Adrenal Support for Dogs with Cushing’s Disease: What You Need to Know

By December 21, 2021 Dog Diseases, Dog Health, Hormonal Support 0 Comments

Adrenal Support for Dogs with Cushing's Disease: What You Need to Know

Adrenal support for dogs with Cushing’s disease or other adrenal issues can help manage their symptoms. Cushing’s disease is a disorder that is often overlooked in dogs, but if left untreated, it may cause serious health problems.

Cushing’s disease is not lethal in and of itself, but it can lead to a slew of other illnesses and consequences that can last a lifetime.

Cortisol is a stress hormone that regulates protein, carbohydrate, and fat metabolism and is released into the circulation to prepare the body for a flight or fight reaction. Cortisol is produced by the adrenal glands — two small glands located next to each kidney in the abdomen.

The hormone ACTH controls the production and release of cortisol from the adrenal glands. The pituitary gland, a pea-sized gland situated near the base of the brain, produces ACTH.

The concentration of cortisol in the blood of healthy animals varies as much as the body’s requirement for cortisol. It is natural for the adrenal glands to produce more cortisol during a period of anxiety or sickness, for example.

Cortisol levels in the blood return to normal once the stressful phase has finished. But what is the relationship between the levels of cortisol and Cushing’s disease?

Table for content

What Is Cushing’s Disease?

Cushing’s disease (sometimes called Cushing’s syndrome) is a disorder in which the adrenal glands create excessive amounts of various hormones. Hyperadrenocorticism is the medical name for this condition.

The adrenal glands, which are positioned near the kidneys, create a variety of essential compounds that govern plenty of physiological activities and are required for survival. Cortisol, often known as cortisone, is the most well-known of these chemicals. Reduced or excessive production of these hormones may lead to different adrenal problems in dogs.

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What Causes Cushing’s Disease?

Cushing’s in dogs is divided into three categories, each with its etiology. Because each type is treated differently and has a different prognosis, it is vital to identify out what is causing the problem (expected outcome).

Tumor of the Pituitary Gland

A tumor of the pituitary gland is the most prevalent cause of Cushing’s disease (85 percent to 90 percent of cases). Often, it is located at the base of the brain. The tumor might be benign (harmless) or malignant (cancerous).

The pituitary gland overproduces a hormone (ACTH) that encourages the adrenal glands to produce cortisol because of the tumor. The adrenal glands create more cortisol when the pituitary gland releases more ACTH. When the pituitary detects elevated cortisol levels, it produces less ACTH, which reduces cortisol production.

Pituitary gland tumors can range in size from microscopic to big. Clinical indicators other than those of Cushing’s disease may be present.

That depends on the size of the tumor, since an enormous tumor may push on or interfere with surrounding tissues. Many dogs with this type of Cushing’s disease can live regular lives for many years if the adrenal gland’s activity can be controlled, as long as they take their medication and are well monitored by their veterinarian.

If the pituitary tumor spreads, it will impact the brain, causing neurological symptoms and a poor outlook for the cat. Approximately 15 percent of these patients experience this.

Tumor of the Adrenal Gland

A benign or malignant tumor of the adrenal gland itself can cause Cushing’s disease (adenoma or carcinoma, respectively). If the tumor is benign, it can be surgically removed, and the condition will be cured. Surgery may assist for a while if the tumor is malignant, but the prognosis is significantly less favorable.

Cortisol levels are too high as a result of long-term steroid usage. Iatrogenic Cushing’s disease is the third kind of condition. When an oral or injectable steroid is used in excess, this condition develops. Although the steroids were normally supplied for a genuine medical reason, in this case, the patient’s overuse of them has caused damage.

What Are the Clinical Signs of Cushing’s Disease?

Cushing’s disease symptoms differ so much from dog to dog. Increased thirst and urine are the most typical symptoms. After years of not having an accident, some dogs abandon their housetraining. Many dogs’ appetites rise, and some gain weight as a result.

Your dog may seem plump around the abdomen yet skinny in the limbs because cortisol induces muscular weakening and breakdown. Some dogs seem thin throughout as if their muscular mass is eroding. Hair loss is very common, especially on the back and tail.

Because cortisol affects sugar metabolism in the body, if your dog is diabetic, his sugar levels will become uncontrollable and hard to manage if he gets Cushing’s disease. At the same time that Cushing’s disease is identified, some dogs will acquire diabetes, either temporarily or permanently.

Cushing’s disease can also result in reversible liver abnormalities. Cushing’s disease is frequently suspected when normal blood testing reveals elevated liver enzymes. Urine tests might be abnormal, indicating that the urine is more dilute than usual. Cushing’s disease can also cause a protein to seep into the urine.

Cushing’s disease, if left untreated, can lead to a variety of life-threatening complications. Because cortisol influences insulin action, patients with diabetes can get gravely unwell.

