Boxer Dog with Cushing's disease
Discussion
Hi all, our 12 year old Boxer has just been diagnosed with Cushing's disease. She's been very healthy for an old girl but the last 2 weeks has been drinking excessively and has started toileting in the house. She is sluggish, life-less and seems really off colour. Took her to the vet who, after lab tests, has diagnosed Cushing's disease.
Does anyone have any experience of this in dogs, do they respond well to treatment, etc?
I'm desperate to try and get her sorted and wondered if anyone has had similar experiences.
Many thanks.
Does anyone have any experience of this in dogs, do they respond well to treatment, etc?
I'm desperate to try and get her sorted and wondered if anyone has had similar experiences.
Many thanks.
Vet student here.
Cushings disease (hyperadrenocorticalism) is a condition where the adrenal glands end up producing too much cortical steroid hormones resulting in the symptoms you have described and others. It is more common among older dogs.
The cause could be a small tumour on the adrenal gland secreting the extra hormone and if it is benign or not metastisised (spread) it can usually be removed. It could also be a slight irregularity in the amount of hormone produced from the pituitary gland (which could be from a tumour again) resulting in the extra hormone being released. There is a medicinal treatment available but cushing's cannot be cured exactly, the treatment blocks cortisol production and should see your dog respond well and settle back down once you and your vet have worked out the right medication routine.
Your vet should have done a few blood tests to test for cortisol levels to establish their diagnosis as they can fluctuate throughout the day then done an ACTH stmulation test or low dose dexamethasone supression test to confirm their diagnosis.
Hopefully your dog will respond and get back to her normal self soon,
Best of Luck.
Cushings disease (hyperadrenocorticalism) is a condition where the adrenal glands end up producing too much cortical steroid hormones resulting in the symptoms you have described and others. It is more common among older dogs.
The cause could be a small tumour on the adrenal gland secreting the extra hormone and if it is benign or not metastisised (spread) it can usually be removed. It could also be a slight irregularity in the amount of hormone produced from the pituitary gland (which could be from a tumour again) resulting in the extra hormone being released. There is a medicinal treatment available but cushing's cannot be cured exactly, the treatment blocks cortisol production and should see your dog respond well and settle back down once you and your vet have worked out the right medication routine.
Your vet should have done a few blood tests to test for cortisol levels to establish their diagnosis as they can fluctuate throughout the day then done an ACTH stmulation test or low dose dexamethasone supression test to confirm their diagnosis.
Hopefully your dog will respond and get back to her normal self soon,
Best of Luck.
Our Boxer has had Cushings for nearly 7 months now. He started with messing in the house and then started drinking constantly, sometimes 6 or 7 litres a day. As he was only 7 when this started it took a few trips to the vets to diagnose.
After Cusings was confirmed the vet then recommend he went for a CAT scan to confirm the underlying cause, though it was obvious even to me. The scan confirmed it was a tumour but a small one at that. The specialist that carried out the scan advised he could live for 3 months or 3 years.
He is now on two tablets a day for the rest of his life (it was 11 a day!) Putting it simply they have worked and the constant drinking has stopped and messing in the house has reduced to almost nothing.
However, he has suffered a couple of side effects one being calcification of the the skin. Another is that the reduction in hormones can cause any previously undiscovered arthritis issues to surface. He now struggles with his usual walk but is happy enough to limp around for a mile or so.
The tablets cost about £90 a month, the blood test costs about £120ish and happen about once every three months or so.
The only other thing to mention is that his character has changed. He is no longer a lunatic but a mild mannered gent but he still hates and chases cats!
Hope that some of that helps, if you have any more questions please let me know.
After Cusings was confirmed the vet then recommend he went for a CAT scan to confirm the underlying cause, though it was obvious even to me. The scan confirmed it was a tumour but a small one at that. The specialist that carried out the scan advised he could live for 3 months or 3 years.
He is now on two tablets a day for the rest of his life (it was 11 a day!) Putting it simply they have worked and the constant drinking has stopped and messing in the house has reduced to almost nothing.
However, he has suffered a couple of side effects one being calcification of the the skin. Another is that the reduction in hormones can cause any previously undiscovered arthritis issues to surface. He now struggles with his usual walk but is happy enough to limp around for a mile or so.
The tablets cost about £90 a month, the blood test costs about £120ish and happen about once every three months or so.
The only other thing to mention is that his character has changed. He is no longer a lunatic but a mild mannered gent but he still hates and chases cats!
Hope that some of that helps, if you have any more questions please let me know.
Edited by russ_a on Sunday 31st July 21:45
Glad to be of help,
Hopefully, you dog is insured - as the fee's soon start to pile up!
I think we have spent (well direct line) around £3000 to date. We have a 4k / 12 month limit and will hit this in December.
Luckily, the most expensive part (CAT scan £1200) has already been completed. Though the vet was pushing for another to just check on the tumour growth. Part of me thinks this is just to expand his knowledge as they can't operate so what difference does it make.
