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Background  Naturally occurring adrenocortical insufficiency ( NOAI ) in dogs is considered an uncommon disease with good prognosis with hormonal replacement treatment. However, there are no epidemiological studies with estimates for the general dog population.    Objectives  To investigate the epidemiological characteristics of  NOAI  in a large population of insured dogs.    Animals  Data were derived from 525,028 client‐owned dogs insured by a Swedish insurance company representing 2,364,652 dog‐years at risk ( DYAR ) during the period between 1995–2006.    Methods  Retrospective cohort study. Incidence rates, prevalences, and relative risks for dogs with  NOAI  ( AI  with no previous claim for hypercortisolism), were calculated for the whole dog population, and for subgroups divided by breed and sex. Mortality rates were calculated and compared in dogs with  NOAI  and the remaining dogs overall.    Results  In total 534 dogs were identified with  NOAI . The overall incidence was 2.3 cases per 10,000  DYAR . The relative risk of disease was significantly higher in the Portuguese Water Dog, Standard Poodle, Bearded Collie, Cairn Terrier, and Cocker Spaniel compared with other breeds combined. Female dogs overall were at higher risk of developing  AI  than male dogs ( RR  1.85; 95%  CI , 1.55–2.22;  P  < .001). The relative risk of death was 1.9 times higher in dogs with  NOAI  than in dogs overall.    Conclusion and Clinical Importance  The data supports the existence of breed‐specific differences in incidence rates of  NOAI  in dogs.

Naturally Occurring Adrenocortical Insufficiency – An Epidemiological Study Based on a Swedish‐Insured Dog Population of 525,028 Dogs