Dogs most at risk from Cushing’s tend to be small or toy breeds, although it can affect dogs of all breeds.

This chronic disorder, so cannot be cured, it can lead to a variety of symptoms and health issues, but with proper care and management, your dog can lead a very happy and fulfilled life.

Early Signs and Symptoms of Cushing’s Disease in Dogs

Most of the time the symptoms of Cushing’s Disease are quite mild, because of this getting a confirmed diagnoses can sometimes be difficult. In addition, many of the symptoms for Cushing’s, are similar or the same as other conditions which affect dogs at the same age. Just to make things even more confusing, dogs who have longstanding health problems, have an increased chance of a false positive result for Cushing’s. This is where they test positive for the disease, but in fact do not have it.

Unfortunately, there is no one simple test which can diagnose Cushing’s. Diagnosis typically involves a combination of blood tests, urine tests, imaging studies (such as ultrasound or CT scans), and an adrenal function test, called the low-dose dexamethasone suppression test (LDDST).

Common symptoms for Cushing’s Disease include:

• Increased thirst and urination
• Increased appetite
• Panting more than usual
• Hair loss, bald patches or thinning coat
• Pot-bellied appearance
• Muscle weakness
• Lack of energy or apathy
• Skin changes (thin and fragile skin, often looks dry and is susceptible to infections)
• Development of a "food or water" belly (accumulation of fat in the abdomen)

What Causes Cushing’s Disease in Dogs?

Hormones and steroids are essential for your dog’s bodies to function correctly. One of these essential hormones is called cortisol. It is produced by the adrenal gland, which is situated next to the kidney. When and how much of this cortisol hormone is produced by the adrenal gland, is controlled by signals sent from the pituitary gland, in your dog’s brain. Cushing’s disease develops when the adrenal gland becomes overactive and releases too much of the cortisol steroid.

There are two main forms of Cushing's disease in dogs: adrenal-dependent and pituitary-dependent.

Pituitary-dependent Cushing’s Disease

• The more common form of Cushing's disease in dogs, it is caused by a tumour in the pituitary gland (located in the brain), which leads to increased production of adrenocorticotropic hormone (ACTH). This, in turn, stimulates the adrenal glands to produce excess cortisol. A tumour in the brain can sound scary but usually this is a very tiny and benign growth, which apart from the Cushing’s, causes no issues.

Adrenal-dependent Cushing’s Disease

• This form occurs when there is a tumour in one or both adrenal glands (located next to the kidneys), causing an excessive production of cortisol. These tumours can be either benign or malignant

There is also a third, but much less common condition called Cushing’s syndrome. This is caused by high dose, long-term steroid medication. There can be a variety of reasons why your dog might have had to have long-term steroid treatment however one of the side effects from this, is the development of Cushing’s syndrome. If this applies to your dog it is important that you do not discontinue or decrease the dose of steroid medication your dog is receiving. Instead, if you are concerned you should seek advice from your vet.

What Age does a Dog get Cushing’s Disease?

Cushing’s disease usually develops in dog’s who are middle aged or in their later years. It can also however affect younger dogs who have been on long-term, high dose steroid treatment.

How to Help your Dog Around the House

Cushing's Disease shampoos and lotions
One of the symptoms of Cushing’s disease is thin, dry and flaky skin with hair loss and bald patches. This is due to the hormone imbalances caused through the condition. The breakdown in skin and hair loss can leave your dog very vulnerable to skin infections. Regularly using topical lotions and shampoos can really help however. Here at Zoomadog, we recommend Dermagic products. These shampoos and topical lotions are made from all natural ingredients, specially balanced for your dog’s natural skin pH. See the available range here. It is important to note that human shampoo products are not suitable for dogs, as they are formulated for a different skin pH.

Reduce stress and keep a routine
Cushing’s disease is characterised by the over-production of cortisol, a ‘stress’ hormone, which is involved in the ‘fight or flight’ instinct. This means that symptoms of Cushing’s can be significantly exacerbated by an increase in stress, so try an minimise your dog experiencing stressful situations. Try to maintain a consistent routine and create a peaceful atmosphere at home. Create a comfortable living environment for your dog, ensuring they have a cozy bed, a calm space and access to fresh water at all times.