Excess cortisol can stress the kidneys, leading to blood pressure irregularities and substantial protein loss. Cushing’s disease also raises the risk of a blood clot developing in the wrong place and obstructing a major blood artery.

Thankfully, these life-threatening effects are uncommon; they are more likely in dogs with Cushing’s disease who have been untreated for a long time.

Which Are the Affected Breeds?

Though there is no apparent explanation why Cushing’s disease is more common in specific dog breeds, the data is compelling. Hyperadrenocorticism (also known as Cushing’s disease) is more common in certain breeds.

Cushing’s disease in dogs can range in size from large to little, with no evident breed differentiation. However, veterinarians agree that particular breeds are more vulnerable. These are the breeds in question.

Cushing’s disease is more prone to occur in these three dog breeds, according to most veterinarians:

  • Dachshund;
  • Terrier;
  • Poodle.

Other breeds that are frequently cited but not by all veterinarians include:

  • Beagle;
  • Boxer;
  • German Shepherd;
  • Labrador Retriever;
  • American Eskimo Dogs;
  • Australian Shepherd;
  • Maltese;
  • Cocker Spaniels.

How Is Cushing’s Disease Diagnosed?

Routine tests such as a complete blood count, chemical profile, and urinalysis are typically conducted when Cushing’s disease is suspected. These tests are done to look for any changes in the patient’s health that may have occurred as a result of Cushing’s disease.

Cushing’s disease can be diagnosed using a variety of blood tests. No one test is 100 per cent correct since Cushing’s disease is a hormonal disorder, and hormones vary owing to stress and other illnesses. As a result, confirming a diagnosis of Cushing’s disease might require up to two tests.

Cushing’s disease cannot be ruled out based on a single negative blood test. It might be aggravating to have to repeat costly tests to confirm a diagnosis.

An ACTH stimulation test is a 1 – 2 hour test that measures cortisol levels before and after the administration of a stimulant. The stimulant will cause an excessive reaction in dogs with Cushing’s disease. Once therapy has begun, an ACTH stimulation test is done to assess responsiveness.

The cortisol response to a hormone suppressing medicine is measured in an 8-hour Dexamethasone suppression test. Dexamethasone is a synthetic version of cortisol that causes cortisol levels in normal dogs to decline. In a dog with Cushing’s disease, the quantity may initially decrease. However, it will increase quicker than expected.

The urine cortisol to creatinine ratio is used to determine how much cortisol is discharged into the urine. Excess cortisol is excreted in the urine of a dog with Cushing’s disease.

This is a screening tool for Cushing’s disease, however, it is not a conclusive test. Most dogs will require a follow-up blood test if the urine cortisol to creatinine ratio implies Cushing’s disease.

An abdomen ultrasound is frequently used to determine the size and structure of the adrenal glands, particularly when an adrenal tumor is suspected. It is also a great technique to detect if Cushing’s disease has affected your liver or other organs.

What Treatment Options Are Available?

A medicine called Lysodren / mitotane has been the cornerstone of adrenal support for dogs with Cushing’s for decades. Lysodren works directly on the adrenal gland’s overgrown cells, causing them to die.

Patients with Cushing’s disease have bigger adrenal glands than usual and Lysodren is directly toxic to these cells. The treatment’s goal is to prevent the adrenal gland from producing too much cortisol without causing it to drop too low.

Most dogs will get a daily Lysodren loading dosage for 7 – 10 days before returning for recheck blood testing. Depending on the findings of these tests, a further loading time may be required. Also, the dog may be placed on Lysodren twice-weekly maintenance treatment.

Due to the rapid action of Lysodren in lowering cortisol levels in the body, some dogs become unwell after the loading period. It is critical to keep an eye on pets at home when they are being loaded with Lysodren.

Call your veterinarian right away if you notice lethargy, a decrease in appetite, vomiting, or diarrhea. To raise cortisol levels, your dog may require a dose of prednisone or dexamethasone.

In rare circumstances, hospitalization for fluids may be necessary. When administered by a qualified veterinarian, Lysodren treatment is regarded as quite safe.

Nystatin (ketoconazole) is an antifungal medicine that inhibits the adrenal gland and is used to treat Cushing’s disease in a minority of cases. It is less successful than other drugs for controlling Cushing’s disease, but some doctors prefer it since it decreases cortisol gradually rather than fast like Lysodren.

Cushing’s disease is also treated with anipryl (l-depranyl). It induces a steady decline in cortisol levels, similar to ketoconazole, and is occasionally used when close monitoring is impossible. Both nystatin and anipryl are rarely suggested since they induce less predictable and effective treatment of Cushing’s disease.

Trilostane is a recent Cushing’s disease medicine. It is presently the sole FDA-approved medicine for Cushing’s disease therapy. As a result, it is frequently the first medicine prescribed by veterinarians.

It has been shown in studies to be both safe and effective in the treatment of Cushing’s disease. That indicates that adverse effects are uncommon and that blood tests show that serum cortisol levels are dropping as expected.

