Caring for a Dog with Cushing’s Disease

Caring for a Dog with Cushing’s Disease

by Jenny Lelwica Buttaccio

In 2008, we adopted Caylie, a six-year-old beagle with a list of health conditions (obesity, arthritis, and hypothyroidism). My husband and I worked hard to improve Caylie’s health, and, after a few months, these issues stabilized. Caylie began to thrive. With her friendly, spunky personality, she quickly became a neighborhood favorite among canines and humans alike.

Caylie was 12 years old when she began exhibiting a strange set of symptoms. She was gulping water by the bowl full, panicked when the water bowl was empty, unable to hold her bladder in our apartment, and losing weight. Did she have a urinary tract infection? Maybe her thyroid medication needed to be adjusted? However, those tests came back negative, and our usual, lively hound was still miserable.

After several rounds of testing, the vet determined Caylie had Cushing’s disease, and he placed her on medication. But we were woefully unprepared for the unique needs Caylie would have for the rest of her life, and internet searches yielded no useful tips on helping us care for her. We learned that in the best-case scenario, Caylie’s lifespan would be between 30 and 36 months after the onset of her illness. Somehow, it didn’t seem fair that poor health should strike this sweet beagle for the second time; she’d already overcome so much.

More than three years later, Caylie has beaten the odds. At the age of 15, she’s only just begun to slow down (a little). To the amazement of our vet, she still acts like a puppy every time she sees him. Through trial and error, we’ve been able to give Caylie an excellent quality of life, and I’d like to share the lessons and tips we’ve learned along the way. Cushing’s disease is a challenging diagnosis, but it doesn’t need to be the end of your pet’s happy life.


What is Cushing’s Disease?

The Veterinary Centers of America (VCA) defines Cushing’s disease as a condition in which the adrenal glands–two bean-shaped organs above the kidneys–overproduce the hormone, cortisol, which supports your dog’s stress response, glucose levels, immune system, metabolism of fats, blood pressure, and more.   

Dr. Thomas Johnson, an experienced veterinarian in Skokie, Illinois, reports that Cushing’s disease is mostly diagnosed in middle-aged dogs six years and older. While the disease can affect any breed, Johnson notes smaller breeds tend to be most prone (Poodles, Dachshunds, Terriers, Beagles) to this illness. German Shepherds and Golden Retrievers may be predisposed to Cushing’s disease as well.


What are the early warning signs of Cushing’s disease?

“Some of the early warning signs that might alert an owner something is wrong with their dog are urinating and drinking more, a potbelly, and hair loss,” Johnson describes. Additionally, the VCA notes an increase in appetite (since cortisol acts as an appetite stimulant) and lethargy as red flags to include on the list of early warning signs.


What causes Cushing’s disease?

Michael Blaire, R.Ph., the executive chairman of Diamondback Drugs in Scottsdale, Arizona, provides a thorough explanation of the causes of Cushing’s disease in our four-legged friends. He states, “Cushing’s disease can be caused by a tumor on either the pituitary gland (located at the base of the brain) or the adrenal gland (located on top of the kidneys). Approximately 80 percent of dogs with Cushing’s disease have a tumor on the pituitary gland, which, because of its location and size, makes it untreatable with surgery. Veterinarians can perform a series of diagnostic tests to determine if a dog has pituitary Cushing’s or adrenal Cushing’s.”

In addition, the American Kennel Club comments that Cushing’s disease can occur when excessive amounts of prednisone or dexamethasone are administered to a dog over prolonged periods. Although the symptoms are identical to those caused by a pituitary or adrenal tumor, this type of the illness resolves once the steroids are stopped.


How is Cushing’s disease diagnosed?

Dr. Johnson uses a blood test call an ACTH stimulation test to check for the disease. “It’s basically stimulating the adrenal glands,” he says. When performing an ACTH stimulation test, a small amount of ACTH (the hormone that signals the pituitary to secrete cortisol) is administered by an injection. Then, cortisol levels are measured over the course of a few hours. If your pet has Cushing’s, the ACTH injection will spark the adrenal glands to produce an uncommonly high level of cortisol. These test results, along with additional testing, can help your vet diagnose your pet.


How is Cushing’s disease treated?

According to Blaire, “The two most commonly used medications to treat Cushing’s disease are Trilostane (Vetoryl) and Mitotane (Lysodren). Mitotane is an older medication that actually kills off the cells in the adrenal glands that produce cortisol. Because it is a non-reversible therapy, it had many side effects, especially if too much of the adrenal gland was killed off during treatment. Many dogs would need to take prednisone to supplement their decrease cortisol production until the adrenal gland cells could grow back.

Nowadays, Trilostane is a much safer alternative. It works by blocking a chemical reaction necessary for the adrenal gland to produce cortisol. Unlike Mitotane, if you stop giving Trilostane, the adrenal glands resume producing cortisol almost immediately.”


What steps can I take to ensure my dog has a good quality of life?

Caring for a dog with Cushing’s disease can be both costly and time-consuming. The cost for a 30-day supply of medication could range anywhere from $50 to $350 depending on the size of the dog, the strength of the medication, and the pharmacy. Plus, routine blood tests are needed to make sure your dog is taking the correct dose. Once you’ve placed your precious pooch on the appropriate medication regime, these following suggestions will make caring for them a little easier.

1) Put a water bowl in the rooms where your dog spends the most time.

Since excessive thirstiness is a symptom of Cushing’s disease, your pet may get antsy if water isn’t readily available. Caylie has learned to notify us that her water bowl is empty by tipping it over. It’s one effective strategy!

2) Schedule extra potty breaks.

After Caylie developed Cushing’s, her ability to hold her bladder decreased, and she now has to go outside two times more than she did before. When she gets restless or starts pacing, we know it’s time to take her out.

3) Adhere to a toileting schedule, but know there will still be mistakes.

No matter how diligent you are with keeping a schedule, they may still have accidents on occasion. To keep our home clean, we’ve opted to line our floors with inexpensive rugs that can be washed or tossed out if necessary.

4) Consider purchasing washable beds.

Again, mistakes happen, and they are easier to deal with if you can throw the bed in the washing machine. Bonus points for ease if you can dry the bed in the dryer. Also, it’s nice to have an extra bed on hand for when these unexpected circumstances arise.

5) Keep a roll of paper towels and a bottle of cleaner in each room.

A dog with Cushing’s usually urinates a substantial amount. Keeping cleaning supplies handy allows you to quickly catch and contain a mishap before it becomes a huge mess.  

6) Experiment with feeding your dog more frequently during the day.

Caylie has a ravenous appetite, but she seems to be more content when we feed her every couple of hours. In her case, the disease has caused her to lose weight, so she benefits from the extra calories each day.

7) As long as your dog is feeling well, keep exercising her.

Caylie is happiest when she’s outside; she’ll even trot down the sidewalk from time to time. She is calmer and sleeps better after she’s had some exercise. Despite all she’s been through, Caylie is happy, and her symptoms are well-controlled–which is more than we could ask for from our old girl.