Quick Answer:
Key Cushing's disease symptoms include: Increased thirst and urination, increased appetite, pot-bellied appearance, hair loss (especially on the body), thin skin, panting, lethargy, and recurring skin infections. Most dogs with Cushing's are over 6 years old.
What Is Cushing's Disease?
Cushing's disease, medically known as hyperadrenocorticism, occurs when a dog's body produces too much cortisol (the "stress hormone"). Cortisol is essential for many body functions, but excess amounts cause widespread health problems.
This condition primarily affects middle-aged and older dogs, typically those over 6 years old. It develops gradually, and early symptoms are often mistaken for normal aging.
While Cushing's disease cannot usually be cured, it can be effectively managed with medication, allowing most dogs to live comfortable lives for years after diagnosis.
Cushing's Disease Symptoms Checklist
Symptoms develop gradually over months or even years. Many owners initially dismiss these signs as normal aging. Here are the key symptoms to watch for:
Most Common Symptoms (80%+ of cases)
- * Increased thirst (polydipsia) - drinking much more water than usual
- * Increased urination (polyuria) - frequent urination, accidents in house
- * Increased appetite (polyphagia) - constantly hungry, begging for food
- * Pot-bellied appearance - distended, sagging abdomen
- * Panting - excessive panting, even at rest
Skin and Coat Changes
- * Hair loss (alopecia) - symmetrical, usually on body (not head/legs)
- * Thin, fragile skin - easily bruised or torn
- * Skin infections - recurring bacterial or yeast infections
- * Blackheads (comedones) - especially on abdomen
- * Hyperpigmentation - darkening of skin
- * Calcinosis cutis - hard calcium deposits under skin
Other Symptoms
- * Lethargy - decreased energy, less active
- * Muscle weakness - difficulty climbing stairs or jumping
- * Enlarged liver - hepatomegaly
- * Urinary tract infections - recurring UTIs
- * Neurological signs - if pituitary tumor grows large
The Classic Triad
The three most distinctive signs that should prompt Cushing's testing are: increased thirst, increased urination, and a pot-bellied appearance. If your older dog shows these symptoms together, talk to your vet about testing.
Causes and Types of Cushing's Disease
There are three main types of Cushing's disease, each with a different cause:
| Type | Cause | Frequency | Treatment |
|---|---|---|---|
| Pituitary-Dependent (PDH) | Tumor on pituitary gland | 80-85% | Medication, sometimes radiation |
| Adrenal-Dependent (ADH) | Tumor on adrenal gland | 15-20% | Surgery if possible, medication |
| Iatrogenic | Long-term steroid use | Variable | Gradual steroid withdrawal |
Pituitary-Dependent Cushing's (Most Common)
In most cases, a small tumor on the pituitary gland (at the base of the brain) produces excess ACTH hormone, which signals the adrenal glands to produce too much cortisol. Most pituitary tumors are benign (non-cancerous) and small.
Adrenal-Dependent Cushing's
A tumor on one of the adrenal glands (located near the kidneys) directly produces excess cortisol. About 50% of adrenal tumors are malignant (cancerous). Surgical removal may be possible if the tumor hasn't spread.
Iatrogenic Cushing's
Long-term use of corticosteroid medications (like prednisone) for conditions like allergies or autoimmune diseases can cause Cushing's symptoms. This resolves when steroids are gradually discontinued, though this must be done carefully under veterinary supervision.
Breeds Most at Risk
While any dog can develop Cushing's disease, certain breeds have a higher incidence:
Higher Risk Breeds
- * Poodles (all sizes)
- * Dachshunds
- * Beagles
- * Boxers
- * Boston Terriers
- * Yorkshire Terriers
- * Staffordshire Terriers
- * German Shepherds
Other Risk Factors
- * Age over 6 years (usually 10-12)
- * Both sexes affected equally
- * Long-term steroid use
- * Obesity (may worsen symptoms)
Diagnosis and Testing
Diagnosing Cushing's disease requires multiple tests because symptoms overlap with other conditions and the hormone tests aren't always straightforward.