Vets must have been jumping for joy when pet insurance became popular! The surgery where we had the CAT scan even had a part submerged treadmill to help dogs recover after leg surgery. When I was there they had a little yorkie in it. He was running around like mad when they took him out and had nothing wrong with him. God knows how much they charge for that little extra.
Hopefully, you dog is insured - as the fee's soon start to pile up!
I think we have spent (well direct line) around £3000 to date. We have a 4k / 12 month limit and will hit this in December.
Luckily, the most expensive part (CAT scan £1200) has already been completed. Though the vet was pushing for another to just check on the tumour growth. Part of me thinks this is just to expand his knowledge as they can't operate so what difference does it make.
Vets must have been jumping for joy when pet insurance became popular! The surgery where we had the CAT scan even had a part submerged treadmill to help dogs recover after leg surgery. When I was there they had a little yorkie in it. He was running around like mad when they took him out and had nothing wrong with him. God knows how much they charge for that little extra.
Got to be honest I don't think we've ever sent a cushingoid dog for a cat scan. If it is a tumour it's very unlikely that surgery would be performed.
I hope all goes well with your four legged friends. It's a complicated disease. Medication can work for some but the side effect for others is too great. Just last week we had a dog cvome off it due to it's renal parameters. The owner said the dog is back to her lively old self but obviously now drinking lots more. She has decided true character over length of life is what she wants to aim for (and probably her only choice due to renal complications) the dog is over 12.
There is no straightforward answer re: how to treat, or whether to even treat at all but it all comes down to quality of life, poor qol with or without meds is no life for your dearly loved friends, all the best.
I hope all goes well with your four legged friends. It's a complicated disease. Medication can work for some but the side effect for others is too great. Just last week we had a dog cvome off it due to it's renal parameters. The owner said the dog is back to her lively old self but obviously now drinking lots more. She has decided true character over length of life is what she wants to aim for (and probably her only choice due to renal complications) the dog is over 12.
There is no straightforward answer re: how to treat, or whether to even treat at all but it all comes down to quality of life, poor qol with or without meds is no life for your dearly loved friends, all the best.
The vet stated that if a tumour was found it is virtually impossible to operate and he was unaware of an operation taking place. His reasoning behind the request for a CAT scan was to confirm the cause of the Cushings. Though to be honest I wasn't convinced and had a few chats with the vet before I agreed.
Have to agree that the side effect of the medication is an issue for us but our vet has advised that the none treatment of cushings would result in more issues than what we are experiencing.
At the end of the day our dog seems happy enough, he doesn't seem bothered at all by his skin issues but can no longer go for long walks. Again so long as he goes out for a walk the distance doesn't seem to matter, though he does have a good couple of hours sleep when we get back!
Have to agree that the side effect of the medication is an issue for us but our vet has advised that the none treatment of cushings would result in more issues than what we are experiencing.
At the end of the day our dog seems happy enough, he doesn't seem bothered at all by his skin issues but can no longer go for long walks. Again so long as he goes out for a walk the distance doesn't seem to matter, though he does have a good couple of hours sleep when we get back!
russ_a said:
The vet stated that if a tumour was found it is virtually impossible to operate and he was unaware of an operation taking place. His reasoning behind the request for a CAT scan was to confirm the cause of the Cushings. Though to be honest I wasn't convinced and had a few chats with the vet before I agreed.
Have to agree that the side effect of the medication is an issue for us but our vet has advised that the none treatment of cushings would result in more issues than what we are experiencing.
At the end of the day our dog seems happy enough, he doesn't seem bothered at all by his skin issues but can no longer go for long walks. Again so long as he goes out for a walk the distance doesn't seem to matter, though he does have a good couple of hours sleep when we get back!
"Virtually impossible to operate?" I'm surprised, unless he doesn't think your pocket is very deep - pituitary surgery is probably pretty rare in animals (a vet will correct if I'm wrong), but if it is an adrenal cortical tumour I wouldn't have thought that that was beyond the capabilities of a veterinary surgeon interested in surgery. In humans we get a reasonable number of laparoscopic adrenalectomies for smaller functioning cortical tumours and even large (usually malignant) ones of 500gm+ are removed. The anaesthetist sometimes has a sweaty time with those..!Have to agree that the side effect of the medication is an issue for us but our vet has advised that the none treatment of cushings would result in more issues than what we are experiencing.
At the end of the day our dog seems happy enough, he doesn't seem bothered at all by his skin issues but can no longer go for long walks. Again so long as he goes out for a walk the distance doesn't seem to matter, though he does have a good couple of hours sleep when we get back!
nomisesor said:
russ_a said:
The vet stated that if a tumour was found it is virtually impossible to operate and he was unaware of an operation taking place. His reasoning behind the request for a CAT scan was to confirm the cause of the Cushings. Though to be honest I wasn't convinced and had a few chats with the vet before I agreed.
