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.
We have a 10 year old Boston Terrier, named Ozzie. His health has declined in the past year- loss of hair, “rash” on his back and back leg weakness, a phlegmy cough, His vet he had been going to for his entire life after several visits did diagnose him with an enlarged heart, but nothing else. Said we should enjoy the rest of our time with him, and that was it.
Switched his food, started him on some supplements while we sorted out next steps, and moved to a new vet about three months ago. Over the course of a few visits, he was diagnosed with Cushings about 6 weeks ago. We tried a natural supplement for a period of time, rather than starting Veteroyl. Also put him on Benadryl for the cough (which seemed to help at first but I wouldn’t say it does much any more). About three weeks ago, he started to walk like a drunk person among other things. He had just gotten off of an antibiotic so we were thinking it was vestibular disease or part of cushings. His walking got better for a bit but then it got worse again. About a week ago, we took him back, ready to start Veteroyl, but the vet thinks he had a stroke (or two) so that became the priority and prescribed him a blood thinner to prevent further clots, no Veteroyl (I wasn’t at the appt, my husband took him). The medication was started today (mail ordered for his weight). Since the last vet appointment, he has done less of the drunken walking but the hind legs continue to weaken and he seems to want to walk less. He still has a healthy appetite, and wants to play with his ball during the day for a bit, which is what makes the decision hard.
The phlegmy cough is a problem too- it disrupts his eating, He walks away, coughs a bit, and then eventually comes back to eating. This is been more of an issue as of late, a lot more drooling out of one side of his mouth while eating. When he drinks too, he has to cough. (They did do several scans as well of various parts of his body, so the cough hasn’t been the priority among his issues).
Overall, I’m starting to accept that we are going to have to make a call soon. But there’s a piece of me that hasn’t given up hope yet. I’m ready to throw the kitchen sink at this one last time to see if there’s an improvement, and willing to ask anyone questions 🙂
Is it worth trying to push the vet to get him on Veteroyl? Not sure why to start the blood thinner and not also Veteroyl? I’ve ordered some other supplements as well that are recommended for stoke victims as well as Cushings- at this point, we’ve got nothing to loose.
Any suggestions for the phlegmy cough?
Thanks in advance! I realize a few paragraphs may not be enough to give advice, but I’m at the point where I feel like we’ve got nothing to loose.
Dear Kim,
I am sorry Ozzie is struggling with so many issues at once. It does sound like his quality of life is declining and I understand your concern. You can definitely talk to your vet about starting Vetoryl, but the symptoms that are the most worrisome don’t seem to have much to do with Cushing’s. I am not sure you will see the improvement you are looking for from Vetoryl. Has Ozzie had chest x-rays or had his heart evaluated recently? These could be signs of worsening heart disease. Also, it may be worthwhile to focus on decreasing inflammation in the body. While Cerenia is labeled for treating nausea, it is also a powerful anti-inflammatory. Here is a link to another article with more information: Can Cerenia for Dogs Help Your Vomiting Dog?
You can also look into alternative therapies such as acupuncture or Traditional Chinese Medicine. Hoping you can find the answers you need to give Ozzie relief and peace during this final stage of life. Wishing you all the best and praying for a positive outcome for your sweet boy.
My 14 year old Yorkie was diagnosed with a liver issue. His liver is enlarged, they say he has high liver enzymes. He also has a pot belly, they say. due to his liver being enlarged’ His appetite has gone way down and he has very loose stools but thankfully he hasn’t started vomiting. I don’t want to put him down. He still has alot of life to live. Do you think I should talk to the Vet to have him tested for Cushing’s.
Hi Pamela,
I am sorry your senior pup is facing this severe liver issue. While it is possible Cushing’s could be playing a role in this situation, treatment may not offer much benefit depending on how the rest of his body is functioning. I do think it is worth discussing with your vet and getting their expert opinion. Hoping you can find a way to extend your pup’s life and ensure he is happy and comfortable. Best wishes to you and your sweet boy.
Hi. We are awaiting diagnosis for our 11 year old Beagle, it’s looking very much like she has Cushings. Thank you for the fantastic advice on this webpage.
Hi Denise,
Thank you for the kind words! Hoping you get results soon and there will be a clear plan for treatment. Best wishes to you and your senior girl!
