Dogs with Cushing’s disease have an increased level of the hormone cortisol in their blood. Normally, cortisol is produced by the body in stressful situations to prepare the body for action (flight or fight). However, if your dog has Cushing’s disease, the level of the hormone cortisol in the blood is extremely high. If you do not treat this extremely high hormone, the dog will become increasingly weak and may eventually die from the condition. The disease is named after the American neurosurgeon Harvey Cushing who first described the disease in 1912. Two glands that are located close to the kidneys produce the hormone cortisol. These kidneys are also called the adrenal glands. The production and release of cortisol by the adrenal glands is controlled by the hormone ACTH. This hormone is produced in the pituitary gland, a small gland at the bottom of the brain.
Three Forms of Cushing’s Disease in Dogs
Pituitary-dependent Cushing’s is the most common form of the disease, accounting for 85 percent of cases. It is caused by a slow-growing, often benign, tumor in the pituitary gland. This tumor produces large amounts of the hormone ACTH, which in turn causes the adrenal glands to produce too much cortisol. The second form of Cushing’s is called adrenal-dependent Cushing’s. In this form of the disease, a tumor, often benign, in one or sometimes both adrenal glands produces large amounts of cortisol. The third form of Cushing’s is induced Cushing’s. This form of the disease is caused by long-term treatment with corticosteroids (prednisolone, dexamethasone) to suppress certain disease processes, such as allergies. In this case, treating one condition causes another. Cushing’s disease is particularly common in older dogs. We also see that the disease is more common in smaller breeds. The symptoms of the disease are similar to those seen in older dogs, but more extreme. This sometimes makes it difficult to diagnose. Almost 10 percent of dogs with Cushing’s disease are also diagnosed with diabetes. The most common symptoms are: excessive drinking, frequent urination, possible incontinence, greedy eating, gluttony, fat (saggy) belly, thinner skin, loss of hair, or recurring skin problems, loss of muscle, listlessness, excessive panting and hardening of the skin. Not all symptoms will be shown if your dog has diabetes, but if you have any doubts, consult your vet immediately. The vet will then perform a test on the dog’s urine to determine the cortisol/creatinine ratio. Sometimes blood tests can already provide a clear indication that Cushing’s disease is at play (increased value of the enzyme alkaline phosphatase and often decreased thyroid value T4). Cushing’s disease can be treated well if you catch it in time. If a tumor is present, it can sometimes be removed. However, drug treatment is usually initiated.
Vetoryl® is the only registered veterinary medicine for the treatment of Cushing’s disease in dogs. This medicine blocks the production of cortisol and must therefore be given daily and continuously, with the correct dosage being determined by means of blood tests. If diabetes is present in addition to Cushing’s disease, both conditions must be treated, but the long-term prognosis is less favorable than animals that do not have diabetes.
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