Itsenko Cushing's syndrome symptoms in dogs. Cushing's syndrome in dogs and cats

Cushing's syndrome is an endocrinological pathology caused by an elevated blood level of one of two hormones:

• cortisol produced by the adrenal glands;
• the hormone ACTH, which is produced by the pituitary gland.

Normally, cortisol is responsible for the regulation of blood pressure, blood clotting and reduces inflammation. It is often referred to as the stress hormone. In critical situations, a powerful release of cortisol contributes to instant mobilization of forces.

The functions of the adrenal glands are closely related to the pituitary gland. It is also a gland, but is located in the brain. For proper functioning of the adrenal glands, the pituitary gland produces adrenocorticotropic hormone (ACTH), which inhibits the concentration of cortisol.

The reason for this pathological condition is an excessive amount of cortisol in the blood of an animal with a constant long-term effect on the body.

Normally, it promotes blood clotting, regulates blood pressure, and has an anti-inflammatory effect. In critical situations, its powerful release into the blood allows you to quickly mobilize the body.

The work of these endocrine glands, in turn, depends on the influence of the pituitary gland. The pituitary gland is also a gland that is located in the brain and regulates the functioning of the whole organism.

For proper functioning of the adrenal glands, the pituitary gland secretes adrenocorticotropic hormone (ACTH), allowing you to maintain a normal concentration of cortisol. Violation of this interdependent system leads to the emergence of this endocrinopathy.

Other names for the pathology: Itsenko-Cushing's syndrome, hyperadrenocorticism, hypercortisonemia.

Causes

Genetically determined causes are not well understood. The rest are usually divided into the following forms:

• Cushing's disease (spontaneous hyperadrenocorticism) caused by pituitary adenoma or hyperplasia;
• (glucosteroma) caused by an adenoma or carcinoma of one or two adrenal glands;
• iatrogenic hyperadrenocorticism, may occur with excessive intake of hormones from the outside (long-term treatment with corticosteroid drugs).

Possible consequences

Due to the high concentration of cortisol in the blood, the animal's body is in a state of constant readiness to withstand adverse effects. This leads to rapid wear of the body, depletion of its energy reserves and early old age.

Risk group

Cushing's syndrome is a pathology due to which the pituitary gland secretes cortylosis in large quantities. Cortilosis is the most important hormone, it is this hormone that exists in order to fight stress. The physiological mechanism of cortilosis is very difficult and lengthy to describe, since a huge number of different reactions take place there. You just need to know that thanks to cortilosis, the dog can withstand the negative effects of the external environment.

What is the problem if this hormone is one of the most important for life. For a dog, this amount of cortilosis excretion exceeds all norms. Cortilose is released so much that even an elephant would have enough of that amount of such a hormone. The pituitary gland is obliged to control this hormone, but that's just the point, for some inexplicable reason, it simply stops paying attention to the huge secretions of cortylosis in the dog's body, as a result of which the dog simply begins to languish. If your pet has Cushing's syndrome, then the pet will have to face the following problems:

These are not even the main problems of Cushing's syndrome. The main problem is that many dogs simply die much sooner than they should. For example, many animals barely live up to three years with this syndrome, it is also worth noting that the body of a dog that is 12 years old will practically not differ in its state from the body of a dog that died from Cushing's syndrome. With Cushing's syndrome, the entire body of the dog begins to work faster and faster, thereby exhausting all its biological reserves.

It can be said that this syndrome simply slowly depletes the body of the dog, thereby killing it. And the saddest thing is that those cases are considered a miracle when pets live to the age of four. In general, Cushing's syndrome wears out the dog's body at a tremendous rate.

Cushing's syndrome in dogs or hyperadrenocorticism is one of the most common diseases of the endocrine system in dogs (it is rare in cats) that occurs when the hormone cortisol is excessively produced by the adrenal glands (located in the abdominal cavity) or adrenocorticotropic hormone by the pituitary gland (located in the brain). Therefore, there are three types of Cushing's syndrome in dogs:

• Pituitary hyperadrenocorticism - associated with increased secretion of adrenocorticotropic hormone (ACTH) by the pituitary gland and in most cases the cause of this is a neoplasm of this organ (usually a pituitary adenoma);
• Primary adrenal hyperadrenocorticism - due to a unilateral or bilateral tumor of the adrenal glands, sometimes a structural change - adrenal hyperplasia, which occurs for an unknown reason;
• Iatrogenic hyperadrenocorticism is a secondary change that results from long-term treatment with high doses of a hormonal drug from the glucocorticoid group.

Cushing's syndrome can occur in any breed of middle-aged and older dogs, but it is more common in poodles, dachshunds, small terriers, and boxers. It has also been found that adrenal tumors are more often formed in large breeds of dogs weighing more than 20 kg. Both males and females can get Cushing's syndrome.

Sheltie dog with Cushing's syndrome

This disease manifests itself in dogs when their pituitary gland begins to produce cortisol in excess. This hormone is very important. Normally, it is a means of protection against stress. In emergency situations, thanks to him, the animal's body is fully mobilized to protect itself from the external environment.

That is, the body needs cortisol, but not in the quantities that are produced by the gland in Cushing's syndrome. The pituitary gland ceases to control the process of hormone production. As a result, the animal develops various disorders:

• Disorders of the psyche and behavior.
• Constant thirst and frequent urination. At the same time, urine has such a pungent odor that it is almost impossible to be near it.

In severe cases, this disease can lead to the death of a pet. The cause of death lies in the wear and tear of the body, which has been in a state of complete mobilization for a long time.

At the autopsy of young animals that died from Cushinoga syndrome, veterinarians note that the condition of the internal organs is equivalent to dogs that died of old age.

