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.
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.