Air Travel with a Dog with Addison’s Disease

I have a 10-year old, 25 kg, female lab who was diagnosed with Addison’s disease about 5 years ago. She has been well-controlled on oral Florinef (0.3 mg, twice daily) and prednisone (2.5 mg, once daily).

I am moving from Canada (Nova Scotia) to Europe and do not want to leave her behind, if it is at all possible.  Do you think that I could fly her to Europe with me or that is not an option?

 I'll do whatever you recommend and feel is best for my dog!

My Response: 

As you have proven in your dog, primary hypoadrenocorticism (Addison's disease) is a readily treatable disease with an excellent prognosis, provided that proper monitoring and treat­ment is maintained for life. Dogs on adequate maintenance therapy should expect to lead rela­tively healthy lives, with no obvious impairment to exercise or other usual activities (1,2).

Therefore, if your dog's Addison's disease is well-controlled, flying should not be a problem. Before you go, I'd repeat a serum chemistry profile, which should include tests for kidney function (urea nitrogen and creatinine) as well as serum electrolytes (sodium, potassium). We want to make sure that her Addison's disease is perfectly regulated the day she leaves for her new home in Europe.

However, it is vitally important remember that these dogs have no adrenocortical reserve and cannot secrete additional cortisol in times of stress, like normal animals would be expected to do. Therefore, any non­adrenal illness or stressful event (such as air travel) needs to be matched with an appropriate increase in the amount of gluco­corticoid administered.

So what does that mean in practical terms for your dog? Because of the stress of the air travel, however, I would recommend that you increase the glucocorticoid supplementation (i.e., the prednisone) on the day that you travel. You are giving a relatively low maintenance dose of prednisone now (0.1 mg/kg/day). I'd recommend that you double this daily dose on the day you travel and continue the higher dose (as needed) for 2-3 days once you arrive.

References:

1. Kintzer PP, Peterson ME. Treatment and long-term follow-up of 205 dogs with hypoadrenocorticism. J Vet Intern Med 1997;11:43-49. 
2. Church DB. Canine hypoadrenocorticism In: Mooney CT, Peterson ME, eds. BSAVA Manual of Canine and Feline Endocrinology. Fourth ed. Quedgeley, Gloucester: British Small Animal Veterinary Association, 2012;156-166.