Cushing’s Disease

Dr. David Deresz

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Cushing’s Disease, also known as hyperadrenocorticism, is an endocrine disease that is seen in older dogs, usually over seven years of age. The excessive production of the steroid, cortisol, is the driving force of this disease. Clinical signs include excessive thirst, urinary accidents, voracious appetite, pot-belly appearance, and hair thinning or other skin problems.

The usual presenting complaint for this disease is excessive thirst, which leads to increased urination. Urinary accidents in the house during work hours or at night are often reported. There are many different diseases that can cause increased water intake and urination, so routine bloodwork is the first step in determining which of these is most likely. Once other diseases such as kidney disease, diabetes, and urinary tract infection are ruled out, if characteristic changes to the bloodwork (increased liver values) are noted, then additional testing to confirm Cushing’s Disease will be recommended.

If this test is positive, treatment will be initiated. Treatment usually involves a drug called Vetoryl, or trilostane. It works by blocking the production of excessive cortisol production. Routine monitoring of the pet and bloodwork is needed to make sure the dose of Vetoryl is appropriate. Too small of a dose will not improve clinical signs, and too high of a dose can be dangerous. Care is taken to avoid overdosing. Some clinical signs, such as the excessive thirst, urination, and appetite tend to resolve within a couple weeks if dosing is appropriate. Other signs, such as hair loss can take six to twelve months to resolve.

Dogs can live long, healthy lives after diagnosis and management of Cushing’s Disease. Without treatment, symptoms tend to worsen and can lead to diabetes, high blood pressure, and neurologic dysfunction.