Is your middle-aged or senior dog drinking and urinating more than usual? Does your dog have a pot-bellied appearance? These are just a few signs of Cushing’s disease in dogs (also known as hyperadrenocorticism). Integrative veterinarian Dr. Julie Buzby shares symptoms, diagnosis, medications, prognosis, and life-expectancy for Cushing’s disease in dogs.
“Have you ever heard of Cushing’s disease in dogs?” I asked my new veterinary client, the loving parent of a 15-year-old Labrador Retriever, Jake. I knew it was important that we discuss Cushing’s disease at that appointment because Jake’s symptoms were textbook for the condition.
My client had mentioned noticing Jake’s thirst, urination, and panting were increased. These are three cardinal symptoms of Cushing’s disease in dogs. Also, while we were talking, I sat rubbing the thin skin of Jake’s pot belly. (Yes, thin skin and a pot belly are two more cardinal symptoms.)
By the end of our conversation, my client had a good idea of what Cushing’s disease was, tests for Cushing’s, and what the diagnosis could mean for his dog. And I hope you come away from this article on Cushing’s disease with a better understanding of the condition, too.
What is Cushing’s disease in dogs?
Cushing’s disease in dogs (i.e. hyperadrenocorticism) occurs when an older dog’s adrenal glands produce too much cortisol, a stress hormone. Cortisol is the body’s natural steroid and is absolutely essential for day-to-day life. Normally, the body regulates cortisol levels very carefully. But if the amount of cortisol gets out of whack, as occurs in Cushing’s syndrome in dogs, bad things can happen!
What causes Cushing’s disease?
This increase in cortisol levels can occur for three main reasons—a pituitary tumor, an adrenal tumor, or the administration of steroids. Let’s take a look at each of these three types of Cushing’s disease in dogs.
Pituitary-dependent Cushing’s disease in dogs
Approximately 80% of dogs with Cushing’s disease will have pituitary-dependent Cushing’s disease. This type occurs when the dog develops a tumor in the pituitary gland. The pituitary gland is a tiny structure located at the base of the brain that controls the secretion of various hormones.
One of the many hormones that comes from the pituitary gland is adrenocorticotropic hormone (ACTH). This particular hormone, ACTH, is what tells the adrenal glands (paired bean-shaped glands located near the kidneys) to produce cortisol. When a pituitary tumor releases more ACTH than normal, the adrenal glands obediently make more cortisol. And the end result is pituitary-dependent Cushing’s disease.
Do not fear, though! While the phrase “brain tumor” is frightening when used in the same sentence with our beloved dogs, these tumors are usually small and do not spread. Only occasionally does a dog have a larger tumor.
Overall, smaller breed dogs (e.g. Bichon Frises, Miniature Schnauzers, Yorkshire Terriers, Lhasa Apsos, or Jack Russell Terriers) are more likely to have pituitary-dependent Cushing’s disease. And they tend to be middle-aged or older (at least 7 years of age).
Adrenal-dependent Cushing’s disease
In the other 20% of dogs, a cortisol-secreting tumor grows on the adrenal gland instead. This tumor can be benign or malignant (i.e. cancerous). Since the adrenal glands make cortisol, functional adrenal tumors also lead to elevated levels of cortisol in the body. The official name for this form of Cushing’s disease is adrenal-dependent Cushing’s disease.
Unlike pituitary-dependent Cushing’s, adrenal-dependent Cushing’s is more common in medium or large breed dogs. And the average age at the time of diagnosis is 11 years.
Iatrogenic Cushing’s disease
While the pituitary-dependent and adrenal-dependent forms of Cushing’s disease are the two naturally-occurring varieties, there is also a third reason dogs can have Cushing’s disease—iatrogenic Cushing’s disease. The term “iatrogenic” indicates that a medical treatment or procedure accidentally caused the condition.
In the case of iatrogenic Cushing’s disease, the administration of prednisone for dogs or other corticosteroids causes the Cushing’s disease. These drugs mimic the action of cortisol in the body, so they can cause identical symptoms to adrenal or pituitary tumors. However, this is not to say that every dog who takes steroids will develop iatrogenic Cushing’s disease.
What are the symptoms of Cushing’s disease in dogs?
If you have ever taken a steroid (for example, prednisone) for a medical condition, or your dog has been on steroids in the past, you may have some idea of the symptoms of Cushing’s disease in dogs. They tend to be very similar to the side effects that humans and dogs may experience while on steroids.
Changes in thirst, urination, appetite, and behavior
Dogs with Cushing’s disease may change their normal habits or behavior. Some common signs include:
- Increased thirst in dogs (i.e. polydipsia)—occurs in 80-90% of dogs
- Increased urination (i.e. polyuria)—occurs in 80-90% of dogs
- Leaking urine
- Increased appetite (i.e. polyphagia)
- Restlessness, which may include senior dog anxiety at night
- Panting
- Circling, seizures in dogs or other neurologic signs (mostly seen if the dog has a larger pituitary tumor)
- Being a lethargic dog
Affects of Cushing’s syndrome on a dog’s back legs
Since Cushing’s disease can cause muscle wasting or lack of muscle mass, you may notice that your dog’s back legs are collapsing or your dog looks weak. Additionally, due to loss of muscle mass, dogs with osteoarthritis in dogs who develop Cushing’s disease may suddenly have an worsening of the signs of arthritis in dogs.
Senior dogs with Cushing’s disease may have trouble getting up from lying down, be more prone to slipping on the floor, or generally look more wobbly than normal. Additionally, these changes in the muscle mass, especially of the back legs, can make dogs reluctant or unable to continue their normal activity levels.
Changes in skin or abdominal contour
Additionally, you may notice Cushing’s symptoms related to your dog’s appearance, including:
- Weight gain
- Pot-bellied dog appearance
- Thinning skin
- Hair loss
- Dark pigmentation of the skin
- Comedones (i.e. blackheads)
- Poor hair regrowth (may be more noticeable if your dog was shaved for some reason)
- Firm areas of the skin (i.e. calcinosis cutis)
Increase in conditions related to poor immune system function
Since steroids suppress the immune system, dogs with Cushing’s disease may be more prone to various infections. Skin infections (i.e. pyoderma in dogs) and urinary tract infections (UTI in dogs) seem to be the most common. In fact, about 50% of dogs with Cushing’s syndrome have a UTI at the time of diagnosis, although they may not be symptomatic.
What are the stages of Cushing’s disease in dogs?
While there aren’t well-defined stages of Cushing’s disease in dogs, more and more symptoms may appear the longer a dog has Cushing’s disease. In the early stages of Cushing’s disease, you may notice that your dog is drinking more, urinating more, and eating more but otherwise looks fairly normal.
However, over time the excessive cortisol from Cushing’s disease may weaken the abdominal muscles, cause more fat to accumulate in the abdomen, and increase the size of the liver. Together, those changes can lead to the pot-bellied appearance.
Additionally, as Cushing’s disease progresses, you may notice changes to your dog’s skin and haircoat, increased panting, or more obvious muscle weakness. And your dog may be more prone to infections or show some changes in behavior.
In the final stages of Cushing’s disease, the dog’s symptoms may be severe and greatly impacting his or her quality of life. Your dog may be extremely thirst and hungry all the time or having accidents in the house from producing so much urine. Other symptoms of advanced Cushing’s disease in dogs include struggling to get around due to muscle weakness, painful, inflamed skin, or frequent infections.
How is Cushing’s disease diagnosed?
Sometimes you may see symptoms of Cushing’s disease and schedule a vet appointment. Other times, your vet may suspect Cushing’s disease after talking with you at an appointment. In either situation, the vet will select the diagnostic testing that he or she feels is right for your dog.
Testing to rule OUT Cushing’s disease
Sometimes, I recommend that my client starts with a simple and relatively inexpensive test called a urine cortisol creatinine ratio (UCCR). The UCCR test measures the ratio of cortisol (the hormone overproduced in Cushing’s syndrome) to creatinine (a normal component of urine).
Since cortisol is normally secreted in times of stress, for best results, the client should collect the dog’s urine sample at home, at least two days after a vet visit. This way, the dog doesn’t get anxious from a visit to the veterinary clinic, secrete a bunch of cortisol, and skew the results. Additionally, the first urine sample of the morning seems to provide the best results.
Before I run the test, I always want my clients to understand that the UCCR test rules OUT the diagnosis. But does not definitively rule it IN. In other words, an elevated UCCR doesn’t prove that a dog has Cushing’s syndrome. But a dog with a normal UCCR has a very low chance of having Cushing’s disease. Thus, the UCCR does a very good job of ruling OUT the diagnosis.
This may seem counterintuitive, but it’s actually quite valuable. If the UCCR is normal, we can cross Cushing’s off the list as a possible diagnosis. Then we can move on to figuring out what else could be causing your dog’s symptoms.
And if the dog has an elevated UCCR, this is an indication that we should perform more specific tests to confirm the diagnosis.
Testing to confirm Cushing’s disease
Tests to rule IN Cushing’s (i.e. confirm the diagnosis) are blood tests for dogs. There are three main tests—the ACTH stimulation test, a low dose dexamethasone suppression test, or a high dose dexamethasone suppression test.
ACTH stimulation test
The ACTH stimulation test involves drawing a blood sample to determine a baseline cortisol level. Then the vet will administer synthetic ACTH, which should stimulate the adrenal glands to release cortisol. In dogs with Cushing’s disease, post ACTH blood cortisol levels are usually elevated above what would be expected for a “normal” response to ACTH.
This test is positive in around 80-85% of dogs with pituitary-dependent Cushing’s disease and 60% of dogs with adrenal-dependent Cushing’s. It cannot distinguish between the two types. The ACTH stimulation test is, however, the test of choice for diagnosing iatrogenic Cushing’s disease.
Low-dose dexamethasone suppression test
For the low-dose dexamethasone suppression test (LDDST), the vet will draw a blood sample to obtain a baseline cortisol level. Then he or she will give the dog a low dose of the steroid dexamethasone. In a normal dog, the dexamethasone should tell the body to make less cortisol. However, in dogs with Cushing’s disease, a low dose of dexamethasone will not suppress cortisol production.
The test is positive in about 90% of dogs with Cushing’s disease. And about 50% of the time, it can distinguish between pituitary-dependent and adrenal-dependent Cushing’s disease.
High-dose dexamethasone suppression test
The high-dose dexamethasone suppression test is performed in the same basic way as the LDDST, except it uses a higher amount of dexamethasone. The goal of this test is not to determine if the dog has Cushing’s disease but to attempt to distinguish between the adrenal-dependent and pituitary-dependent forms. Sometimes it is able to do so, but not always.
Each of these three tests has some pros and cons. Your vet will select the one that he or she thinks is right for your dog. In some situations, your vet may recommend more than one of these tests. This is especially likely to be the case if he or she is trying to differentiate between the three types of Cushing’s disease.
Some dogs require further diagnostic testing
Occasionally, the results are still not conclusive. In order to nail the diagnosis, the vet may recommend an abdominal ultrasound to assess the adrenal glands. Or she or she may suggest an MRI or CT, further bloodwork, or other tests.
In addition to tests to rule out or confirm Cushing’s disease, your veterinarian may also recommend a urinalysis and/or urine culture. These tests look for evidence of urinary tract infections, which can be “silent” and accompany Cushing’s disease, especially in female dogs.
How is Cushing’s disease in dogs treated?
In most cases, Cushing’s is a lifelong disease that often requires daily treatment and careful monitoring by your veterinarian. It is a commitment and it can be daunting. However, the good news is that there are several treatment options to help your dog feel better.
Medical treatment for dogs with Cushing’s disease
Often, medications to control cortisol levels are the treatment of choice for managing a dogs with adrenal or pituitary-dependent Cushing’s syndrome long-term. (Treatment for iatrogenic Cushing’s disease just involves carefully weaning the dog off of steroids.)
Common medications used to treat pituitary or adrenal dependent Cushing’s disease in dogs include:
Vetoryl
Vetoryl® (trilostane for dogs) is currently the only veterinary-approved product on the market that treats both the pituitary and adrenal-dependent forms of the disease. It blocks the production of cortisol to bring cortisol levels back to normal.
While side effects of Vetoryl are fairly common, they are thankfully usually mild and only last for a few days. Some of the potential side effects include nausea (which can be decreased by giving Vetoryl with food), vomiting, decreased appetite, lethargy, diarrhea, or weakness.
Lysodren
Another treatment option is a drug called Lysodren® (mitotane). It targets the adrenal glands, which are over-producing cortisol. This medication keeps the glands from producing as much cortisol by selectively killing some of the cortisol-producing cells.
Typically, but not always, the vet will use a two-phased approach to treatment. The first phase, induction, uses higher doses of Lysodren. It is important to watch your dog carefully, especially during this phase. If your dog isn’t eating as much, has vomiting or diarrhea, becomes lethargic, or isn’t drinking enough water, promptly contact your vet. Those symptoms indicate it may be time to switch to the maintenance phase, which uses lower doses of mitotane long-term.
Overall, dogs in either phase may experience side effects such as decreased appetite, lethargy, weakness, vomiting, or ataxia (i.e. unsteady gait). If you see these side effects, it is best to check in with your vet.
Selegiline, ketoconazole or melatonin
Selegiline for dogs, a drug used to manage canine cognitive dysfunction, is also approved to treat the pituitary-dependent form of Cushing’s disease. Also, there are some off-label medication options for Cushing’s disease such as ketoconazole and melatonin for dogs.
However, melatonin and ketoconazole are not approved to treat Cushing’s disease. So they must be used with care and with the understanding that they may not be effective. Plus, if you choose to try melatonin for your dog with Cushing’s disease, please be aware that some products, especially melatonin gummies, may contain xylitol, which is toxic for dogs. Always check the label for xylitol (i.e. birch sugar) before giving melatonin to your dog.
Surgical treatment for adrenal-dependent Cushing’s disease
Additionally, if an adrenal tumor is the cause of the Cushing’s, the affected gland can be surgically removed. This is not a simple surgery and is ideally performed by a board-certified surgeon. Risk of hemorrhage from surgical removal of the gland is significant, as is the risk of other post-operative complications.
Depending on the study you look at, between 10% and 25% of patients may not survive surgery and post-op period. Thus, many pet parents opt to treat their dogs with medical management to avoid the cost and risk of surgery.
What sort of monitoring do dogs with Cushing’s disease require?
It is important to know from the outset that dogs taking medications such as Vetoryl or Lysodren require close monitoring with frequent lab work.