Veterinary medicine distinguishes several varieties of the syndrome, each of which is easily diagnosed, but requires special complex treatment and prevention.

Cushing-Itsenko disease

Occurs as a result of a primary lesion of the stem and subcortical (hypothalamus, limbic zone of the brain) formations. If the primary lesion is not noticed in time, then the pathological foci spread to the adrenal cortex, the pituitary gland.

Hypercortisolism develops. Examination of dogs reveals a basophilic pituitary adenoma, which intensively produces adrenocorticotropic hormone. This entails the rapid growth of the adrenal cortex and, as a result, increased production of cortisol.

Cushing-Itsenko syndrome or glucosteroma

As a result of adrenal dysfunction, dogs can develop a hormonally active (intensely growing) tumor of the adrenal cortex. It is formed from the fascicular zone and promotes excessive secretion of hormones. Mainly glucocorticoids. With this form of the syndrome, a more pronounced secretion (production) of the hormone is observed. It causes a prolonged and rapid growth of the adrenal cortex, the growth of an adenoma, which, if left untreated, can develop into cancer.

The formation of a pituitary adenoma is the cause of Cushing's disease in 15% of cases, the development of a tumor in 80%. However, about half of neoplasms in dogs are benign.

Iatrogenic Itsenko-Cushing's syndrome in dogs

Acquired form of the disease. It occurs during long-term treatment of the animal with drugs containing corticosteroids. They are prescribed to suppress a fairly large number of diseases in dogs, and therefore the symptoms of the disease are less pronounced.

We have already found out that Cushing's disease is the result of excessive production of cortisol or ACTH. Moreover, only a long-term high content of hormones in the blood leads to an imbalance. But why does cortisol begin to be produced in excess? There are two reasons:

1. The appearance of a tumor (adenoma) in the pituitary gland, which begins to produce an excess amount of ACTH. Being in close relationship, the adrenal glands begin an intensive synthesis of the hormone cortisol. This form of the disease is called pituitary hyperadrenocorticism and occurs in 80-90% of dogs. Usually, the neoplasm develops slowly and does not make itself felt for years.
2. The formation of a hormonally active tumor (glucosteroma) in the adrenal cortex, which leads to the growth of glandular tissue and increased production of cortisol. This form of the syndrome is called "primary adrenal hyperadrenocorticism" and occurs in 10-15% of dogs. As a rule, a tumor in the adrenal glands is malignant and develops quite quickly.

These two causes are related to spontaneous hypercortisolism. However, there is another one that leads to the occurrence of this disease. Iatrogenic syndrome, which occurs due to prolonged treatment of the animal with hormonal drugs. For example, Dexafort, Prednisolone, Metipred, Dexamethasone, etc.

The cause of the failure is a tumor of the adrenal glands or the pituitary gland (both malignant and benign). In 85% of cases, Cushing's syndrome is observed in dogs precisely because of a pituitary tumor.

Cushing's syndrome may present in

any breed, but most often affected

boxers,

Mostly dogs older than seven years of age are ill.

What causes hyperadrenocorticism? This is perhaps the most popular question that dog owners ask veterinarians. Even veterinarians do not know the real cause of this disease, which is why it cannot be cured, because there are a huge number of inconsistencies due to which doctors could not figure it out.

The only feature that doctors have noticed in the study of Cushing's syndrome is that cats almost never experience such a disease, for them this case is one in a million, while dogs experience Cushing's syndrome quite often. Why cats constantly bypass this disease, while the pituitary gland in dogs cannot control the release of the hormone in huge quantities, the doctors could not understand.

Despite the fact that scientists have been trying for many years to identify the possible causes of the development of the disease, they are still far from being completely clarified. In some cases, veterinarians simply cannot determine the cause of the failure of the pituitary gland.

Nevertheless, scientists have established several of the most common causes of pathology:

• Hormonally active tumors in the pituitary gland.
• Glandular tumors affecting the adrenal cortex.
• Improper drug treatment using steroid drugs.
• Significant age of the animal.
• Overweight.
• genetic reasons.

Scientists have also identified several forms of this disease. Division by form is determined by the causes of the development of pathology.

• Cushing's disease. In dogs, the symptoms of this pathology are manifested when tumors appear in the pituitary gland: adenomas or hyperplasia. This form of the disease is the most common and is detected in 80% of cases.
• Cushing's syndrome. It is also often called a glucosteroma. The cause of this pathology is dysfunction of the adrenal cortex caused by a tumor. Because of it, a large amount of glucocorticoids are released into the blood, which disrupt the functioning of the pituitary gland.
• Itsenko-Cushing's iatrogenic syndrome. This form of pathology develops as a reaction to the excessive introduction of hormonal agents such as prednisolone and dexamethasone into the animal's body. Usually these medicines are prescribed for dogs with serious colds and allergic reactions. This type of disease quickly disappears after the drug is discontinued.

If the symptoms of Cushing's disease appeared after the start of treatment with hormonal agents, then the supply of these drugs should not be abruptly interrupted. It is necessary to gradually reduce the daily dosage of the drug until the symptoms disappear completely.

Causes of development and varieties

When studying this disease, researchers tried to understand what varieties are there and whether they exist at all? There are indeed varieties of Cushing's syndromes, and it also turned out that sometimes the owners are provocateurs of this syndrome. What is the first variety, because of what does it happen?

It is also worth noting that there are even predispositions for this disease, that is, those breeds of dogs in which such a disease occurs most often. This list includes 3 breeds: terriers, boxers and dachshunds.

