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Cushing's Disease
Cushing's Disease, otherwise referred to as Hyperadrenocorticism, can be managed well with life long medication.
Overview
Cushing's Disease is a problem of middle-aged dogs (5-8 years) whereby the adrenal glands overproduce cortisol. Cortisol is the 'stress' hormone that regulates the body's response to stress including blood sugar levels. It tends to affect females more than males.
Breeds more commonly affected:
- Maltese
- Pomeranians
- Poodle
- Dachshund
- Boston Terrier
- Beagle
- German Shepherd
- West Highland White Terrier
- Springer Spaniel
- German Short Haired Pointer
- Basset Hound
- Staffordshire Bull Terrier
Signs
Common signs of Cushing's Disease:
- Drinking more
- Urinating more
- Change in appetite
- Swollen abdomen
- Hair loss on the sides of the body
- Crusty skin infections
- Vomiting
- Depression
- Weakness
- Weight loss
- Diarrhoea
- Urinary infection
- Muscle wasting or cramping
- Facial nerve paralysis
Causes
Common causes of Cushing's Disease:
- Pituitary disease/tumour (85% of cases)
- Adrenal tumours (15% of cases)
The overdosing of glucocorticoid drugs can cause signs similar to that of Cushing's Disease. This is referred to as Iatrogenic Cushing's Disease. Management involves the gradual decrease and discontinuation of steroid medication.
Diagnosis
Diagnosis may include a thorough history, physical examination, multiple blood tests, ultrasound, and urine tests. Other blood tests may require a short day-stay to perform eg the ACTH Stimulation Test or LDDST Blood Test.
Management
Treatment of Cushing's Disease may involve:
- Ongoing medication if pituitary-dependent Cushing's Disease
- Surgery or medication if adrenal tumours or pituitary tumours are present
- Radiation to shrink a pituitary tumour
Long-term medication will be given as a guide initially - regular blood tests are required to help determine the right dose for your pet.
Complete remission is usually seen with hair regrowth within a few months.
What to Expect
As Cushing's patients require long-term medication such as Trilostane (Vetoryl) or Mitotane (Lysodren), your pet will be monitored for potential side effects such as:
- Off food
- Depression
- Weakness
- Vomiting
- Diarrhoea
These signs are usually seen within the first 2-3 weeks.
Care must be taken when handling Trilostane and Mitotane as they are chemotherapeutic drugs. Please follow the instructions carefully.
Prognosis
The prognosis for a pet with pituitary-dependent Cushing's Disease is good with treatment. Signs such as appetite and water intake may improve quickly or take several months e.g. hair growth to be corrected.
85-95% of dogs that undergo pituitary tumour removal will regain hormonal balance.
Dogs that undergo adrenal tumour removal can be curative.