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, and other treatment options 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. As I was rubbing her senior dog’s pot belly, I sensed my client’s fear and worry. I had just met Jake forty minutes prior and diagnosed two other conditions—hip dysplasia and laryngeal paralysis in dogs.
Now, I suspected her canine companion had Cushing’s disease, which is also known as hyperadrenocorticism. As a veterinarian, it’s a medical condition that I’ve diagnosed often since it’s fairly common in senior dogs—who make up the majority of the patients in my practice.
If your dog has been diagnosed with Cushing’s, you may have questions and concerns much like my client. Along with your veterinarian’s recommendations, please use this ultimate guide to Cushing’s disease to help you help your dog have the best quality of life possible.
What is Cushing’s disease in dogs?
Cushing’s disease (or Cushing’s syndrome) occurs when the body produces too much cortisol, a stress hormone. Cortisol is the body’s natural steroid and is absolutely essential for day-to-day life. The body regulates cortisol levels very carefully. When the amount of cortisol gets out of whack, bad things can happen!
What causes Cushing’s disease in dogs?
As
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 pea-sized and do not spread. Instead, they disturb the normal secretion of hormones in the body. The end result is excessive cortisol. This is the case in about 80% of dogs with Cushing’s disease.
In the other 20% of dogs, a tumor grows on the adrenal gland. (Adrenal glands are small, bean-shaped organs found just above the kidneys. They make cortisol.) However, the end result is essentially the same. These tumors also lead to elevated levels of cortisol in the body.
Also, I think it is important to mention iatrogenic Cushing’s disease. The term “iatrogenic” indicates that a medical treatment or procedure accidentally caused the condition. The administration of prednisone for dogs or other corticosteroids may cause iatrogenic Cushing’s disease. These drugs mimic the action of cortisol in the body, so they can cause identical symptoms to adrenal or pituitary tumors.
Playing the odds, I suspected my Lab patient had a small brain tumor called a pituitary microadenoma.
Jake’s Cushing’s disease clues
But let’s back up for a second. Why did I suspect Jake had Cushing’s disease? In my conversation with the my client, she had mentioned noticing Jake’s thirst, urination, and panting were increased. These are three cardinal symptoms of Cushing’s disease in dogs.
Also, while I was speaking with my client, I sat rubbing the thin skin of Jake’s pot belly. (Yes, thin skin and a pot belly are two more cardinal symptoms.) In additional to these, what are other clinical signs and symptoms of Cushing’s disease? The list is long.
What are the symptoms of Cushing’s disease in dogs?
If you have ever taken a steroid (for example, prednisone) for a medical condition, you may have felt restless or had an increased appetite. The symptoms of Cushing’s disease in dogs are similar to some of the side effects human patients experience when taking steroids.
Symptoms of Cushing’s disease in dogs may include:
- Restlessness, which may include senior dog anxiety at night
- Panting
- Possible behavior changes
- Increased drinking and urinating
- Increased appetite
- Weight gain
- A pot-bellied appearance
- Thinning skin
- Weakness
- Muscle wasting or loss of muscle mass (It’s worth noting that due to the loss of muscle mass, a dog suffering from arthritis may suddenly worsen.)
- Hair loss
- Skin changes—much like that of a teenager!
- Skin infections (called pyoderma)
- Urinary tract infections
Also, it’s important to mention that dogs with Cushing’s disease are more prone to infections. This is why skin infections and urinary tract infections in dogs are on the list. Both of these can be recurrent.
How is Cushing’s disease diagnosed?
As an
I recommend that my client starts with a simple test called a urine cortisol creatinine ratio (UCCR). This test is collected at home and rules OUT the diagnosis, rather than ruling it IN. Let me explain…
Testing to rule OUT Cushing’s disease
First, the UCCR test measures cortisol in a urine sample. Cortisol is the hormone “over produced” in Cushing’s syndrome, but animals and people naturally produce it as part of a healthy response to stress.
For best results, the client should collect the dog’s urine sample at home. This way, the dog doesn’t get anxious from a visit to the veterinary clinic, secrete a bunch of cortisol, and skew the results.
Second, the test doesn’t prove that a dog has Cushing’s disease. On the contrary, all it can tell us is that a dog does NOT have Cushing’s, thus 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.
However, an elevated UCCR simply indicates your dog COULD have Cushing’s disease. Thus, we would need to run more tests.
Testing to confirm Cushing’s disease
Tests to rule IN Cushing’s (aka confirm the diagnosis) are blood tests. There are three options: the ACTH stimulation test, a low dose dexamethasone suppression test, or a high dose dexamethasone suppression test.
Each of these 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, especially if trying to differentiate between the three types of Cushing’s disease.