If one of the readers of this article has something to do with medicine, then they can say that a syndrome is a complex of signs, symptoms. They often vary from case to case. Based on this, scientists have long suggested that Cushing's pathology can be divided into several categories. The researchers were right, as indeed there are different types. Let's look at them in a little more detail.

First, iatrogenic Cushing's syndrome in dogs. What it is? This is a vivid example of the fact that the care of the owners can sometimes go sideways for the pets themselves. The fact is that this term refers to a disease that has arisen due to an overabundance of ... hormones. More precisely, those of them that are similar to endogenous (internal) cortisol. Where can they even come from, if the adrenal glands of the organism itself are “responsible” for the production of such substances?

And the thing is that synthetic substances of this nature are part of many hormonal drugs. With them, good owners, without consulting a veterinarian, begin to “treat” their pets. The result is Cushing's syndrome. What is especially offensive, due to such “therapy”, the pituitary gland of dogs sometimes loses the ability to produce endogenous cortisol altogether.

What other reasons are there? As we have already said, they are far from being clear in all cases. For example, the mechanism of the occurrence of genetically determined "Kushiga" has not been practically studied. But there are also clearer cases. They are associated with tumors, and not only malignant, but also quite benign.

Finally, do not forget about the defeat of the adrenal glands themselves. Even if the pituitary gland is absolutely healthy, it will not be able to influence the excessive release of cortisol in the event of their tumor or toxic damage.

Main features

Is it possible to somehow determine that a pet is starting to develop Cushing's syndrome or has it already occurred? During the research, several symptoms of Cushing's syndrome were identified, they can be identified by the following signs:

1. As mentioned earlier, the pet begins to constantly drink water, and urination is constantly working. If you notice that your pet is surprisingly very thirsty with urination, then you should pay attention to this. Keep in mind that some dog breeds are just naturally heavy drinkers. Hyperadrenocorticism in dogs is quite difficult to identify precisely by this symptom.
2. Hair begins to fall out and wool to degrade. With Cushing's syndrome in dogs, the skin becomes quite brittle, as a result of which they simply begin to lose them. This happens quite quickly, it takes from two weeks to a month for a dog to completely lose hair, it all depends on the breed of the dog, because some breeds are very susceptible to this disease, while others are quite resistant to it. This symptom looks very scary, and you will definitely notice if your dog begins to lose his hair.
3. The pet begins to lose weight very much, her physique also changes. If the dog used to have a good weight, then it can lose weight very quickly in a short amount of time. A rather strange symptom is that their body is losing weight, but the stomach becomes even fuller. After concluding this fact, the researchers noticed that in some cases, pets do not lose weight, but get fat, they could not give any explanation for this. In general, we can only say with certainty that with a very rapid change in weight, a pet may have hyperadrenocorticism.
4. It is also worth noting that with hyperadrenocorticism, dogs not only drink a lot, but also begin to constantly eat. They do not eat as much as they drink water, but still, their diet is almost doubled, they just start eating everything they see. The most interesting factor is precisely the fact that with a huge diet, they can even lose weight, not get fat. But, often dogs still gain weight after constantly eating a lot of food, this weight will not be more than 15% of the initial weight of the dogs.

If you have a dog that is used as a guard, then with such an illness it will be useless for its previous position, because during training they are simply depleted at a tremendous rate. As mentioned earlier, at first, pets will simply become exhausted during training, after which they may simply stop listening to your commands, because their body will not be up to training. And also they begin to simply lose potency due to this disease, in males complete atrophy of the testicles can occur.

It is also worth noting that the bones of dogs become as fragile as possible with hyperadrenocorticism, they develop a bone disease called osteoporosis of the bones of the skeleton. Dogs should not receive blows or any other stress, because because of this they can simply get seriously injured, after which they will be able to rehabilitate with great effort.

Diagnosis and treatment

And now the most important thing, is it possible to cure this disease? The answer is yes, but first you will need to have your pet diagnosed so that doctors can be sure that your pet has hyperadrenocorticism. You will have to do a lot of research for your dog, it's not easy and it takes a lot of time.

Ketoconazole is the drug used to treat Cushing's syndrome. This drug is designed to suppress the production of hormones, it was not created for this disease, so your pet will have to increase the dose by 3 times, after which the drug will have an effect. The drug is an excellent way to fight the disease, it has practically no side effects and it is not so expensive, but the disadvantage of this drug is that it is only useful in the early stages of the disease, in the advanced stages of hyperadrenocorticism it is practically useless.

And there is also such a drug as trilostane, it is called much more effective than ketoconazole. There are two downsides to using this medicine, the first is that it has a lot of side effects, so it should only be used as directed by a doctor so as not to accidentally harm your pet. The second negative is the price, trilostane is far from the cheapest drug given that you have to buy it several times.

And also, there is an operative intervention that can help your dog in case of a tumor in the pituitary gland. There are various therapies, such as treating this disease with herbs, but this is just a waste of time and money because they have been tested and do not help pets in any way.

As you already understood, it is still possible to cure Cushing's syndrome, but for this you need to immediately contact a veterinarian who can prescribe a course of therapy. Your pet will be prescribed the medications they need to use, after which you just need to give those medications. As a rule, ketoconazole or trilostane is prescribed, it all depends on the stage of the disease, at an early stage it is possible that ketoconazole will help the dog, at a later stage, trilostane cannot be dispensed with.

And now we will consider those symptoms that more or less accurately indicate the presence of this particular disease. Here they are:

• As we said, thirst and constant urination.

• Wool and skin catastrophically degrade, which is especially noticeable in dogs of long-haired breeds. Hair falls out, and deep cracks and erosion appear on the skin, the occurrence of which can sometimes cause even a slight mechanical impact! This is due to the fact that the skin becomes brittle and “fragile”.

