Essentially, Cushing’s Disease is a hormonal imbalance. Let’s start with how things normally work. The pituitary gland produces a hormone called ACTH, which stimulates the body to produce cortisol.
When there is enough cortisol circulating around, the body recognizes it, and shuts down further production. Cushing’s Disease, or hyperadrenocorticism, is a condition where cortisol is overly produced (The system designed to prevent “overflow” of the hormone does not work).
On average, the survival rates for pets diagnosed with Cushing’s disease were:
- 70% after one year,
- 50% after two years, and
- 20% after four years.
In this article, we will discuss life expectancy with dogs diagnosed with Cushing’s disease, and review how veterinarian treatments can help improve your dog’s quality of life.
How Will Cushing’s Disease Affect My Dog?
Cortisol, a steroid, affects several body systems. The most common signs pet owners recognize are excessive drinking and peeing, a distended or pot belly appearance, and hair loss. The excessive steroids alter how the kidneys filter the blood and retain water, causing the excessive urination. They drink to make up for it. The pot belly appearance is caused by muscle wasting, liver increasing in size, and full bladder.
The excessive production of steroids also interferes with liver function, especially how it metabolizes sugar. Additionally, it can decrease the immune system, thus making patients more susceptible to skin, urinary, and other infections.
Less common clinical signs include lethargy, generalized muscle weakness, increased hunger, blackheads on their skin, and seizures.
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The history and physical exam will give the vet some clues. Diagnostics typically start with a complete blood count (CBC), a chemistry, urinalysis and maybe abdominal X-rays. The CBC will look at the Red Blood Cells (RBCs), which carry oxygen throughout the body; RBCs are usually normal with Cushing’s Disease. White Blood Cells (WBCs) are the immune system of the body, and may show evidence of increased stress here (due to the increase of the stress hormone). The chemistry is a blood panel looking at organ function. Liver enzymes and cholesterol are usually elevated. The urine test usually shows protein and dilute pee, since the kidneys are not filtering as they should. X-rays may show an enlarged liver.
The next steps would be an additional blood test. A sample of the dog’s blood without the steroid is taken to establish normal levels. They are given a specific dose of a steroid, and draw more blood hours later. A normal dog should shut down steroid production, and the values after the test should be normal. However, if the results are high, that suggests the body doesn’t stop producing cortisol, and Cushing’s can be diagnosed. Your vet may want to do one or more of a few different tests; these are sometimes helpful to differentiate which type of Cushing’s the pet has. An abdominal ultrasound may be helpful in this as well.
Cushing’s is manageable, but not curable. Usually, the dog will be on a long-term medication called Trilostane, which reduces the production of cortisol. There is a broad dose range, and every individual responds to it a bit differently. Typically, we start at the lower dose range, and retest in two weeks. Based on the cortisol levels in the blood, and the response to treatment seen at home, the dose may be changed. It may take a few trials to find the right dose. This medication has mild side effects (lethargy and decreased appetite) which usually subside 4 days after starting treatment.
The medication may not prolong survival time, but may improve quality of life. Symptoms would decrease, as Trilostane is pretty effective. The following shows the survival rates for dogs after diagnosis:
|Time After Diagnosis||Survival Percentage|
If left untreated, the clinical signs will get worse, decreasing the quality of life, leading to a poorer prognosis. With treatment, dogs will feel better, and typically pass away from other causes.
Frequently Asked Questions (FAQs)
Is Cushing’s disease in dogs always fatal?
It is not curable, but it is manageable. With proper treatment and monitoring, the quality of life is pretty good.
Do dogs with Cushing’s disease suffer?
If left untreated, dogs may have an increased risk of skin, urinary, and other infections because of a weaker immune system. They may become weak and lethargic, and not want to do the things that make them happy (running, chasing, etc.). It may also lead to liver disease, which can worsen their symptoms.
Do dogs with Cushing’s disease have trouble walking?
They may have generalized weakness and muscle wasting, which can affect their balance.
Do dogs with Cushing’s disease get aggressive?
Behavioral changes such as aggression are not typically associated with Cushing’s Disease.
What are the neurological signs of Cushing’s disease in dogs?
Dogs may exhibit ataxia (wobbliness) and disorientation. Uncommonly, they may have seizures if the tumor on the pituitary becomes large enough.
Do dogs with Cushing’s disease smell?
They may have more accidents in the house. Additionally, localized infection may contribute to odors.
Does Cushing’s disease cause dogs to shake?
Shaking is not reported as a direct cause. Shaking is typically associated with too little cortisol.
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