Cushings In Dogs — 101

What is Cushing’s Disease

Cushing’s disease, also known as Cushing’s syndrome or hyperadrenocorticism, is a common endocrine disorder in dogs caused by excessive production of the hormone cortisol from the adrenal glands.

It is often the result of a benign or malignant tumor in the pituitary gland or, less commonly, the adrenal glands, leading to excessive production of cortisol by the adrenal glands.

Too much cortisol in dogs can weaken the immune system and contribute to symptoms such as kidney damage, diabetes, and can be life-threatening.

Iatrogenic Cushing’s syndrome occurs due to prolonged steroid use causing excessive cortisol; some treatments for this condition work by destroying adrenal tissue to reduce cortisol production.

Causes and Risk Factors Involving the Adrenal Glands

The most common cause of dogs Cushing's disease is a pituitary gland tumor that overproduces adrenocorticotropic hormone (ACTH), stimulating the adrenal glands to produce excess cortisol. This form is known as pituitary dependent Cushing's disease or pituitary dependent hyperadrenocorticism.

Adrenal gland tumors, which may be benign or malignant, can also cause Cushing’s disease. These adrenal tumors are responsible for adrenal dependent Cushing's disease and adrenal dependent Cushing's. Surgical removal may cure a benign adrenal gland tumor.

Certain breeds may have a genetic predisposition to Cushing’s disease. Steroid medications can cause iatrogenic Cushing's disease; however, iatrogenic Cushing's syndrome specifically results from long-term steroid use and is distinct from naturally occurring forms.

Dogs with Cushing’s disease have a higher risk of developing other diseases, such as diabetes, high blood pressure, and kidney disease.

Clinical Signs and Symptoms

Monitoring your dog's symptoms is crucial for recognizing Cushing’s disease. Common signs include increased thirst, urination, hair loss, and notably, increased appetite due to elevated cortisol levels.

Other frequent symptoms are a pot-bellied appearance, which results from the accumulation of fat in the abdominal organs and muscle atrophy, as well as thin skin and poor wound healing. An enlarged liver is also a common finding on imaging studies such as abdominal ultrasound or X-ray.

Recognizing these signs early helps prompt veterinary diagnosis and treatment.

Dogs with Cushing’s disease are also at risk of developing blood clots, high blood pressure, and kidney damage. Blood tests may reveal changes in white blood cells, which can support the diagnosis and indicate underlying health issues.

Diagnosis and Testing: The ACTH Stimulation Test

Diagnosis involves physical exams, blood tests, urine tests, and imaging studies, such as abdominal ultrasound or magnetic resonance imaging (MRI), to assess symptoms and rule out other diseases. A urine culture may be performed to rule out urinary tract infections that can mimic or contribute to similar symptoms.

The ACTH stimulation test and low-dose dexamethasone suppression test are common diagnostic tests used to confirm Cushing’s disease. Veterinarians diagnose Cushing's and diagnose Cushing's disease by using these specific tests, along with additional hormone assays and imaging, to differentiate it from other conditions.

Accurate diagnosis is essential for appropriate treatment planning and to prevent complications. Once Cushing's disease is diagnosed, treatment planning can begin.

Diagnosing Cushing’s

Diagnosing Cushing’s disease in dogs requires a combination of physical examination, medical history, and diagnostic tests, including complete blood count, blood chemistry profile, and urinalysis.

Imaging studies, such as abdominal ultrasound or MRI, may be used to evaluate the adrenal glands and detect tumors.

The diagnosis of Cushing’s disease is often confirmed by the presence of excess cortisol production, which can be measured through blood tests or urine tests.

Types of Cushing’s: Including Pituitary Dependent Cushing's Disease

Cushing’s disease in dogs is either pituitary-dependent (80-85%) or adrenal-dependent (15-20%).

Pituitary-dependent Cushing’s disease is caused by a tumor in the pituitary gland that produces excess ACTH, stimulating the adrenal glands to produce cortisol.

Adrenal-dependent Cushing’s disease is caused by a tumor in one or both adrenal glands that produces excess cortisol.

Iatrogenic Cushing’s disease is caused by prolonged use of steroid medications.

Treatment Options

Treatment for Cushing’s disease in dogs depends on the underlying cause and may include medication, surgery, or radiation therapy. To treat Cushing's disease, it is essential to have veterinary supervision to determine the best approach for each individual dog.

Medications, such as trilostane or mitotane, can help reduce cortisol production and manage clinical signs. Treating Cushing's disease with medication can result in few medication side effects if the dog is properly monitored and the dosage is carefully adjusted.

Surgical removal of the tumor may be an option for some dogs, especially those with adrenal-dependent Cushing’s disease. Removing the entire tumor is important for a positive outcome, particularly if the tumor is benign.

