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What Is Cushing's Disease in Dogs?
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What Is Cushing's Disease in Dogs?

Critter Culture Staff

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As our dogs grow older, they face various health issues, just like humans do. One common condition in dogs, especially those over six years old, is Cushing's disease, also known as hyperadrenocorticism (HAC). While this disease can also affect horses and cats, it's much more common in dogs.

Every year, about 100,000 dogs are diagnosed with Cushing's disease. This makes it important for dog owners, particularly those with older pets, to understand what this disease is. Getting the right diagnosis is key because it leads to the best treatment options. The tricky part about Cushing's disease is that its symptoms don't show up all at once. They develop slowly, much like the signs of aging, so it's easy for them to go unnoticed at first. Often, it's only when the more serious symptoms begin to show that dog owners realize something is wrong.

Knowing about Cushing's disease, its gradual onset, and the importance of early detection can make a big difference in managing the condition. It's all about keeping an eye out for the subtle changes in your dog's health and behavior as they age. This awareness can help ensure that our canine friends get the care they need to live comfortable lives, even as they get older.

1

What is Cushing’s disease?

Cushing’s disease causes the body to produce too much cortisol, a hormone that the adrenal glands produce and store. Normally, cortisol helps dogs adapt to stress and plays a role in the “fight or flight” response. It regulates skin health, body weight, and tissue structure. An overabundance of cortisol weakens the dog’s immune system. Cushing’s disease mimics other diseases, so the symptoms may not be as noticeable in the early stages.

cortisol stress dog delectus / Getty Images

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2

The three types of Cushing’s disease

Over 80% of the dogs diagnosed with Cushing’s have developed a tumor on the pituitary gland, located at the base of their brains. Pituitary-dependent hyperadrenocorticism (PDH) is usually benign. A smaller number of dogs, about 15%, develop a tumor on the adrenal glands just in front of the kidneys. Adrenal tumor hypercortisolism produces tumors. Research shows that about half of these tumors are malignant, while the other half are benign. Vets describe the third type as iatrogenic Cushing’s disease. If a dog receives long-term, cortisol-like steroids as a treatment for a legitimate medical condition, they are at a higher risk of developing the disease. Steroids can lead to an excess of cortisol and cause the same symptoms as the naturally occurring Cushing's disease.

tumor pituitary treatment Kerkez / Getty Images

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3

Breeds more commonly diagnosed

Larger breeds are more prone to adrenal tumor hypercortisolism. Female dogs are three times more likely than male dogs to develop adrenal-type Cushing’s disease. Most research indicates that veterinarians diagnose PDH in higher numbers in specific breeds, including dachshunds, terriers, and poodles. Some vets say that there is a higher prevalence of PDH in beagles, boxers, German shepherds, Labrador retrievers, American Eskimo dogs, Australian shepherds, Maltese, and cocker spaniels.

breeds diagnosed dachshunds lumenphoto / Getty Images

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4

Early signs and symptoms of Cushing’s disease

Because the signs mimic aging, the early symptoms often go unnoticed. Most dogs with Cushing’s disease experience a significant increase in appetite. This is because cortisol stimulates the appetite. Owners also notice an increase in their dog’s water consumption. Their pet may also pant more than usual. Lethargy is another early symptom. The dog isn’t as active as usual. They may seem drowsy or have no interest in playing, going for walks, or other normal activities. Owners will likely notice that their dog is urinating more often. Their pet may start accidentally urinating indoors.

cortisol stimulates appetite AVAVA / Getty Images

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5

Other symptoms of the disease

Cushing’s is a progressive, chronic disease. As it progresses, the owner notices hair loss on their dog’s back and body, but not on the head and legs. Some owners observe that their dog’s hair doesn’t grow back as quickly between groomings or clippings. Increased muscle weakness leads to the dog’s inability to perform activities they didn’t have trouble with before. This includes climbing stairs or jumping into a car. Their skin may thin out, which makes them more prone to skin infections. But one of the most prominent symptoms is an enlarged abdomen. Dogs with Cushing’s have a pot-bellied appearance.

hair loss body tzahiV / Getty Images

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6

Diagnosis

Because the symptoms mimic other conditions, a veterinarian will first consult with the owner and discuss the symptoms. After examining the dog, the vet will determine whether or not the symptoms indicate Cushing’s disease. They will then perform basic blood and urine tests. Dogs that have the condition usually exhibit high blood pressure, urinary tract infections, dilute urine, and increases in blood cholesterol. If the urine and blood tests confirm the initial diagnosis, the vet may perform additional tests to determine the type of Cushman’s disease. These include:

