Cushing’s disease in dogs

Hi everyone, and thanks for joining me on this episode of Val Talk’s Pets. In a previous episode, we looked at the rise of Addison’s disease in dogs. Now, in this episode we’ll take a look at Cushing’s disease in dogs. A topic which is being talked about more now than in the past.

According to FDA.gov, Cushing’s disease known as hypoadrenocorticism, (hyper-a-dren-ocort-icism) occurs when the body produces too much cortisol which is a hormone. The adrenal glands sit on top of the kidneys and cortisol is produced and stored by the adrenal glands. According to Ann Stohlman V.M.D. who is with the FDA’s Center for Veterinary Medicine, “Cortisol is one of the body’s natural steroids. A normal amount of cortisol helps the body adapt in times of stress. Cortisol also helps to fight infections and maintain proper body weight and condition. Too much cortisol weakens the immune system, leaving the body vulnerable to other diseases and infections.”

Cushing’s is not straight forward. There are actually two common types of Cushing’s in dogs. As FDA.gov points out, it is either pituitary-dependent or adrenal-dependent. The pituitary-dependent is the most common with about 80-85% falling into this category. This means there is a tumor, about pea-sized at the base of the brain. The pituitary gland produces the hormone ACTH which is the, are you ready… andreno-corti-co-tropic, hormone. The tumor on the pituitary causes overproduction of ACTH. This “travels through the bloodstream to the adrenal glands, stimulating them to produce more cortisol than the body needs.” In the adrenal-dependent Cushing’s, which is only about 15-20% of dogs, there is a tumor in one or both adrenal glands and it is doing the same things, which is overproducing cortisol. A vet will need to do blood test and more than likely an ultrasounds to determine which Cushing’s disease a dog may have. Knowing this will be important to determine the correct treatment.

The next question is what are the signs that may indicate that your dog may have Cushing’s? FDA.gov states that Cushing’s often happens in middle-aged to older dogs, so some of the symptoms can get missed in the early stages as they mimic what an ageing dog would often demonstrate. The symptoms may be as follows: increased thirst, increased urination, increased appetite, reduced activity, excessive panting, thin or fragile skin, hair loss, recurrent skin infections, enlargement of the abdomen, resulting in a “pot-bellied” appearance.

You can see how some of these symptoms would go unnoticed. An older dog, often has less activity or more frequent need to pee. Increased thirst is always a sign to look into because that can mean many things. Increase in appetite is not a common ageing thing, so that should raise a red flag as well as the panting or thinning of the skin. So, these signs are definitely telling of something going on.

In terms of treating Cushing’s, the first thing that came to my find when realizing that it is a tumor based condition, is why don’t they just remove the tumor? Well, apparently it’s not as easy as that. The only way to cure Cushing’s would be to remove the tumor if the disease is adrenal-dependent and there has been not spread. But, according to FDA.gov, “because of the complexity and risks of the surgery, most cases are treated with medication. Surgical techniques to remove pituitary tumors in dogs are being studied, but surgery is not a widely available option.” That means that just like Addison’s the dog will be on medication for its life and regular blood tests and medication management is the protocol. The big thing is to find the medication that doesn’t cause severe side effects in the dog.

The next thing is also a big one just like getting the medication correct and that is what and how to feed a dog with Cushing’s. According to Lignins for Life, “dogs suffering from Cushing’s disease have high adrenal steroid levels including cortisol. All such steroids are made from cholesterol and its various metabolites. Thus, a low cholesterol diet can limit the body’s synthesis of cortisol and other steroids. The AAFCO recommended diet limits fat content based on dry matter to 12% or less.” What is important however, is whether the fat is saturated or unsaturated and the cholesterol level. Unfortunately, that is not going to be set out on the Guaranteed Analysis of the product. So, I would say, look for the lowest fat content and then, contact the manufacturer and ask them to send you any further information about the breakdown of the fat content. This is something they should have and should have no problem forwarding to you. Most high end pet food companies have a veterinarian on staff and animal nutritionist, so they are usually quite excited to talk about their product at that level.

The next thing to look at is the fibre content. Soluble fibre can reduce cholesterol levels, and we now know that cholesterol can be an issue. The crude fibre based on dry matter should be 5 – 17%. However, I know that some guaranteed analysis on the products do not always list the crude fibre so again, there is no reason you cannot contact the company for this information. But, let’s talk about fibre later when we look at supplementation.