• The physique of the dog changes dramatically: it loses weight, but at the same time the volume of the abdomen increases. However, in some cases, sick dogs, on the contrary, grow fat ugly (this is easily noticeable in the photo).

• Almost all animals with "Cushing" begin to literally "burrow everything." A distinctive feature - fattening no more than 15-20%. All others, with a "swine" diet, only lose weight.

If a hunting or service dog falls ill, then even minimal physical exertion instantly causes severe exhaustion and fatigue. Of course, it becomes completely impossible to use such animals in the previous job. Another symptom is severe problems in the genital area. In females, even if they are in the most reproductive age, estrus completely disappears. In males, if the pathology is not treated at all, complete atrophy of the testicles can be observed.

Very often there is osteoporosis of the bones of the skeleton, which makes them noticeably thinner and more fragile. Any blow, any mechanical force, can lead to a severe fracture. Occasionally, in dogs with this pathology, involuntary, rhythmic contractions of the limbs appear. This phenomenon can be observed both on all paws, and only on the hind legs.

Symptoms and treatment

The hormone cortisol affects the functions of the entire body of the dog, therefore, with Cushing's syndrome, almost all systems are affected:

• immune;
• urinary;
• musculoskeletal;
• reproductive;
• nervous;
• cardiovascular.

Other glands also change the usual production of hormones, so the kidneys, liver and skin can suffer. The syndrome develops gradually, but the first symptoms you may notice are as follows:

• excessive appetite;
• increased thirst and, as a result, frequent urination;
• alopecia (the appearance of bald patches in the kidney area).

Concomitant symptoms are manifested in urinary incontinence and rapid obesity. At the same time, excess weight is localized not in the subcutaneous tissue, but in the chest, neck and abdomen. There is a "sagging belly" effect.

After baldness in the kidney area, alopecia appears on the back, neck, chest and even the tail. If you look closely at the skin, you will notice small bumps that are hard to the touch (calcification). The skin becomes thinner, dry and cold to the touch. Bedsores and pyoderma (pustular lesions) may be observed.

Further, muscle weakness (myopathy) develops and the abdomen sags even more. The dog becomes drowsy, depressed, lethargic. You may notice a lack of coordination, as well as sudden changes in mood and behavior. Sometimes infections in the genitourinary system can occur.

The disease affects the reproductive system of the animal. In females, the sexual cycle may be disturbed and estrus may disappear. In males, atrophy of the testicles is possible. The animal may suffer from gastritis, pressure drop, osteoporosis (curvature of the limbs, fractures of tubular bones).

Given the wide impact of cortisol on the functioning of the whole organism, Cushing's syndrome affects the immune, nervous, reproductive, genitourinary, reproductive, cardiovascular and musculoskeletal systems. Kidneys, skin, liver can suffer. Other glands also change the normal production of hormones.

The disease develops gradually, so you should know the main symptoms of Cushing's syndrome in dogs:

• increased thirst and urination;
• excessive appetite;
• deterioration of the coat with the appearance of bald patches.

You can also observe other signs of a developing disease. Along with the increased urge to urinate, urinary incontinence appears. The dog gains excess weight, and the fat leaves the subcutaneous tissue and is localized mainly in the neck, abdomen and chest.

With the deterioration of the coat, it begins to fall out and the appearance of alopecia (symmetrical bald patches) in the region of the kidneys. Further, baldness spreads throughout the back, chest, neck and tail. Hyperpigmentation and calcification can be seen on the skin.

There is muscle weakness and a sagging belly as a result. In females, the sexual cycle is disturbed, up to the disappearance of estrus, and in males, atrophy of the testicles is possible.

The dog becomes lethargic and sleepy. Unbalanced behavior may be noticed. In the case of pituitary adenoma, coordination disorders and depression are possible.

As concomitant diseases, the following symptoms of Cushing's disease in dogs are observed: pyoderma, thromboembolism, signs of secondary diabetes mellitus, the genitourinary system is exposed to infections. The animal may experience drops in blood pressure, signs of gastritis.

Cushing's disease in dogs is accompanied by osteoporosis with possible fractures, a disorder of the cardiovascular system.

Diagnostics

Severe symptoms of the disease can be diagnosed already with a visual examination. Additional methods for diagnosing a dog include general and biochemical blood and urine tests.

The next step will be to conduct functional tests associated with the introduction of dexamethasone and the hormone ACTH. Judging by the reactions of the body to these drugs, the work of the adrenal glands is evaluated.

To do this, an ultrasound of the abdominal cavity is performed, which will reveal the possible presence of neoplasms or an increase in the adrenal glands. X-ray will detect their mineralization, identify a possible enlargement of the liver, characteristic of Cushing's syndrome.

To detect tumors in the pituitary or adrenal glands, MRI and CT are used where this type of diagnosis is available. Cushing's syndrome causes irreversible consequences, tk. affects all systems and organs.

Treatment

Treatment for Cushing's syndrome in dogs can be surgical or medical. If a tumor of one of the adrenal glands is detected in the absence of metastases, it is removed.

Surgical removal of both affected adrenal glands is possible, after which further lifelong replacement therapy is prescribed in the form of taking glucocorticoids and mineralcorticoids.

With a pituitary adenoma, it is possible to use drugs that suppress the production of cortisol. Unfortunately, such drugs are very expensive and inaccessible. Conservative treatment involves the use of Mitotan, Lysodren, Chloditan, L-deprenyl, Ketoconazole, Cyproheptadine.

The course of treatment is prescribed based on the clinical picture, localization of the pathological focus and constant monitoring of the dog's condition.

As an additional alternative treatment, you can use the homeopathic preparation Gormel, which generally normalizes the functioning of the hormonal system and is compatible with conservative treatment.

