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Pet Health

Identifying the Initial Signs of Cushing's Disease in Dogs

Cushing's disease in dogs, caused by an overproduction of cortisol often due to tumors, can significantly impact your pet's health. Early signs include increased thirst, urination, weight gain, and skin conditions. Timely diagnosis and treatment, including medications, surgery, or holistic approaches, are essential.

Dr. Karen Whala

June 12, 2024

What is Cushing's Disease in Dogs?

Cushing's disease, also known as hyperadrenocorticism, is an overproduction of cortisol over a prolonged period of time and is a hormone that is crucial to managing stress and immune responses. While cortisol is necessary for many normal body functions, too much can cause harmful effects. The majority (85%) of Cushing's disease cases in dogs are due to a benign tumor in the pituitary gland, leading to this abnormal increase in cortisol. The remaining 15% of Cushings is due to a tumor on the adrenal gland. Understanding Cushing's disease is important for timely diagnosis and treatment, which can markedly improve the quality of life for our affected pets.

Understanding the Canine Body System

As a responsible pet owner, understanding the canine body system, particularly the functioning of the adrenal and pituitary glands, is essential. The adrenal glands, which are peanut-sized organs located in front of the kidneys, control the cortisol levels in your pet’s body. The pituitary gland, a tiny gland at the base of the brain, releases the AdrenoCorticoTrophic Hormone (ACTH), which signals the adrenal glands to release cortisol, also known as glucocorticoids, a type of steroid. In dogs with Cushing's disease, a tumor in the pituitary gland or occasionally in one of the adrenal glands causes the adrenal cortex to release an excess amount of cortisol. Understanding these mechanisms can help you better manage your dog's health and well-being.

Brief Overview of Cushing's Disease Impact

Cushing's disease can have a significant impact on both your dog's life and your own. As this condition is chronic, it requires persistent management and ongoing monitoring. The treatment can be complex and, over time, may lead to financial implications for pet owners. However, with early detection and consistent veterinary care, the effects of Cushing's disease can be managed, helping your beloved pet maintain a good quality of life. Resources and support are essential in navigating this condition, and our commitment is to offer the guidance needed during this challenging time.

Importance of Early Detection

Recognizing the symptoms of Cushing's disease early on is crucial, as the disease can progress and cause your dog to lose muscle and become weak if left untreated. The symptoms, including increased thirst, appetite and urination, obesity, and lack of energy, may take at least a year to develop and are often mistaken for common signs of aging. Early detection allows for a more effective treatment plan, potentially slowing the progression of the disease and improving your dog's quality of life. Regular vet checks can aid in the early detection of this disease, and we cannot emphasize enough the importance of these regular check-ups.

Common Causes of Cushing's Disease in Dogs

Tumors Leading to Cushing's Disease

Cushing's disease in dogs is often attributed to the growth of tumors on either the pituitary or adrenal glands. Pituitary gland tumors are the predominant cause, with over 90 percent of Cushing's cases in canines arising from such growths. These tumors are typically benign and may only measure a few millimeters in diameter, yet they significantly disrupt normal bodily functions. They produce and secrete excessive amounts of adrenocorticotropic hormone (ACTH), which overstimulates the adrenal cortex, leading to an overproduction of cortisol.

Adrenal gland tumors, on the other hand, are less common but can also lead to Cushing's disease. These tumors directly produce cortisol without the need for ACTH stimulation. Identifying whether a dog has a pituitary or adrenal tumor is critical for determining the appropriate treatment approach. While human medicine has made substantial progress in surgically removing pituitary tumors, such treatments for dogs are less advanced and not commonly practiced.

Excessive Use of Corticosteroid Drugs

Chronic administration of special steroid medications like prednisone or dexamethasone can inadvertently lead to a form of Cushing's disease in dogs. Importantly, this can also include steroid-containing ear drops, which are absorbed through the skin and can trigger the same condition. Dogs may display symptoms that are similar to those caused by a tumor-causing variety of the disease. Fortunately, upon discontinuation of the steroid use, this drug-induced form of Cushing's disease typically resolves. It's crucial for pet owners to discuss all medications, including topical treatments, with their vet to understand the potential risks and any side effects that may affect their dog's health.

