All Pet Naturals Blog

by William Greenbaum, aka Love ya Woof!

What is Cushings Disease?

Canine Cushings Disease is a rather nasty and insidious disease known medically as hyperadrenocorticism, which is a condition of the adrenal glands in which they over-produce a hormone known as cortisol.

Adrenal glands are important. They are small and live beside each kidney (which explains why surgery is tricky) and their purpose  is to regulate systems and metabolism.

Under normal conditions, the adrenals secrete cortisol in balanced amounts which is important  for the regulation of protein, carbohydrate and fat; body weight, mineral balance, and skin health and this helps your dog fight illness and  remain healthy.

However when Cushing’s Disease occurs, the adrenal glands produce too much cortisol (corticosteroids) and this has adverse effects. The origins and causes of  the disease are not so well understood.

In the majority of cases, Cushings Disease is found in senior animals and small breed dogs and comes about as a result of a benign tumors in the pituitary gland. The tumor cells produce excessive amounts of ACTH, which in turn stimulates the adrenal glands to produce excessive amounts of cortisol.

The remaining 15% of the cases of Cushings disease are caused by either a tumor in one (or very rarely both) of the adrenal glands, resulting in overproduction of cortisol, or excessive use of corticosteroid drugs.

What are Cushings Disease Symptoms?

Symptoms of Cushings Disease include:

• Excessive Drinking and Urination
• Appetite gain
• Lethargy
• Excessive panting
• A sagging pot belly
• Diabetes Mellitus (more frequent in cats, but less frequent in Canine Cushings)
• Endocrine (hormone-related) skin diseases (hair loss and slow-healing wounds)
• You notice a general sense of your pet not feeling well

If you think about it the above conditions are consistent with what you would expect to see in older dogs and this explains why its sometimes quite tricky to diagnose Cushings Disease in its early stages.

So whats the end game with Cushings Disease? The answer is that left unchecked, an unfortunate raft of troubles may occur such as:

1. diabetes
2. urinary tract infections
3. pancreatitis
4. liver disease
5. kidney failure
6. skin infections
7. ear infections
8. congestive heart failure
9. hypothyroidism

Can Herbal Remedies Help?

At our company Allpetnaturls.com we have always said that classical veterinary medicine used in combination with alternative therapies is a reasonable way to proceed, so always, always work with an animal health care professional.

From a herbal perspective, and the answer to this important question, can herbal remedies fight Cushings Disease? The answer is that a holistic approach to the disease can help, particularly if you think of boosting the immune system — which is under pressure from the disease.

Allpetnaturals has a product called Constitutional Blend which is available for $21.95. This herbal tincture has two active ingredients -  dandelion and burdock root – among others which are key to flushing the body of toxins and effective in strengthening an overtaxed liver, kidneys, and digestive system.

Both herbs are also rich in minerals such as potassium and magnesium, which are good for the body because much is lost due to excessive urination.

What Other Ways is Cushings Disease Treated?

Conventional treatment of Cushings Disease  in dogs includes drug therapy and surgery. The good news is that drugs do work but the side effects can be rough stuff.

Surgery works as well but that depends where the tumor is located. If the tumor is on the pituitary gland then generally their is no cure because the gland sits right underneath the brain and its generally too risky a location for surgery. If the tumor is located on the adrenal glands, the tumor is then removed.

Conventional drugs used to treat cushings disease include: Lysodren and Ketaconazole. Side effects would be: nausea, diarrhea, appetite loss, lethargy. A new drug entered onto the market about 10 years ago showing some promise. It is called Anipryl. Again, possible side effects include: lethargy, vomiting, diarrhea.

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Cushing’s Disease or Hyperadrenocorticism

by Michael Richards, DVM

Cushing’s disease is probably more accurately referred to as hyperadrenocorticism — the production of too much adrenal hormone, in particular corticosteroids. It can be naturally occurring or due to over administration of corticosteroids such as prednisone (iatrogenic Cushing’s). The latter is easy to cure – just cut out the corticosteroid administration slowly to allow the body to return to normal function. The former is more difficult.

Hyperadrenocorticism occurs for two reasons — a tumor of the adrenal gland that produces adrenal hormones or stimulation of the normal adrenal glands from the hormones that control it. The primary reason for this to occur is a pituitary gland tumor that produces excessive ACTH, which stimulates the adrenal gland to produce corticosteroids. Adrenal gland tumors account for 15% of the cases of spontaneous hyperadrenocorticism. Pituitary tumors account for 85%.

Cushing’s disease causes increased drinking, increased urination, increased appetite, panting, high blood pressure, hair loss – usually evenly distributed on both sides of the body, pendulous abdomen, thinning of the skin, calcified lumps in the skin, susceptibility to skin infections and diabetes, weakening of the heart and skeletal muscles, nervous system disease and other symptoms. Most owners reach a point where the water consumption and urination become bothersome to them.

The diagnosis of Cushing’s can be done with several blood tests. A general hint of Cushing’s can be obtained by a blood panel. To confirm it, a test known as a low dose dexamethasone test is done. A baseline blood sample is drawn in the morning, an injection of dexamethasone given and a follow-up blood test done 8 hours later. In a normal dog, the dexamethasone should suppress cortisol levels in the blood stream. In Cushing’s disease this effect does not occur. Once the disease is diagnosed, it is possible to differentiate between the adrenal tumors and pituitary gland tumors using a second test, a high dose dexamethasone suppression test. Most dogs with pituitary tumors will have cortisol suppression on this test. There are other tests used, including ACTH response tests and urine cortisol/creatinine ratios to diagnose this disease. X-rays and ultrasonography can help determine if an adrenal gland tumor is present.

If it can be determined that there is an adrenal gland tumor, it can be removed. Many veterinarians prefer to have a specialist attempt this since the surgical risks can be high. Pituitary gland tumors are not usually removed in veterinary medicine. This situation is treated using Lysodren (o’p'-DDD, which is a relative of DDT) or ketaconazole. Some research with Deprenyl for treatment of this is being done, too, I think. Lysodren selectively kills the outer layer of the adrenal gland that produces corticosteroids. By administering it in proper amounts it is possible to kill just enough of the gland off to keep the production of corticosteroids to normal levels. Obviously, close regulation of this using blood testing is necessary since overdoing it can cause severe problems with Addison’s disease – hypoadrenocorticism. Adverse reactions to Lysodren occur at times but it is the standard treatment at this time. Over medication with Lysodren can cause inappetance, vomiting, diarrhea, lethargy and weakness. If any of these signs occur then your veterinarian should be immediately notified.

Treatment of Cushing’s disease caused by pituitary tumors is symptomatic therapy — it does not cure the pituitary tumor. The average lifespan of dogs diagnosed with Cushing’s, with or without treatment is estimated at 2 years by Dr. Mark Peterson, but in a recent conversation with another endocrinologist I came away with the impression that this was an “educated guess” rather than the result of extensive survey of Cushing’s patients. At present, though, I think that treatment should be viewed as a means of providing a better quality lifestyle rather than as a method of extending longevity.

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