My foster dog is a case of extreme medical neglect. She came to the rescue with Cushing’s disease that has been left untreated for a very long time, Poor dog had lost almost all of her hair, skin and bones (ribs visible, legs weak, sunken face), calcinosis on both elbows, random wounds on her very dry skin and a super enlargened belly.. She was immediately started on Vetoryl, first at 5mg, then 7mg then 10mg, She goes for an ACTH test every month. After 5 months of vetoryl and hepapet plus, a lot of skin and hair care and proper nutrition, she almost looks ‘normal’ except for her huge belly. She looks as if she’s ready to pop a litter of 12 puppies, its firm, and hard to the touch, no doubt it makes her uncomfortable when touched around the belly (ie picking her up) – and she’s a chihuahua mix, so she’s a small lady of 8kg’s. The belly is VERY prominent. Why wouldn’t her belly go smaller? The vet says its not filled with fluid (which I assume is a good thing) – they don’t say anything else. Unfortunately the vet that the rescue works with isn’t the most collaborative. I often struggle to reach out to them or get an answer (there’s also a language barrier as I’m a foreigner). I’m just worried sick about this poor dog who’s undoubtedly uncomfortable because of this belly. Any ideas?
Hi Gunes,
I understand your concern for your girl and applaud you for advocating for her health and well-being. Unfortunately, without examining her myself it is hard to make specific recommendations. Sometimes the “potbellied” appearance of Cushing’s dogs just doesn’t resolve despite aggressive treatment. It would be best to rule out any other conditions that could be contributing to this situation. I encourage you to talk to your vet (maybe it’s time to get established with a different veterinary facility besides the rescue?) and see if they are willing to do some x-rays or abdominal ultrasound. Hoping for clear answers and praying your sweet girl has many happy years ahead. Keep up the good work!
My Riley is 12-year old Border collie/spaniel has many of the symptoms of CD but has not been officially diagnosed. Excessive thirst/urination, increased hunger, pot-belly, hair not growing back after grooming, flaky skin, panting. Recently, he started having trouble going up stairs and getting up from lying down on our wood floor. I thought that was due to his arthritis (his knees and hips crack terribly), but now I’m thinking muscle wasting as well. My question is, are all his symptoms (besides the arthritis) resolvable with medication for CD (assuming its confirmed)? I guess I’m wondering if it’s too late and too hard to do much to make him significantly better and I should just work on making him comfortable. He doesn’t seem to be in pain, thankfully.
Hi Kim,
I am sorry Riley is experiencing all these worrisome symptoms. If he does in fact have Cushing’s disease, then starting treatment could greatly improve his quality of life. It would also be a good idea to rule out diabetes and hypothyroidism. Your vet can let you know what testing is recommended and offer guidance as you navigate this difficult path. Hoping for clear answers and an easy solution. Best wishes to you and your sweet boy.
Dr Busby,
I have a 10 year old Maltese that was recently diagnosed with Cushing’s (we did the test only because she had 2 very mild episodes of vestibular syndrome).
She is 100% asymptomatic (only some gallbladder sediments but other that that all her bloodwork is great). She as regular abdominal echos done since he had her spleen removed last year due to lymphoma. In her echos her glands are fine, which makes us think is it pituitary gland related.
In her case would you recommend monitoring the disease and see if it progresses before we give medication? or should we start medication as soon as possible?
We are a little worried about the side effects of medication on her since it won’t help improve any clinical signs.
Hi Dania,
I understand your concern for your senior girl and think it is great you are searching for advice. She is lucky to have you advocating for her health and well-being. It is still up in the air about whether a dog should be treated for Cushing’s if they don’t have any symptoms. I was always taught that treatment was aimed at decreasing symptoms, so if a dog was asymptomatic (had no symptoms) then you would not treat. I did some quick research before replying to your question and it seems the American College of Veterinary Internal Medicine does not even recommend testing for Cushing’s if the dog is asymptomatic. With all that being said, I think veterinarians have to look at each case individually and consider the benefits vs. the risks. I think it would be fine if you choose to forgo treatment for your pup until she starts having other issues. Ultimately, the choice is yours and you have to trust your intuition. Wishing you both nothing but the best. Keep up the good work!