The main indicator of correctly chosen treatment tactics is to reduce the amount of water consumed by the dog. Also, the animal will need regular monitoring of the condition with the help of a blood test and ultrasound.

The results of treatment can be different and depend on many factors, including how attentive and responsible the attitude of the owner of the dog will be.

Despite the different types of the disease, the external clinical signs are similar, and any owner of their pet can notice the main ones. These include: increased thirst and urination (polydipsia and polyuria), increased appetite (polyphagia) - good appetite is a sign of a dog’s health, but its increase may indicate an emerging problem and the owner should pay attention to this sign and once again consult with your pet’s doctor, obesity, skin changes (alopecia without signs of itching, thinning and inelasticity of the skin, comedones), as well as muscle weakness / malnutrition, sagging abdomen (“bellied” appearance), violation of the sexual cycle in bitches and atrophy of the testes in males, noisy and rapid breathing, neurological signs.

Dachshund dog with Cushing's syndrome

Dog with Cushing's syndrome with skin calcification

Hyperadrenocorticism develops slowly, so it may not manifest itself for a long time. In this case, the disease can be detected only with a laboratory blood test for the level of cortisol in the blood.

Clinical manifestations appear in the later stages of the disease. In this case, the following symptoms appear:

• The dog develops a strong thirst.
• The dog urinates frequently but little by little.
• The coat becomes dry and brittle. There is an increased loss. First, the hair falls out in clumps in the abdomen, and later it can become completely bald.
• The animal is depressed and tries to move less.
• The abdominal muscles are weakened due to which it sags.
• The fatty layer is thinned out. At the same time, muscle atrophy occurs.
• Violated the cyclical sexual behavior. Males do not want to mate, and bitches lose heat.

Dogs with Cushing's disease may experience psychiatric disturbances, but this is rare. Much more often, sick pets get tired quickly and move little. They have a significant decrease in reflexes.

Sometimes animals show involuntary convulsive movements. As a rule, cramps affect the hind legs.

A blood test of sick pets gives the following picture:

• The number of lymphocytes is reduced. Cells are destroyed under the influence of steroid hormones.
• thrombocytosis.
• An increase in the number of neutrophils.
• Increased alkaline phosphatase.

Veterinarians are rarely able to make an accurate diagnosis based on symptoms alone. Therefore, sick animals are subjected to additional research methods.

The symptoms of the disease described by veterinary medicine are the same for both the syndrome and Cushing-Itsenko disease. Distinguish only the severity and intensity of manifestation of individual symptoms. With a mild form, the obvious symptoms are moderately expressed - the animal is of little concern. And in severe (advanced stage of the disease) form, in addition to pronounced clinical symptoms, complications are often observed:

• pathological bone fractures;
• severely progressive muscle weakness;
• the appearance of hypertonic kidney syndrome;
• cardiovascular disorders.

The clinical picture is as follows. Against the background of the general weakness of the animal, there is:

• rapid weight gain. This is the first symptom that dog owners pay attention to. With advanced Cushing's syndrome, a specialist diagnoses obesity (fat is deposited in the abdomen, neck and chest);
• the presence of excruciating pain in the joints, bones;
• the formation of purple-red stripes on the skin in the area of ​​\u200b\u200bthe abdominal wall;
• a sharp decrease in muscle mass, muscle atrophy;
• profuse hair loss in the chest, back and abdominal wall;
• pathology of the cardiovascular system (left ventricular hypertrophy);
• jumps in blood pressure;
• gastritis;
• subsequent development of either bulimia or polydipsia.

Also, experts distinguish two forms of the course of the disease: progressive and torpid. In the first case, both the syndrome and Cushing's disease proceed very quickly, in the second case, the disease has a protracted form (the dog can be sick for several years).

Breeds that are at increased risk for Cushing's syndrome include:

• all poodle breeds
• breeds of small terriers (Yorkshire, toy terrier, etc.)
• dachshunds
• german shepherds
• hound breeds
• Labrador Retriever
• boxers
• boston terriers

Diagnostics

To establish a diagnosis, the veterinarian uses several methods of examination:

• inspection;
• blood and urine analysis;
• functional tests;
• Ultrasound, MRI and radiography.

You can also visually determine the signs of osteoporosis, the presence of a bone fracture.

The second stage is a general and biochemical analysis of the blood, urine of the animal. Laboratory set the content of ACTH and cortisol, which indicate changes in the pituitary gland, hypothalamus and adrenal cortex. A complete blood count establishes hypokalemia, erythrocyte count, lymphocytopenia, hemoglobin level, neutrophilic leukocytosis, eosinopenia. A biochemical study determines the change in protein fractions, an increase in alkaline phosphatase and hepatic transaminases.

The third stage is the conduct of functional tests that allow you to evaluate the function of the adrenal cortex. Their essence is simple: first, the basic content of cortisol in the blood is determined, and then a small dose of ACTH or dexamethasone is administered. Next, doctors monitor changes in the concentration of the hormone.

After confirming Cushing's syndrome, the doctor needs to accurately establish the source of the pathology - the pituitary gland or adrenal glands. For this, an ultrasound of the abdominal cavity is performed. It will show the structure of organs, help compare the left and right adrenal glands, and see neoplasms. X-ray reveals organ mineralization, liver enlargement, bone lesions with osteoporosis, which are characteristic of the syndrome.

MRI and CT are used to detect pituitary adenomas. But this device is not always available in veterinary clinics.

Diagnosis of Cushing's syndrome in dogs is quite complicated and consists of several types of tests:

• blood tests - clinical and biochemical;
• special tests for the level of cortisol in the blood;
• functional tests confirming that the elevated hormone level is due precisely to Cushing's syndrome;
• Ultrasound of the adrenal glands.