Have to agree that the side effect of the medication is an issue for us but our vet has advised that the none treatment of cushings would result in more issues than what we are experiencing.
At the end of the day our dog seems happy enough, he doesn't seem bothered at all by his skin issues but can no longer go for long walks. Again so long as he goes out for a walk the distance doesn't seem to matter, though he does have a good couple of hours sleep when we get back!
"Virtually impossible to operate?" I'm surprised, unless he doesn't think your pocket is very deep - pituitary surgery is probably pretty rare in animals (a vet will correct if I'm wrong), but if it is an adrenal cortical tumour I wouldn't have thought that that was beyond the capabilities of a veterinary surgeon interested in surgery. In humans we get a reasonable number of laparoscopic adrenalectomies for smaller functioning cortical tumours and even large (usually malignant) ones of 500gm+ are removed. The anaesthetist sometimes has a sweaty time with those..!Have to agree that the side effect of the medication is an issue for us but our vet has advised that the none treatment of cushings would result in more issues than what we are experiencing.
At the end of the day our dog seems happy enough, he doesn't seem bothered at all by his skin issues but can no longer go for long walks. Again so long as he goes out for a walk the distance doesn't seem to matter, though he does have a good couple of hours sleep when we get back!
Yes if the tumour was on the adrenal glands it would be possible to operate on. However, the tumour could be on the pituitary gland located at the base of the brain, causing it to produce too much ACTH (Adreno Corticotrophic Hormone) which in turn causes the adrenal glands to produce the excess hormone resulting in the symptoms. So although there is nothing structurally wrong with the adrenal glands they will still be affected. Brain surgery is highly risky in all cases and that also due to the tumours position is why the vet said it was virtually inoperable.
Hope this helps.
you have to remember that envelope pushing surgery is difficult enough in humans, so nearly alway slags behind in animals, combined with shorter lifespans in animals, costs, facilities etc, it tends to make surgery less stunning. I'm sure intra-cranial surgery will have been attempted in the states, but would be regarded a bit more sceptically here. Adrenal surgery will be rather more humdrum in the vet schools and research centres, but not very common outside of there. However, medical therapy of cushings, is much better than it used to be, with very good results and fewer risks.
swiftwill said:
Vet student here,
Yes if the tumour was on the adrenal glands it would be possible to operate on. However, the tumour could be on the pituitary gland located at the base of the brain, causing it to produce too much ACTH (Adreno Corticotrophic Hormone) which in turn causes the adrenal glands to produce the excess hormone resulting in the symptoms. So although there is nothing structurally wrong with the adrenal glands they will still be affected. Brain surgery is highly risky in all cases and that also due to the tumours position is why the vet said it was virtually inoperable.
Hope this helps.
Thanks, I understand the potential causes of Cushings. The dog is on Trilostane so the treatment is, as you say, providing symptomatic relief by blocking the synthesis of corticoids and unless I've missed the findings on CT, we don't know if he has a pituitary adenoma with bilateral adrenocortical hyperplasia, diffuse autonomous adrenal nodular hyperplasia, an autonomous solitary or multiple adrenal adenoma/s, an adrenal cortical carcinoma, or, presumably this can very rarely happen in dogs as in H. Sapiens (the only animal I'm qualified to deal with), ectopic ACTH or corticoid production as a paraneoplastic phenomenon - something we see occasionally, usually in small cell Ca of lung - the OP would have been told if that was the case as the prognosis would be dismal and presumably there would be appropriate chemo options as well as blockade of the adrenals. Yes if the tumour was on the adrenal glands it would be possible to operate on. However, the tumour could be on the pituitary gland located at the base of the brain, causing it to produce too much ACTH (Adreno Corticotrophic Hormone) which in turn causes the adrenal glands to produce the excess hormone resulting in the symptoms. So although there is nothing structurally wrong with the adrenal glands they will still be affected. Brain surgery is highly risky in all cases and that also due to the tumours position is why the vet said it was virtually inoperable.
Hope this helps.
I'm sure that for sufficient ££ one could find a canine endocrine surgeon, or even one specialising in skull base or neurosurgery, if not here, in the USA! I agree however that it may only be appropriate to give symptomatic relief as the cost, morbidity and mortality of surgical treatment may well outweigh the chance of a cure - and, on a happy note, things seem to be going well on the current Rx.
ETA - also as the post above says, the dog is elderly, so surgery probably wouldn't be appropriate.
I had a whippet with Cushings up to a couple of years ago. He presented with it at around 7 years old and responded quite well to the medication but did suffer from scurfy skin. Regular bathing helped that. Eventually though, his health declined and he lost muscle badly and became very weak. We finally did the best thing for him at around 10 years old. I must stress it can vary from dog to dog, some go on for years with little sign of the disease, unfortunately ours didn't. He was happy enough for the three years he had it until the very end, but he was never quite the same, his joie de vivre had gone. Good luck with your dog.
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