Is your dog slowing down, putting on weight and sleeping more?
If he is is over a certain age, it’s possible that you’ve put these changes down to his advanced years. However, what if there was a condition that mimicked old age and, if treated, gave your dog back his mojo? You’d want to know about it, right?
Actually, such a condition does exist. It’s called Cushing’s disease.
Case Study: Meg the Staffie
Meg was once a lively dog. She was a star at her local agility club. But over several months, her enthusiasm for exercise dwindled. Instead of jumping hurdles, she was more inclined to sleep.
She started to put on weight, which her family didn’t think too much about because Meg wasn’t burning calories as she used to. She had also become thirstier — but again, given that Meg was no longer in the first flush of youth, her caretakers weren’t too concerned.
But that changed when Meg went on vacation with her family. Meg started having urinary accidents. When she came back from vacation, Meg’s family decided it was time for a checkup.
Classic Clinical Signs
I took a history and examined Meg. Her problem list looked something like this:
- Lack of energy
- Weight gain around the tummy (a potbelly)
- Drinking more
- Needing to pee more often
- Poor coat
- Muscle loss on her back legs
All of this made me suspicious that Meg had Cushing’s disease.
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What Is Cushing’s Disease?
The signs of Cushing’s disease are caused when the body is exposed to long periods of high levels of natural steroid, or cortisol, in the blood. Cushing’s disease (hyperadrenocorticism) is when your dog has too much steroid in the blood.
It is normal for the body to produce steroid at times of stress. It’s essential to cope with stress, and a lack of steroid makes a body very ill. But too much (as with some things in life) is bad.
Steroids are linked to hundreds of essential jobs in the body, including:
- Controlling inflammation
- Regulating the use of fats and protein in the body
- Regulating the production of sugar for the body’s tissue to use
- Maintaining blood pressure
Steroid production is controlled by an area in the brain called the pituitary gland and manufactured by a gland in front of the kidney called the adrenal gland. Overproduction of cortisol happens when a small tumor forms in the pituitary gland (this is the most common site) or the adrenal gland (less common) and results in increased cortisol production.
In this video by the American College of Veterinary Internal Medicine, Steve Dale and veterinary internist Dr. Keven Gulikers discuss Cushing’s disease in more detail:
Diagnosing Meg’s Condition
Reaching a diagnosis can be tricky. In Meg’s case, I ran blood tests to see if her kidneys and other organs were healthy (they were), but certain changes on her results did hint at Cushing’s.
To confirm this growing suspicion, I ran a blood test that stimulates the body to produce steroid. We were able to put another puzzle piece into place: The results were consistent with a problem in the pituitary gland. We started treatment.
In other cases, the results are less clear-cut. Additional blood tests or an ultrasound scan of the tummy to search for enlarged adrenal glands may be necessary.
Once I reached a diagnosis, we checked Meg’s blood pressure. Hypertension (high blood pressure) is a common consequence of Cushing’s disease. Indeed, Meg had very high blood pressure and was started on medication to target this issue.
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Meg’s treatment was a drug called trilostane (Vetoryl), which down-regulates cortisol production. Just as Cushing’s disease comes on slowly, the signs reverse slowly — which happily they did. A few weeks later, Meg had her mojo back.
Once a dog is started on treatment, the Vetoryl is needed for life. However, a new surgical treatment has become available (at specialist centers) that involves removing the pituitary gland. This means the dog returns to normal without the need for medication.
If Meg reminds you of your older dog who is slowing down, bear in mind that a trip to your vet may well be the first step to help him get his old bounce back.
This pet health content was written by a veterinarian, Dr. Pippa Elliott, BVMS, MRCVS. It was last reviewed April 17, 2015.