Sometimes these medications can work TOO well and cause the opposite condition—hypoadrenocorticism (i.e. Addison’s disease in dogs). If you notice signs of Addison’s disease such as vomiting, diarrhea, lethargy, tremors, or loss of appetite, contact your veterinarian immediately. Addison’s disease can be life threatening, so it is critical your dog gets veterinary attention right away.
On the other hand, if it seems like your dog’s Cushing’s symptoms aren’t resolving, or if they go away and then come back, you should also give your vet a call. This may be an indication that the Vetoryl or Lysodren dose isn’t sufficiently controlling your dog’s Cushing’s disease. Or it could mean that your dog has developed a concurrent condition with similar symptoms, such as diabetes in dogs.
In addition to monitoring your dog’s symptoms, you will need to bring your dog back to the vet periodically for an examination and follow-up bloodwork. This is important so the vet can determine how well the medications are working.
In the interest of full disclosure, these vet visits can represent a significant financial and time commitment. When initially starting therapy and when making dose adjustments, your vet may need to examine your dog and run bloodwork as often as every few weeks or months.
How can I help comfort a dog with Cushing’s disease?
In addition to treating your dog’s Cushing’s disease and keeping up with the necessary monitoring, here are five more things you can do to be vigilant in managing your dog’s condition.
1. Keep your dog’s water bowl full of fresh clean water
Always have fresh water available. As I mentioned, Cushing’s causes increased thirst and urination, so your dog will want to drink more and need to go out frequently for potty breaks. Make sure you refill the water bowl often and give your dog plenty of opportunities to go potty.
2. Be on the lookout for signs of skin problems
Keep a sharp eye on your dog’s skin. If you notice signs of skin infection such as bumps, crusts, hair loss, or red irritated skin, speak with your vet. It is important that skin infections are addressed promptly. In some cases, your vet may also prescribe antifungal and antibacterial shampoos and wipes to proactively help combat skin infections.
3. Know how to recognize the signs of a UTI
Watch for signs of urinary issues such as increased frequency of urination, foul odor to the urine, straining to urinate, and/or blood in the urine. If you observe any of these signs, take your dog to your veterinarian. For dogs with Cushing’s, urinary tract infections are nearly impossible to prevent. However, you can help your dog by seeking treatment promptly.
4. Partner with your veterinarian
Keep in close contact with your veterinarian about any changes in your dog’s symptoms. You see your dog every day and know your dog better than anyone else. So you are in the perfect position to spot signs that may signal you dog has flipped over to having Addison’s disease or indicate the medications aren’t working. Trust your instincts and reach out to your vet if you have any concerns.
5. Address mobility issues due to Cushing’s disease
If your dog is having mobility issues due to muscle wasting, look for options to minimize discomfort and falling. I recommend the following to many of my clients:
- Keep your dog on carpet
- Avoid slick floors
- Learn how to relieve arthritis pain in dogs
- Choose a soft bed for your dog’s comfort (Consider a memory foam dog bed)
- If possible, avoid stairs
- Consider laser therapy for dogs and physical therapy
- Teach your dog to use ramps
- Additionally, I’ve had many patients with muscle wasting due to Cushing’s syndrome thrive using ToeGrips® dog nail grips. The non-slip grips fit on dogs’ toenails to improve traction on hardwood floors, preventing sliding and falling.
Is my dog in pain with Cushing’s syndrome?
While you are thinking about how to keep your dog with Cushing’s disease comfortable, it is understandable to wonder if Cushing’s syndrome is painful. Thankfully, Cushing’s disease doesn’t cause pain in dogs in the traditional sense of the word. It isn’t like a torn ACL in dogs or intervertebral disc disease (IVDD) in dogs. However, I would argue that it can negatively impact quality of life. Hear me out.
Dogs with uncontrolled Cushing’s disease are thirsty all the time and need to urinate frequently. Sometimes they may have accidents in the house if they can’t make it outside in time. That can be hard on a dog’s dignity. It may also be more difficult for them to rest peacefully since they are prone to panting and pacing.
We can’t know for sure the emotional impact those changes have on a dog. And I’ve seen hundreds of “untreated” Cushing’s patients over the years who seemed fine. However, living with symptoms of Cushing’s is not ideal for the dog nor their family. The good news, though, is that treating your dog’s Cushing’s disease will help get those symptoms under control. This can greatly improve your dog’s quality of life.
What is the prognosis for dogs diagnosed with Cushing’s disease?
The prognosis and life expectancy for dogs with Cushing’s disease can vary depending on which form of Cushing’s disease they have and how well they respond to therapy.
Life expectancy for pituitary-dependent Cushing’s disease in dogs
With pituitary-dependent Cushing’s disease, the moderate-term prognosis is good with treatment. Median survival time (i.e. the point at which 50% of dogs with the condition are still alive) is 2 – 2.5 years. Most of the time, the majority of the clinical signs will go away quickly after starting medication. But it may take about three months for the skin-related signs to resolve. And sometimes symptoms like calcinosis cutis don’t fully disappear.
Unfortunately though, there is a small number of dogs with pituitary-dependent Cushing’s who don’t respond as expected to treatment. Thus, their prognosis may be worse. Additionally, if the dog has a large pituitary tumor rather than the more common tiny tumor, the prognosis is also worse. This is especially the case if the dog is showing any neurological abnormalities.
Life-expectancy for adrenal-dependent Cushing’s disease in dogs
For adrenal-dependent Cushing’s, the method of treatment and whether the tumor was benign or malignant (i.e. cancerous) both impact prognosis and life expectancy. Benign tumors and those that are small and less invasive usually carry a better prognosis. Overall, the median survival time is 1.5 – 4 years (depending on the study) with surgical removal of the tumor. But average life expectancy is closer to one year with Lysodren or Vetoryl therapy.
Concurrent conditions may impact quality of life
Additionally, your dog’s prognosis for either form of Cushing’s disease will also depend on any other conditions your dog may have. If your dog has concurrent medical problems such as diabetes or arthritis, the symptoms from those problems can compound with the symptoms of Cushing’s or make Cushing’s harder to manage. This can contribute to a decline in quality of life.
Knowing when it is time to say goodbye
Despite the fact that dogs with Cushing’s disease have a reasonably high chance of having a good year or several good years, the time may eventually come when you need to consider when to euthanize your dog with Cushing’s disease.
Some dog parents may start preparing for their dog’s euthanasia when they begin to see symptoms of advanced Cushing’s disease that are not controlled by medication. Others may decide to say goodbye because their dog is no longer taking pills well or tolerating the frequent vet visits. Or dog parents may know it is time when the financial toll or pet caregiver fatigue become too much to bear.
Sometimes it may also be a different medical problem, not the final stages of Cushing’s disease, that ultimately mean setting your dog free is the kindest course of action.
There isn’t one universally right time or right reason to make that decision. But your trusted veterinarian and your close friends or family members can help you determine what is right for your dog and your family. And they can help support you as you grieve the loss of your dog.
Don’t lose hope
I know that these statistics and the discussion of the final stages of Cushing’s disease and when to say goodbye may seem grim. But I want you to know that Cushing’s disease in dogs is not a hopeless diagnosis. Yes, your dog may need a risky surgery or daily medication and frequent rechecks with the vet. But once Cushing’s disease is under control, your dog can often have an excellent quality of life for years. And that is huge.
Let me remind you too that you can play an important role in your dog’s health. Watching him or her carefully for symptoms, keeping up with all medication monitoring appointments, and working closely with your vet can all help your dog feel his or her best despite having Cushing’s disease.
This is exactly the pep talk I gave to Jake’s mom when I diagnosed my sweet senior Lab patient with Cushing’s disease. I’m optimistic that he has several happy years ahead. And I look forward to partnering with his mom to provide him the longest, healthiest life possible. The same may be true of your dog too. So don’t lose hope!
What questions do you have about Cushing’s disease in dogs?
Please comment below.
Hi. We are awaiting diagnosis for our 11 year old Beagle, it’s looking very much like she has Cushings. Thank you for the fantastic advice on this webpage.
Hi Denise,
Thank you for the kind words! Hoping you get results soon and there will be a clear plan for treatment. Best wishes to you and your senior girl!
My foster dog is a case of extreme medical neglect. She came to the rescue with Cushing’s disease that has been left untreated for a very long time, Poor dog had lost almost all of her hair, skin and bones (ribs visible, legs weak, sunken face), calcinosis on both elbows, random wounds on her very dry skin and a super enlargened belly.. She was immediately started on Vetoryl, first at 5mg, then 7mg then 10mg, She goes for an ACTH test every month. After 5 months of vetoryl and hepapet plus, a lot of skin and hair care and proper nutrition, she almost looks ‘normal’ except for her huge belly. She looks as if she’s ready to pop a litter of 12 puppies, its firm, and hard to the touch, no doubt it makes her uncomfortable when touched around the belly (ie picking her up) – and she’s a chihuahua mix, so she’s a small lady of 8kg’s. The belly is VERY prominent. Why wouldn’t her belly go smaller? The vet says its not filled with fluid (which I assume is a good thing) – they don’t say anything else. Unfortunately the vet that the rescue works with isn’t the most collaborative. I often struggle to reach out to them or get an answer (there’s also a language barrier as I’m a foreigner). I’m just worried sick about this poor dog who’s undoubtedly uncomfortable because of this belly. Any ideas?
Hi Gunes,
I understand your concern for your girl and applaud you for advocating for her health and well-being. Unfortunately, without examining her myself it is hard to make specific recommendations. Sometimes the “potbellied” appearance of Cushing’s dogs just doesn’t resolve despite aggressive treatment. It would be best to rule out any other conditions that could be contributing to this situation. I encourage you to talk to your vet (maybe it’s time to get established with a different veterinary facility besides the rescue?) and see if they are willing to do some x-rays or abdominal ultrasound. Hoping for clear answers and praying your sweet girl has many happy years ahead. Keep up the good work!
My Riley is 12-year old Border collie/spaniel has many of the symptoms of CD but has not been officially diagnosed. Excessive thirst/urination, increased hunger, pot-belly, hair not growing back after grooming, flaky skin, panting. Recently, he started having trouble going up stairs and getting up from lying down on our wood floor. I thought that was due to his arthritis (his knees and hips crack terribly), but now I’m thinking muscle wasting as well. My question is, are all his symptoms (besides the arthritis) resolvable with medication for CD (assuming its confirmed)? I guess I’m wondering if it’s too late and too hard to do much to make him significantly better and I should just work on making him comfortable. He doesn’t seem to be in pain, thankfully.
Hi Kim,
I am sorry Riley is experiencing all these worrisome symptoms. If he does in fact have Cushing’s disease, then starting treatment could greatly improve his quality of life. It would also be a good idea to rule out diabetes and hypothyroidism. Your vet can let you know what testing is recommended and offer guidance as you navigate this difficult path. Hoping for clear answers and an easy solution. Best wishes to you and your sweet boy.
Dr Busby,
I have a 10 year old Maltese that was recently diagnosed with Cushing’s (we did the test only because she had 2 very mild episodes of vestibular syndrome).
She is 100% asymptomatic (only some gallbladder sediments but other that that all her bloodwork is great). She as regular abdominal echos done since he had her spleen removed last year due to lymphoma. In her echos her glands are fine, which makes us think is it pituitary gland related.
In her case would you recommend monitoring the disease and see if it progresses before we give medication? or should we start medication as soon as possible?
We are a little worried about the side effects of medication on her since it won’t help improve any clinical signs.
Hi Dania,
I understand your concern for your senior girl and think it is great you are searching for advice. She is lucky to have you advocating for her health and well-being. It is still up in the air about whether a dog should be treated for Cushing’s if they don’t have any symptoms. I was always taught that treatment was aimed at decreasing symptoms, so if a dog was asymptomatic (had no symptoms) then you would not treat. I did some quick research before replying to your question and it seems the American College of Veterinary Internal Medicine does not even recommend testing for Cushing’s if the dog is asymptomatic. With all that being said, I think veterinarians have to look at each case individually and consider the benefits vs. the risks. I think it would be fine if you choose to forgo treatment for your pup until she starts having other issues. Ultimately, the choice is yours and you have to trust your intuition. Wishing you both nothing but the best. Keep up the good work!
Thanks so much for your reply! It gives me more info to make my decision. She has great vets taking care of her and double checking if her results are actually accurate.
Our 13 y.o. toy poodle, Annie, has been diagnosed with Cushings Disease. It took several months to get the diagnosis as the LDDSTs were always normal. After finally doing the ACTH testing we had a diagnosis. She was started on Vetoryl and after testing and dosage adjustments, her ACTH was within normal limits. However, there is very little change in her symptoms. The drinking and urinating have improved somewhat, but she is still ravenous and the weakness and panting/coughing seem to be worsening. Why does it seem that the Vetoryl is not working? Is there any more that can be done – especially with her breathing? She is taking Theophylline 3 times a day and using an inhaler twice a day. It is so sad to hear her panting most of her waking hours and even when resting her breathing looks labored. If you have any insight into what is going on, we would appreciate hearing it. Thank you so much!
Dear Carol,
I am sorry Annie has received this difficult diagnosis and is not responding as hoped to the Vetoryl. Unfortunately, some dogs just don’t see as much benefit from treatment as is expected. I am not sure I have any great advice to offer other than it may be time to consider a consultation with an internal medicine specialist. They have lots of experience with complicated cases and could have ideas about other treatments or therapies to try. Hoping you can find the answers you need to ensure Annie is feeling her best. Praying for a clear path forward and for many happy days ahead for your sweet girl.
Hi – our 11.5 year old GSP was diagnosed with Cushing’s last Oct. Vetoryl made a pretty much instant improvement in her excess drinking and urination. But over time she became less interested in food to the point she stopped eating. After consultation with the vets, we stopped her meds until her appetite returned and then restarted her on a much lower level. The same pattern returned and she stopped eating.
She’s currently off meds, and seems fairly stable in terms of drinking and eating. But she’s struggling in the heat, panting a lot, and her coat/skin is thickening considerably. She’s having physio to help with hind leg weakness. All in all she’s comping ok without any meds, but is there anything else that is recommended we could do in the absence of meds?
Hi Sal,
I am sorry your senior girl is living with this difficult diagnosis. While I do not have any personal experience with using supplements to treat Cushing’s disease, I have read the testimonies of several readers that have seen benefits from using melatonin and lignans. This may be something to discuss with your vet. Also, you could look into alternative therapies such as acupuncture. Hoping you can find the best way to maintain her quality of life for as long as possible. Take care and bless you both!
