Cushing’s disease: Symptoms and treatment

Certain breeds are more prone to Cushing's disease

Cushing’s disease is an increasingly recognized hormonal disorder of middle age and older dogs. Although it can occur in any breed, some of the more common breeds include Dachshunds, Schnauzers, Poodles, and Beagles. Symptoms most commonly observed include significant increased thirst, urination, or appetite, as well as weight gain and the development of a pendulous and distended abdomen.

Thin skin often develops as well as the propensity to recurrent skin and/or ear infections. Hair thinning and loss can occur on its own without any accompanying itching, and also involves the lower back in symmetrically on both sides.

The disease is due to an overproduction of cortisol by the body, either most commonly due to a small tumor in the pituitary gland of the brain, or a tumor of the adrenal gland that manufactures most of the body’s own cortisol. Various blood tests done by your veterinarian, as well as ultrasound can usually distinguish between these different causes of Cushing’s disease. Along with the excessive production of the hormone cortisol, the pet becomes at increased risk for secondary infections of most commonly the skin or urinary tract, with some pets even developing secondary diabetes.

The other major complication of untreated Cushing’s disease includes the development of high blood pressure or hypertension which if not treated can lead to kidney damage, sudden blindness, heart failure, or even the development of blood clots and sudden death.  Most veterinarians can now measure the blood pressure of your pet, and there are some excellent prescription medications such as Norvasc, Enalapril and drugs called beta blockers, which can help manage this common complication of Cushing’s disease.

One of the biggest mistakes that veterinarians make in treating this disease is in over diagnosis based on laboratory tests alone. This is especially important to understand and recognize, since some of the treatments used to treat Cushing’s disease can have occasional serious side effects. So, it is important to be as accurate on the diagnosis of the condition as possible. For example, if a pet does not have some combination of the above symptoms, especially the increased thirst/urination and appetite, a veterinarian should reconsider the diagnosis before starting treatment for Cushing’s disease, as many of the blood and urine tests used in diagnosis can have false positive tests. Without the clinical symptoms present and/or hypertension, I would think long and hard before deciding to presumptively treat a dog for this serious medical condition with many of the drugs I am about to mention.

One of the oldest and still most effective treatments for Cushing’s disease is the prescription drug called Lysodren. While it is one of the more economic alternatives for long term treatment of this disease, some dogs can have side effects of vomiting, loss of appetite, and lethargy at some point during treatment. It is always important to be under the regular care and blood test monitoring of a veterinarian when being treated for this disease.  A newer drug which many have deemed the drug or choice now in treating this disease is called Trilostane (trade name Vetoryl). While this drug has fewer side effects than Lysodren, rare but severe reactions can still occasionally occur, thus again stressing the need to be under a veterinarian’s care and supervision while using these drugs.  Other drugs such as Ketoconazole, Anipryl and Selegiline have been much less effective in my opinion, as well as most others in treating this disease.

It is also important to also appreciate the role that good and healthy nutrition through natural diets such as Wysong or Azmira, as well as nutritional supplementation with products like Proanthozone, Super Pure Omega 3 and NaturVet Enzymes and Probiotics (conveniently and economically packaged as the endocrine package deal) can help in managing dogs with these and other hormonal diseases. Vetri-DMG liquid is also an excellent immune system modulator that is wonderful to include to help keep a pet’s immune system strong, when an animal suffers from such a severe and chronic stressful hormonal condition like Cushing’s disease.

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