Cushing’s
Disease (Hyperadrenalcorticism)
By Debbie Martin
March 15, 2003
Alt. CH. Hoofprint Day Light Star,
O.P, TT, CGC, Therapy Dog was diagnosed with Cushing’s Disease
in June of 2002. Day was 11 ½ years old at the time of
diagnosis.
Day’s Symptoms:
1. Increased water consumption: Would drink the toilet dry
2. Increased hunger: Would almost attack you for food
3. Increased urination: Started to urinate in the house
Disease
Description:
Cushing’s Disease, (Hyperadrenalcorticism) is caused by a tumor
on either the adrenal gland or the pituitary gland. These tumors
are usually non-cancerous.
Cushing’s
Disease is the exact opposite of Addison’s Disease, but they are
not related.
The tumor
causes an increase in the production of “cortisol” in the body.
Cortisol is a naturally occurring hormone similar to steroids.
The symptoms of Cushing’s Disease are the same as if the dog was
taking steroid pills.
Cushing’s
Disease is a disease of middle age and old age. It is an
inherited disorder. The mode of inheritance is unknown.
Cushing’s
Disease often goes undiagnosed. Many of the symptoms are very
gradual in onset and are often viewed as the normal result of
aging. Many dogs, because of their age and other health problems,
are euthanized because the assumption is made that the dog is
going into kidney failure.
Disease
Progression:
If left untreated, Cushing’s Disease can lead to muscle weakness,
an enlarged liver and a sagging, swollen looking abdomen from
the enlarged liver and loss of muscle tone. There may be
increased panting and lung disorders, such as blood clots, may
occur.
There is an
increased chance that a dog with Cushing’s Disease may develop
Diabetes.
The disease can
also cause neurological symptoms such as seizures, stiffness of
gait and walking “knuckled” over on the feet.
Hair will thin
on the body to the point of baldness.
Skin lesions
and skin infections can also develop.
Method of
Diagnosis:
A complete biochemical profile was run. Day had a very high
amylase level which can indicate pancreatic disease. She also
had a high Alkaline Phosphatase Level which can be an indicator
of Cushing’s Disease. She had a C.B.C. (complete blood count)
which was normal.
Her urinalysis
showed that her kidneys were not concentrating her urine. This
can be an indicator for Kidney Disease or Cushing’s Disease.
We then did a
“water deprivation” test to see if her kidneys could concentrate
her urine when she was not drinking a lot of water.
The urinalysis
after the water deprivation test, showed that her urine was more
concentrated, but still not within normal ranges. This could be
an indicator of Diabetes Insipidis.
Rule Outs:
She had blood further blood tests to rule out Pancreatic
Disease. These tests were normal.
A kidney
protein ratio test was done to determine how well her kidneys
were functioning. This test was within normal ranges.
A test for
diabetes insipid was done. This involved putting drops in her
eyes for 4 days and then drawing more blood samples. This test
was normal.
An ACTH
stimulation test was done and confirmed the diagnosis of
Cushing’s Disease.
She also had an
abdominal and cardiac ultrasound done to rule out cancer.
Treatment:
If the tumor is on the adrenal glands, surgical removal can be
considered.
There are
several drugs that can be used to treat Cushing’s Disease. Many
of these drugs must be carefully given and blood tests must be
repeated on a regular basis to prevent causing Addison’s Disease.
At this time, I
have chosen to treat Day with a drug called Anipryl, which is a
drug used to help “doggy dementia”. This drug is very safe and
has no side effects. She has been on this drug at a very low
dose for 8 months. The symptoms of Cushing’s Disease have
returned, so her dose has been doubled.
The cost of
each pill is approximately $4.00 and she is now on two pills a
day.
The cost of
obtaining a diagnosis was approximately $700.00. This also
included the ultrasound.
The diagnosis
does not need to be so expensive, but in view of some of the
discrepancies in her blood work and urinalysis, I chose to
explore each possible rule out.
The minimum
bloodwork necessary to obtain a diagnosis of Cushing’s Disease
is the ACTH stimulation test which is approximately $60.00. A
biochemical profile, CBC and urinalysis should be performed also
and will cost approximately $130.00 to $150.00. The total
minimum cost will be $200.00 to $250.00.
Comments:
At this time, Day is 12 years old. She is still athletic and
energetic in spite of her disease.
This is a
disease that cannot be cured, but can be controlled. Of all the
diseases a dog her age could have, I consider us lucky to have
this one. |