Good afternoon!
We have a 14 year old English Tree Hound mix. She was diagnosed with CD a year ago. She has been showing many of the symptoms as described for about a year, but she had been doing well until this week. She had a very rough night of vomiting, and she seems to be not able to have a bowel movement as we see her trying with no luck. We are taking her to an urgent care vet today as our vet can’t see her until Monday. She has been on Vetoryl for a year and an Omega gel capsule for her joints. It seems we may be near the end of her life, but I am not sure if there is anything else that can be done. Surgery wasn’t an option last year after all the testing that our vet did. I am just not good at making this type of decision when our personal vet isn’t available. Is it time to make the decision to put her down? Thank you for your time and this website!!!
Dear Debbie,
I understand your concern for your senior girl and think it is good you planned to have the urgent care vet evaluate this situation. Without knowing what is causing these GI issues, I can’t say if euthanasia is the right choice at this time. These worrisome symptoms may not be related to the Cushing’s, and it is quite possible all this can be resolved with some simple medications. What did you find out from urgent care yesterday? Hoping all is well and there is a clear plan for treatment. Feel free to leave an update if you have a chance.
hi My bichon Mollie has been diagnosed with CF 2 years ago. she is on 40mg of Vetoryl twice a day. she has recently starting losing her sight and become extremely lethargic. can the sight be in anyway related to the CD?
thanks from a concerned doggy mum
Rachel
Hi Rachel,
I am sorry Mollie is living with this difficult disease. Yes, Cushing’s does commonly affect vision as it can cause changes to the cornea or even the retina in the back of the eye. These changes do tend to be permanent, but most dogs do just fine with limited vision (just don’t rearrange the furniture!). Make sure your vet is aware of these changes so they can stay on top of things. They may want to evaluate your girl and see if a dosage adjustment needs to be made to the Vetoryl. Wishing you and Mollie all the best and praying for many happy days ahead.
My 15 year old lhasa apso/shih tzu mix was diagnosed with Cushing’s a year ago. We kept doing the stim tests and upping the dose because Vetoryl was barely working. He’s on the max dose now (he weighs 19 pounds, 30mg twice daily). The drinking and peeing has improved somewhat at the max dose. Before that, I don’t think it worked. The vet won’t refill his prescription without another stim test. Does that make sense? What are we going to learn if he’s on the max dose, which is the only dosage that made a difference? Is there any possibility a lower dose would now work? Thank you!
Hi Heidi,
I am sorry your pup has not responded as hoped to the Vetoryl. Without playing a personal role in your boy’s medical care, it is hard to make assumptions as to why certain choices are being made. It could be that your vet is trying to ensure this high dose isn’t causing more harm than good. If you need an expert opinion, I would recommend a consultation with an internal medicine specialist. They can offer guidance on how to proceed and let you know if the medication dosage should be adjusted. Hoping you can find a way to maintain your dog’s health and quality of life. Wishing you all the best as you navigate this unknown path.
Hi Dr. Buzby,
Thanks for your response. This is part of the mystery! We have seen the internal medicine specialist. He did all the diagnostic tests. The regular vet did the stim tests till we were at the second to highest dosage. My dog was still drinking and peeing a lot. The internal medicine specialist said given that, it’s worth just going ahead and trying the 30mg/twice daily. The other vet in the practice agreed. The owner of the practice is the one now saying he needs another stim test. This dosage has made a difference. I don’t recall hearing or reading that once the right dosage is found, you may end up subsequently reducing it, so that’s really what I”m trying to figure out. It could be that the owner just didn’t look carefully at the records and see the email from the specialist, and then didn’t realize it’s the max dosage so it’s not like raising it is even an option like it was earlier. I’ve spent way more than I can afford on this, and am just trying to not throw good money after bad! Anyway, thank you very much!
Hi Heidi,
I agree this may just be a lack of communication. I would encourage you to have an honest conversation with this vet and make your concerns clear. I would want to know if the results of the stim test will change the course of action moving forward. Because if the results have no impact on decisions being made, there is no reason to run the test. You always have the final say on what medical procedures and testing are performed. Trust your intuition. You are doing a great job advocating for your pup’s health and well-being. Wishing you all the best and keep up the good work!
Thank you!!!
Hi My lab mix had blood work done recently. His ALP is 2000. He did have elevated ALP a year ago of 1200 and his urine cortisol test was normal. Vet is thinking Cushing’s disease. He doesn’t have any of the symptoms such as thirst, appetite etc. he is a bit sluggish. I’m trying to get a first AM urine sample for the cortisol test again. Not an easy task. What else could this high ALP be related to if not Cushing’s ?
Hi Sue,
I understand your concern for your pup and think it is good you are searching for answers. Here is a link to an article that may offer the information you are looking for: What Does a High ALP in Dogs Mean?
Hoping your vet can get a diagnosis and help you navigate this unknown path. Best of luck to you and your sweet boy!
Hi Thank you for the response. My dog’s urine test for cortisol/creatin ratio was normal. His protein is 3+. The vet is thinking the issue isn’t Cushing’s. He has requested 3 consecutive AM urine samples for testing and most likely an ultrasound when the results come back. I forgot to add info about my dog in my last comment. He is lab/doberman, 7 years old and 122 lbs.
I assume this is a kidney issue?
Thank you
Hi Sue,
I am glad your pup may have avoided a Cushing’s diagnosis, but I understand that still leaves you with more questions than answers. A kidney problem is a possibility, but it sounds like the liver may be playing a role in this as well. There are so many different diseases and conditions that could be the culprit and narrowing down an exact cause can be tricky. It sounds like your vet has a great plan and is being very proactive and thorough with testing. I am hopeful you will get to the bottom of this soon. Feel free to keep us updated on how things are going. Praying for a positive outcome for your big boy.
Hi The results of the 3 day urine test showed protein. The vet did another urine test called Electrophoresis. That test came back with protein. He did mention he was looking for Myeloma. Nothing like that was present. He prescribed Enalapril Maleate 20mg tabs ,2 tabs twice a day. After reading about this medication that is apparently used for blood pressure and the side effects, I’m a bit reluctant to give it to him. Unfortunately the vet isn’t available due to vacation. Is this medication safe? Thank you.
Hi Sue,
I understand your worry with this new treatment, but this is exactly what I would have prescribed in a similar case. All medications have risks and possible negative side effects, but often the benefits outweigh the risks. Here is a link to an article that discusses enalapril in more detail: Can Enalapril for Dogs Help Your Senior Dog?
Of course, if you have unanswered questions or lingering concerns, you should talk to your vet. If you feel better about waiting to start the enalapril until after you discuss things with your vet, then that would be ok. I just wouldn’t want to hold off your pup’s treatment for too long! Praying for comfort and clarity. Best wishes to you and your sweet boy.
Thank you for your response and the article to read. It was helpful. I know there are many more issues that are concerning. I would just like to find out the underlying issue instead of treating issues that come up before we know what exactly we are treating. I’m sorry if I’m confusing but I am confused. Thank you again
My 11year old Maltese has been diagnosed with cd, I have been prescribed vetoryl but as she showing no symptoms not sure wether to start them please help
Hi Linda,
I understand your concern and see why you are conflicted about starting this medication. If your girl doesn’t have any symptoms, what made your vet want to test for Cushing’s? I feel like this may be an instance where a lack of communication is causing some confusion. I encourage you to reach out to your vet and see if you can get some clarification. Best wishes to you and your little pup.
My dog Bandit is 11yrs old. He has a mass blocking 80%of his gull bladder. This was diagnosed about 3 yrs ago. He also has Cushing disease for 1 yr now. His liver counts are so high they won’t put him under anymore for dental cleaning as of 3 yrs ago. He has knee bone on bone and hip pops out. He is very slow moving. For about 3 months he drinks a lot and pees a lot. He had accidents in the house. He started just hiding under our bed and not coming out when he hears us come home. We go find him and he rolls over to scratch his belly. He always looks bloated. He has so many skin tags that stink and black and break open. He sleeps all the time. We have to help him up onto/off furniture and up the stairs. Is it time to let him go? I don’t want to give up on him.
Dear Michelle,
Goodness, it sounds like Bandit is dealing with so much at once. I understand how hard it can be to evaluate the situation and truly assess quality of life. When the changes are slow and the decline is gradual, it is easy to overlook how desperate things may be. From what you describe, it sounds like your boy is dealing with pain, stress, and anxiety every day and no longer finds joy in his daily routine and activities. Saying goodbye may be the most loving option at this point. Don’t hesitate to reach out to your vet and ask them for a quality-of-life assessment. I will also attach links to other articles with more information and great advice from other readers. Praying for clarity and comfort as you navigate this difficult path. Bless you and your senior boy.
Hi Dr. Buzby- My 11 year old Lab mix recently started losing all feeling in his hind legs, seemingly overnight! I have him in therapy at a rehabilitation vet. We don’t know if it’s working yet as we just started. He is receiving home laser treatments and massage. I have also purchased a wheelchair so we can get him walking better. He also recently had a high (extremely) blood glucose of 500+ and has elevated liver enzymes. My question is with Cushings Disease do the dogs have elevated blood glucose?
He has been with me through some of the roughest times of my life, and I don’t want to put him down, but I am also a former medical professional and realize when it is time to say “when” and let him be at peace if his quality of life decreases. Currently, he seems willing to hang in there so I am waiting to see if we can restore some of the wasting in his muscles and get him back on his feet. Thank you for your time.
Hi Trina,
I am sorry your senior Lab is experiencing this strange issue with his rear legs. I am glad you have him established with a rehab professional and hope you will begin to see some improvement. Cushing’s should not cause blood glucose to increase to that level. But many dogs with Cushing’s also end up developing diabetes and this is what I would suspect in this case. If your boy has not had his urine checked, that would be my next recommendation. If there is glucose in his urine, then you would have your answer. Hoping you can find the answers you need to maintain your boy’s health and happiness. Wishing you all the best of luck. Bless you both!
Hello! Our 8.5 yr old rat terrier has had UTI sx monthly X 4. No Rx 4th time as UA was neg. Vet suspects possible CD. Referral to state vet school was offered. Unfortunately, we are financially at the end of our resources. (Older couple, fixed income, now difficult to manage acute care and checkups, but it is our priority.) We absolutely cannot afford CD tests or treatment; vet school is 4 HR away. Presently our Gabe appears more vigilant; drinks more, voids every hour, no incontinence. Sleeps 6-7 HR nightly. We are to have frequent UA’s. Rx diet for UTIs ) Vet is excellent, informative and kind. This dog is my heart. I feel such guilt that he is not with affluent ‘parents’, but he is loved and cared for every moment. (Our beloved 16 yr old cat was compassionately euthanized 3 days ago for illness; we are still reeling from that pain. My 2 dogs seem to be searching for their ‘cat brother’.) My Question: what does the future of an untreated CD dog look like? His comfort outweighs our pain by far.
Thank you,
Gayle
Dear Gayle,
My heart goes out to you as you face this difficult situation with your senior pup. It is clear that you want to do everything you can, but I understand how finances can sometimes limit the options. Dogs with untreated CD can get along ok for a while as long as their symptoms are not severe. But at some point (there is no way to know when) he will begin a steady decline and you will be faced with tough decisions. If you think your boy is managing decently and your vet agrees he is not in pain or suffering, it is fine to take things day by day and give him more time. Here is a link to an article with more information on what to expect as CD progresses to an end stage: When To Euthanize A Dog With Cushing’s Disease: A Vet’s Advice
Hoping you can find the advice you need to feel confident with your choices moving forward. Wishing you and Gabe all the best.
Hello. Thank you for your article.
My Pomeranian/ Shih Tzu (about to be 13 years old in October) was diagnosed with Cushings Disease about 2 years ago. He has been doing amazing, with the medication Vetoryl.
Within the past month, he has been having problems with his anal glands. He isn’t able to express them himself. The vet told me that this is partly due to him losing muscle mass on his back legs, straining while trying to go #2. He has now started biting at his tail to the point that it’s bleeding. We now have to cone him while we’re gone and watch him relentlessly when we’re home. The vet has put him on an antibiotic and pain medication while the tail is healing.
I feel like I am going to have to get his anal glands expressed weekly now. He constantly is panting again, drinking more water, and going to the bathroom constantly. I did recently have a conversation with my vet about the near future. I am just struggling with the fact that he still has ALL his personality, still runs around like crazy, plays with his toys, eats normally, and everything. I don’t see how I could even consider euthanizing him when he’s still full of life! Any advice would be great.
Thank you!
HI Kait,
I am sorry your senior guy is having these worrisome issues with his anal glands. Without examining him myself, it is hard to make specific conclusions and recommendations. Sometimes it is possible to improve normal anal gland expression by adding a bit of fiber to the diet. Canned pumpkin can be a great option, but you would need to talk to your vet to ensure this addition to your dog’s diet would not cause an issue for your boy. I will attach links to other articles with more information. Hoping you can find a solution that is easy for you and offers your pup some relief. Best wishes and good luck!
1. Dog Anal Glands: Everything Your Vet Wants You To Know
2. 4 Dog Anal Gland Issues: Impaction, Infection, Rupture, & Cancer
3. Canned Pumpkin For Dogs: A Veterinarian’s Guide
Hello,
Our 10 year old Samoyed has been diagnosed with a Cushing disease, has bladder stones, and hypothyroidism. She refuses to eat all the medical foods prescribed and we don’t know what to feed her with. Could you please give some more information about (people’s) foods that are good for dogs with Cushing disease and bladder stones?Is it ok to give her fish, eggs, yogurt?
Thank you!
Hi Magdalena,
I understand your concern for your Samoyed as she is dealing with so many issues at once. Without playing a personal role in her medical care, it is hard to make specific recommendations about her diet. While fish, eggs, and yogurt are healthy and safe for dogs to eat, I am not sure if they will achieve the desired result your vet is hoping for with the prescription diet they have prescribed. When dealing with bladder stones, it is common to try and achieve a specific pH of the urine to help dissolve the stones. Reaching this pH is usually done by feeding a prescription diet that is formulated to change the acidity of the urine in specific ways. If you want to pursue a home cooked diet for your pup, then I highly encourage you to ask about a referral to a veterinary nutritionist. They can help design a home cooked diet for your girl that will be compatible with all the dietary goals your vet has in mind to help treat the Cushing’s, hypothyroidism, and bladder stones. A nutritionist will also ensure the diet is complete and not lacking in any essential nutrients. Hoping this offers some guidance and ideas about how to start a conversation with your vet. Wishing you all the best of luck and keep up the good work!