Initial Testing
- Blood chemistry panel: Often shows elevated liver enzymes (ALP), high cholesterol, high blood sugar
- Complete blood count: May show elevated white blood cells
- Urinalysis: Dilute urine, possible urinary tract infection
Hormone Tests
| Test | What It Measures | Notes |
|---|---|---|
| ACTH Stimulation Test | Adrenal response to ACTH | Quick, best for iatrogenic cases |
| Low-Dose Dexamethasone Suppression (LDDS) | Cortisol suppression | Most sensitive screening test |
| High-Dose Dexamethasone Suppression | Differentiates PDH from ADH | Helps determine type |
| Urine Cortisol:Creatinine Ratio | Cortisol in urine | Good screening test, at-home collection |
Imaging
- Abdominal ultrasound: Examines adrenal glands for tumors or enlargement
- CT or MRI: May be used to visualize pituitary tumors
Treatment Options
Treatment depends on the type of Cushing's disease and the dog's overall health.
Medication (Most Common)
Most dogs with pituitary-dependent Cushing's are treated with oral medications that reduce cortisol production:
| Medication | How It Works | Cost (Monthly) |
|---|---|---|
| Trilostane (Vetoryl) | Blocks cortisol production | $50-$200 |
| Mitotane (Lysodren) | Destroys part of adrenal cortex | $30-$100 |
Trilostane (Vetoryl) is the most commonly prescribed medication. Dogs typically need lifelong treatment with regular monitoring through ACTH stimulation tests.
Surgery
Surgical removal of an adrenal tumor may cure Cushing's if the tumor is benign and can be completely removed. This is major surgery with significant risks, so it's typically reserved for:
- Adrenal tumors without evidence of spread
- Dogs healthy enough for major surgery
- Owners able to afford the procedure ($2,000-$10,000+)
Radiation Therapy
Radiation may be used for large pituitary tumors causing neurological symptoms. It's available at veterinary specialty centers and can help shrink tumors.
Living with Cushing's Disease
With proper management, most dogs with Cushing's disease can enjoy a good quality of life.
What to Expect
- Symptom improvement: Usually within 4-8 weeks of starting treatment
- Drinking/urination: Often first symptoms to improve
- Hair regrowth: May take 3-6 months
- Pot belly: May improve as muscle tone returns
Ongoing Care
- Regular vet visits: ACTH stimulation tests every 3-6 months
- Medication adjustments: Doses may need fine-tuning
- Monitor for side effects: Watch for vomiting, diarrhea, lethargy
- Skin care: Regular grooming helps manage coat issues
Prognosis
- * With treatment, many dogs live 2-4+ years after diagnosis
- * Quality of life is usually good with proper management
- * Dogs with adrenal tumors that can be surgically removed may be cured
- * Regular monitoring is key to successful management
Frequently Asked Questions
What are the first signs of Cushing's disease in dogs?▼
The earliest signs of Cushing's disease include increased thirst and urination (often the first symptom owners notice), increased appetite, and panting. As the disease progresses, dogs may develop a pot-bellied appearance, hair loss, and skin changes.
What causes Cushing's disease in dogs?▼
About 85% of Cushing's cases are caused by a pituitary gland tumor (pituitary-dependent). About 15% are caused by an adrenal gland tumor. A third cause is long-term use of corticosteroid medications (iatrogenic Cushing's).
How long can a dog live with Cushing's disease?▼
With proper treatment, many dogs with Cushing's disease can live 2-4 years or longer after diagnosis. The prognosis depends on the type of Cushing's, the dog's age, overall health, and how well they respond to treatment.
Is Cushing's disease painful for dogs?▼
Cushing's disease itself isn't typically painful, but it can cause uncomfortable symptoms like constant thirst, frequent urination, muscle weakness, and skin infections. The pot-bellied appearance results from muscle wasting and fat redistribution.
How is Cushing's disease diagnosed in dogs?▼
Diagnosis involves blood tests, urinalysis, and specialized hormone tests like the ACTH stimulation test or low-dose dexamethasone suppression test. Ultrasound or CT scans may be used to locate tumors on the pituitary or adrenal glands.
Can Cushing's disease in dogs be cured?▼
Cushing's caused by adrenal tumors can sometimes be cured with surgery if the tumor is benign and can be completely removed. Pituitary-dependent Cushing's is usually managed with lifelong medication rather than cured, but treatment can effectively control symptoms.
The Bottom Line
Cushing's disease is a manageable condition when caught and treated appropriately. If your older dog is drinking more, urinating more, and developing a pot-bellied appearance, don't assume it's just aging - talk to your vet about testing for Cushing's disease.
With proper medication and regular monitoring, most dogs with Cushing's can enjoy a good quality of life for years. Early diagnosis and consistent treatment are key to the best outcomes.
Regular grooming appointments can help you and your groomer notice changes in your dog's coat and skin that might indicate health issues like Cushing's disease.
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