Protein. This is always a big question. A dog with Cushing’s needs according to Lignans for Life, a high level of digestible protein. This would include, muscle meat, organ meat, and egg whites. This is why I often find pet parents who have been researching diet for the Cushing’s dog feed them raw. The raw diet gives them the high protein they need with the organ meats. Some proteins however, are more digestible than others. But, I would say here, based on experience, what works with one dog does not always work with another.

Generally if we are looking for a protein for a dog with a sensitive stomach for example, we will look at lamb or fish. Some dogs do just fine with chicken which can be highly digestible, but again, it depends on the dog. Some dogs like Tundra for example, do horribly on chicken. I know this, because if he eats it, he is super gassy. In a Cushing’s dog, you still have to watch the fish too because some can have that elevated fat level. Sardines for example, are on the no list. It’s a tough one and a pet parent with a Cushing’s dog is up against trial and error. Foods that should be avoided are high fat foods. So that means the table left overs are out unless you are adding some cooked vegetables that are not in oil or gravy. Stick to the obvious like carrots, sweet potato, green beans and even some apples without the skin or seeds and blueberries. They are a good source of antioxidants.

As Lignans for Life also points out, “Cortisol increases both heart rate and blood pressure. Thus dogs suffering from Cushing’s disease often also suffer from hypertension. A low sodium diet can help keep blood pressure in the normal range.” But, most guaranteed analysis does not give the sodium level no matter how high end the food is. So, again, this may mean contacting the manufacturer. And “chronically high cortisol levels are associated with increased levels of oxidative stress” therefor adding ingredients high in anti-oxidants is a good idea. For example, selenium or vitamin C. As well, some milk thistle to support the liver cannot go amiss, as well as “Omega 3 fatty acids to reduce the triglycerides and fat levels in the blood.” Some other natural supplements that can help with the frequent urination and thirst are Arsenicum, Sulphur and Mercuries.

Researching these supplements may give a pet parent some more tools for the toolbox. Now I have mentioned Lignans for Life, but what exactly is Lignans? Lignans or HMR Lignans “is extracted from the knots of the Norwegian Spruce tree, yielding high amounts of Hydroxymatairesinol (hydroxy-ma-tear-esinal) (HMR) Lignans. HMR Lignans are phytonutrients and antioxidant and other properties that may benefit” a dog with Cushing’s. TCVM Pet Supply explains that Lignans or HMR “is metabolized in the body into a powerful antioxidant that prevents or limits oxidative stress.” Wiki explains that oxidative stress “reflects an imbalance between the systemic manifestation of reactive oxygen species and a biological systems ability to readily detoxify the reactive intermediates or to repair the resulting damage.”

Basically there is an excess of free radicals in the body’s cells. Because the Lignans balance hormones they can be a great support boosting the immune system. Lignans for Life also states that “studies have also revealed that Lignans, combined with melatonin for dogs, can be a natural remedy for canine Cushing’s.” Melatonin is a “natural hormone produced by the pineal gland that aids in maintaining a normal hormone balance.” A lot of vets are seeing the benefit of having a Cushing’s dog on a combination of Lignans and melatonin. These two can be administered along with Vetoryl or Trilostane, which are the usual prescriptions a dog with Cushing’s are on. It’s worth a discussion with the vet about this combination and it would be recommended to have this discussion before adding this supplement.

Unfortunately, the lifespan of a dog with Cushing’s disease if pituitary-dependent is around two to two and half years after diagnosis. Vetdepot.com says that a dog with adrenal-dependent Cushing’s is about 36 months. So, if a dog has been diagnosed with Cushing’s, the pet parent knows that time is of the essence. Getting the dog on medication and monitoring blood levels regularly is really important to make sure that the dog is making it to the most realistic expectation living with the disease. This is why it is even more important to look at natural support, diet and reducing stress.

Just like in Addison’s disease, stress can really complicate this disease, so massage, Reiki, tapping therapy can all be engages to create a good quality of life and to push the odds. I think when you have had the diagnosis of Cushing’s with your dog, this is when it becomes very important to have a really good relationship with your veterinarian. Both of you need to discuss protocols and alternative. For this reason, I think it is extremely important that you see the same vet on a regular basis and avoid a clinic that has you transferred around. You will need the team work.

Why there is a rise with Addison’s and Cushing’s disease is complete speculation. Addison’s is thought to be more of an autoimmune process where Cushing’s is tumor based. So many things are different now. Food, how it is grown, how it is processed, water, air, soil, everything. It stands to reason that pets are reacting just as humans are. If Cushing’s disease has been diagnosed in your pet, research is going to be key, because as I say, knowing is caring.

Tagged as: pet health,  Cushing's disease,  dog health.