Hello Dr. Buzby – I commented on another Cushings post when I was in Oregon visiting and Bear began to do ‘I’m stressed and there’s another dog in this house to boot’ kinds of behavior – like Pica, which led to him eating what was an eye-popping piece of the other dog’s cloth toy – he had surgery to remove it. He also had some pancreatitis attacks, since it was difficult to keep him from eating some found dog food (other dog) or other things he found on the floor. The Vet in Oregon and the surgeons there said he could have cushings as there were some markers.
Fast forward I got him home and here my house is very calm and quiet, and we returned to his routine, and there isn’t anything on the floor (he doesn’t chew or tear up his own cloth toys – likely because they don’t have the other dog’s saliva on them). When I first got him home, he was drinking a lot of water still and had some accidents–he’s had a ravenous appetite for some time.
I had him tested – the shorter one that’s maybe 2-3 hours that requires blood drawn. His numbers were in a “not sure” spot – I can’t remember them now but let’s say Not Having Cushings is 12; having Cushings is 16 – Bear had 14, right in the middle (using those numbers as examples or approx). So pretty much inconclusive. The vet and I decided no treatment and a ‘wait and see’ – the night of his test he urinated a lot on the floor, but I attributed that to stress and elevated cortisol levels.
he does have a pot belly but has for many years. He’s around 11-13 years old long haired chihuahua mix–I got him full grown.
He has not had an accident since then and that was February 20 – over a month ago! He’s not drinking a lot of water any more either. He’s still ravenous. His coat looks great. I take him for daily walks. He eats a pancreatitis low-fat diet and no people food other than carrots, pumpkin, apple without the skin.
So I am flummoxed. I am considering myself lucky though after reading these comments and this post. However, it’s like I’m waiting for things to change and the bottom to drop out of my good luck – accidents, drinking water again. I’m not sure what to think.
So, can dogs have stress-related cushings? Like when they are in a stressful (for them) environment or stressed about something out of their normal routine, etc, can the cushings symptoms increase and then abate once they are not stressed any longer?
I know this is long, but I’ve been doing so much reading and research and I am not sure what the future brings for sweet Bear. I likely should just relax and enjoy my little guy as long as he’s doing well!
Hi Kat,
I understand your concern for Bear and know you just want to make sure you are doing what is best for him. It is possible that a stressful situation could make a dog’s Cushing’s disease a bit worse. Stress causes the body to release more cortisol and Cushing’s is a disease of too much cortisol in the body. I can only imagine how hard it must be to just wait and watch for signs that things could be declining. But I think your vet is right to wait and not start treatment yet. Treatment is usually geared toward decreasing symptoms. So, if Bear’s symptoms are mild or non-existent, then I would say the benefits of the medication definitely do not outweigh the risks of the side effects. You are doing a great job taking care of your sweet boy. I wish you both nothing but the best and look forward to updates in the future! Keep up the good work!
What are the neurological abnormalities that present in the pituitary dependent cushings? Our dog 9 year old English bulldog was recently diagnosed and has been having some type of vestibular symptoms (acting drunk, head leaning to one side, off balance..etc) which is why we took her to get checked out. She’s had the blood work, tests and US. Her adrenal glands and pituitary are affected. We started her on Vetoryl Sunday and take her back to the vet on the 12th for ACTH stimulation test to check her levels. Our vet wasn’t sure how the vestibular symptoms were related or had never experienced another patient with these symptoms.
Hi Rachel,
I understand your concern for your Bulldog with these severe neurological symptoms he is exhibiting. I too have never had a Cushing’s patient that had neurological signs due to a pituitary tumor. I did some research and found that the most common abnormalities seen are wobbling, ataxia, lethargy or acting “dull”, and circling. What you describe definitely fits as a possibility. It is also possible that your boy has Cushing’s but also has suffered a vestibular episode and the two may not necessarily be related. Here is a link to another article with more information on vestibular disease: Vestibular Disease in Dogs: Doggy Vertigo
My best advice is to ask for a referral to a specialist. They can offer ideas about testing and treatment that may not be readily available in general practice. I am hopeful you can find the answers you need to restore your boy’s quality of life. He is very lucky to have you advocating for his health and well-being. Wishing you all the best and keep up the good work!
Hi there! My 5/6 year old rescue (small breed mutt — mostly chihuahua/shih tsu/poodle/yorkie). She’s generally very happy with no big issues, but this past year, she’s gone through periodic bouts of being unwell (becomes very sad/scared, shaky, vomiting, starts peeing inside) — last time, her normal vet did tests and thought she might have diabetes, but ended up being ruled out when her fasting blood glucose was normal a week later. She became unwell again this morning, which led me to the emergency vet. Of course by the time we got there, she magically started acting like her normal self. Nothing was found on exam, but I went ahead with some testing. Her only blood test concern was a high ALP — the vet thinks she might be developing Cushing’s but isn’t clinical yet. The only thing I can really associate from these symptoms is skin problems (has always had itchy paws and one side of her mouth — vet previously called it atopic dermatitis). I suppose in these bouts of illness she also gets weakness and urination issues (not excessive, but accidents)… Is this a common early presentation of Cushing’s? It’s tricky, I’m so worried for her when she’s like this… but every time, things seem to resolve on their own!
Hi Ella,
I understand your concern for your pup and think it is good you are searching for answers. These “bouts of being unwell”… are they taking place over several days or is this all happening within minutes to hours? The reason I ask is because being scared, shaky and losing control of urination can all be symptoms of seizure activity. Is there any chance you can catch this behavior on video for your vet to review? It is common for dogs that develop epilepsy to do so in middle age and to have completely normal lab work. Of course, without examining your girl myself I can’t make specific conclusions, but I am highly suspicious! If the Cushing’s testing is negative, then it may be time to consult with a specialist. Hoping you can get some answers and ensure your girl has many happy years ahead. Wishing you all the best of luck!
Hello Dr,
Need some help please. Our 6-year-old Dobie, Ren, suddenly started drinking massive amounts of water a little over 3 weeks ago. One night we were sleeping normally in bed, the next night we were sleeping on the couch to let him out every two hours to urinate.
He had an x-ray and ultra sound. His Vet said his spleen looked enlarged but his liver looked about 1/2 to 3/4 the normal size (rough estimate). His ALT was 506, AST 125 and ALP 332. We don’t have any reference x-rays for his liver. No tumors or anything observed. His glucose was normal. Kidneys were healthy. Urine was normal. No pot belly or other symptoms. Other than the constant drinking and urination, he’s as normal as can be, which is usually very high-strung. He comes back in and runs straight to his bowl. He was very lethargic for 2 days after the anesthesia. He didn’t take it well. His Vet thinks it was because of his small liver.
Another set of urine was sent for a culture a week ago for some rare disease normally found with farm dogs (Ren doesn’t live on a farm). The Vet said that if this comes back negative, which he’s guessing it will, he’ll start him on some hormone eye drops to see if this help. I’m guessing this is ostensibly for Cushing’s. After reading your article, I’m not sure why he wasn’t tested for Cushing’s.
Kind of at a loss. Our life and Ren’s life have been severely disrupted. Our Vet has been practicing for 30 years and is a great guy, but we’re a little lost. Should we wait to try the eye drops or seek a second opinion?
Thanks!
Shashi
Hi Shashi,
I understand your concern for Ren and think it is good you are searching for answers. It sounds like your vet is being very thorough and ruling out the diseases that best fit with Ren’s lab work and symptoms. Cushing’s is definitely a possibility, and your vet may decide to do testing after results from these other tests are obtained. I am assuming the rare disease of farm dogs you mentioned is leptospirosis. I always like to test for this if I think there is any possibility of infection. While cows can shed this parasite, it is more commonly spread by rodents. Lepto is actually not that rare and is found in every state in the US, present in urban environments, and is contagious to people! It sounds like the eye drops your vet wants to try next would be desmopressin. This is a way to test for diabetes insipidus (which is what came to my mind first after reading your post). I will attach links to other articles with more information. Hoping a diagnosis can be made and you can partner together with your vet to make a plan for treatment. Wishing you and Ren all the best and praying for a positive outcome.
1. Liver Disease in Dogs: Signs, Symptoms, Causes, Treatment
2. High Liver Enzymes in Dogs: A Vet Explains What It Means
3. Diabetes Insipidus in Dogs: Signs, Diagnosis and Treatment
Hi. My 14 year old rat terrier has liver disease & enlarged adrenal glands. He has an enlarged liver & has has high liver enzymes for years. He’s on Denosyl & Denomarin. His enzymes were in the 100s on January 19 but his most recent bloodwork revealed them to be in the 500s! He’s also on anti seizure medication. He’s had X-rays of his abdomen & chest & throat. And a liver aspiration. Only thing that was found was enlarged liver & adrenal glands. We’re almost positive he has Cushing’s but haven’t tested him. Should we put him through testing? Is it worth it? If he does have it, is it worth getting treatment at this point? He’s already drinking more water than usual & has a DECREASE in appetite which our last Cushing’s dog had at the end stage of her life. He’s also been sleeping a lot. Thanks.
Hi Mrs. Christine,
I am so sorry your senior boy is dealing with so many issues at once. I am not sure there is truly a right or wrong way to proceed, it all depends on what you are most comfortable with. It would not be wrong to pursue testing and treatment, but I am a strong advocate for palliative and hospice care as well. Trust your intuition. You know your pup better than anyone. If you want to make him comfortable and let him live out his days, then that could be the most loving option. Here is a link to another article with good advice and great comments from other readers: When To Euthanize A Dog With Cushing’s Disease: A Vet’s Advice
Wishing you both peace and strength to face each new day. Bless you and your sweet boy.
Thank you. So now he’s no longer eating kibble & hasn’t for a while. He was eating eggs, chicken, ground beef & steak depending on his mood for a while. Recently he stopped eating those. He will, however, eat freeze dried beef dog food. He’ll also eat liver treats. Still drinking lots of water & sleeping a lot. Has good energy when he’s awake. I just need to make sure I don’t let him go too soon. I keep waiting for some kind of sign. All our other dogs that have passed, I knew it was time & I don’t think we waited too long or let them go too soon. I don’t think he’s suffering yet. Any advice?
Dear Christine,
I understand how difficult it can be to determine when is best to say goodbye to a beloved dog. I am glad your boy is still eating, but the presence of an appetite does not necessarily equal a good quality of life. Is your pup still happy to receive affection from you and other family members? Does he still do things that bring him joy (playing, going for walks, watching birds out the window, etc.)? Would you say he is truly living or just merely existing? I always think it is better to say goodbye one day to early rather than one day too late and allow unnecessary suffering. I will attach links to other articles with more information on making this hard choice and great advice from other readers as well. Hoping you will know when it is time to give your boy the freedom and rest he deserves. Bless you and take care. ♥
1. Using a Quality of Life Scale for Dogs
2. Dog Euthanasia: Knowing When to Say Goodbye
3. Preparing for Your Dog’s Euthanasia: 10 Thoughts for Peace
Our Doxen, Precious, has Cushins and is 14 years old. She is on the Vetoryl 60 mg and 30 mg 60 in am, 30 nite time. Our vet has been real good treating her. She has suddenly not wanting to eat as usual. We have tried a lot of foods people and regular dog food. She ate Fresh Pet but not now snifs and walks away. I need suggestions of what to try that she might eat. She can’t keep going and not eating. I would appreciate help. Also, She has the test stim every 3 months. Our vet tests her as you stated.
Hi Pat,
I am sorry Precious is not eating well. I understand why you are concerned and agree this sounds worrisome. Without examining her myself, I can’t make specific conclusions or recommendations. Is your vet aware of this recent change in your dog’s appetite? They may need to do some testing to narrow down the cause. An appetite stimulant might be helpful, and I encourage you to discuss this with your vet. Hoping there will be a way to restore your sweet girl’s quality of life. Bless you and your Dachshund, Precious.
My 14 year old Mexican rescue pup for at least a year isn’t the keen walker he was; also struggles to get his rear end up on his rear legs, especially on lino or wood floors in house. When out walking or short distance to pee, his rear end trembles. He pants frequently, drinks a lot, and all day, if not sleeping, needs out to pee; since last October has begun peeing inside unless I’ve let him out soon enough…but at least always on the newspapers covering the plastic protection over the hardwood floor, along the same wall of his room. In the evening, after being fed, the agitated pacing has increased! 4 weeks ago, my vet analyzed urine and blood samples, which showed nothing of concern, although he mentioned Cushings disease, could be an issue. He sent us home with Fluoxetine, which finished 3 days ago, perhaps it helps the agitation and more frequent urinating! Beginning tomorrow, vet clinic opens, so I can call to pick up more. I accept that he’s got CCD, and don’t want to wait too long before deciding to euthanize him, since he’s been a strong survivor of a rotten start in life, but don’t want to put him through un-needed vet visits, since he gets so anxious there, nor can my patience with dealing with the soaked newspapers, or the incessant pacing in the evening.
Dear Karen,
I am sorry your senior guy is struggling a bit, and his health is beginning to decline. I agree, it would be a kindness to offer your boy peace instead of more stress and hardship. I know that deciding on the “right time” is difficult. But I encourage you to trust your intuition as you know your boy better than anyone. Wishing you both strength and comfort as you navigate this emotional path. Bless you.
I’m starting to suspect that my 8 year old cattle dog mix might have Cushings. It was first mentioned 1.5 years ago when I took her in for frequent urination thinking it was a uti which came back negative. 3 months she developed grand mal seizures and has had 2 so far in which she is now on Potassium Bromide. Her thirst and urination is still so excessive, her appetite has increased, back legs are showing weakness, and she is panting so badly when at rest mainly at night. I am waiting to get in to the vet to talk about testing but I guess my question is with her now developing seizures and if she has cushings, I am really worried about her quality of life but don’t want to think about euthanasia too soon.
Hi Michele,
I am sorry your girl is dealing with seizures and possibly Cushing’s as well. I understand your concern about her quality of life and think it is good you are reaching out for advice. While there is no way to know how things will progress, I do think it would be worth pursuing testing for the Cushing’s disease. Most dogs show vast improvement once Cushing’s treatment is started. Many owners talk about how their senior dog almost seems like a puppy again. Hoping you can make the best choice for everyone involved. Praying your sweet girl still has many happy years ahead.
