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Cushing’s

Cushing’s disease is one of the most common hormonal problems of older dogs. The disease is characterised by an excessive production of cortisol. 

Clinical Signs

Dogs with Cushing’s or Hyperadrenocorticism tend to

  • Gain weight – often with a pot belly
  • Have excessive thirst and hunger
  • Urinate excessively
  • Pant and puff more
  • Have thin skin with hair loss and often repeated skin infections

Internally this high level of cortisol causes

  • Sudden ageing
  • Fatty deposits in the liver
  • Weakening of muscle and connective tissue
  • High blood pressure
  • High cholesterol
  • Eye damage

Treating Cushing’s disease is very rewarding as these sudden signs of ageing can be rapidly reversed. It is however a disease that needs complex blood tests to diagnose and then monitor treatment. You will also need to give your dog a pill every morning for the rest of it’s life.

Diagnosis

Cushing’s disease is often suspected from markers at a routine blood profile.

Markers such as a raised ALKP and Cholesterol along with physical changes in your dog will prompt us to suggest a screening test.

The screening test is the Low Dose Dexamethasone Suppression test. To perform this test your pet is hospitalised for the day, given a very low dose of dexamethasone intravenously and blood is taken at 0,4 and 8 hours. The result of the test will indicate to us if your dog has Cushing’s and would benefit from treatment. Sometimes the result is inconclusive. These dogs often develop the condition with time so are monitored closely. 

If the result is positive your dog is likely to have Cushing’s disease. It may then need a second blood test called the ACTH Stimulation Test, which is sometimes needed to diffentiate between pituitary and adrenal dependent Cushings disease.  This test can indicate if your dog will respond to oral treatment with Trilostane. 

If your dog has Trilostane responsive Cushing’s Disease we can then start daily medication with a tablet given with food every morning. The dose of medication varies for each dog and it is really important to ensure that your dog is on the correct dose of medication. To ensure your dogs medication level is correct, an ACTH Stimulation Test is performed at 10 and 28 days after starting medication. Some dogs are more difficult to predict the correct dose of Trilostane and may need additional tests. 

The timing of the monitoring ACTH Stimulation Test is very important. We need you to have given the medication as usual and then the blood test is performed 4 hours after the medication has been given. This is necessary to get accurate results.

Once your dog is on the correct dose of medication we will then do a monitoring  ACTH Stimulation Test every 3 months to make sure the Trilostane dose remains correct. This is very important as the wrong dose of medication could lower the cortisol levels to a dangerous level and put the body into crisis.

Dogs on Trilostane are recommended to have a medication review with comprehensive blood profile twice yearly once the condition is stabilised.

Dogs with Cushing’s Disease that is well controlled with a daily Trilostane tablet will often have vastly improved health and quality of life. They will live longer and be happier but it is a big financial and time commitment for the owner. This is usually so worthwhile when you see your pet improve.

Don’t hesitate to ask us for a comprehensive estimate of blood test and medication charges.

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