Occasionally, the results are still not conclusive. In order to nail the diagnosis, an abdominal ultrasound, X-rays of the chest or abdomen, further bloodwork, or other tests may be recommended.
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?
Like my client who was concerned for her beloved senior dog, your next question may be, “What happens if my dog is diagnosed with Cushing’s?”
In most cases, Cushing’s is a lifelong disease. Treatment requires careful monitoring by your veterinarian. It is a commitment and it can be daunting. However, the good news is that there are many treatment and management options to help your dog feel better.
Medical treatment options for Cushing’s disease
Since over 80% of dogs diagnosed with Cushing’s disease have tumors in their brain that are very small, management with medication is usually the preferred route. Your veterinarian may prescribe medications such as the ones listed below.
Vetoryl and Lysodren
Vetoryl (trilostane) is currently the only veterinary-approved product on the market that treats both pituitary and adrenal-dependent forms of the disease. It blocks the production of cortisol to bring cortisol levels back to normal.
Another drug called Lysodren (mitotane) targets the adrenal glands, which are over-producing cortisol. This medication keeps the glands from producing as much cortisol.
For more information on how these medications work, please read this article by Veterinary Partner on treating the pituitary form of Cushing’s.
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 (aka Addison’s disease). Follow-up bloodwork with your veterinarian will be necessary.
In the interest of full disclosure, this can represent a significant financial and time commitment. When initially starting therapy and when making dose adjustments, your vet may need to run bloodwork as often as every few weeks or months.
Selegiline and off-label medications
Selegiline, a drug used to manage canine cognitive dysfunction, is also approved to treat the pituitary tumor form of Cushing’s disease. Also, there are other off-label medication options such as ketoconazole and melatonin for dogs. However, these are not approved and must be used with care and with the understanding that they may not be effective.
Surgical treatment for Cushing’s disease
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. Thus, many pet parents opt to treat their dogs with medical management to avoid the cost and risk of surgery.
Is my dog in pain with Cushing’s?
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.
How to comfort a dog with Cushing’s disease
What can you do to help your beloved dog? In addition to treating your dog’s Cushing’s disease, here are more things you can do to be vigilant in managing your dog’s condition.
- 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 and giving your dog plenty of opportunities to go potty.
- 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.
- 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.
- Keep in close contact with your veterinarian about any changes in your dog’s symptoms. If you notice vomiting, diarrhea, lethargy in dogs, tremors, or loss of appetite, contact your veterinarian immediately. These may be signs that your dog has flipped from Cushing’s disease (too much cortisol) to Addison’s disease (too little cortisol). Addison’s disease can be life threatening, so it is critical your dog gets veterinary attention right away.
Addressing 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.
As the founder of Dr. Buzby’s ToeGrips® dog nail grips, I often hear from customers who share success stories and leave positive ToeGrips® reviews. One of our customers wrote to let us know that her dog, Brew, a 14-year-old Bichon and Cavalier Spaniel with Cushing’s syndrome, saw an immediate improvement in his mobility with the addition of ToeGrips® dog nail grips.
Read Brew’s story:
Just under 24 hours of having the toegrips on and I must give a rave review. It really is amazing to see my boy get up off the floor on the first try! He (Brew) has Cushings Disease which makes him run a bit warmer than the average dog. So he minds the heat a lot, causing him to want to shift around and find new cold spots on the laminate floor. I was skeptical about these at first, not personally knowing anyone that has tried them, but seeing nothing but good reviews, I was hopeful. Well, here I am gushing. He is no longer doing a Bambi on ice I really hope anyone on the fence about these reads this and goes and gets them sooner than later.
I wish I had tried them sooner seeing just how good they work on my Brew. I would also like to say that the customer service from this company is amazing!!! Thank you Dr. Buzby and anyone else that helped to get this product in my home and on my dog. I will tell anyone that will listen to get these for their dog, and when my other dogs get old enough to need them, they will be getting them without a doubt! Thank you, Thank you, Thank you!!! —Crystal W.
What is the prognosis for dogs diagnosed with Cushing’s disease?
Cushing’s disease in dogs is not a hopeless diagnosis! But it IS a disease that requires careful and observant monitoring, both by you and your veterinarian.
Regular veterinary checks with bloodwork and urine tests should be expected. Despite all this, a dog with Cushing’s disease can have an excellent quality of life.
I’m optimistic that Jake, my sweet senior Lab patient, has several happy years ahead. I look forward to partnering with his mom to provide him the longest, healthiest life possible through appropriate veterinary diagnostics and treatment.
What questions do you have about Cushing’s disease in dogs?
Please comment below.
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 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