Other Underlying Health Conditions

Chronic health issues are a significant contributor to the development of Cushing's disease in dogs. Hormonal imbalances, such as those arising from thyroid problems or diabetes, can interfere with the body's natural regulation of cortisol. Additionally, diseases that compromise the immune system, such as autoimmune disorders, may increase the risk of an atypical form of Cushing's disease. Monitoring dogs with long-standing health conditions closely is crucial, as these diseases may mask or mimic the signs of Cushing's, making diagnosis more challenging. Understanding the interconnectedness of these health issues allows veterinarians and pet owners to remain vigilant for early signs of Cushing's disease, facilitating timely intervention and improved outcomes.

Genetic Predisposition

Similar to many other health conditions, certain dog breeds are more genetically predisposed to developing Cushing's disease. Breeds such as the Poodle, Dachshund, Boston Terrier, Boxer, and Beagle are at a higher risk. Moreover, the disease tends to develop in dogs that are older than eight years. Understanding your pet's breed-related health risks can help you be more vigilant and proactive in managing their health. At CodaPet, we emphasize the importance of understanding your pet's unique health needs and risks based on their breed and age.

Initial Signs of Cushing's Disease in Dogs

Increased Thirst and Urination

One of the initial signs of Cushing's disease in dogs is a significant increase in thirst and urination. Owners often report that their first clue something might be wrong was their dog wanting to go out at night to urinate. A dog with Cushing's disease tends to drink tremendous amounts of water and urinate frequently, potentially leading to house soiling issues. This increased thirst and urination are due to the excessive production of cortisol in the body. If you notice these changes in your pet's behavior, it's important to consult with your vet to rule out Cushing's disease and other potential health issues.

Unexplained Weight Gain

Another common sign of Cushing's disease in dogs is unexplained weight gain. This can be particularly concerning for pet owners as sudden changes in weight can indicate various health issues. In the context of Cushing's disease, the disease leads to an increased production of cortisol, which can foster an increase in appetite, and that often results in significant weight gain. If your furry friend is gaining weight rapidly coupled with an increase in appetite without any noticeable changes in diet or exercise habits, it could be indicative of an underlying health condition such as Cushing's disease. Monitoring your pet's weight regularly and consulting with a veterinarian if any sudden changes occur is advisable for the health and well-being of your companion.

Excessive Panting

Excessive panting is another symptom often seen in dogs with Cushing's disease. Panting can be a response to the increased thirst and urination caused by the disease, or it could result from the increased strain on the body due to weight gain and loss of muscle strength. It’s also vital to consider that panting, though it may occur as a result of the elevated cortisol levels inherent in Cushing's, is a symptom that can be associated with numerous other causes as well. Among other symptoms such as hair loss, skin issues, and a pot-bellied appearance, excessive panting without an apparent cause, should prompt a thorough veterinary examination. Observant pet owners should note when panting is out of character for their dog and seek veterinary advice to discern potential underlying causes.

Skin Conditions

Dogs with Cushing's disease often develop various skin conditions, another sign of this disease. You may notice a thinning of your dog's skin on the abdomen where the skin can take on a ‘crepey’ like appearance as well as hair loss on the flanks, neck, and perineum. The overproduction of cortisol can lead to these skin changes. If you notice any of these symptoms in your dog, it's important to seek veterinary advice as early as possible. Always emphasizing the importance of regular grooming and skin checks, as many health issues can present initial symptoms through changes in the skin and coat.

Diagnosis of Cushing's Disease in Dogs

Physical Examination

When diagnosing Cushing's disease, or hyperadrenocorticism, in dogs, the physical examination serves as a crucial initial step for veterinarians. During this examination, vets are on the lookout for characteristic physical indicators of the disorder. Some of the signs include thinning skin with or without skin infections, hair loss, increased body fat particularly around the abdomen (often described as a "pot-bellied" appearance), and signs of frailty. Muscle weakness is another symptom that can be apparent during a physical exam. A thorough examination not only investigates these tell-tale signs but also rules out other health issues that might present similar symptoms.