Hi Julie,
Thanks for this article. Thanks for sharing this information! My dog is 7 years old and has been diagnosed with Cushing’s disease.
Is it possible for the potted stomach to disappear with treatment? Additionally, she used to love walking, but now she doesn’t. Can she go for walks again?
Thank you.
Hi Rebecca,
I am glad to hear the article was helpful and informative. I hate that your senior girl has received this difficult diagnosis but am hopeful you can get things stabilized quickly. It is possible for the “potbellied” appearance to decrease a bit with treatment, but it will probably still be noticeable for the majority of Cushing’s dogs. You should see an increase in her energy level and also a decrease in water consumption and frequency of urination (if your girl is experiencing these symptoms). Praying your pup will start to feel better soon and wishing you both many happy years ahead!
Do you not recommend lignans and melatonin for Cushings? It has been recommended by an internal medicine specialist for our sheltie with Cushings disease.
Thank you
Hi Kathy,
There are many supplements that can be very beneficial to Cushing’s patients. You are correct that melatonin is gaining more attention and showing positive results when used as part of the treatment plan for this disease. This article was published back in May of 2021 and intended to cover the basics. We routinely go through older articles and try to update them to the most recent information available. I am sure when this article comes up for review that supplements will probably be added and discussed. Thank you for calling this to my attention. I will pass this along to the team!
Hello, I have a Service Dog my Chocolate Lab. She is almost 12 yrs old. I never had tested for Cushings but the signs are there.
I’ve took 2 approaches.
1. Equine Vet very smart but busy so he’s no nonsense, he prescribed Ketoconozole didn’t work. Made her symptoms worse.
2. The Holistic approach, seems to have everything in check with all cortisol issues However skin gets better to worse to ok to bad it’s never ending.
Needless to say I have my baby on Prana Pets Holistic regimen.
A. Adrenal suppressant 10-12 drops
B. Immune Support
C. Melatonin and Lignins pills ( will knock your dog out be careful) I do not use CBD and Melatonin together.
D. Liver support liquid drops.
E. Joint support liquid.
I’m on it daily with her. I give cooked organic egg white in her food, coconut oil I melt in her food mix up to help with skin.
She’s also had TPLO surgery less than a year ago. So we really watch that close. Her legs do get weak I do walk her to prevent atrophy. (very short walks) this seems to help and believe me I’ve treated her with everything. Now working on her skin issues. Good luck but I’d really try prana pets (combo) their customer service is awesome as well.
I’d get the complete kit includes melatonin & lignan. pills, adrenal support, immune support and CBD around $200 give or take a little less last way over a month. I give 2/ things 4-5 times a day. (10 drops ea. of adrenal and immune support. Melatonin at night (1) pill always. Any more eyelids droop…. DONT DO IT!
CBD when legs hurt but not with Melatonin….
Every once in a while it’s carprofen for inflammation because surgery and arthritis. But watch liver. Feel free to reach out anyone if questions
Rick 716-803-5479 cell
Hi Rick,
It sounds like your senior girl is doing well and it is clear she is dearly loved. Thank you for sharing your experience with us! Wishing you and your pup all the best. Take care!
Hello. My 9 year old Maltese/Yorkie mix was diagnosed with Cushing’s disease, She has been successfully taking Vetoryl (20 mgs daily) for the past 14 months. We do have her dosage monitored regularly with blood work and ACTH testing. However, I have noticed at night she seems to be too warm and sleeps on the cooler tile floor off/on during the night. Is this a normal condition of Cushing’s? Also, will the appetite she developed with Cushing’s ever subside? she used to only eat until she her hunger was satisfied, now she seems to be hungry all the time. Is this normal for treated Cushing’s? Thank you.
Hi Shirley,
I am glad your pup seems to be doing well with treatment and your vet is monitoring things closely. Yes, the behavior of seeking cool surfaces is common and should not be cause for worry. A ravenous appetite is a symptom of Cushing’s disease and is also common with steroid administration. Some dogs will have their appetite return to normal with treatment while others just see a slight improvement. Resolution of symptoms can be a way to evaluate how well the treatment is working. Please make sure your vet is aware this is persisting. They may decide to adjust your dog’s dosage of Vetoryl or may think it is not worth the risk of your girl becoming unregulated. Wishing you both the best. Keep up the good work!
HELLO, Please I need help on what I should do, I need an advice on what I should do. my dog has been diagnosed with Cushing disease just recently she’s 14 years old and this more small shih-tzu. she’s the only family I have. I currently don’t have the money to take her to vets and get treatment right away but she’s been having it for almost a year and a half now and I didn’t know I thought she was just getting a bit bigger and older so I really just put her on a diet to limit her food portion, and even had her exercise more. I started noticing the patches and her skin her tail losing for her eyes building too much eye boogers and becoming white and cloudy almost a bit blind, she survived two strokes, she can’t even walk anymore, her back legs has gotten too weak and she doesn’t have any desire to eat or drink water, it’s been about 2 days and a half now, she is heavy breathing and just laying down and sleeping majority of the time. I just want to know how much time she has left is what I can do it treat her in the meantime until I get money take her to the vet, please email me back very soon, I need answers please.
Dear Esmeralda,
I am so sorry your girl’s health is declining and you are in this difficult situation. From what you describe, it sounds like she may be nearing the end of her life. I know you mentioned there are financial issues and a vet visit is not an option. Without immediate treatment I am afraid you may have to make some tough choices about saying goodbye. Hoping you were able to get the help you needed for your sweet girl.
Our 11-tr ld Yorkie, Bella, has been diagnosed with Cushing. She does not pant so much anymore, nor does she have a pot belly or skin problems, but she refuses to eat her food endlessly barking all day for treats. Is this normal, and how can we get her to quit her endless barking at us?
Thanks, Paul & Jill Belcher
Hi Paul,
I understand your concern for Bella and these worrisome behaviors she is displaying. Without examining your dog, myself, it is hard to make specific conclusions or recommendations. It would be a good idea to discuss these problems with your vet. They can let you know if Bella’s medication needs to be adjusted or if diet changes might help. Bella may be starting to show some early signs of dementia/canine cognitive dysfunction and your vet can explain this in greater detail if they suspect it could be an issue. I am hopeful you can find a way to make Bella more comfortable and content. Wishing you both the best.
My vet is pretty certain My dog has Cushing’s disease. He is a 14 year old Bichon…they did do a blood test & Although he is my only child. I don’t have the money to see for certain. Harley does have all the symptoms.
And I don’t know if he is suffering. He’s the only dog I have had as an adult and I don’t.
know how to tell if he’s suffering. I would appreciate any advice you may have..
Hi Felecia,
I am sorry you are in this difficult situation with Harley. I understand that it can be hard when you want to do what is best for your boy but there are financial constraints that limit the options. Please make sure your vet is aware of the circumstances. They may have some ideas about how to proceed with the care Harley needs with also being mindful of your concerns. Also, it is ok to focus on quality of life and discuss palliative care if that is something you would be comfortable with. I am hopeful you will find a way to do what is best for everyone involved. Wishing you and your sweet boy many happy days ahead.
My dog developed a rare condition called Autoimmune Neutropenia. Without Prednisone his neutrophil count will drop to unsustainable levels and he develops a high fever. However, after a year on the Prednisone he is developing signs of Cushing’s disease. ‘
I feel we are caught between a rock and a hard spot- continue with the prednisone to control the autoimmune disease and at the same time create iatrogenic Cushing’s syndrome.
Looking any advice or suggestions you may have.
Thank you for your time and consideration.
Kris
Hi Kris,
I am sorry you dog is struggling with this rare autoimmune disease. It is difficult to balance the good with the bad when it comes to needing immunosuppressive medications to remain stable. My best advice is to schedule a consult with an internal medicine specialist. They can let you know if there are other treatment options that could give the same benefits without the harsh side effects. It may be possible to slowly switch your dog over to a different medication like cyclosporine, but this would be best discussed with your vet. I hope you can find a good solution that allows your pup to feel good and continue to thrive. Best wishes to you both.
Hello, I know that this is an odd request, but I have a few question.
My husband and I have a 3 year old American Bully mix and she’s a the most wonderful girl, but when we adopted her they ARL in our neighborhood informed us that she has been on antibiotics and prednisone prior to her realize for adoption.
Fast forward to two years later, and we’ve had a few bouts of trouble with her so far.
We don’t have a lot of extra money on hand and in fact we are on a very strict budget, so we’ve taking Ellie to see a sponsor vet, because we qualified for a few grants because she’s a rescue. Anyhow, she gets the worst and I mean the worst allergies. She will constantly lick and chew herself until she bleeds. Whimpers and whines because she’s so terribly uncomfortable ,and my heart just hurts for her. So 5 different occasions in two years we’ve taken Ellie to the same vet and they always prescribe her a high dosage of 750mg cephyalexin and 20mg prednisone. And while she’s on the medication she seems to be better, and she’s more like her happy go lucky self. But within days of her last dosage, her symptoms are 3x worse than before the vet visit. My husband and I have has several disagreements about this, as I’ve pretty adamantly put my foot down that for the 10 days she’s medicated ,and healing are not worth the price of how significantly more miserable she is after. I’ve asked and asked my vet if there are any other options, if any other kind of care can be administered. They’ve suggested a brand name allergy pill, by Zoetis, and it’s very expensive, and doesn’t seem to help her much. And when I mention the Streep price and the i affordability of it, they just tell me that that the grant program doesn’t cover anything but prednisone and antibiotics,
Right now, we’re 3 weeks out of the office, and she’s just gets worse each day. I’ve tried medicated shampoos, antifungal shampoos and conditioners. I’ve tried literally everything I can think of. Changed her diet, adapted new walking routines to avoid certain types of grass, increased excessive, and decreased it, but with no avail. She is covered in big scratchy bumps, and lately she is just not herself. She doesn’t want to play, or eat, or go outside, or even chase the cats around like she normally does. This morning she won’t even accept her favorite treats of Kong filled peanut butter. I’m at my wits end. I’m terribly worried and I can’t stand the through of her being so miserable, but I’m still very reluctant to take her back and get more prednisone..
Is there anything you.d recommend.
. Anything I can do to help her., that is even moderately affordable? I wish we had more options in our neighborhood tel help her. I do hope you might have some suggestions. Any think at all would be greatly appreciated .
Thank you ,
Amy Crawford
Hi Amy,
I am so sorry your girl is struggling from severe allergies. Unfortunately, skin issues are common in bully breeds and allergies are the most difficult thing I treat on a routine basis. There is no magic cure, and this will be a lifelong battle. The best treatment for allergies is combination therapy. Most pets that are well controlled have a year-round routine of oral allergy medication, weekly shampoos, spray or another topical to use between bathing, and then antibiotics or steroids for when flare ups occur. The goal is to get to a maintenance state and then treat the flare ups when the first signs are noticed. I know cost is an issue. But the best way to get things under control would be to schedule a consult with a dermatology specialist. There would be a significant cost up front, but once you reach a maintenance routine you would actually save money in the long run by preventing all the frequent vet visits. Here is a link to another article with more information: Allergy Medicine for Dogs: 9 Solutions to Calm Your Dog’s Itch
I hope you can find the answers you need to give your sweet girl some relief. Praying for quick answers and a positive outcome.
I have had 2 male galgo rescues from Spain.. They both showed signs of Cushing’s after 7 years old..The first was on lysodren and did well .The second had been on vetoryl which finally stabilized his Cushing’s at 40mg 2X daily He was due to go in for bloodwork and due for the ACTH stim test. He also took gabapentin for atopia and trazodone pre vet due to fear.He also took telmisarten for HBP and cloplidgil to help prevent clots. He had had a toe removed due to possible cancer and had been in for a bandage change and some strong local medication. .He came came home, ate some food then stretched out on his favoirite leather chair. My husband went to wake him a couple of hours later and he seemed dead. We still rushed him to the ER.. He was starting to rigor at the front I was going to have a necropsy done but a local pathologist seemed a little sketchy and through my regular specialty $5000 to $1000. My husband and daughter said to let it go as it would not bring him back. I am still in schock and cannot believe this has happened twice. He was my 24/7 dog and will always be with me. Maybe I have to switch to females only.; never had this problem in any of my greyhounds, It is so frightening, like something out of a horror movie.
Dear Catlin,
I am so sorry for the sudden and tragic loss of your sweet boy. Since I did not examine your dog myself, I really can’t make specific conclusions. Galgo’s are rare and not much is known about genetic predispositions or common health problems in the breed. I would be more inclined to think that it may be something with the breed/blood line rather than an issue with male dogs. My heart goes out to your while you grieve over your pup. I hope with time your heart will heal. May his memory be a blessing as you continue along life’s journey.
Dogs temperature: How to tell if the dog has a fever?
Hi Trissten,
If you are concerned that your dog may be sick and have a fever, I recommend you take him to your vet. At the veterinary clinic, a dog’s temperature is taken rectally. “Normal temperature” for a dog can vary with their activity level and the environment, but typically it will range anywhere from 99-102.5 degrees Fahrenheit.
Thank you so much for your article!
I have a 14 yo Jack Russell female, diagnosed (in the context of another disease) almost two years ago. She was basically asymptomatic but we started treatment with Trilostane but had to discontinue after three weeks. A year later, her thirst and hunger increased and we started with incontinence. Now she pees every 2-3 hours max.
Due to the prior issues with Trilostane, we started treatment with a fungicide that had proven to be efficient in Cushing’s (discovered by mistake), as a last resort.
We have been in treatment and under strict vet control for several months but meds seem not to be working.
I love my dog, we love our dog. I work from home so I adapt my schedule to her needs. I sleep in the living room with her so we have time to make it outside during the night. In average she urinates three times per night (7 hour sleep). This has started to take a toll on me but I would do anything for her.
My question is (I apologize for the long intro), how do I know when it’s time? To be fair, she is more active (could also be the winter) but she rarely wants to be outside. Sometimes she does play, but my preoccupation is about her anxiety. She is absolutely obsessed with food, to the point she can cry for six hours non stop if I cook something. She has her pot belly, pants when gets all excited or nervous, and although her character has changed, she still interacts with us.
Does this anxiety with food harm her? Is this an ok quality of life? I love her to death but I don’t want her to suffer.
Thank for your time and your wonderful post.
