Hyperadrenocorticism (Cushing’s Disease) typically affects middle-aged and older dogs.
Cats can also develop this condition, though it is much rarer than in dogs and, to a lesser degree, horses (PPID: Pituitary Pars Intermedia Dysfunction) and humans.
What exactly is Canine Cushing’s Disease?
Put simply Cushing’s is hormonal disorder in dogs where the adrenal glands produce excessive cortisol. This can lead to a range of health issues and often caused by a tumour (benign or malignant) in the pituitary or adrenal glands.
Signs of Cushing’s Disease
The disease develops slowly, with the early signs not always noticed. Symptoms in dogs may include the following:
- increased thirst and appetite
- increased urination
- reduced activity or behavioural changes like circling or pacing
- excessive panting
- thin or fragile skin, or wounds that are slow to heal
- fur loss (alopecia) or slow to no regrowth after clipping fur
- Lethargy or muscle wasting
- recurrent skin infections
- enlarged abdomen or “pot-bellied” appearance
Atypical Presentations with Weight Loss:
Just to confuse things; Cushing may not always present with some of the key signs seen above, some cases of Cushing’s may present with “atypical” features, including weight loss and muscle wasting, although this is less common and may be suggestive of a specific type of ectopic ACTH production.
In rare instances, particularly when related to ectopic ACTH production (tumours producing ACTH in locations other than the pituitary or adrenal glands), dogs with Cushing’s can exhibit marked weight loss and Hypokalemia (low potassium levels).
How is Cushing diagnosed?
No single test or combination of tests is 100% accurate to diagnose Cushing disease.
With no “one stop” tool for diagnosing Cushing’s, veterinarians will access multiple tools to rule out other conditions with similar symptoms before making a final diagnosis of Cushing’s Disease. These tools could be a combination of physical examination, urine tests, blood tests, and imaging such as ultrasound or MRI.
Two of the most common tests undertaken are “Adrenal Function Tests”:
Adrenocorticotropic Hormone Stimulation Test (ACTH):
This test involves taking a baseline blood sample to check the cortisol level (normal is 30-100/L), then a synthetic ACTH injected into the dog, and another blood sample taken a brief time later to measure cortisol levels. If the cortisol levels have increased, showing a high reading after the injection, this can confirm Cushing’s disease.
Low-Dose Dexamethasone Suppression Test (LDDS):
A baseline cortisol level is measured, a low dose of dexamethasone is injected into the dog, and blood samples are checked again in 8 hours may help identify the type of Cushing’s disease. However, there is some speculation of accuracy.
Treatment for Cushing’s:
Medication: The most common treatment for Cushing’s is medication Trilostane is available both in a liquid and tablet form depending on the dosage required. For small dogs, this drug may require a prescription to a compounding laboratory.
Surgery: Depending on the type of tumour (pituitary or adrenal) surgery may be an option, particularly for adrenal tumours.
Prognosis:
The condition usually requires lifelong management. Your dog can live a quality life if treatment is carefully monitored and managed.
Read about Amber’s symptoms and diagnosis of Cushing’s Disease.
Author Bio: Nikki is pack leader at Pressplay Pets, a blog for the modern age pet parent interested in health & care, news, reviews & personal accounts of unconditional love & at times heartfelt pain of pet parenting. She is also proud mum to cute and cheeky Papillons ‘Amber’ and ‘Indy’!
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