As soon as the excess rate of the hormone is confirmed by blood tests and tests, you need to find out which organ provokes this pathology - the adrenal glands or the pituitary gland. This is done by ultrasound. The owner should take into account that the preparations for tests, the ultrasound procedure are quite expensive. But this is a trifle compared to the cost of treatment in case of confirmation of the diagnosis.

After examining the dog, the doctor will prescribe general blood tests - clinical and biochemical, and a urine test to detect comorbidities, a survey ultrasound / x-ray of the abdominal cavity, as well as more specific tests - a blood test for the hormone - cortisol, but the determination of the level of cortisol in the blood is done under the influence drugs.

To clarify the preliminary diagnosis, veterinarians resort to various diagnostic methods. The most commonly used ultrasound and x-rays.

The latter is needed to detect salt deposits on the mucous membranes of the trachea and bronchi. In addition, X-ray examination reveals an enlarged liver and a distended abdominal wall. These are typical symptoms for Cushing's syndrome.

Ultrasounds are usually used to examine the adrenal glands. Using ultrasound, doctors can assess the condition of the glands and determine the presence or absence of tumors.

Various tomographs are used to use the pituitary and hypothalamus.

An ACT test is mandatory. First, the level of cortisol in the blood is determined in the dog, and then an injection with ACTH is given. After 60 minutes, the level of cortisol is re-determined. The disease is confirmed if the level of the hormone after injection exceeds 600 nmol / l.

As you might have guessed, the detection of this disease is possible only in a veterinary clinic. Those signs of the pathology that we have just examined may well correspond to other ailments. Moreover, they can also be of hormonal origin. Not the most fun prospect, is it?

It is not difficult to identify a disease at any of its stages and make a diagnosis for an animal, since the syndrome is an easily diagnosed ailment with a pronounced clinical picture. The diagnosis is made on the basis of a visual examination of the dog and laboratory data. At the same time, both the symptoms and laboratory data for both forms of the disease will be virtually identical.

To make a diagnosis, the following are required:

• Complete blood count of a dog. When examining the material, an increased content of erythrocytes, glucose, leukocytes and hemoglobin in the plasma is revealed. Data indicating the presence of pathological processes in the body of the animal.
• Biochemical analysis. In the blood serum, an increase in the level of cholesterol, cortisol and alkaline phosphatase, changes in protein fractions are found.
• X-ray. Identification of osteoporosis of bones, enlargement of the liver. In some cases, in some dogs, experts diagnose the mineralization of the walls of the bronchi and adrenal glands.
• Ultrasound is necessary for both mild and severe forms of the disease, since the syndrome proceeds with the formation of tumors and adenomas. The study shows an increase in the adrenal glands, the presence or absence of neoplasms.

For the correct diagnosis of Cushing's syndrome, special tests are often used - taking dexamethasone in small doses.

If your dog is showing any of these symptoms, it's best to make an appointment with your veterinarian as soon as possible. Left untreated, Cushing's disease can cause further complications such as diabetes. If you think your dog has started to drink noticeably more, then you can measure how much water he is drinking.

This information will be of great help to the veterinarian. Use a measuring cup at the start of the day to record the exact amount of water you put into your dog's bowl. Then, at the end of the day, you will be able to determine the amount of water that is left in it, and you will only have to calculate the water that the dog drank.

If your dog is very thirsty, then you may need to refill the bowl. Water consumption should not normally exceed 100 ml per kg of body weight in a 24 hour period. Keep in mind that your pet may start drinking more water if you change his diet to dry, but excessive water intake will still help confirm that the flow is still too high.

Also, a sample of your dog's urine collected on the morning of the appointment can be a useful test for the veterinarian. Unfortunately, however, there is no single diagnostic test that can guarantee 100% diagnosis with a urine sample alone, so the veterinarian will have to perform several other tests. A blood test is usually used to rule out any other diseases that may be causing the symptoms. Your dog may also need an abdominal ultrasound.

Treatment

Treatment for Cushing's disease in dogs can be medical or surgical. The choice of method depends on where the pathology is localized.

conservative

Drug therapy is aimed at reducing the production of cortisol and ACTH production, the correction of metabolic processes in the kidneys, bone tissue and the normalization of the cardiovascular system. To suppress the secretion of hormones, they are usually prescribed: Bromocreptine, Chloditan (mitotane), Ketoconazole, Cyproheptadine.

Chloditan is given orally to dogs for 2-3 weeks, the dosage is 25 mg/kg of body weight. The frequency of admission is 2-3 times a day. The drug is prescribed until the level of cortisol is established in the range of 50-100 nmol / l. After that, secretion is maintained by prescribing a dosage of 50 mg / kg (1 time per day).

Bromocreptine (Bromergon) is prescribed to dogs at an initial dosage of 0.1 mg/kg for 1 week. Then the concentration is halved and after 2-3 weeks a maintenance course of therapy is prescribed - 0.05 mg / kg. The total duration of treatment does not exceed 6-8 weeks.

Ketoconazole in the form of tablets is prescribed not for the regulation of hormones, but for the treatment of the animal's skin. The dosage is as follows:

• the first week - 10 mg / kg (1 time per day);
• the second - 20 mg / kg (1 time per day);
• the third - 30 mg / kg (2 times a day).

To normalize the metabolism in the bone tissue, drugs are prescribed that enhance the absorption of calcium from the intestines. For example, Tridin or Osein.

In any case, the veterinarian sets the dosage and the drug, based on the characteristics of the course of the disease in the animal. Therefore, it is recommended not to risk the life of the pet and not to self-medicate.

