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 in dogs)
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.
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.