Dog Addison's Disease Diet Guide

Practical, evidence-based nutrition guide for dogs with Addison's (hypoadrenocorticism): electrolyte balance, sodium use, stress-day feeding, and consistent nutrition.

Nutritional Snapshot

• Key metabolic issues: hyponatremia (low sodium), hyperkalemia (high potassium), risk of hypovolemia and hypotension.
• Energy: Calculate RER = 70 × (kg^0.75); typical maintenance MER ≈ 1.4–1.8 × RER depending on activity (see examples below).
• Macronutrient aim: protein 20–30% kcal, fat 20–40% kcal, carbohydrates 30–50% kcal; fiber 2–6% (DM basis).
• Electrolytes: monitor sodium (Na) and potassium (K) closely; maintain consistent daily sodium intake; avoid supplemental potassium unless directed by your veterinarian.
• Supplements commonly considered: veterinary-guided sodium chloride (NaCl) if hyponatremic and not fully corrected by medication, omega-3 fatty acids for overall health, probiotics during GI upset.

Why diet matters in Addison's disease (hypoadrenocorticism)

Primary hypoadrenocorticism commonly causes both glucocorticoid and mineralocorticoid deficiencies. Loss of mineralocorticoid (aldosterone) activity results in sodium loss (hyponatremia) and potassium retention (hyperkalemia). These electrolyte shifts, and the risk of poor appetite, vomiting or diarrhea during “Addisonian crises,” are the main reasons nutrition and fluid/electrolyte management are critical.

Medical therapy (fludrocortisone or DOCP injections plus glucocorticoid replacement) is the cornerstone of treatment; dietary management is an important adjunct to help maintain steady electrolytes, body condition, and reduce GI upset during stress.

Sources: WSAVA Global Nutrition Guidelines; AAFCO nutrient profiles; NRC 2006 nutrient guidance; Small Animal Clinical Nutrition (Hand et al.).

Energy requirements — specific calculations and examples

• Resting Energy Requirement (RER) = 70 × (body weight in kg)^0.75
• Maintenance Energy Requirement (MER) = RER × activity factor (commonly 1.4–1.8 for adult neutered/active dogs). Use lower end for less active dogs.

• 5 kg dog: RER = 70 × 5^0.75 ≈ 293 kcal/day → MER ≈ 410–530 kcal/day
• 15 kg dog: RER ≈ 533 kcal/day → MER ≈ 750–960 kcal/day
• 25 kg dog: RER ≈ 831 kcal/day → MER ≈ 1,160–1,500 kcal/day

Macronutrient recommendations (practical targets)

• Protein: 20–30% of kcal (AAFCO adult dog foods have a minimum of ~18% crude protein on an as-fed basis; aim for high-quality animal protein). Protein supports repair and lean body mass.
• Fat: 20–40% of kcal. Adequate fat ensures calorie-dense meals for dogs with reduced appetite.
• Carbohydrates & fiber: remaining kcal; moderate fiber (2–6% on DM) for GI health.

Key micronutrients and supplements (what to watch and why)

• Sodium (Na): the most critical electrolyte in Addison’s. Many dogs with untreated mineralocorticoid deficiency benefit from higher sodium in the short term, but sodium dosing must be individualized after medical therapy starts. Maintain consistent daily sodium intake — rapid swings can destabilize fluids and blood pressure.
• Potassium (K): typically elevated in Addison’s. Avoid potassium-rich supplements and high-K foods unless your veterinarian instructs otherwise.
• Chloride (Cl): follows sodium; important for acid–base balance.
• Magnesium, calcium: monitor if clinical signs suggest electrolyte disturbances or with long-term steroid use.
• Vitamin D: generally not required as specific therapy for Addison’s but monitor calcium/phosphate.
• Omega-3 fatty acids (EPA/DHA): beneficial for general health and may help with inflammatory conditions or skin issues.
• Probiotics: useful for dogs with intermittent GI upset.

Sodium supplementation — considerations and safe approach

• Sodium supplementation (oral NaCl) is sometimes used temporarily in dogs with persistent hyponatremia despite appropriate mineralocorticoid therapy, or in dogs who are not yet stabilized on medication.
• The dose is highly individualized. Small amounts of table salt added to food (for example, a small pinch) are sometimes suggested by clinicians, but this should only be done under veterinary guidance. Excess sodium can cause hypertension and fluid retention, especially once mineralocorticoid therapy is optimized.
• If your veterinarian prescribes oral sodium, they will base the dose on clinical signs, serial electrolyte measurements (Na, K), blood pressure, and the type/dose of replacement medication.