  • ACTH stimulation blood tests
  • Low-dose dexamethasone suppression (LDDS) blood test
  • Chest X-rays
  • CT scan
  • MRI
  • Abdominal ultrasound
  • Hair analysis

veterinarian blood test simonkr / Getty Images

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7

Treatment for PDH

If the testing confirms a pituitary tumor, the veterinarian may suggest removing the tumor surgically. However, this type of treatment is still under development and not widely available. Radiation is another option. Most vets prescribe medications instead. Some of these medications block cortisol production. Other types of medications kill cortisol-producing cells. Administering the proper amount of prescribed medication is essential. Under-dosing can lead to continued symptoms and complications. If the dosage is too high, it may cause the dog to become seriously ill or lead to additional symptoms.

surgically removing tumor faustasyan / Getty Images

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8

Treatment for adrenal-type Cushing’s disease

Veterinarians usually treat adrenal tumors surgically. The vet may remove the tumor. However, some vets use a minimally invasive procedure using a fiberoptic instrument called a laparoscope. Leading up to the surgery, the vet may prescribe additional medical treatments. Following the surgery, the vet usually prescribes cortisone replacement therapy. This can last for a few weeks to several months. If the tumor is malignant and the malignancy has spread to other areas, the vet will likely not recommend surgery. Instead, they will prescribe medical treatments to control the dog’s symptoms.

vet treatment adrenal KatarzynaBialasiewicz / Getty Images

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9

Prognosis

Most dogs respond well to treatment. Medications usually keep Cushing’s tumors in check. If the tumor is malignant, however, the prognosis is poor. Dogs with pituitary-type Cushing’s usually survive an additional 2 years. Without treatment, the dog will continue to have problems that may get worse. They will eat more, drink more water, and experience increased urination. Uncontrolled Cushing’s disease leads to weakness, high blood pressure, diabetes, lung and respiratory disease, fragile skin that is prone to infections, recurring urinary tract infections, pancreatitis, and protein loss.

medications prognosis treatment 3bugsmom / Getty Images

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10

To treat or not to treat

Cushing’s disease itself does not cause death. Because it occurs in older dogs, the causes of death are usually unrelated to the disease. However, if an owner feels their pet is doing well and doesn’t see any outward abnormalities, vets may not recommend treatment. Most vets determine treatments based on whether or not they will improve the dog’s quality of life. They also prescribe treatment for those dogs at a higher risk of developing complications of the disease. Owners who want to ensure their pet’s comfort usually opt for treatment if the cost justifies the expense. However, life span prognosis is generally the same, with or without treatment.

owner dogs comfort Halfpoint / Getty Images

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11

Behavioral and mental changes in Cushingoid dogs

sad dog

Cushing's disease does more than alter a dog's physical health; it can also impact their mental well-being and behavior. Owners might notice increased anxiety, irritability, or even depressive-like symptoms in their pets.

These changes are likely due to elevated cortisol levels affecting brain function. Regardless of the underlying reason, understanding these behavioral shifts is crucial for providing a supportive environment.

Regular mental stimulation, gentle exercise, and consistent routines can help manage these psychological effects, ensuring that affected dogs maintain a good quality of life despite their condition.

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12

Nutritional strategies for managing Cushing's disease

dog eating

Nutrition plays a pivotal role in managing Cushing's disease. A tailored diet can help mitigate some symptoms and support overall health. Dogs with Cushing's often gain weight, so it helps to provide a high-fiber diet low in fats and carbohydrates. Antioxidants may help combat oxidative stress, and omega-3 fatty acids can reduce inflammation.

It's essential to work with a veterinary nutritionist to create a meal plan that addresses the individual needs of a Cushingoid dog, especially since they might experience increased appetite and face a higher risk of concurrent conditions like diabetes.

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13

The latest in Cushing's disease surgery

dog in surgery

Surgical intervention for Cushing's disease has advanced in recent years, with minimally invasive procedures offering new hope. For dogs with adrenal-dependent Cushing's, laparoscopic adrenalectomy is a cutting-edge option that can lead to a definitive cure. This technique minimizes recovery time and reduces complications. However, it requires specialized equipment and expertise.

Owners should be aware of the potential risks and benefits and the fact that not all dogs are candidates for this surgery. It's a significant decision that should be made in close consultation with a veterinary surgeon.

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14

Financial planning for Cushing's disease management

finance

Managing Cushing's disease can be a long-term financial commitment. The costs of ongoing medication, regular vet visits, specialized diets, and potential surgeries add up. Pet insurance may cover some expenses, but policies vary widely in their coverage of chronic conditions. Owners should explore insurance options early and consider setting aside a healthcare fund for their pets. Some veterinary hospitals offer payment plans or accept pet healthcare credit cards, which can alleviate the immediate financial burden.

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15

Quality of life and compassionate end-of-life decisions

hugging sick dog

As Cushing's disease progresses, the dog's quality of life becomes a central concern, especially in its advanced stages. Owners may face tough decisions regarding their pet's comfort and well-being. It's important to regularly assess the dog's happiness and ability to enjoy daily activities.

Veterinarians can provide valuable guidance on pain management, mobility aids, and when it might be time to discuss end-of-life care. Support from pet bereavement groups and counseling services can also help owners navigate these challenging choices.

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