Radiation therapy may also be used to treat pituitary tumors.

Managing Dogs with Cushing’s Disease

Managing dogs with Cushing’s disease requires regular veterinary check-ups, blood tests, and adjustments to medication dosage as needed. Most dogs with Cushing’s disease can be successfully managed with proper treatment and monitoring.

Dogs with Cushing’s disease need to be monitored closely for signs of complications, such as diabetes, high blood pressure, and kidney disease.

A balanced diet and regular exercise can help manage the disease and improve the dog’s quality of life.

Owners should work closely with their veterinarian to develop a treatment plan and make adjustments as needed.

Life Expectancy and Prognosis

The life expectancy of dogs with Cushing’s disease varies depending on the underlying cause, severity of the disease, and response to treatment.

With proper treatment and management, many dogs with Cushing’s disease can lead normal lives and have a good prognosis.

However, dogs with Cushing’s disease are at risk of developing complications, such as diabetes, high blood pressure, kidney disease, and heart disease, which can affect their life expectancy.

Regular monitoring and adjustments to treatment can help minimize the risk of complications and improve the dog’s quality of life.

Diet and Nutrition

Dogs with Cushing’s disease may require a special diet to manage their condition and prevent complications.

A low-fat diet can help manage high cholesterol and triglycerides, which are common in dogs with Cushing’s disease.

A balanced diet that includes essential nutrients, such as protein, fat, and carbohydrates, can help support the dog’s overall health and well-being.

Owners should work with their veterinarian to develop a diet plan that meets their dog’s specific needs.

Natural Remedies and Alternative Therapies

While there are no natural remedies that can cure Cushing’s disease, some alternative therapies may help manage the condition and improve the dog’s quality of life.

Acupuncture, herbal supplements, and homeopathic remedies may be used in conjunction with conventional treatment to help manage clinical signs and prevent complications.

However, owners should consult with their veterinarian before using any alternative therapies to ensure they are safe and effective.

A holistic approach to treatment that includes conventional and alternative therapies may be the most effective way to manage Cushing’s disease in dogs.

Living with Cushing’s Syndrome

Living with Cushing’s syndrome in dogs means committing to ongoing care and close communication with your veterinarian. Dogs with Cushing’s disease, especially those with pituitary dependent Cushing’s disease, require regular veterinary visits to monitor their adrenal gland function and adjust medication dosage as needed. Blood tests, such as the ACTH stimulation test, are essential tools for tracking cortisol production and ensuring that your dog’s hormone levels remain within a healthy range.

Owners should be vigilant in observing clinical signs, including excessive thirst, increased urination, changes in appetite, hair loss, and any new or worsening symptoms. Promptly reporting these changes to your veterinarian can help in making timely adjustments to the treatment plan and prevent complications. In cases of adrenal dependent Cushing’s disease, where an adrenal tumor is present, surgical removal of the affected adrenal gland may be recommended. While this major abdominal surgery can help some dogs regain normal health, it is typically reserved for cases where the tumor is benign and can be completely removed.

Veterinary medicine offers a range of options for treating Cushing’s disease, from medication to surgery, and your veterinarian will help determine the most appropriate treatment for your dog’s specific needs. Supporting your dog’s overall well-being may also involve dietary changes and lifestyle modifications. By staying proactive and working closely with your veterinary team, you can help your dog maintain a good quality of life despite the challenges of Cushing’s disease.

Conclusion on Canine Cushing’s

Cushing’s disease in dogs is a common endocrine disorder that results from excess cortisol production, most often due to a pituitary tumor or, less commonly, an adrenal tumor. Accurate diagnosis relies on a combination of physical examination, diagnostic tests such as the low-dose dexamethasone suppression test and ACTH stimulation tests, and imaging studies like abdominal ultrasound or magnetic resonance imaging. Once Cushing’s disease is diagnosed, treatment typically involves medication to control cortisol production, and in some cases, surgical removal of the tumor may be necessary.

It is vital for dog owners to recognize the signs of Cushing’s disease—such as increased urination, excessive thirst, hair loss, and changes in appetite—and seek veterinary care promptly. With appropriate treatment and regular monitoring, including follow-up blood tests and urine tests to track cortisol levels and adjust medication dosage, many dogs can regain normal health and enjoy a good quality of life. However, ongoing vigilance is needed to prevent complications like high blood pressure, blood clots, and kidney damage.

By understanding the causes, clinical signs, and treatment options for Cushing’s disease, and by working closely with your veterinarian, you can help your dog manage this condition effectively. Regular check-ups, diagnostic tests, and careful observation at home are key to ensuring your dog’s continued well-being and helping them thrive despite their diagnosis.