While vital, it’s important to recognize that a physical exam on its own cannot confirm Cushing's disease but it can increase suspicion for it. To help confirm, additional testing, such as blood work, urine tests, and possibly imaging studies like ultrasound, is required to establish a definitive diagnosis. Early detection is key in managing this condition effectively, which is why regular veterinary check-ups play a significant role in your pet's health regime. Consistent and thorough examinations can help detect changes that could indicate the development of Cushing's disease or other medical concerns.

Blood Tests

Special blood tests are an essential tool in diagnosing conditions like Cushing's disease in our beloved canine companions. When testing for Cushing's disease, veterinarians commonly use two specific blood tests.

The first one is the measurement of liver enzymes, especially alkaline phosphatase (ALP), as elevated levels can suggest the possibility of Cushing's disease. This elevation is typically seen due to the excess of cortisol, which is a byproduct of this condition, affecting the liver's normal function.

A pivotal test is the adrenocorticotropic hormone (ACTH) stimulation test. This involves taking an initial blood sample to measure the dog's baseline cortisol level, followed by administering an injection of synthetic ACTH. A few hours later, a second blood sample is taken to measure the cortisol response. Normally, cortisol levels should rise slightly in response to ACTH; however, in dogs with Cushing's disease, the cortisol levels may start high and rise significantly higher, confirming the diagnosis. For this test, your veterinarian will need your pet to spend several hours in the hospital to complete.

These tests are not only crucial for diagnosis but also play a role in the ongoing management of a pet's health. Regular monitoring ensures that our furry friends stay as healthy and comfortable as possible.

Urine Tests

Urine tests can play a supportive role in the comprehensive diagnostic approach to Cushing's disease in dogs. By analyzing a dog's urine, veterinarians can detect signs that are suggestive of Cushing's disease, such as a low specific gravity which indicates dilute urine. This dilution is often a response to increased water consumption, a symptom frequent in dogs with Cushing's disease. Additionally, urine cortisol:creatinine ratios may be used to screen for the disease. Elevated cortisol levels found in urine can further support the suspicion of Cushing's disease, but must be interpreted with caution, as they can also be elevated due to stress or other conditions. These urine tests contribute valuable information and, when combined with blood tests and other diagnostic measures, can greatly aid in making an accurate diagnosis.

Imaging Tests

Imaging tests, such as ultrasounds, are also supportive in the diagnosis of Cushing's disease in dogs. An ultrasound examination can reveal valuable details about the condition of the adrenal glands, including the presence and characteristics of a tumor. A ‘negative’ finding only indicates that an adrenal tumor is less likely and doesn’t eliminate the possibility of a pituitary tumor which is more common. By identifying whether a tumor is located in the pituitary or adrenal glands, veterinarians can tailor treatment approaches specific to the tumor's location. Advanced diagnostic tools are at the forefront of providing comprehensive care, ensuring a methodical and informed approach to your pet's health needs.

Treatment Options for Cushing's Disease in Dogs

Medication for Cushing's Disease

Once a diagnosis of Cushing's disease is confirmed, treatment can begin. Most dogs with pituitary-based Cushing's disease are treated with medication. Two common medications prescribed are Mitotane (Lysodren) and Trilostane (Vetoryl).

Mitotane acts by selectively destroying parts of the adrenal cortex, which results in a decrease in cortisol production. On the other hand, Trilostane is an inhibitor that prevents the synthesis of cortisol in the adrenal glands. While these medications differ in their approach, both aim to reduce the overproduction of cortisol caused by the condition.

Monitoring your pet closely while on these medications is essential. This oversight ensures that the therapy targets the right balance – enough adrenal tissue should remain functional to prevent Addison's disease, characterized by an underproduction of cortisol. Regular veterinary check-ups will help adjust dosages and monitor your dog’s adrenal function to avoid complications.

