What is cushings?
Cushing’s disease, which is formally known as Hyperadrenocorticism, is one the most commonly diagnosed hormonal disease in dogs.
Hormones are special molecules which circulate around the body to regulate bodily functions. Imagine them as ‘messengers’, relaying signals to different organs in the body to make sure they’re functioning normally. When these signals are inappropriately sent, hormonal diseases develop which have many negative effects on the body.
Cushing’s disease is when there is an excessive production of the hormone ‘cortisol’. Cortisol – also known as the stress hormone is crucial to the normal function of the body. In fact almost every organ system in the body has a receptor for cortisol! Hence Cushing’s can have a wide array of systemic effects on the body.
There are 2 main types of Cushing’s – adrenal dependent & pituitary dependent, which are named after where the inappropriate hormonal signals are coming from.
When should I suspect Cushings?
Cushings can be a difficult disease to diagnose, however there are numerous symptoms that you may notice at home. These include:
• Excessive thirst
• Excessive urination
• Increased appetite
• Thinning of the skin with potential hair loss
• Muscle wastage
• A ‘pot bellied’ appearance
Please note that these symptoms are not exclusive to Cushing’s and can also be indicators of other disease processes.
How do we diagnose Cushing’s?
If we suspect your dog may have Cushing’s based on the history and physical exam, there are a few special blood tests to help diagnose Cushing’s. There are 2 main blood tests to diagnose Cushing’s – the ACTH stimulation test & LDDST. In some more complicated cases, both tests may be necessary. Usually a routine screening blood test will also be recommended to rule out other concurrent diseases.
An abdominal ultrasound is also usually recommended, which will help visualise and screen the adrenal glands themselves for any structural abnormalities – such as tumours which may be responsible for the Cushing’s disease.
In some cases, a special urine test may also be recommended to help rule out Cushing’s.
Generally speaking – there are two routes to manage Cushing’s – medical therapy and surgical intervention. Medical therapy is usually the preferred option for managing Cushing’s. One key thing to understand is the success of Cushing’s treatment is measured by the reduction of the clinical signs (which you’ll need to assess from home), so at MyVet, we will be working closely with you to ensure the treatment plan is optimised for your dog. This usually means lots of lengthy conversations about how everything is going!
The most common medication used to treat Cushing’s is called Trilostane. This medicine works by reducing the production of cortisol from the adrenal gland itself. Finding the exact dosing of this medication is extremely important, as inappropriately high doses can lead to oversuppression of cortisol production, which can lead to Addisonian crisis (when the cortisol level is too low!).
To achieve this fine balance, multiple blood tests are required until the dose can be titrated to the optimal level to achieve control of the disease. This can be a lengthy and sometimes frustrating process, however is absolutely necessary.
For some particular cases of Cushing’s, surgery is another option to treat the disease. The surgery involves removing the adrenal gland (and any tumour associated with it) entirely. Although this procedure is considered a ‘curative’ option, the surgery itself carries a significant risk and lifelong medications will be required to replace the hormones lost.
What does this mean for my furbaby now that they have Cushing’s?
This is a question we get asked alot at My Vet – and for good reason, Cushing’s unfortunately is usually a lifelong disease. With that being said, when appropriately managed and treated, most dogs will be able continue living normal happy lives!
That’s why at My Vet we have a very strict protocol that is consistently updated with the gold standard practices, to ensure your furbaby gets the best treatment plan possible.
If you suspect your pet has Cushing’s disease or any other health issues, please feel free to contact us on (02) 8484 2020 and make an appointment to see us.