Excessive thirst and frequent urination are signs of four serious canine medical problems, including diabetes, kidney problems, liver disease, and Cushing’s disease. Unfortunately, not treating Cushing’s disease could precipitate the others.
After running basic tests, your vet has ruled out the first three, leaving Cushing’s disease as the diagnosis.
What is Cushing’s disease?
Cushing’s disease or Cushing’s syndrome, as it is sometimes called, is also known as hyperadrenocorticism. Due to the fact that older dogs are more prone to tumors, it is most often found in middle-aged and older dogs. That doesn’t mean younger dogs are immune.
The disease is a disease caused by excessive production of cortisol, a natural steroid hormone. It is normally released in response to stress or low levels of glucocorticoids in the blood. The main functions are to increase blood sugar, metabolize fats, proteins, and carbohydrates, and suppress your dog’s immune system.
This disease can be controlled, but not cured.
There are three known origins of Cushings. They are: Tumors, Lactrogenic or “Veterinary Induced Cushings” from excessive use of glucocorticoid medications (steroids, i.e. prednisone, prednisolone, hydrocortisone, etc.) and andrenocorticotropic hormone (ACTH) also produced by the pituitary gland.
Most often, the source of the disease is an overactive pituitary gland, which is located at the base of the brain. Approximately 85% of Cushings in dogs are from a tiny benign tumor in the pituitary gland.
In the other 15% of cases, it can be caused by a tumor in one or both of the adrenal glands, which are located in front of the kidneys. Approximately 50% of these tumors are benign.
Signs and Symptoms – What to watch for.
There are more than a few signs and symptoms of Cushing’s disease in dogs, including: swollen belly, excessive thirst, frequent urination, accidental urination in the house, increased appetite, weight gain, excessive shedding, baldness, difficulty breathing, lethargy, seeking cooler places to sleep, loss of muscle mass, high blood pressure, excessive panting, anxious/restless appearance, delayed wound healing, thin skin, easy bruising, and mood changes. For some, they are reluctant to get on or off furniture. Changes in the coat, such as brittleness and dullness, are also an indication.
Dogs suffering from Cushing’s are prone to ear, skin, and urinary tract infections.
Who gets Cushing’s Syndrome?
All races and ages are at risk. The middle age and older people even more so.
The breeds that seem most predisposed are: Beagle, Boston Terrier, Boxer, Dachshund, German Shepherd, Golden Retriever, Jack Russell, Labrador Retriever, Scottish Poodle and Yorkshire Terrier.
Women are thought to be at slightly higher risk. Spayed and neutered dogs are thought to be more prone than intact animals.
Signs and symptoms often begin to appear when the animal is about 10 years old or older. The sooner the owner suspects and acts, the better it is for his pet.
How is Cushing’s diagnosed?
Starting with the basic blood tests used as a baseline, there are a number of tests that can be done to help diagnose the disease.
The ACTH sham test uses the initial blood test as a reference. Your dog is then injected with ACTH, andrenocorticotopic hormone, to stimulate the glands to release their hormones. A dog will have a very high level of cortisol. The elevated cortisol level is then measured and compared to baseline. This test cannot differentiate between pituitary and adrenal Cushing’s.
Urine cortisol/creatinine ratio test can rule out Cushings.
The low dose dexamethasone suppression test is the most recommended and has shown the best results in diagnosing Cushings.
The high-dose dexamtasone suppression test is used to differentiate which type, pituitary or adrenal Cushing’s.
MRIs and CT scans are also used to detect and monitor the progress of this disease.
Is Cushing’s treatable?
Yes, but be careful, there is no cure. There are options to help make your pet more comfortable and improve their quality of life. They include:
1. If your dog is older and suffers from arthritis or other serious health problems, it may be best to leave him alone. At his age and in his condition, treatments can be too stressful.
2. Chemotherapy can be used for both pituitary and adrenal tumors.
3. Radiation is most often used for pituitary tumors.
4. Surgery is most often used to remove adrenal tumors, since they are usually larger. Only experienced veterinarians should perform this surgery.
5. Medications: Some have serious side effects for the dog. You must be careful when handling Lysodren!
Lysodren, the most common medication prescribed for pituitary tumors. Serious side effects are known. Periodic ACTH testing is needed when using this medication. It should not be handled by pregnant women. Surgical gloves should be worn during handling. Wash your hand well!
Anipryl is a psychotropic drug, whose various side effects have been found to have some positive effects on Cushings.
Ketoconazole is an antifungal drug whose side effects have been found to have several positive effects on Cushings.
Vetoryl is an adrenosuppressant. The British have encouraging reports of its safety and efficacy.
6. By gradually reducing and eliminating the amount of steroids your dog has been prescribed by your vet, you can treat Lactrogenic or “Vet-Induced Cushings”. This allows the acorns to return to their normal function.
What happens if Cushings is not treated?
As mentioned, there is no cure for Cushings, but depending on your dog’s age and general health, it can be managed. If left untreated, your dog can develop diabetes, hypertension, seizures, congestive heart failure, blood clots, pancreatitis, liver and/or kidney failure.
Bottom line: Cushing’s disease is serious. Taking into account your dog’s age and general health, as well as the progression of the disease, plus sufficient research and talking to not only your vet, but also getting a second opinion, will help you make a responsible decision. about what you think is best. Treatment for your pet. Knowing that there is no cure, his conclusion will focus on giving them the best quality of life, during the time they have to share together.