If you need guidance or support in managing your pet's medication, we are here to help navigate this intricate part of your pet's journey back to health.

Surgical Options

In certain instances, particularly for dogs with adrenal-based Cushing's disease, surgery can be a treatment option worth considering. It's pertinent to understand the nature of the adrenal tumor in question—malignant or benign—as this distinction greatly influences the prognosis and the approach to surgical intervention. Malignant adrenal tumors, which account for approximately 50% of cases, are typically aggressive with a propensity to metastasize rapidly, making complete surgical removal challenging and often non-curative. In contrast, benign adrenal tumors present a more favorable scenario where surgery can potentially serve as a cure.

Notwithstanding the tumor type, one must be cognizant of the inherent challenges and risks that accompany such an intricate surgery. Potential complications include bleeding, infection, and adverse reactions to anesthesia. Furthermore, given the delicate nature of the endocrine system, and specifically the adrenal glands' close proximity to major blood vessels, a high degree of surgical expertise is required. We are here to assist you with clear information and compassionate support, helping you navigate through the complexities of your pet's treatment options, understanding the risks, and weighing the decision for surgery.

Radiation Therapy

Radiation therapy plays a pivotal role in the management of Cushing's disease in dogs, particularly for those with pituitary tumors that aren't candidates for conventional surgery. The approach involves the administration of high-energy radiation with pinpoint accuracy to target and shrink the tumor, which can lead to a significant reduction in the overproduction of adrenocorticotropic hormone (ACTH). This, in turn, helps to alleviate the symptoms associated with Cushing's disease.

While the success rate of radiation therapy varies, it offers a non-invasive alternative to traditional surgery with some studies showing positive outcomes. However, it's essential for pet owners to understand the potential risks and side effects, which may include tissue damage, hair loss, and changes in skin texture at the site of treatment. Post-treatment, dogs might experience temporary discomfort or fatigue but these symptoms typically subside as they recover.

At CodaPet, part of our commitment to pets and their families includes providing comprehensive information about these treatment options. We encourage owners to consider the success rates, weigh the risks and benefits, and discuss all available avenues with our team to ensure the management plan aligns with their pet's needs and their personal wishes.

Holistic Approaches

In addition to conventional treatments, some pet owners may choose to use holistic approaches to manage their dog's Cushing's disease. These can include changes in diet, such as incorporating omega-3 fatty acids and lean proteins to support the dog’s adrenal and overall health. Herbal supplements like dandelion, burdock root, and milk thistle may also be beneficial due to their detoxifying and supportive properties for liver function, which is crucial in dogs with Cushing's disease. Recently Vitamin A has shown promise in supporting collagen strength in dogs with Cushing's that are known to have poor wound healing.

Acupuncture has been reported to be helpful in managing symptoms and improving quality of life, possibly by modulating the endocrine system and reducing stress. Homeopathy and chiropractic care are other complementary therapies that some believe can help restore balance within the body.

While these methods may help improve your dog's overall health and well-being, they should not replace conventional treatments prescribed by a veterinarian. It is essential to have a conversation with a veterinary professional before starting any new treatment regime. These approaches are usually considered adjuncts to traditional therapy, providing a multi-faceted approach to the management of Cushing's disease.

Holistic treatments may have benefits such as fewer side effects and improved general health, but limitations exist, including a lack of scientific evidence for some modalities and the potential for interactions with standard medications.

Living with a Dog with Cushing's Disease

Managing Your Dog's Diet

If your dog is diagnosed with Cushing's disease, managing their diet is an essential part of their care. A balanced, nutritious diet can help support your dog's overall health and well-being, while also managing symptoms of the disease. Dogs with Cushing's disease often benefit from a diet low in fat and high in fiber. It's also important to ensure they have access to fresh water at all times, especially as the disease can cause increased thirst. We can provide advice and resources on managing your dog's diet to help them live a healthier, more comfortable life with Cushing's disease.

