Spot lumbered into the exam room.
Spot walked somewhat bowlegged, carrying a distended belly and appearing as if he swallowed a basketball.
“So, what brings you to the veterinarian today?” inquired Dr. Smith.
“Well, Spot’s not acting like himself.”
“He is shaking, agitated, and eating everything in sight.”
“He also pees and drinks all the time.”
“And Spot’s hair loss and skin infections are really an issue.”
Spot’s owners are very concerned.
Spot has been a family pet for 12 years, and he is still an important family member loved by all.
His death would rock the family.
After examining Spot, Dr. Smith concludes that he may suffer from Cushing’s disease, a disorder in which the adrenal gland produces too much cortisol.
Cushing’s is also called hyperadrenocorticism.
Anatomically, the adrenal glands are two triangular shaped glands located adjacent to the kidneys.
The outer layer, called the cortex, primarily produces three hormones:
- Cortisol: regulates metabolic activity and the immune system
- Aldosterone: blood pressure and water metabolism
- Sex hormones: estrogen and progesterone
The inner layer, called the medulla, primarily produces two hormones:
There are two forms of Cushing’s Disease in dogs, typical Cushing’s Disease and atypical Cushing’s Disease.
Typical Cushing’s Disease
The first form of Cushing’s disease is called typical Cushing’s.
In typical Cushing’s adrenal cortex produces too much cortisol resulting in irregular metabolic and immune system activity.
Typical Cushing’s is most often caused by hypersecretion of ACTH from the pituitary gland, a gland located at the base of the brain.
For this reason, Cushing’s disease originating from the pituitary gland is termed pituitary-dependent Cushing’s and as many as 80% of dogs diagnosed with Cushing’s are labeled as pituitary-dependent.
The other 20% of the time, the adrenal glands, due to tumors are the cause of Cushing’s disease. Cushing’s caused by renal tumors is called adrenal-dependent Cushing’s.
Atypical Cushing’s Disease
The second form of Cushing’s disease, atypical Cushing’s, was recently discovered.
Atypical Cushing’s occurs when the adrenal cortex produces an excess of steroid hormones resulting in similar signs as typical Cushing’s.
Both typical and atypical Cushing’s affect mostly middle-aged to older dogs of all breeds. Males and females are affected equally.
Dr. Smith says, “It seems to me that Spot may have Cushing’s. Blood tests should confirm my suspicions. And, after we get the results and if the tests do indeed confirm a diagnosis of Cushing’s, then we will discuss Cushing’s treatment options, prognosis, and life expectancy.”
Spot’s owners, a young couple, are dejected and upset. On the positive side, hope exists for dogs with Cushing’s.
With a proper diagnosis and treatment, Spot can live a very productive, pain-free life well into his golden years.
From a diagnostic perspective, your veterinarian will perform a battery of tests including one or more of the following:
- Urine cortisol/ creatinine ratio: screening test
- Low dose dexamethasone test: screening test
- High dose dexamethasone test: differentiation test
- ACTH stimulation test: differentiation test
- Abdominal ultrasound: identification of adrenal tumor or adrenal enlargement
All of the above tests will help your veterinarian diagnose and categorize Cushing’s.
Furthermore, your veterinarian will ascertain valuable information related to the type of Cushing’s and the best treatment to initiate.
Whether the treatment involves diet, a natural treatment, pharmaceutical drugs, or even all of the above, Spot’s future shines bright.