known to cause gastrointestinal upset. I began treatment for giardiasis and Zelda seemed to be feeling better after a few days.
However, one week later Zelda came back to see me as her vomiting had suddenly returned. At this visit, she was extremely lethargic and dehydrated. Labwork performed at that time showed abnormal electrolyte levels and otherwise was suggestive of pancreatitis, a severe condition that causes inappetance, vomiting, diarrhea, and abdominal pain. While it is possible for parasites like giardia to cause enough GI upset to eventually lead to pancreatitis, something just didn’t add up with Zelda’s waxing and waning lethargy and episodic vomiting. She remained in the hospital for several days receiving supportive care and treatment. We were able to stabilize her condition but she just did not seem to be improving. I can still remember how worried her mom and grandmother were as we all struggled to make sense of this sudden and debilitating illness. As a result, I decided to perform a specific test for a relatively rare condition known as Addison’s that seemed to explain many of her symptoms and labwork changes. Addison’s disease is a condition in which the adrenal glands fail to produce enough steroid hormones to allow the body to function normally. It is an extremely serious condition that can lead to dehydration, coma, or even death.
As suspected, she tested positive which allowed me to begin an injectable medication called Percorten. Almost immediately, her strength returned, she began eating, and was able to return home to her family. We have continued to give Zelda her injections every 28 days, and other than occasional labwork monitoring, she has been able to live a normal, happy life. She is as sweet as she looks in her picture, and we always look forward to her visits.