Excessive thirst and frequent urination are signs of five serious dog health problems: diabetes, kidney failure, liver disease, leptospirosis, and Cushing’s Disease.
Regrettably, not treating Cushing’s Disease could precipitate the others. After running the necessary tests, your veterinarian can eliminate the others, leaving Cushing’s Disease as the diagnosis.
What is Cushing’s Disease?
Cushing’s Disease or Cushing’s Syndrome, as it is sometimes called, is also known as hyperadrenocorticism. Due to the fact, older dogs are more prone to tumors, the disease is most commonly diagnosed in middle age and senior dogs. That does not mean younger dogs are immune to it.
The disease is caused by the overproduction of cortisol, a natural steroid hormone. It is typically released in response to stress or low levels of blood glucocorticoids. The primary functions are increasing blood sugar, metabolizing fat, proteins, and carbohydrates, and suppressing your dog’s immune system.
This disease can be managed but not cured.
There are three known origins of Cushing’s. They are tumors, lactogenic or “veterinary induced Cushings” from the overuse of glucocorticoid drugs (steroids, i.e., Prednisone, Prednisolone, Hydrocortisone, etc.) and Adrenocorticotrophic hormone (ACTH) also produced by the pituitary gland.
The majority of the time, the source of the disease is a hyperactive pituitary gland, which is found at the base of the brain. Approximately 85% of Cushing’s in dogs is from a minute benign tumor on the pituitary gland.
In the other 15% of cases, it may be caused by a tumor on one or both of the adrenal glands located in front of the kidneys. Approximately 50% of these tumors are benign.
Excessive thirst is a sign and symptom
There are more than a few signs and symptoms of Cushing’s Disease in dogs, including extended belly, excessive thirst, increased thirst, frequent urination, accidental urination in the house, increased appetite, weight gain, excessive shedding, baldness, shortness of breath, lethargy, seeking cooler places to sleep, loss of muscle mass, hypertension, excessive panting, appears anxious/restless, delayed wound healing, thin skin, easy bruising, and mood swings. Some dogs are reluctant to jump on or off furniture. Coat changes such as brittleness and dullness also indicate Cushing’s Disease.
Dogs suffering from Cushing’s are prone to ear, skin, and urinary tract infections. The disease will cause your dog to both drink and pee a lot.
How much water should your dog drink? As a general rule, dogs need an ounce of water per pound. So, a 15-pound dog needs about two cups of water per day. Puppies, lactating dogs, and active dogs will need more. During excessive heat, dogs also will need more water.
If you notice your dog drinking excessive water, contact your veterinarian.
Who gets Cushing’s Syndrome?
All breeds and ages are at risk. Middle-age and senior dogs are at greater risk.
Breeds that appear most predisposed are: Beagles, Boston Terriers, Boxers, Dachshunds, German Shepherds, Golden Retrievers, Jack Russells, Labrador Retrievers, Poodles Scottish, and Yorkshire Terriers. Female dogs are slightly more prone to the disease, and so are dogs that have been spayed and neutered.
Signs and symptoms like excessive thirst frequently begin appearing when the animal is approximately ten years or older. The sooner the owner suspects and acts, the better it is for their pet.
How is Cushing diagnosed?
Starting with the necessary blood tests used for a baseline, your vet can do several tests to help diagnose the disease.
The ACTH Simulation Test uses the initial blood test as a baseline. Your dog is then injected with ACTH, adrenocorticotrophic hormone, to stimulate the glands to release their hormones. A dog will have a significantly elevated level of cortisol. The level of cortisol is then measured and compared to the baseline. This test cannot differentiate between pituitary and adrenal Cushings.
The Urine Cortisol/Creatinine Ratio Test also can rule out Cushing’s.
The Low Dose Dexamethasone Suppression Test is the most recommended and has shown the best results to diagnose Cushing’s.
The High Dose Dexamethasone Suppression Test is used to differentiate which type, pituitary or adrenal Cushings.
MRIs and CAT scans also are used to detect and monitor the disease’s progress.
Is Cushing’s treatable?
Yes, but be aware, there is no cure. There are options to help make your pet more comfortable and improve the quality of their life. They include:
1. If your dog is a senior and suffers from arthritis or other serious health issues, it may be best to leave them alone. At their age and in their condition, the treatments may be too stressful.
2. Chemotherapy can be used for both pituitary and adrenal tumors.
3. Radiation is most frequently used on pituitary tumors.
4. Surgery is most often used to remove adrenal tumors, as they are usually larger. Only experienced veterinary surgeons should do this surgery.
5. Medications: Some have serious side effects for the dog. Be cautious when handling Lysodren!
Lysodren is the most common medication prescribed for pituitary tumors, but it can cause serious side effects. Periodic ACTH Tests are needed when using this medication. Should not be handled by pregnant women. Use surgical gloves and wash your hands thoroughly.
Anipryl is a psychotropic drug that can help control Cushing’s.
Ketoconazole is an anti-fungal medication that can help.
Vetoryl is an adrenosuppressant. The British have encouraging reports on its safety and effectiveness.
6. Gradually reduce and eliminate the number of steroids your veterinarian prescribes to your dog. That will allow the gland to return to its normal function.
What happens if Cushing’s is left untreated?
Although there is no cure for Cushing’s, depending on your dog’s age and general health, you can manage the disease. If left untreated, your dog may develop diabetes, hypertension, seizures, congestive heart failure, blood clots, pancreatitis, liver, and kidney failure.
Cushing’s Disease is serious. Consider the age and general health of your dog, as well as the progression of the disease, plus sufficient research and consultation with your vet will help you make a responsible decision as you consider the best treatment for your pet.
Knowing there is no cure, you need to focus on providing your dog with the best quality of life for whatever time you have left together.
Karen A. Soukiasian is the owner of Good Dog! — Dog Training in St. Augustine, Florida. You can follow Karen on Facebook.