Veterinarians evaluate and discern different pet health situations daily. We do the best we can to inform our clients and give credible information.
Sometimes, though, we have to give advice and make decisions with a limited amount of information.
Whether we are advising a client on the symptoms of Cushing’s disease or explaining how their dog will respond with Cushing’s left untreated, we must draw upon our clinical experience.
The same is true with a dog Cushing’s disease prognosis and predicting life expectancy.
The reality is that each and every one of you cannot or will not run every test for canine Cushing’s disease.
It would be great, but it’s not always practical or necessary. Consequently, determining a prognosis is not exact.
Cushing’s Disease Prognosis Guidelines
Prognosis for dogs with pituitary-dependent Cushing’s treated medically is good with a reported median survival rate of 2 years.
A more recent study found a survival rate of 900 days for dogs treated with twice daily trilostane, versus 720 days for dogs treated with mitotane.
Uncontrolled urination and excessive drinking are the most important factors in considering euthanasia.
Dogs with neurologic signs from a pituitary tumor have a poorer prognosis, but may do well with radiation therapy and medical treatment.
Prognosis for dogs with adrenal-dependent Cushing’s due to a tumor is good to excellent with complete surgical excision of adrenal tumors without metastasis.
Medical therapy for adrenal-dependent Cushing’s has a fair to good prognosis with a median survival of 14–15 months.
As you can see, predicting prognosis is tough and requires the veterinarian to draw on their wealth of knowledge and experience to give you good, sound advice.
In my practice, I have seen and been involved with dogs that read the Cushing’s guidelines and laughed.
The dogs lived much longer than I ever expected and defied many of the odds I read about in textbooks.
Consequently, I always preface my Cushing’s prognosis with “Well, the textbooks say… But, dogs don’t read textbooks!”