Despite blood tests showing sufficient cortisol control, physicians are seeing an increasing number of patients with persistent clinical indications of Cushing’s disease as this medicine becomes more widely used. As a result, some physicians recommend Lysodren, a non-FDA authorized medicine, over trilostane.

Drug selection is frequently complex, and it is ultimately up to the patient’s family to make an informed decision. Because Trilostane inhibits the synthesis of all adrenal hormones, it must be administered by patient family members with caution.

If your dog has Cushing’s disease, it may need surgery to remove an adrenal tumor. Because some of these tumors are malignant, further therapy may be necessary.

What Should I Know if My Dog’s Disease Is Treated with a Medication?

For your pet’s unique ailment, your veterinarian will develop a treatment strategy. Make careful to follow his or her instructions to the letter, as these therapies generally rely on continuous and regular drug delivery.

The majority of dogs may be successfully treated with minor negative effects from medication. Blood tests and clinical symptoms, on the other hand, must be closely watched for your pet. Follow-up blood tests are critical to ensure that your pet is getting the correct amount and not too little or too much of the medicine, which can lead to issues.

Cushing’s Disease in Dogs: Diet Recommendations

When utilized effectively, canine Cushing’s disease recommended diet can help to lower cortisol levels in the blood and regulate secondary and underlying illness processes. It may also extend the life of your dog.

To begin, avoid feeding your dog fatty or high-sugar table scraps and snacks, and instead follow your veterinarian’s instructions for finding the correct Cushing’s disease diet for your dog.

Here is what your veterinarian looks for in a suitable dog Cushing’s disease diet:

  • Adult-specific: the diet should adhere to the requirements of the Association of American Feed Control Officials (AAFCO) for adult maintenance (ideally one that is not formulated for all life stages). That will compensate for the muscular loss caused by the condition, although it will be less calorically dense than other life stages, such as puppyhood.
  • Low fat, moderate fiber: dogs with Cushing’s disease have high cortisol levels, which raise triglycerides and cholesterol. A diet that is lower in fat (less than 12 percent on a dry matter basis) can assist to prevent these increases.
  • Highly digestible protein: the food’s protein should be easily absorbed. Egg whites, muscle meats (chicken, beef, lamb), and organ meat are some examples of eligible foods.
  • Low in sodium and chloride: if you have hypertension, your vet will suggest you avoid high-chloride diets. Low-sodium diets aid in the maintenance of normal blood pressure.

Do You Need to Supplement a Cushing’s Disease Diet for Your Dog?

Here are some suggestions on which vitamins can be beneficial:

  • Cortisol causes calcium excretion and vitamin metabolism to increase. Supplements are not required if the diet is AAFCO-formulated for adult maintenance.
  • Antioxidant treatment with a mix of tocopherol, carotene, vitamin C, vitamin A, selenium, and methionine may help decrease blood fat levels.
  • Supplementing with fish oil can assist to reduce circulation triglycerides and lipids. Fish oil may also aid in the improvement of a dull skin coat and inflammatory skin disorders caused by Cushing’s disease in dogs.

Supplements might be recommended by your veterinarian if necessary.

What Is the Prognosis?

Most dogs with Cushing’s disease have a good prognosis, especially if they are detected early enough to avoid consequences like insulin resistance and renal problems. Most patients can be effectively maintained for years by a skilled physician who follows up regularly. Cushing’s disease will have a small impact on life expectancy if it is regularly monitored and treated as needed.

Cushing’s disease, which is now being treated, must be monitored regularly. If Lysodren is utilized, the patient is monitored every one to two weeks during the loading period.

For the first 3 – 4 months after starting maintenance medication twice weekly, the patient must return for an ACTH stimulation test as often as monthly. They will be tested every six months or so if they are doing well to assess how their hormone levels are progressing. Because hormones change over time, it is critical to keep track of your canine adrenal support frequently.

The Takeaway

Cushing’s disease is a complicated ailment that should only be handled by veterinarians who have a thorough grasp of the disease and how to treat it. The most essential thing to remember as a pet owner is that these recommendations should only be used as a guideline, not as the be-all and end-all of guidance.

Make sure to discuss the optimal treatment strategy for your pet with your veterinarian. Remember that your veterinarian and medical team have years of expertise working with Cushing’s disease patients and should be able to offer you all of the information you need to make the best treatment decision for your dog.

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  • Supporting your dog’s normal adrenal function.
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  • Promoting normal thirst and appetite.
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These herbs have been studied for their beneficial effects to the adrenal glands, which produce a number of hormones, which regulate the functions of target organs throughout the body. They can also favorably affect the pituitary gland, which helps to regulate the functions of other endocrine glands and connects the nervous system to the brain’s hypothalamus, which is responsible for a variety of functions.

Image source: Wikimedia / Takashi Hososhima.

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