Virginia
Hi Virginia,
I know how difficult it can be to evaluate your dog’s quality of life and make decisions about when to let go. Honestly, it’s different for every dog and every owner no matter how many times you have faced this situation. It might be a good idea to have a consult with a veterinary internal medicine specialist to see if there are any other medication options that would benefit your senior girl. Ultimately, you have to take your own quality of life into account. Even if your sweet girl could hang on several more months, if it will leave you frustrated, exhausted, and possibly bitter, saying goodbye while things are still happy might be the most loving option. Eventually the stress can cause hard feelings that can break the bond with a beloved dog. I will attach some links to other articles that might offer new information. Some of the articles deal more with canine cognitive dysfunction, but I believe the advice on evaluating quality of life rings true in all situations. No matter what you choose, know that allowing your girl to find peace and rest is the most difficult and loving decision you will ever make. I wish you the best as you navigate this difficult road ahead.
1. Signs Your Dog is Dying: A Caring Message to Bring You Peace
2. Dementia in Dogs: When to Euthanize Your Beloved Senior Dog
3. Dog Hospice Care Can Bring Peace and Dignity to Your Dog’s Final Days
4. Dog Euthanasia: Knowing When to Say Goodbye
Hi. I wanted to say thank you. I found your article really interesting!
I have a (nearly) 12 yr old small cockerpoo, who was diagnosed with Cushings about 9 months ago. Her symptoms were extreme lethargy and fur loss (she had allergic bumps/growths/fatty like globules on her skin for about a year before diagnosis of CD, which I think are CD related, but my vet does not appear to familiar with all CD issues, and they were just classed as an allergic reaction to ‘something’? along with the initial fur thinning – a few ‘growths’ were removed an tested to check they were benign, she has also had a cyst removed which was just under the skin). The CD symptoms increased to drinking more, extremely dry flaky skin and having a good appetite, whilst diagnosis was occurring. She never had a pot belly.
After lenghty urine samples, then checking her blood samples to confirm CD we started off at 10mg Vetoryl, but then cortisol levels were still alleviated so increased to 15mg (I’m in the UK, and Vetoryl isn’t so easy to get in very specific doses here).
All has been reasonably ok (but with continued hair thinning) until about a month ago when the lethargy started to return. She’s always been a fussy eater (at first diagnosis her appetite was unusually good, which for her was a plus), but now she’s refusing to eat most things. Trying to tempt her is very difficult. She may eat something one meal and refuse to eat it that thing again for days or not at all. Though she looks hungry and goes to her bowl to see if there’s anything interesting in it – boiled chicken was working for a few days, but now she will eat only a tiny bit, tho she can be tempted by a few treats up to a point, so I’m never sure if it’s fussiness or lack of appetite. She unfortunately has a delicate stomach and has been on a specific diet for years, which she now wont touch (stomach complaint caused, I think, by continual bad cases of giardia picked up in our local park when she was young – treated with Panacur, of which complaint she has never quite got rid off), so when she has nothing in her stomach it gets upset and she brings up bile, and has an upset stomach/diarrhoea etc. So I have always fed her 3 times a day, small and often as she will fussily never eat much in a single meal anyway. Therefore, initially I thought her being off her food was just another Giardia bout, although it’s been quite a while since she has had one. I dosed her accordingly a few weeks ago, then tried a follow up course in the last few days. However, she now wont eat much at all, has no bad diarrhoea (not much feces at all, since she isn’t eating much), is drinking more, and is extremely lethargic. In the last few weeks she’s also showing classic signs of dementia (CCD?). Just in the last 2 weeks she seems to get confused about where she is, gets lost in corners/behind furniture and wandering in a circle. She’s also going blind (her eyesight was never great). ? She doesn’t seem in pain, or particular discomfort. I took her to the Vets last week for a brief check incase it was anything obvious, since she’s lost weight and her loss of muscle (which I didn’t know was a symptom of Cushings until I read your article). But she can go from looking alert to flaked out from one moment to the next. She was looking ok at the Vets, and they found nothing obvious!
I’ve booked her in again at my Vet on Monday to do more blood work and check her cortisol levels. But I wondered possibly, as mentioned in your article, if she’s swung the other way and now her cortisol levels are too low? I’m having difficulty getting her to eat the Vetoryl pills, as I hide them in treats, as she’s taken to refusing. Opening her jaws and popping them in may lose me a finger as she’s going a bit snappy in her old age when forced to do anything she doesn’t want to (in general she has very good manners).
Just thought I’d ask for a general opinion, as my Vet never seems to have struck Cushings before and is just looking it up in the basic manual, though she is doing her very best. Lack of appetite does not seem a CD issue, and she might obviously have another underlying condition as well.
Any thoughts?
Thanks
Hi Fesans,
Your girl is very lucky to have you as her advocate. You are right to be concerned about these new changes to her symptoms. Since I have not examined your dog myself, I really can’t make any specific recommendations. I am glad you have an appointment scheduled for Monday with your vet. It does seem like blood work needs to be rechecked to look for changes. Many times, when a dog has been well regulated on medication and then suddenly becomes ill again, it can point to a new issue that may not have been present at the time of diagnosis. Also, it may be a good idea to get a referral to a veterinary internal medicine specialist in your area. They have lots of practice managing complicated cases as it sounds like your girl fits this category. I hope you can find some answers with the lab work and can figure out how to get your pup’s disease regulated again. I wish you both the best and keep us updated on her progress!
Wow, it’s like you have been watching but what I’ve been going through in my living room with my dog. Your story is identical to mine in every detail. I adopted him when he was 10 and he’s always had weird gross on him but in the last year they’ve become crusty and disgusting and sometimes bleed. His muscles are weaker. My vet has never explained that both of these things could be caused by Cushing’s. This article was wonderful and this person‘s inquiry has brought me to tears but I also feel more sane now. Seems to me that my dog is quite advanced in a disease with which he was never even diagnosed, trying herbal remedies but in my heart I feel like it might be too late. He’s 14 according to the timeline I was given, but who knows how old he really was when I adopted him at 10. ?
Hi Isabella,
I understand your concern for your sweet senior guy. It does sound like he has some issues that probably need to be evaluated by your veterinarian. Since I haven’t examined your pup myself, I can’t make specific recommendations or really make any guesses as to what the actual diagnosis would be. It is very common for senior dogs to lose some muscle mass as they age and therefore experience some weakness. Also, Cushing’s disease does not necessarily cause lumps or tumors to form on the skin and any growths that are bleeding or oozing should be checked by your vet. While it is possible that your dog could in fact have Cushing’s disease, it does make me suspicious there are other problems that need to be addressed. I hope you can figure out the best way to help your boy live out his senior years with grace and dignity. I wish you both the best.
Hello. I have a 10-12 (estimated) old miniature schnauzer with Cushings. I rescued him from the pound 2 1/2 years ago. His only symptom of Cushings was a severe pot belly, ravenous appetite and some mobility issues. He never drank or urinated excessively. The vet tested him and confirmed Cushings. He has been on 30mg of Vetoryl since. Nothing much has changed in the past 2 1/2 years. Some additional mobility worsening and skin issues are the only new things since his initial DX. My husband and I have been away for the past week. My house sitter, whom he adores as she is also my housekeeper and is here with him daily, called me mid trip to say he was drinking massive amounts of water and had a couple of accidents. By the time we got home he was not able to control his bladder at all, He has been peeing massive amounts right in front of me. I put a pad under him last night and it was soiled this morning along with several accidents. He drank water all night and this has continued all day today. What would cause this sudden onset of bladder in continence and excessive water intake ? He also threw up the food he ate yesterday evening this morning. It was undigested. But he has eaten great all day and has not vomited. He does act if he doesn’t feel great but he’s not lethargic by any means. His urine is still yellow and clear.
Hi Amy,
These new symptoms in your Schnauzer are of great concern. There could be an additional disease process at play that is making the Cushing’s appear to be worsening. I highly recommend you have your senior guy examined by your veterinarian as soon as possible. They will probably want to run some lab work or other tests to rule out a diabetic crisis, pancreatitis, etc. Anytime you have a dog that has been well regulated on medication, that all of a sudden becomes unregulated, it could be a medical emergency. I hope you can figure out what is happening with your sweet boy and get him comfortable again. Best wishes to you both and please keep us updated!
My 14 year old Schnoodle was diagnosed in June and confirmed with Cushings. Her meds were increased gradually. Now we are taking 17.5 mg Vetoryl, gabapentin, and melatonin but her symptoms remain. The Vetoryl is split between morning and night. What’s next if her symptoms are not being managed? My vet is very diligent, but I’m still searching for answers. Thank you!
Hi Carolyn,
Sorry to hear that your Schnoodle recently got diagnosed with Cushing’s. It sounds like your vet is doing a great job of trying to manage her symptoms. Sometimes it does just take time to get to the right dose of Vetoryl since you have to increase gradually like you said. However, other times, it ends up that there is some other underlying factor that is making the Cushing’s harder to manage than usual. This is where having an appointment with an internal medicine specialist can be helpful. They can be a great resource for managing the more complicated cases because of their focus on these sorts of diseases and specialized training. I would suggest talking to your wonderful vet about your concerns and seeing if he or she thinks it is time to consider an internal medicine consultation or if you should stay the course a bit longer first. I hope that you are able to get your sweet gals symptoms under control. Hang in there as I know it can be difficult to be several months out from a diagnosis and still trying to fine tune treatment. ❤
My sweet rescue dachshund Barley (about 8 yrs old) has been diagnosed with Cushings. In addition to this, he has a heart murmur (4/6), gall bladder has been removed (11/2020) and his liver enzymes are elevated. Those values haven’t responded to Denamarin (4 rounds) or antibiotics. Symptoms include excessive thirst and frequent urinating, and a pot bellied appearance. My concern is treating with Vetoryl and risks of meds on top of his other issues. I fear overwhelming his system and possibly creating a worst situation for him. Can you help me with my concerns?
Hi Cynthia,
Sorry to hear that your sweet Barley is facing so many health problems. I can definitely understand your concern with adding Cushing’s treatment on top of everything else. Since I can’t examine him, look at his bloodwork, etc, I can’t make any definitive recommendations about if it is or is not a good idea to pursue treatment with Vetoryl. I think that the best way for you to get the information you need to feel comfortable with the plan (whatever it ends up being) would be to make an appointment with an internal medicine specialist. These vets have spent years studying and treating problems such as liver disease, gall bladder disease, and Cushing’s. They also have lots of experience with balancing the treatment for multiple problems, and in some cases may work in a facility that also has a cardiologist they could consult about the heart murmur if needed. I hope this helps you find some answers for your sweet boy!❤
I have an 8 yr old Boxer mix girl. She has Cushings that currently is not controlled. She was started on too high of a dosage of Vetoryl and her cortisol dropped to .7. She has been off Vetoryl for 6 weeks. ACTH test shows we are ready to start back up with a lower dose. In the meantime she has been diagnosed with Laryngeal Paralysis and probable pancreatitis. We have an appt Aug 19 with a surgeon for tie back surgery consult. However, due to switching her to a low fat diet I haven’t been able to start the Vetoryl yet. I’m so confused. Should I reschedule the surgeon appt? Does the Cushings need to be under control before we can proceed with surgery? She also has CCD and spinal arthritis. Thank you.
Hi Debbie,
Sorry to hear that your sweet girl has been dealing with so many health problems recently. I understand how complicated balancing multiple concerns, treatments, and appointments at once can get. Without being able to examine her and look at her bloodwork and history, I don’t feel like I can correctly advise you on how best to proceed. However, your current vet and the surgeon should hopefully be able to work together to formulate a plan for your pup, whether that is managing the pancreatitis and Cushing’s first then going for the surgery consult, going forward with the consult now, or something else. I would recommend getting in touch with your vet and the surgeon now to get the ball rolling so you will know what to do about the surgeon consult appointment.
Also, if you haven’t already, you may find this articles useful:
Laryngeal Paralysis in Dogs: The Ultimate Guide
Canine Laryngeal Paralysis: A Veterinarian Answers Your Questions
Tie Back Surgery for Dogs with Laryngeal Paralysis
Pancreatitis in Dogs: Do You Know the Signs, Risk Factors?
Best of luck to you and your sweet girl as you navigate these health concerns and appointments! ❤
My dog, a 12 year old cocker spaniel, was diagnosed with Cushings (after the 4 hour blood test and the 8 hour blood test) about 2 months ago due to highly elevated cortisol levels. She was prescribed 2.5mg of Trilostane (she weights 30 lbs) to begin with and her symptoms did not sufficiently abate. After the first month, her cortisol levels were measured with the ACTH stim test which showed continual excess cortisol levels and her symptoms had not abated so she was moved up to 5mg/2x day. The results of the ACTH stim teast after 3 weeks were 6.7 pre test and 13.1 post. She then was put on 7.5mg 2x.day of Trilostane and her results after 3 weeks were 4.6 pre and 11.4 post. We are now up to 10mg 2x/day. Shes’ been on that dosage for 4 days and her symptoms remain relatively steady: She is ravenous all of the time, is putting on weight, and she pants a great deal even at rest. Each blood test costs $400 and it seems we are making very little and very slow progress. Any recommendations? It is hard to witness her being in such prolonged discomfort.
Hi Nina,
It can definitely be difficult to watch your dog continue to be symptomatic for Cushings as you and your vet continue to work together to figure out how to get her Cushings under control. Some dog seem to be easier to get under control than others, and it can definitely be a long process sometimes. It sounds like your vet is doing a good job of gradually increasing the dose and rechecking the ACTH stim to get an idea of how it is working. Since it sounds like she is one of those dogs who may be a bit more difficult to regulate or who may end up requiring a higher dose to get regulated, you could also consider having her seen by a vet who specializes in internal medicine. These vets can be a great resource for the complicated cases and by virtue of being a specialist, may have more tools at their disposal to figure out if there is some underlying reason why she isn’t responding yet. Hope you are able to find a dose that works for her soon!
I would like to invite you to join the face book group (Dogs with Cushings Support and Information.)
I am sorry that you are having problems with her meds.
I couldn’t find this website, but I found “dogs with Cushing’s”…
Is this a good option?
Hi-thanks so much for your page and info ?. Our 25 pound 13 year old labradoodle has had diabetes for 4+ years with insulin shots 2x a day. She is totally blind now from the diabetes. She has every symptom of Cushings that has been suspected for awhile. She appears to now have severe anxiety and muscle weakness and pain in her rear end and legs. She recently nipped at two of my friends which is shocking. She is scheduled for a Cushings test but we don’t want to cause her any more anxiety being away from us all day.
At this point in her life, what would you suggest?
