Suspect Cushing’s in Your Dog? Diagnosis & Treatment Steps

If your dog has been drinking or eating more than usual, seems to be gaining weight, or has a coat that no longer looks as healthy, you may wonder if something more serious is at play. 

Cushing’s Disease, also known as hyperadrenocorticism, is a hormonal condition that primarily affects middle-aged to older dogs. It occurs when the adrenal glands produce excess cortisol, a hormone essential for regulating many bodily functions. While Cushing’s can be concerning, timely diagnosis and treatment can help manage symptoms and improve your dog’s quality of life. 

In this article, we’ll discuss the common signs of Cushing’s Disease, the diagnostic process, and available treatment options, so you feel informed and prepared to take the next steps.

Recognising the Signs of Cushing’s Disease in Dogs

Cushing’s Disease can present in various ways, and some symptoms might initially seem subtle or easy to dismiss. However, recognising them early can significantly aid in managing the condition. Here are the most common signs to look out for:

• Increased thirst and urination
• Increased appetite
• Pot-bellied appearance
• Excessive panting
• Hair loss or thinning coat
• Lethargy and muscle weakness
• Skin changes and slow wound healing

If your dog is showing one or more of these symptoms, it’s a good idea to schedule an appointment with your vet to discuss your concerns.

What to Do Next: Consulting with Your Veterinarian

When you bring up Cushing’s Disease with your veterinarian, they will likely start by taking a full history of your dog’s health and recent changes in behaviour or habits. They may perform a physical examination to check for visible signs of Cushing’s, such as coat changes or a pot-bellied appearance.

Your vet may recommend blood and urine tests to check for abnormalities commonly associated with Cushing’s. These initial tests can help rule out other conditions with similar symptoms, like diabetes or kidney disease. If these tests suggest Cushing’s might be the cause, further specific testing will be necessary to confirm the diagnosis.

Diagnostic Testing for Cushing’s Disease

Diagnosing Cushing’s Disease requires tests that measure your dog’s cortisol levels and their body’s response to hormones that regulate cortisol production. Here’s what you can expect from the diagnostic process:

• Baseline Blood and Urine Tests: As an initial step, blood and urine tests may reveal elevated liver enzymes and increased protein in the urine, both common with Cushing’s. While these results don’t confirm the disease, they can guide your vet’s next steps.
• ACTH Stimulation Test: One of the most common tests for diagnosing Cushing’s. It involves taking a baseline blood sample, administering synthetic ACTH (a hormone that stimulates cortisol production), and taking a second blood sample about an hour later to measure cortisol levels. Dogs with Cushing’s tend to show an exaggerated cortisol response.
• Low-Dose Dexamethasone Suppression Test (LDDST): This test involves injecting a low dose of dexamethasone, a synthetic steroid, and measuring cortisol levels at intervals. A healthy dog’s cortisol levels should drop after receiving dexamethasone, but in dogs with Cushing’s, cortisol remains elevated.
• Ultrasound: In some cases, an abdominal ultrasound may be recommended to examine the adrenal glands’ size and shape. This can help determine if Cushing’s is adrenal-dependent (due to a tumour on one adrenal gland) or pituitary-dependent (the more common type).

Your vet will discuss these tests in detail, along with any preparations, such as fasting. It’s also helpful to bring a list of any medications your dog is currently taking, as some can affect cortisol levels.

What to Expect During Diagnosis

The diagnostic process may require a few vet visits, as some tests, like the LDDST, require multiple blood samples over several hours. Many veterinary clinics offer in-clinic monitoring to keep your dog comfortable between samples. Keep in mind that Cushing’s can be complex to diagnose, and it’s not uncommon for your vet to recommend several tests to confirm the diagnosis.

Treatment Options for Cushing’s Disease in Dogs

Once your dog is diagnosed with Cushing’s, your vet will discuss the best treatment plan based on the type and severity of the condition. The primary goal is to manage symptoms by reducing cortisol levels and monitoring for side effects. Here are some common treatment options:

Medications:

• Trilostane: This is the most commonly prescribed medication for managing Cushing’s Disease, as it works by inhibiting cortisol production in the adrenal glands. While generally well-tolerated, regular monitoring is essential to ensure that cortisol levels stay balanced.
• Mitotane: Used less frequently than Trilostane, Mitotane works by selectively destroying adrenal tissue that produces cortisol. Due to its effects, it requires close monitoring and is typically reserved for specific cases.

Both medications require follow-up blood tests to monitor cortisol levels and adjust dosing as needed.

Surgery: If your dog’s Cushing’s is caused by an adrenal tumour, surgical removal might be an option. Adrenal tumours can be benign or malignant, and surgery can be complex. Surgery is typically recommended for younger, otherwise healthy dogs with adrenal-dependent Cushing’s.

Lifestyle Adjustments: While lifestyle changes alone won’t treat Cushing’s, they can help manage symptoms. Regular gentle exercise and a high-quality, balanced diet can support your dog’s overall health. Avoid sudden dietary changes, and consider working with your vet to adjust your dog’s nutrition based on their specific needs.

Ongoing Monitoring: Regardless of the treatment chosen, regular veterinary check-ups are essential for dogs with Cushing’s. Monitoring blood tests helps keep cortisol levels within a safe range, and your vet will watch for any side effects from medication.

Supporting Your Dog Through Cushing’s Disease

Caring for a dog with Cushing’s requires extra attention, but your dog can live a happy, healthy life with proper management. Regular check-ins with your vet, a well-regulated treatment plan, and a consistent routine at home can make a world of difference. Keep a close eye on any new or worsening symptoms, and don’t hesitate to reach out to your vet with questions.

While Cushing’s Disease can seem overwhelming initially, there are effective ways to help manage your dog’s symptoms and improve their quality of life. By taking these steps and working closely with your vet, you can support your beloved dog through this condition and ensure they continue to enjoy each day to the fullest.