Surgical

An alternative (surgical) treatment for this syndrome is to remove the adrenal, pituitary, or hypothalamic tumor if it has not metastasized. It is possible to excise the adrenal glands themselves, after which the dog will be on hormone replacement therapy for life (taking glucocorticoids and mineralcorticoids).

The difficulty is due to the fact that the syndrome, as a rule, affects elderly animals, and by that time other diseases surpass it in importance.

Treatment for Cushing's syndrome in dogs depends on whether the tumor is found in the adrenal glands or the pituitary gland. When the adrenal glands are damaged, a surgical operation is performed to remove them - provided that there are no metastases. Since these glands produce hormones necessary for the body, replacement therapy is suggested. In practice, it looks like this: the dog takes mineralcorticoids and glucocorticoids for life. It's not a big problem

The situation is more complicated when the pituitary gland is affected. With this form of hyperadrenocorticism (another name for the disease),

drugs that suppress the production of excess cortisol by the adrenal glands are recommended. This point presents the main difficulty. There are no such drugs in domestic veterinary pharmacies, they need to be purchased abroad, and they are very expensive.

Treatment

Speaking about the treatment of hypercortisolism, as in other cases, it is always immediately emphasized that the method will completely depend on the form of the disease. However, in this case, the choice of method plays a role only in the situation when it comes to surgical intervention.

With regard to drug therapy, treatment will depend on the cause of the disease, of which there are only three:

1. For a long time, the dog took hormones similar in composition to cortisol.
2. Hypersecretion of adrenocorticotropic hormone (ACTH) by pituitary adenoma.
3. Hypersecretion of cortisol by the cortex of a tumor-affected adrenal gland.

Reference. Some experts, when listing the reasons, in addition to those already mentioned, additionally name two more: absolutely any brain tumor that, with its volume, compresses the pituitary gland and blocks its signals. As well as toxic poisoning of the animal.

In these cases, the treatment will be etiotropic: aimed at the root cause of the development of pathology.

To treat the disease, surgery may be prescribed (with a unilateral tumor of the adrenal glands), but drug treatment in the form of tablets is more often used.

In foreign veterinary medicine, studies have been conducted proving that the treatment of hyperadrenocorticism prolongs the life of animals at times. Therefore, timely treatment and subsequent cooperation with veterinary specialists will prolong the joy of communication between owners and their pets.

If the disease was caused by a tumor of any gland, then it is completely impossible to cure the dog. However, treatment makes it possible to prolong the life of the pet and save him from some pathological symptoms.

The choice of one or another treatment strategy is determined by the results of the study and the causes that caused the pathology. Thus, therapeutic assistance is provided only to animals with clearly visible symptoms.

If the dog was diagnosed on the basis of laboratory data, but there are no symptoms of pathology, then therapy is not carried out, since it can significantly accelerate the development of the disease and worsen the well-being of the animal.

As an emergency measure, veterinarians may go for surgery. It's about removing the tumor. Most often, it is removed along with the gland.

It should be noted that operations in our country are not performed in case of damage to the pituitary gland. Veterinarians have too little experience in this area. In addition, surgery on the pituitary gland has the following negative aspects:

• She is very expensive.
• There are very few qualified specialists, so the result of the intervention is unpredictable.
• Lifelong hormone therapy after surgery.
• High risk of developing diabetes in the animal.

The veterinarians are much more willing to operate on the adrenal glands, since the operation is less complicated. Despite this, many animals die after the operation, and the survivors experience various hormonal disorders and complications.

Due to the high risks associated with surgery, drug therapy remains the best treatment.

Most often, Mitotan is used to stabilize the condition of a four-legged patient. It destroys tumor cells in the adrenal cortex.

This drug should be used according to the following scheme:

• The medicine is added exclusively to the feed.
• At the beginning of the course, the dosage does not exceed 12 mg of the drug per kg of body weight.
• Treatment continues until the symptoms of the pathology disappear.
• After the disappearance of symptoms, the drug is continued to be given to the animal along with food at a dose of 2 mg / kg once every few days.

Mitotane prolongs the life of the animal for several years. In this case, the intake of this medication should be lifelong.

Sometimes Mitotan is replaced by Trilostan. The latter drug acts differently: it suppresses the production of hormones in the adrenal glands.

Trilostane is given to dogs at 6 mg per kg of body weight once a day. After two weeks of therapy, an assessment of the level of cortisol in the blood is carried out, and the dosage is adjusted upward or downward.

Other drugs can also be used for therapeutic purposes, however, their effectiveness is low, so there is simply no alternative to Trilostan and Mitotan today.

In recent years, veterinarians have begun to practice radiation therapy in the treatment of hyperadrenocorticism in dogs. This technique shows good results, but so far it is not going to the masses, since the mechanism of such therapy itself has not yet been sufficiently developed.

The described disease is amenable to effective treatment with medications. But often after the diagnosis of the disease, the life expectancy of a dog is 2-2.5 years. This is due to the fact that Cushing's syndrome causes a chain of irreversible consequences - complications affect the musculoskeletal system, cardiovascular and nervous systems, reduce the body's resistance to infections, and increase blood pressure.

The main goal of the veterinarian prescribing the treatment of the disease is to ensure the normal production of cortisol by the adrenal cortex without causing a deficiency in the body. The specialist may prescribe: Lysodren (lysodren), Mitothan (mitotane), Chloditanum (chloditan) or op'DDD. At the same time, for each individual case, treatment and the drug (dosage) are prescribed individually.

The first sign that Cushing's treatment was administered correctly is a decrease in the amount of water consumed by the dog. However, against the background of the course of drug therapy, the animal may develop complications (vomiting, increased lethargy, refusal to eat), which may indicate the development of concomitant diseases.