Hi Lois,
It can be so difficult to know how to make the best decisions for our dogs. I’m sorry to hear that your sweet pup is now struggling with anxiety, pain, and muscle weakness on top of her blindness, Cushing’s signs, and diabetes. You have very valid concerns, and I would recommend discussing them with your veterinarian. Without being able to examine your dog and really get a feel for things, I unfortunately can’t give you too much direction. I hope that you are able to have a fruitful discussion of the pros and cons of the testing and possible ways to decrease her stress during that day so you can come to a decision that you feel good about. ❤
At 2 years old my yorkie was showing signs of Cushings disease. His symptoms were: pot belly, overweight (19 lbs), always hungry, recurring skin infections and panting so I asked my vet to test him for Cushing’s disease and it came back positive. He was on Vetoryl pills for 6 months then switched to Trilostane liquid for the last 6 months. Even being on medication he is still starving all the time. He is now up to 21 lbs and even though my vet and I have tried adding vegetables and low calorie food to his diet, it not helping. He cries for food all day long. Any suggestions?
Hi Dianna,
I can definitely understand your concern with your dog’s continued weight gain and insatiable hunger all day long. Before I make any suggestions, I wanted to confirm your dog’s age because that may make a difference. Was he actually diagnosed with Cushing’s disease at age 2, making him around 3 years old now?
Yes he was diagnosed at 2 years old and has had 3 more tests since then to check his cortisol levels to make sure he is taking the proper dose of medication. He is now 3 years, 4 months old.
Hi Dianna,
Thanks for the clarification. Since this is not the typical Cushing’s situation and I’m concerned that any advice I’d provide would be inappropriate without knowing the entire medical records for your dog, I would recommend talking to your veterinarian about if he or she thinks referral to a board certified internal medicine specialist for a second opinion would be a good idea. I hope you are able to find some answers for your dog. ❤
Hi. Thank you so much for this informative article. My 11 year old cockapoo was diagnosed with SARDS in January and lost her sight. In the past few weeks she has every symptom of cushings as well and underwent the 8 hour cushings test yesterday. My question is, do Cushings dogs have a hard time settling down when they are trying to sleep. Ever since she started the excessive drinking/panting/urinating, she has been very whiny, but only when she lays down.. she is constantly restless and cannot get comfortable. Have you seen this before?
Hi Liane,
Sorry to hear your cockapoo was diagnosed with SARDs and is now showing signs of Cushing’s disease. Although SARDS is not well understood, it does seem to be connected with the development of Cushing’s disease or signs that are similar to Cushing’s disease in some cases. It is good that you are having her tested for Cushing’s and I hope that you are able to get some answers for her. Some Cushing’s dogs do seem to struggle with restlessness or anxiety at night, as do some blind dogs. I recently wrote an article about nighttime anxiety that I think might be helpful for you. Senior Dog Anxiety at Night? 6 Solutions for Better Sleep Also, I wanted to mention that I have seen ToeGrips help many blind dogs become more confident when moving around, so that might be something to keep in mind too. I hope you are able to find some solutions to help you and your sweet pup get some rest! ❤
My dog is about to go in for the test to see if she has cushings or not (she’s 14)
I already spend a hefty amount a month managing her arthritis and bladder condition so it’s unlikely I’ll be able to triple that financial budget a month to treat cushings as well.
I was wondering you would be able to provide some insight as to what cushings would be like left untreated, I haven’t been able to find much online.
Hi Brooke,
I’m sorry to hear that your sweet pup might have Cushing’s on top of her arthritis and bladder condition. It is difficult to watch our pets age and to be doing everything that we can to keep them comfortable while also trying to be mindful of the budget. You are doing a great job caring for her and she is lucky to have you. Your question is a good one, and it is one that I have seen plenty of people wrestle with. Dogs with uncontrolled Cushing’s are more likely to have skin infections, urinary tract infections (some of which are asymptomatic) or other infections. I don’t know what kind of bladder condition she has, but due to the risk of urinary tract infections with untreated Cushing’s I would definitely recommend discussing this aspect with your veterinarian. Dogs with untreated Cushing’s also continue to show the clinical signs such as increased thirst, increased urination, excessive panting, etc, which can be a bit distressing over time. While treatment is the recommendation, I have seen my fair share of clients who have elected not to treat their dogs with Cushing’s, so there is no judgment for whatever path you take. Feel free to keep us updated on how the Cushing’s testing goes. Wishing you and your sweet pup all the best as you navigate this hurdle together.❤
My 11 year old papillon mix was diagnosed with Cushings when she was about 7. Ever since I got her dental done, her skin issues from cushings have gotten worse. Is there a shampoo you recommend using to help? It’s not always a fungal infection it’s sometimes just very dry, flaky skin.
Hi Kristy,
Sorry to hear that your dog is struggling with skin issues related to Cushing’s. I think it is great that you want to find a shampoo that would help her out. There are a wide array of prescription dog shampoos available which can be geared toward a specific problems (skin infection vs dry skin vs itchy skin, etc) which is great. However, without being able to see and feel her haircoat and skin, it is hard to make a specific recommendation, so I would suggest seeing what your veterinarian thinks is best.
Can Encore Mobility be used by Cushing’s patients?
Hi Gina,
Thanks for your interested in Encore Mobility. The answer to your question is – yes, Encore Mobility can definitely be used by Cushing’s patients. It can have a protective effect on the liver as well as supporting the tendons and ligaments, two qualities that make it excellent for Cushing’s patients. Hope this helps!
What wonderful information on your page. I have a 12 year old flat coated retriever that has Cushings. The other day she suddenly couldn’t walk. After aboiut 24 hours she’s shaking but can walk again. Do you think this is Cushing related?
We did take her to the vet. All her bloodwork was normal
Hi Stephanie,
I’m sure that must have been a scary experience to see your dog suddenly be unable to walk, and I am glad to hear that you were able to get her to the veterinarian to have her evaluated. Cushing’s disease can cause some muscle weakness, but I would not typically expect it to cause a sudden inability to walk then back to walking in a day or so. Without being able to examine your dog I can’t offer a whole lot more specific insights unfortunately. I’m glad she seems to be doing better and I hope that you and your veterinarian are able to find some answers for your sweet girl. ❤
Hi Dr Buzby,
What helpful info on this page. I would love an opinion here – I asked my vet to run the UCCR test, although my dog’s bloodwork/urinalysis did not reveal abnormal cortisol. (15 lbs about 10-11 yrs old papillon/pom mic.) She does have a small amount of protein in her urine and some, but not all of the cushings symptoms – no skin/hair issues at this time. THere was only 1 very mildly elevated liver enzyme. In fact, the vets – 2 – said she didn’t have cushings based on bloodwork. Unfortunately the UCCR test I did came back as elevated. I did do a free-catch at home doing a 3 day pooled samplem which was recommended due to protein.. There is some stress the 2nd and 3rd day because she is very smart and after day 1 – she anticipated the urine collection and it does get her stressed (as in, walking ages before peeing) but, not as stressed as at the vet/needle sample. I am doing additional tests but am concerned and would love to know *if an elevated UCCR leans heavily to confirming cushings even though I know the vet can’t only use this test -as stated, 2 vets I spoke to rarely use the test – via DR Google, I found out about it and asked for it. Would Love any feedback here as we are already nearly $2k into testing but more importantly I am worried. Thank you so much – Also – these samples were all 1st pee of the day about 11/12 hours after eating. The vet did put her on a 5 day Rimadyl treatment and her last pill was 4 days before I took the sample. Sorry for the very long post, but it is complicated.
Hi Marcy, Great questions. I typically do the 3-day pooled sample when I run UPCs but not UCCRs. I think a one time collection (as you said–with minimal stress) is all you need. Keep in mind the UCCR has nothing to do with protein (unlike the UPC). UCCR is urine cortisol-to-creatinine ratio. We have an upcoming blog on the topic because I think it’s huge! But now that it’s come back positive, I don’t think you need to rerun it. Bottom line–if negative, it virtually rules out Cushing’s. If positive, it doesn’t really help with a diagnosis. It just means that it’s possibly Cushing’s. I’m not sure what this means: “…my dog’s bloodwork/urinalysis did not reveal abnormal cortisol” because that is a specialized test, Did your dog actually have cortisol levels checked? It is not routinely screened for in regular lab testing. Also, keep in mind that RBCs and WBCs are protein, so the only time you can make any judgement about the protein in the urine is IF the “sediment is benign”, meaning there are not cells found, which can falsely throw off the protein. I think directing you back to your vet to look at the urine and lab test results to go over what you HAVE and HAVE NOT established as a baseline and then formulating a plan from there is the way to go. I hope this is helpful!
Hi Dr Buzby
Really helpful postings and product suggestions. I have an 11 year old Brittany recently diagnosed, after suspecting he had this underlying condition for some time. Although I sought regular veterinary care, including for classic Cushings symptoms, none of us were able to piece this together.
Over a 30 day period his liver enzymes have elevated further. He was prescribed Vetoryl but experienced some concerning behavioural changes so I stopped the medication. My question is whether it can be too late into a diagnosis to effectively treat the symptoms. I don’t mind giving him more water/potty breaks but he is eating about 4 cans of specialized wet gastro dog food and always seems starving/frantic to eat, is panting/has bad breath; glassy eyed and getting lame. Wondering what is going on. Wondering if you have any insights.
Thank you
Ps toe grips will be useful, particularly for stairs
Hello Angela, so glad to hear that your dog has gotten a Cushing’s diagnosis now. Not that I want any dog to be diagnosed with a health problem, but proper diagnosis is half (or more!) of the battle. If I’m understanding your question correctly, the answer is YES! By getting the Cushing’s under control (through medication), the symptoms will dramatically improve. If the symptoms are the same (or worse) this tells me that the medication dosage is not right yet. I hope this helps! And, yes, I love ToeGrips for my Cushing’s patients. ♥️ Thanks for the shout out!
My 9 year old irish setter was recently diagnosed with Cushings. She had the increased thirst, increased appetite, potbelly, and panting typical of Cushings. Also had a recurring ear infection on one side that would not go away no matter what meds were tried. Went to the vets for a day for the testing and it came back positive. She has been on trilostan for a few weeks. She seems MUCH better, its like a miracle. However she is having a weird side effect that I have not seen listed anywhere and I’m wondering if it is a side effect or something new. Within a week of starting the Trilostan my other dog (unfixed – he is scheduled for January surgery) has been EXTREMELY attracted to her – just as though she was in heat – but she was spayed years ago. It seems to vary throughout the day – mornings he won’t leave her alone, but by evening either he’s tired or whatever is attracting him has waned because he totally ignores her. Have you ever heard of this?
Hi Laurie,
I am so glad to hear that your dog is responding so well on the trilostane. It really is amazing what a difference Cushing’s treatment can make. An intact male dog may sometimes be attracted to a spayed female if she has an anal gland infection/impaction, vaginitis, skin infection of the region around the vulva, urinary tract infection, retained ovarian remnant, or other conditions. Although spayed females attracting males is not a commonly reported trilostane side effect, I did find mention of vaginal discharge and vulvar swelling in a spayed female when looking at the data for approval of the drug in the UK (but not the US approval study). The adrenal gland is responsible for making a small amount of sex hormones, so I could postulate that while we mostly think about trilostane decreasing cortisol production, it could also shift the sex hormone balance towards those that simulate a heat cycle. If the behavior persists, I would recommend an appointment with your veterinarian to rule out any of the other causes for attraction that I mentioned and a discussion how to proceed from there. Thanks for asking this interesting question. I hope you find a solution and that she continues to do well with her Cushing’s treatment.
Dr. Buzby ~ I have a 15 year old, 12 pound maltipoo. Diagnosed in March 2020 with Old Dog Vestibular Disease. Treated with antibiotics by our vet in Lincoln NE. Resolved in a few weeks.
When making the diagnosis of Old Dog Vestibular Disease, the vet did a CBC. That test apparently showed some elevations that could indicate Cushing’s Disease. After many tests, the diagnosis was made and for 3 months we have been on Vetoryl. Initially 10 mg in the am and 5 mg in the p;m. About a month ago a follow up blood test showed improved cortisol levels, but she was still panting, so DVM bumped up the dose in the pm to 10 mg. We also give her 50 mg of trazadone in the late afternoon to help calm her down.
With that all said, here is my question ~ It there any logic that the combination of outdoor temperature and elevated humidity (hence high dew point), can be a significant contributing factor to the symptoms? (She is an inside dog, 95% of day and we do have the AC on).
Earlier this week , on same meds, with low humidity and high of 75 and low of 55, minimal symptoms. Today, high of 90 with 72% humidity (outside), even when inside, heavy panting, with all the other Cushing Syndrome symptoms.
Is this just a coincidence, or is there a connection between the two?
Hi Robert, You ask great questions! Based on what you said, have you considered this? https://toegrips.com/laryngeal-paralysis-in-dogs/
I don’t think about Cushings being related to humidity/temperature but absolutely do with laryngeal paralysis (although it’s usually not a small dog disease, it’s possible.) Perhaps worth discussing with your vet if your maltipoo is showing any symptoms? Your observations are astute and I’d recommend you start keeping a journal to chronicle all this because sometimes we can put health puzzles together with the advantage of hindsight. All my best to you and your dog! ?
How expensive is the test to check the urine to rule out Cushing’s? I have a thirteen old Westie that is also a diabetic.
Thank you for your help!!
Hello Evora, The gamut of labwork to “work up” a dog for Cushing’s is expensive. There’s no way around it, unfortunately. The urine test specifically will vary from hospital to hospital but it should be somewhere between $125 and $175. I hope this helps!
My 11 year old English Bulldog, Lucy was found to have conditions of Cushings Disease when she was about to undergo a tail amputation for continuous infections. My vet suggested I look up a study done at the University of Tennessee about Cushings in dogs. It was found that Lignans (a supplement from the Norwegian spruce tree knots or flaxseed lignans) are extremely beneficial is the treatment of CD to lower the cortisol. I also gave her melatonin and fresh steamed broccoli with her kibble. We had great results as the panting stopped (allowing me to get sleep as it was more evident at night). I hope others may find this helpful as well.
Great tip, Kristine. I’ve been using this combo for many many years myself after learning about it from the University of Tennessee’s vet school, but only in ATYPICAL Cushing’s cases, which is a whole different ball of wax. Would you be willing to tell us a bit more about Lucy’s diagnosis? Thanks for sharing!
