Case Study: Uncovering Atypical Addison’s Disease in a Great Dane
“Sometimes the most important finding is the absence of an expected response.” What happens when a patient’s lab work looks deceptively normal, even as they are getting sicker? Join us for the case of Libby, a Great Dane whose pneumonia was apparently improving on x-rays, yet she was mysteriously deteriorating, with recurrent vomiting and lethargy. The pivotal clue wasn’t an abnormality on her CBC, but rather the glaring absence of one.
In this episode of Tails From the Lab, Drs. Holly Brown and Brad Ryan unravel a case where the lack of a classic stress leukogram in a critically ill dog pointed toward a hidden diagnosis. Libby’s journey from aspiration pneumonia to a life-changing discovery of atypical Addison’s disease highlights how looking for what’s missing can be the key to solving the most confusing medical mysteries.
Listen now to discover:
- Why the absence of an expected stress leukogram in a sick dog should be a red flag for clinicians
- How hypoadrenocorticism can be missed when it presents without classic electrolyte abnormalities
- The importance of integrating all diagnostic data, including labwork and imaging studies, for more accurate diagnoses and appropriate care
Tails From the Lab is a production of Antech Diagnostics™. The intent of this podcast is to provide education and guidance with the understanding that any diagnostic testing and treatment decisions are ultimately at the discretion of the attending veterinarian within the established veterinarian-patient-client relationship.
Meet Your Hosts
Brad Ryan, MSC, DVM, MPH
Dr. Brad Ryan graduated cum laude with his Bachelor of Arts in public relations from Miami University in 2003, his Master of Science in mammalian biology with distinction from the University of Pretoria in South Africa in 2008, his Doctor of Veterinary Medicine from The Ohio State University College of Veterinary Medicine in 2016, and his Master of Public Health in veterinary public health from The Ohio State University College of Public Health in 2017. Dr. Ryan has treated small animals, exotic pets, and wildlife in veterinary hospitals across the United States and served as Program Manager for the Smithsonian Global Health Program at the National Zoo in Washington, DC. His professional interests include veterinary public health and abating the spillover of zoonotic diseases from animals to people. Speaking/presenting topics: zoonotic diseases, vector-borne diseases, parasitology, and promoting “One Health”.
Dr. Ryan resides in Ohio with his giant schnauzer, Evan Williams. He is an avid outdoorsman, has thru-hiked the Appalachian Trail from Georgia to Maine and successfully summited Mt. Kilimanjaro. He enjoys wildlife photography and international travel. In May 2023, Dr. Ryan completed his journey to all 63 U.S. National Parks with his 93-year-old Grandma Joy, the oldest person to accomplish this feat. He is an accomplished keynote speaker advocating for LGBTQ+ inclusivity in the great outdoors, mental health, and the power of intergenerational connection.
Holly Brown, DVM, PhD, DACVP
Holly is a veterinarian, board-certified clinical pathologist, and figurative hand-holder. She practiced small animal medicine before, during, and after her specialty training — grateful to have combined her love of clinical practice and the laboratory diagnostics that support it. Holly remains in the trenches at a general, referral, and emergency practice. She loves making an impact at the interface of laboratory data and patient care. Holly recently transitioned into her new role as Chief Veterinary Educator for Antech Diagnostics — exercising her passion for delivering education about maximizing diagnostic testing. When away from the office, she enjoys traveling with her family, snuggling her sugar-sweet bird dog and tripod cat, and dreaming of home renovations that rarely come to fruition.