Thanks so much for your reply! It gives me more info to make my decision. She has great vets taking care of her and double checking if her results are actually accurate.
Our 13 y.o. toy poodle, Annie, has been diagnosed with Cushings Disease. It took several months to get the diagnosis as the LDDSTs were always normal. After finally doing the ACTH testing we had a diagnosis. She was started on Vetoryl and after testing and dosage adjustments, her ACTH was within normal limits. However, there is very little change in her symptoms. The drinking and urinating have improved somewhat, but she is still ravenous and the weakness and panting/coughing seem to be worsening. Why does it seem that the Vetoryl is not working? Is there any more that can be done – especially with her breathing? She is taking Theophylline 3 times a day and using an inhaler twice a day. It is so sad to hear her panting most of her waking hours and even when resting her breathing looks labored. If you have any insight into what is going on, we would appreciate hearing it. Thank you so much!
Dear Carol,
I am sorry Annie has received this difficult diagnosis and is not responding as hoped to the Vetoryl. Unfortunately, some dogs just don’t see as much benefit from treatment as is expected. I am not sure I have any great advice to offer other than it may be time to consider a consultation with an internal medicine specialist. They have lots of experience with complicated cases and could have ideas about other treatments or therapies to try. Hoping you can find the answers you need to ensure Annie is feeling her best. Praying for a clear path forward and for many happy days ahead for your sweet girl.
Hi – our 11.5 year old GSP was diagnosed with Cushing’s last Oct. Vetoryl made a pretty much instant improvement in her excess drinking and urination. But over time she became less interested in food to the point she stopped eating. After consultation with the vets, we stopped her meds until her appetite returned and then restarted her on a much lower level. The same pattern returned and she stopped eating.
She’s currently off meds, and seems fairly stable in terms of drinking and eating. But she’s struggling in the heat, panting a lot, and her coat/skin is thickening considerably. She’s having physio to help with hind leg weakness. All in all she’s comping ok without any meds, but is there anything else that is recommended we could do in the absence of meds?
Hi Sal,
I am sorry your senior girl is living with this difficult diagnosis. While I do not have any personal experience with using supplements to treat Cushing’s disease, I have read the testimonies of several readers that have seen benefits from using melatonin and lignans. This may be something to discuss with your vet. Also, you could look into alternative therapies such as acupuncture. Hoping you can find the best way to maintain her quality of life for as long as possible. Take care and bless you both!
Good afternoon!
We have a 14 year old English Tree Hound mix. She was diagnosed with CD a year ago. She has been showing many of the symptoms as described for about a year, but she had been doing well until this week. She had a very rough night of vomiting, and she seems to be not able to have a bowel movement as we see her trying with no luck. We are taking her to an urgent care vet today as our vet can’t see her until Monday. She has been on Vetoryl for a year and an Omega gel capsule for her joints. It seems we may be near the end of her life, but I am not sure if there is anything else that can be done. Surgery wasn’t an option last year after all the testing that our vet did. I am just not good at making this type of decision when our personal vet isn’t available. Is it time to make the decision to put her down? Thank you for your time and this website!!!
Dear Debbie,
I understand your concern for your senior girl and think it is good you planned to have the urgent care vet evaluate this situation. Without knowing what is causing these GI issues, I can’t say if euthanasia is the right choice at this time. These worrisome symptoms may not be related to the Cushing’s, and it is quite possible all this can be resolved with some simple medications. What did you find out from urgent care yesterday? Hoping all is well and there is a clear plan for treatment. Feel free to leave an update if you have a chance.
hi My bichon Mollie has been diagnosed with CF 2 years ago. she is on 40mg of Vetoryl twice a day. she has recently starting losing her sight and become extremely lethargic. can the sight be in anyway related to the CD?
thanks from a concerned doggy mum
Rachel
Hi Rachel,
I am sorry Mollie is living with this difficult disease. Yes, Cushing’s does commonly affect vision as it can cause changes to the cornea or even the retina in the back of the eye. These changes do tend to be permanent, but most dogs do just fine with limited vision (just don’t rearrange the furniture!). Make sure your vet is aware of these changes so they can stay on top of things. They may want to evaluate your girl and see if a dosage adjustment needs to be made to the Vetoryl. Wishing you and Mollie all the best and praying for many happy days ahead.