My dog has Cushing disease and takes trilostane. His liver enzymes are slightly elevated so they want to start him on denamarin. Will that really help? That will put my monthly med bill to $110.00. Besides , the lab work he gets done. He just had an acth test and his trilostane dose is right on.
Hi Barb,
I am glad to hear your dog is well regulated on the Trilostane. I know the elevated liver enzymes are adding an extra piece to this already complicated puzzle and that can be frustrating. As far as Denamarin is concerned, yes it can be very helpful, but it varies with each individual dog. One of the active ingredients in Denamarin that helps protect the liver is milk thistle. In the past I have used milk thistle as a supplement by itself for patients that could not afford Denamarin. I recommend you talk to your vet to see if this could be an option for your dog. If they decide to prescribe it, they can give you a dosage to use and a recommendation on which brand they prefer. I hope you can find an option that works for you and your budget. Best of luck!
Hello,
My 14 year old dog has in the past been suspected of Cushing’s. He never used to care for food but he wants to eat all the time now. I haven’t noticed a thirst issue. I have seen him panting sometimes. But he is having issues with his left paw and I read that sometimes Cushing’s can affect the nails. He has a dew claw that comes out very twisted and didn’t used to, I always keep them clipped. He has another that kept breaking off and now it doesn’t have blood supply through it, it grows and breaks and as long as I keep it very short it does ok. But, Now I’ve noticed he had some blood on him and found another nail that looks like it might be having issues now. It is a white nail and has a dark ring at the base like it may be blood. He is limping and I’ve had him to the vet to no avail. I feel so bad for him. He used to run constantly for a ball and now he is lame. Do you think this nail issue is related to CD?
I forgot to also mention that his liver enzymes have been high and he has been on denamarin.
Hi,
I have a Boston terrier that is about 11 years old and Cushing. On no meds. Over the last 2 weeks sometimes when you touch her lower back or belly she jumps like it hurts. Is that a symptom of CD? Thanks
Hi Pam,
I’m sorry to hear your Boston may be acting painful. Lower back or belly pain are not common Cushing’s disease signs, so I would recommend making an appointment with your veterinarian to get to the bottom of this. I hope you are able to find some answers for her and that she is back to her usual self soon. ❤
Hello Janna, Unfortunately it’s hard to tell with only information via a blog comment, but my gut would lean to this NOT being related to Cushings. I would definitely continue to pursue veterinary care (even if it means a second opinion) until you get to the bottom of the nail issue. Dogs can get infections (bacterial or fungal) at their nails which can cause this, as well as auto immune conditions. Because it does seem to be painful and impacting quality of life, I would want you to pursue a diagnosis so that you could treat appropriately.
My 11 year old boston terrier has been diagnosed with cushings almost 4 weeks ago. On his 3rd week lab draw it came back with a BUN of 111. 2 days of hydration and the BUN has gone down to 50’s. He is currently on Trilostane 10 mg. Is kidney disease/assault part of Cushings? Should we stop Trilostane cause of the elevated BUN?
Hello Bev, Great questions! Idiosyncratic drug reactions are always possible with any drug, but Trilostane is not a known “kidney damaging” drug. Also, I wouldn’t think this is related to Cushing’s Disease. Is creatinine also elevated or only BUN? Most likely your dog had some undiagnosed renal insufficiency that is now coming to light (so common in older dogs) or it’s related to dehydration, etc. I think you need to track more data (serial lab work) to determine what to do about the Trilostane/treatment plan.
Are there homeopathic remedies to help a 15 year old dog stay comfortable? My dog has the pot belly, increased appetite and thirst, and sometimes her tummy swells a little more, she pants and is listless for short periods. Still loves her walks, and no skin problems. Still plays and seems normal in her personality.
Hello Marcie, I am not familiar with homeopathic remedies for Cushing’s and would advise you to find a veterinary homeopath to consult with. This may help: https://www.ahvma.org/find-a-holistic-veterinarian/
Past vets have suspected Cushings for my Dad’s 12yr old lab who is now with me for past 2 months. He is arthritic & I am addressing with vet and starting physical therapy this week. He does not want to go for “walks” and not very mobile, he can hold his pee, normal poop etc. He drinks a alot, like a lab always wants food & pants but vet said LarPar. Question- if he has Cushings & is treated will he be more mobile ,able to go for walks etc? It is hard for me to see him not able to take walks.
Hi Tara, first of all, have you read our blog on LarPar?
https://toegrips.com/laryngeal-paralysis-in-dogs/ I hope you find it helpful.
Second, treating Cushings may or may not help your dad’s lab be more mobile. Typically I do not think of Cushing’s as a disease that limits mobility, BUT several of the side effects of Cushing’s could secondarily affect mobility. I would return to your vet with the specific complaint of his reluctance to move/go on walks and look at that as a separate concern until proven otherwise.
Our 14.5 year old, mixed breed has not yet been diagnosed with CD but has a number of symptoms and raised liver enzymes from a recent test (to be repeated next week). My problem is that our vet has advised that CD is difficult to diagnose (as Ive also read) and that mis-treatment can actually cause Addisons which is worse. Ive also read on various sites that the side effects of some medication for CD can be bad. I dont know if natural treatments proposed on sites such as https://boulderholisticvet.com/a-holistic-approach-to-cushings-disease/ can cause similar problems? She also gets really stressed during vet visits and so we want to minimise them (which could exacerbate the CD condition).
So, I’m currently concerned about undergoing numerous, (stress-related) tests just to get an uncertain diagnosis followed by risky medical treatment. Im more tempted to wait to see if her condition worsens and, if so, try the natural treatments.
I welcome your views.
Hi Danny, I agree with the premise of your comment, but I have also found treatment to be extremely helpful for quality of life for these dogs. However, it is definitely a commitment and expensive. If she were my patient, I would start with a test called a UCCR (urine cortisol creatinine ratio) which is done on a urine sample that you collect at home. (important to be done in a no-stress environment, thus at home!)
Here’s why I’d recommend the test: If positive, you would still have to pursue more testing for confirmation. But if negative, you could be 99% sure that CD is NOT the diagnosis and move on.
Hello
My 13 year old mix breed (West Highland, Poodle, Afghan, Huskey) is showing some early signs of Cushing Disease. Increased thirst, panting, and elevated liver count in his blood work. In his pre-surgery X-ray that he had, due to calcium oxalate stones, his liver is slightly enlarged. He has no other symptoms thus far. Are there any kind of supplements that you would recommend to help with slowing down the development of this disease?
Hello Tahirih, I don’t know of a supplement to slow Cushings, but you could absolutely do a supplement like SAMe or Denamarin to support the liver. Talk to your vet about this. In the meantime, I’d recommend taking in a urine sample from your dog that you collect at home for a test called a urine cortisol creatinine ratio: https://vcahospitals.com/know-your-pet/urine-cortisol
It’s a nice test because the dog doesn’t need to go into the hospital, but if it’s negative, then we conclude with 99% certainty that Cushing’s is NOT the diagnosis. If positive, further testing is needed, but it’s a great screening test.
Is there a special shampoo to use on a dog that is going threw cushions disease that I can use frequently.
Hello Donna,
It would really depend on what secondary skin conditions your dog has as a result of the Cushing’s. Cushing’s disease affects the immune system, which means any skin “invader” could be an issue–bacteria or fungus. There are some fabulous medicated shampoos on the market, but you’ll want to get the one specifically designed to address the skin problem your dog has. Definitely talk to your veterinarian for a recommendation.
My question is , my dog has cushing disease. Is it make it worst for him when he gets wound up? Sometimes he doesn’t want to go in the car. But on occasion I really want him to go with me. Am I making it hard on him by having him go? We also got a puppy just before he was diagnosed the puppy is pretty rowdy.. Does that affect him?
Hi Susan, This is an interesting question. In general, just like for people, stress is not good for health. So if your dog is getting “stressed/anxious” in the car or in rough play, I would avoid them! But if he’s just getting excited, then the answer is “no”. I don’t think you are causing him any harm. I do think keeping senior dogs in their “routine” is very valuable for their physical and emotional health.
I would love to know what to do with the issue of panting because of Cushings. I feel helpless when it’s happening to my dog and yet it puts stress on her heart which I don’t want.
Any suggestions?
Thank you,
Hello Carolyn,
The simplest thing you can do is to keep your dog in a cool/low humidity environment, and one without stressful triggers.
But beyond that, the only thing that will “cure” the panting is to treat the actual disease. Improving the Cushing’s will improve the panting.
I would like to know if CD can effect both the heart and liver of a dog. My 10 year old Yorkie has been recently diagnosed with pituitary Cushing’s. He has developed a heart murmur and an enlarged liver.
Judith, great questions. The answer is “yes” and “no”. Cushing’s disease is notorious for causing a “pot bellied” appearance, liver enlargement, and elevation of liver enzymes (particularly ALP). But we don’t generally associate heart disease with Cushing’s disease. However, there are tons of senior dogs who have both issues because both heart murmurs and Cushing’s tend to be common in older dogs.
My sheltie was recently diagnosed with low thyroid. Once we started medication (thyro-tab 4 mg) he started having skin lesions. He had a small tumor on his tail removed recently and my vet suspected he may have CD as well. Did blood test and it came back in grey area. How can I confirm whether or not he has CD? He’s 10 years old.
Hello Rindy, Great question. There are 2 very specific tests for Cushing’s. One is called the ACTH Stimulation test and the other is the LDDS (Low-Dose Dexamethasone Suppression test). There is debate in our profession as to which one is best so please talk to your veterinarian about where to go from here, especially since you may have already done one of these tests based upon your comment. By the way, it’s not uncommon for dogs to have multiple endocrinopathies (ie. having hypothyroidism + Cushing’s disease both). Finally, if your dog is on any sort of oral or even topical steroid or product with a steroid in it (like an ear medication), this will affect the results of the Cushing’s test, so another thing to discuss with your veterinarian in advance.
Is there a correlation between Cushings Disease & Laryngeal Paralysis? I have a 15 year old Husky/St. Bernard cross which started showing signs of CD (still waiting on bloodwork to confirm) but amongst his other common CD symptoms his Laryngeal Paralaysis symptoms rapidly advanced. If he is diagnosed CD and the LP is associated with it could treatment regain proper function of the larynx?
Hello Kelly,
Great question, please stay tuned for our article on laryngeal paralysis (GOLPP) coming out in the next few weeks! It is certainly possible for a senior dog to have both Cushing’s and laryngeal paralysis, but I don’t know of a direct link. There may, however, be a link between hypothyroidism and laryngeal paralysis. Cushing’s can cause ligament laxity which should respond to treatment, but if it is true laryngeal paralysis, then I don’t expect it to respond to treatment for Cushing’s. Both can be frustrating diseases to manage, but it sounds like you are well on your way to getting to the bottom of this.
My 7 year old chiweenie was just diagnosed with Cushings Disease today. She has recently been having increased drinking and urinating and has pretty much always acted like she just don’t get enough to eat. I had also been commenting about her belly looking fatter. We had several tests run on her yesterday, and back today to check if Cushing’s. What is usually the life span of a pretty young dog with Cushing’s on medication (Trilostane). I am very scared about this medication as she could end up with too much cortisol or not enough and needs to be closely monitered. Is there anything that can make me feel more at ease about giving this medication. I don’t want to cause her more problems.
Hello Denise,
I understand how scary this is, and indeed, treating a young dog with Cushing’s can be a serious commitment. However, if everything goes as planned, it should dramatically improve her (and your) quality of life. If you are committed to monitoring and adjusting according to your veterinarian’s recommendations, then I don’t think we’d expect this to impact her life span. Trilostane is also my treatment of choice. Please be encouraged! 🙂
My 9+ year old Whippet cross as just been diagnosed with CD. He as had symptoms since December 2018 and I have been monitoring him before I took the root of Bloodwork. He hasn’t had all the symptoms mainly excessive thirst and excessive urinating which of late started having accidents in the house. He started Vetoryl 30mg on Saturday 16th March 2019. Reading your article as answered alot of my questions obviously I am new to this illness. Hopefully I can finally get his quality of life bk and also mine as I work full time as a single parent and have been managing on 2-3 hours sleep for the past 2 months. Thank you so much for the article.
Thanks so much, Claire, for letting me know this article was helpful to you. Our mission is to help you help your dog, so your message brings me great joy! I’m optimistic that you and your Whippet have brighter days (and nights) ahead!
Is there any special dietary guidelines for a Cushings dog. My Rudy is now overweight, but it has been a battle with his appetite to cut back
Thanks for the comment, Lynn. There are no special diets for a dog with Cushing’s disease, unless the dog has concurrent medical issues such as pancreatitis, diabetes, heart disease, etc. I’ve recently read on Dr. Google that dogs with Cushing’s should eat a diet low in purines, but I can’t find any support or evidence for that in actual veterinary literature. So I wouldn’t worry about a specific Cushing’s diet, but I would recommend you talk to your vet about a weight loss diet for Rudy so that he can feel his very best!
This is great information! I would love to have more information on the holistic treatments for cushings. I have had success with 4 supplements: melatonin, flaxseed lignans, milk thistle and Phosphatidylserine. The last of which made a whole body change within 2 weeks (fur grew back after 2 years of thinning). The research I have done has found evidence that these are equally successful as prescribed medication. Thanks for writing about Cushings Disease! I love all that you do!! ♥️
So honored to have the beloved Odie and his mom comment on our blog! Thanks, Alicia. Really interesting comment! From my experience, and in discussing it with colleagues, I haven’t had that combo of supplements be very helpful for “straight up” Cushing’s disease. However, I definitely have for “atypical” Cushing’s. And I know exactly what you mean about the hair growth. Sweet little Jimmy the Pomeranian was patchy bald patient of mine, but regrew his coat nicely after many weeks. I like this article because it highlights all the “variations” of Cushing’s in the big box and some of THESE are the ones that I’ve seen respond to the “cocktail” you reference 🙂
http://veterinarymedicine.dvm360.com/meal-induced-hyperadrenocorticism-dogs-not-be-overlooked
Will treatment just stop or slow the progression of Cushings or can the symptoms be reversed??
Hi Brandi, Great questions! If the disease is caused by an adrenal tumor AND the entire tumor is surgically removed AND the tumor is benign, then surgery would cure the dog. However, these are a lot of “ifs” and is rarely the case. The more likely scenario is that the dog is “managed”, improving the clinical signs (as you mention), and Lysodren and Trilostane work quite differently. Please check out this link for an in depth explanation of treatment: https://veterinarypartner.vin.com/default.aspx?pid=19239&id=4951512