Regular Vet Check-ups

Regular vet check-ups are an essential aspect of managing a dog's Cushing's disease. These visits provide an opportunity for the veterinarian to assess the progression of the disease and the effectiveness of any ongoing treatments. During these appointments, veterinarians can perform necessary blood tests, adjust medications, and offer advice on any changes in care that may benefit the dog's health and comfort. It's typical for a dog with Cushing's disease to require more frequent vet checks, which may vary from every few months to more regularly, depending on the stage of the disease and the dog's response to treatment. Understanding the tailored frequency of visits for each dog is vital, as Cushing's can affect dogs differently.

Daily Exercise and Activity

Despite their condition, dogs with Cushing's disease can still benefit greatly from regular exercise and activity. Exercise can help manage your pet's weight, strengthen their muscles, and improve their overall well-being. It is essential to choose activities that are safe and appropriate for your pet's condition and fitness level, considering their increased susceptibility to joint problems and fatigue. Gentle walks and play sessions tailored to your dog's endurance can provide not only physical benefits but also mental stimulation, which is crucial for their emotional health. Always monitor your dog's response to activity and consult with a veterinarian to ensure any exercise plan meets your pet's unique requirements. For individualized advice on what exercises and activities are best suited for your dog with Cushing's disease, reach out for a professional consultation.

Emotional Support and Care

Living with a chronic condition like Cushing's disease can be stressful for both you and your pet. Providing emotional support and care for your dog during this time is just as important as managing their physical health. Regular interaction, gentle play, and lots of affection can help your dog feel loved and secure despite their health challenges. Cushing's disease can impact a dog's emotional well-being significantly, thereby affecting its quality of life. Recognizing behavior changes and providing a comforting environment can help mitigate these effects. We recognize the emotional toll a pet's illness can take on the entire family and provide support and guidance, helping you care for your pet's emotional well-being as well as their physical health.

Summary of Cushing's Disease

Cushing's disease is a complex health condition that can significantly impact your dog's quality of life. It's caused by an overproduction of cortisol, usually due to a tumor in the pituitary gland or occasionally in one of the adrenal glands. Symptoms include increased thirst and urination, unexplained weight gain, skin conditions, and excessive panting. Treatment options range from medication to surgery, with the choice depending on the location of the tumor. While the disease can be managed with treatment, the impact of Cushing's disease on a dog's lifespan remains significant.

Importance of Regular Vet Visits

Regular vet visits are crucial in the early detection and effective management of Cushing's disease. These visits allow for regular monitoring of your pet's health and timely adjustments to their treatment plan. They also provide an opportunity to discuss any concerns or questions you may have about your pet's condition. Proactive pet healthcare, which includes regular vet check-ups, is strongly advocated. Early detection can make a significant difference in the management of Cushing's disease and your pet's quality of life.

Promoting Dog Health Awareness

Raising awareness about common dog health issues, such as Cushing's disease, plays a vital role in promoting the well-being of our beloved pets. Educating pet owners about the signs, potential causes, and various treatment possibilities equips them with the knowledge to take decisive, proactive measures in overseeing their dog's health. Knowledge is a powerful tool that can lead to earlier detection and more effective management of conditions, thus improving the quality of life for our canine companions. By sharing this crucial information, we provide pet owners the support they need to ensure their pets enjoy fulfilling and vibrant lives.

Final Thoughts

Managing a pet's health condition such as Cushing's disease is undoubtedly challenging, but you don't have to face it alone. With support, resources, and guidance from our team, you can navigate this journey with confidence. We're here to assist in understanding the condition, managing treatments effectively, and offering emotional support when you need it most. Remember, together, we can provide your pet with the best possible care for a comfortable and happy life.

Related Content: When to Euthanize a Dog with Cushing's Disease

Dr. Karen Whala

Fresno, CA


Dr. Karen Whala has always had a soft spot for the older pets she’s treated in practice and saw a need for these beloved pets to pass peacefully at home rather than in a clinic setting. To that end, she started Peaceful Passing in 2018 to help families assist their terminally ill, injured, or suffering pets as they transitioned from life in the Fresno and Clovis areas.  Read More

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