Common Disease Name:

Cushing's disease, Cushing's syndrome

Medical Term for Disease:

Canine Hypoadrenocorticism

Species Affected by Disease:

Dogs; rare in cats

Age Animal Usually Affected:

Most dogs diagnosed with Cushing's disease are at least nine to ten years old. It is one of the most common endocrine disorders in dogs

Commonly Affected Breeds:

The poodle, dachshund, Boston terrier, boxer, and beagle have been reported to be at higher risk than other breeds.

Sex Usually Affected:

Either sex in dogs with pituitary dependent Hypoadrenocorticism (PDH). Two-thirds to three-quarters of dogs with adrenal tumors are female.

Disease Symptoms:

A variety of symptoms can result from excess cortisol, the most common of which include increased thirst and urination, increased appetite, panting, and skin changes such as hair loss, darkening of the skin, thinning of the skin, abdominal enlargement, skin infections, flaky or greasy hair coat, weakness, tiredness, obesity, reproductive changes, and bruising.

Method(s) of Diagnosis:

Efforts to distinguish which form of the disease is present are important, as this can influence treatment recommendations. Blood tests, imaging procedures, including abdominal ultrasound, may be needed to make this distinction.

Disease Causes:

Cushing's disease results from excessive production of cortisol, a hormone normally produced by the adrenal glands, which are small glands located by the kidneys. Cortisol is a hormone that is necessary for many normal body functions. This excessive cortisol production can result from tumors within the adrenal glands themselves, or abnormalities in the pituitary gland in the brain secreting excessive adrenocorticotropic hormone (ACTH). In turn, excessive ACTH causes the adrenal glands to produce excessive cortisol. In addition, increased cortisol production can be caused by a combination of these factors.

Treatment:

Pituitary-dependent Cushing's disease is usually treated with medication. Adrenal gland tumors are best treated surgically, although they can also be treated medically in situations in which surgery is not advised.

Prognosis:

Depending on the source of the problem, clinical signs resolve within several days to months of appropriate treatment. Untreated, Cushing's disease is generally a progressive disorder with a poor prognosis.

Complications:

Side effects of medication (mitotane) are not uncommon, but are mild in most dogs. Side effects of medication include: lethargy, weakness, loss of appetite, vomiting, diarrhea, staggering, and a rapid onset of an Addisonian crisis.

Prevention:

The exact cause of Cushing's disease is unknown, and there is no way of preventing the disease from developing. Similar signs can occur in dogs that are treated for long periods of time with high doses of cortisone. This treatment should be avoided wherever possible. This is called "iatrogenic Cushing's", or illness caused by chronic administration of steroids.

Medicines Used for Treatment of Disease:

Mitotane (Lysodren, o, p'-DDD) is the drug of choice for the medical management of both PDH and adrenal tumors in dogs.

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