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
Vomiting
Depression
Weakness
Weight loss
Diarrhoea
Urinary infection
Muscle wasting or cramping
Facial nerve paralysis

Causes

Common causes of Cushing's disease:

Pituitary disease (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 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 hospital stay to perform the ACTH stimulation or LDDST blood test.

Management

Treatment of Cushing's disease involves:

Ongoing medication if pituitary-dependent Cushing's disease
Surgery or medication if adrenal tumours are present

Long-term medication will be given as a guide initially - regularly 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.

Tips

As Cushing's dogs require long-term medication such as trilostane (Vetoryl) (or less likely 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 mitotane as it is a chemotherapeutic drug. Please follow instructions carefully. We mainly use trilostane these days though).