Foods to include and foods to avoid

Foods to include

• High-quality, AAFCO-complete commercial diets labeled for adult maintenance (consistent brand/recipe to avoid daily sodium swings).
• Moderately sodium-enhanced formulations only if prescribed by your veterinarian.
• Easily digestible proteins (chicken, turkey, lean beef, fish) for dogs with poor appetite or GI upset.
• Cooked rice and lean cooked potatoes (note: potatoes have potassium — limit if your dog has hyperkalemia and follow vet advice).
• Added palatability enhancers (low-sodium broth, warm food) during stress days.

• High-potassium foods when hyperkalemia is a concern: bananas, avocado, spinach, tomato, potatoes/sweet potatoes in large amounts, beans/legumes.
• Uncontrolled high-sodium human foods (processed meats, bacon) unless sodium is being increased under veterinary direction.
• Large, fatty meals during GI upset — offer smaller, bland meals.

Stress-day feeding adjustments (illness, travel, vet visits)

• Primary action for a stressed Addisonian dog is medical: follow your veterinarian’s “stress dose” steroid plan (usually an increase in oral glucocorticoid or parenteral injection). Nutrition supplements are adjunctive.
• Feeding approach during stress:

• If the dog is vomiting, has severe diarrhea, or is lethargic, seek immediate veterinary care — oral feeding may need to be paused and IV fluids/electrolyte correction started.

Recommended feeding schedule

• Typical adult schedule: 2 meals per day (morning/evening) to maintain steady intake and electrolyte balance.
• For dogs with poor appetite or during stress: 3–4 small meals/day.
• Keep daily diet composition and sodium content consistent day-to-day.

Sample feeding guidelines and meal plan (examples)

All sample amounts are illustrative. Consult your veterinarian for exact portions for your dog.

Example A — 15 kg adult dog, moderately active (MER ~ 850 kcal/day)

• Commercial diet (kcal content 350 kcal/cup): feed ~2.4 cups/day split into 2 meals (~1.2 cups twice daily).
• If adding a palatability topper: up to 10–15% of daily kcal as low-sodium broth or small amount of cooked lean meat.

• Commercial diet (400 kcal/cup): feed ~3.0 cups/day split into 2 meals (1.5 cups twice daily).

• 2/3 cup cooked white rice + 1/3 cup cooked shredded chicken (skinless) per 10 kg body weight divided into 2–3 small meals. This is not a complete diet long-term; use for 1–3 days and transition back to a balanced commercial diet.

Transitioning tips (introducing or changing diets)

• Gradual transition over 7–10 days: start with 25% new food/75% old for 2–3 days, then 50/50 for 2–3 days, then 75/25 for 2–3 days, then 100% new.
• For dogs with very sensitive appetites or GI signs, extend the transition to 2–3 weeks and change in smaller increments.
• Keep sodium content stable during transitions — swap to a new food with similar sodium content when possible.

Signs your diet is working

• Stable body weight and body condition score.
• Normal energy and activity for your dog.
• Normal appetite with few missed meals.
• Stable electrolyte panel (sodium and potassium within reference ranges) on rechecks performed by your veterinarian.
• No recurrent vomiting or diarrhea; normal stool quality.
• Stable blood pressure and absence of signs of dehydration or edema.

Red flags — when the diet or plan needs adjusting (seek veterinary care)

• Recurrent weakness, collapse, severe lethargy, or collapse — possible Addisonian crisis.
• Repeated vomiting or severe diarrhea leading to inappetence or dehydration.
• New or worsening weight loss despite adequate calories.
• Cardiac signs (slow heart rate, arrhythmia) or signs of hyperkalemia.
• High blood pressure after sodium supplementation or after changing mineralocorticoid dose.

Practical tips to keep nutrition consistent and safe

• Use the same commercial food and predictable treat allowances every day to avoid large sodium swings.
• Weigh food on a kitchen scale for accuracy rather than estimating by cups when precise intake matters.
• Keep a record (log) of daily food, treats, medications, and any episodes of vomiting/diarrhea to share with your veterinarian.
• Schedule regular rechecks (electrolytes, renal values, blood pressure) when adjusting diet or medication.

Final notes and resources

Dietary management is supportive — medical therapy for cortisol and mineralocorticoid replacement is essential. Because sodium and potassium handling can shift with medication, diet must be individualized and monitored.

Consult your veterinarian or a board-certified veterinary nutritionist for personalized dietary recommendations.

Primary resources and guidelines referenced:

• WSAVA Global Nutrition Guidelines
• AAFCO Dog Food Nutrient Profiles
• NRC (National Research Council) Nutrient Requirements of Dogs and Cats (2006)
• Hand MS, et al. Small Animal Clinical Nutrition (standard reference)

Consult your veterinarian or a board-certified veterinary nutritionist for personalized dietary recommendations.

Frequently Asked Questions