Environment
Cushing’s disease also leads to an increase in thirst and therefore urination. Your dog may require more frequent toileting and may struggle to ‘hold it in’ overnight. Make sure they always have access to a clean water supply and are able to drink as much as they need. If it is suitable, you may consider installing a dog flap, so that they can more easily toilet themselves when you are not there or overnight. Alternatively placing absorbent pads somewhere and teaching your dog to use these, can also be helpful.

Treatment for Dog Cushing’s Disease

Treating dogs with Cushing’s varies on the individual dog; which type of Cushing’s they have and what is most appropriate treatment option. You can be guided by your vet in which treatment option is most suitable for your individual dog. Most often treatment involves monitoring and/or medication, although in some cases surgery is a recommended option. Although it cannot be cured, there is no reason why your dog cannot live a full and happy life with the condition, as long as they are given the correct treatment, support and care.

Non-medical management

For some dogs treating their Cushing’s requires nothing more than monitoring and regular check-ups with your vet as well as good home management. Non-medical management includes:

1. Low-fat diet

One side affect of Cushing’s is weight gain and fat redistribution. A low-fat diet which is rich in lean proteins, complex carbohydrates and essential nutrients and minerals can be very helpful.

2. Reduce salt intake

Excess salt can worsen the symptoms of Cushing’s disease. Check the packaging on your dog’s food and compare levels with different dog food companies to find the right one for your dog. Many dog treats also have a very high salt content, so be aware of this too, as it will all add up.

3. Hydration

Every dog should always have access to a good supply of clean water at all times however this is especially important in dog who have Cushing’s to help improve their oral health and flush out toxins in their body.

4. Exercise

Often dogs with Cushing’s become lethargic however regular exercise is vital. It helps to maintain muscle mass and tone as well as weight management. Having said this, don’t strain or push your dog to do strenuous exercise. Short, regular walks or a game of gentle throw and catch. Activities such as gentle swimming can also be very beneficial.

Medical management

If your dog has developed pituitary-dependent Cushing’s (the most common form) it is likely that they will be started on medication / tablets which contain trilostane or mitotane. These help to regulate and reduce the production of the hormone cortisol by the adrenal glands.

If your dog has developed Adrenal-dependent Cushing’s (a tumour in one or both adrenal glands) then in the first instance your dog will be scanned to determine the extent of the tumours/growths and weather they are malignant or benign. Once this is known your dog will either be started on a course of medications, which will aim to shrink the tumour(s) or treated surgically.

Surgery to remove the tumour(s) or removal of the affected adrenal gland(s) may be suggested as the most suitable way of treating the problem. Occasionally radiation can be used to try and shrink tumours which are inoperable also. Very sadly in some dogs who have this form of Cushing’s disease, further tumours may spread through their body and the disease becomes incurable.

If your dog is being treated for Cushing’s with tablet medications, this will be life-long. Furthermore, your dog will need regular monitoring with your vet in the form of check-ups and blood tests. Medications used to treat Cushing’s disease can have significant side-affects, so giving your dog the medications without regular check-ups can be dangerous.

Cushing’s Disease which develops in dogs for another reason, such as long-term steroid use, are often treated by being weaned off their steroid therapy. Weaning off steroids too quickly however can be fatal if done incorrectly, so you should always seek advice and a plan for this from your vet.

Conclusion

Once treatment has commenced, your dog should respond well, showing a visible improvement within the first few weeks, although some symptoms can take a little longer to resolve. Many dogs with well-controlled Cushing’s go on to lead long, happy and relatively normal lives.

If your dog continues without treatment, they can carry on for some time however their quality of life progressively deteriorates. When left untreated, their general symptoms will worsen, recurrent infections occur and your dog will become progressively more lethargic and unengaged with their environment.

While Cushing’s disease cannot be cured, it is able to be managed well for the majority of dogs however, it is a costly condition to treat medically. Treatment for Cushing’s disease can become very expensive, especially because it’s an ongoing condition that needs lifelong medication and monitoring. If your dog is insured, much of this cost could be covered however it is important to discuss your options, cost of treatment and any financial limitations with your vet in order for you to find the best solution for your dog.