1. Pituitary-dependent Cushing's syndrome: for treatment, you will need to take a drug containing the active element trilostane. Treatment is aimed at suppressing the production of cortisol. Drugs usually require daily intake throughout the life of the dog. Symptoms generally decrease fairly quickly, often within the first 2 weeks of starting treatment.

The dog will need regular checkups and blood tests to make sure the medication is working and not causing any side effects or complications. A blood test is usually done after 10 days of taking the drug, after 4 weeks, and then every 3 months. The prognosis of treatment is usually good.

Therapeutic activities

Here we come to the most important. How is all this treated, and is it treated at all? It is worth immediately warning pet owners that therapy for this disease is not cheap and long, so you will have to be patient.

As for drugs, ketoconazole is often used. Oddly enough, but this is ... an antifungal agent! What do fungi have to do with Cushing's syndrome? Basically, they have absolutely nothing to do with it. Just the action of the drug is based on the suppression of the production of adrenal hormones. It's what we need!

Much more effective trilostane. What is the treatment regimen for vetoril (another name for trilostane)? It should be prescribed exclusively by a veterinarian, but in most cases a single (per day) dose of no more than 2.5 mg / kg is used. Alternatively, the daily amount is divided into two times. Attention!

In some cases, surgery may be prescribed. But this applies only to tumors of the adrenal glands themselves, since the pituitary gland in dogs in our country is practically not operated on. Are there any alternatives? After all, the treatment with Cushing's herbs in dogs is advertised! So it is, but such “therapy” does not have any effect. At all.

Forecast and consequences

Given all of the above, we conclude that the owner of a dog affected by Cushing's syndrome has a choice between bad and very bad options. Namely:

• in case of damage to the pituitary gland, provide the pet with expensive imported drugs;
• in case of damage to the adrenal glands, perform a surgical operation and use hormone-replacing drugs until the end of the dog's life;
• leave the dog alone and let him die a natural death;
• put to sleep, if there is no strength to look at his torment.

In case of damage to the pituitary gland, if funds allow, it is possible to buy medicines abroad. Nowadays, this can be done with the help of online pharmacies. If the owner

faced with the problem of Cushing's syndrome, one can only sympathize with him and the animal. But miracles happen, and perhaps the pet will live for several more years, however, on artificial hormones. Not the worst way out of this situation.

Risk group

Cushing's disease can occur in dogs of any breed and gender. However, older animals are most often at risk. It has also been found that the breeds most prone to the disease are the Dachshund, Poodle, Beagle, Boxer, German Shepherd, Basset Hound and the entire group of terriers.

boxers,

Prevention

There is no prophylaxis for spontaneous Cushing's syndrome. Veterinarians advise regular examinations of their pets. Only in this case, it is possible to detect the primary signs of pathology even before the disclosure of symptoms.

To prevent the development of an iatrogenic variety of the disease, do not self-medicate, especially with hormonal drugs. Carefully study the information about the composition of the medicine. Do not neglect the advice of a veterinarian, even if you want to cure the simplest dog disease.

In most cases, this pathology is detected in older dogs. Given the insufficient knowledge of the etiology of tumors of the pituitary and adrenal glands, the development of effective preventive methods seems impossible.

Veterinarians advise dog owners to regularly examine their pets as a preventive measure for Cushing's disease. In this case, it will be possible to identify the pathology in a timely manner and begin its treatment, which will extend the life of the pet.

Treatment of Cushing's syndrome is very expensive and does not give guaranteed results. Therefore, if the dog is in old age, then veterinarians suggest that the owners put the pet to sleep. And here each person decides the fate of his four-legged friend.

Forecast

Cushing's syndrome (hyperadrenocorticism) is a common hormonal disorder in older dogs that can have a significant impact on their quality of life. In this article, you will find information about the causes, control of the disease, and how to recognize if your dog may have been affected.

Disease

Cushing's disease can develop either spontaneously or as a result of long-term use of steroid drugs.

1. Spontaneous hyperadrenocorticism: In spontaneous Cushing's syndrome, dogs' adrenal glands (glands located next to each kidney) produce excessive amounts of the hormone cortisol. In healthy dogs, cortisol is released in response to stress and has the following effects:

• increases blood sugar levels
• suppresses the immune system and reduces inflammation
• promotes fat storage and breaks down proteins

The production of cortisol by the adrenal glands, in turn, stimulates the production of the hormone ACTH by the pituitary gland of the brain. In dogs with spontaneous Cushing's syndrome, excessive cortisol production causes a constant stimulation of these processes even in the absence of stress, which leads to serious health problems for the animal. There are two causes of Spontaneous hyperadrenocorticism: 1) pituitary-dependent - accounts for 85% of cases, and is caused by a pituitary tumor that produces excessive amounts of the hormone ACTH, which leads to excessive production of cortisol by the adrenal glands. While "tumor" sounds ominous, try not to worry - unlike aggressive cancers, these tumors grow extremely slowly and rarely cause any problems other than Cushing's syndrome. 2) Depends on the adrenal gland - makes up the remaining 15% when it is caused by tumors in the adrenal glands themselves. Approximately 50% of these tumors are benign while the other 50% will be aggressive tumors that can spread to other organs such as the lungs. Unfortunately, there is no reliable diagnostic tool to distinguish between benign and aggressive tumors.

2. Development of hyperadrenocorticism due to the use of drugs. Cushing's disease can also be caused by long-term use of high doses of certain steroid pills and medications (such as prednisolone), as well as eye or ear drops containing steroids, which work in the same way as natural cortisol. Therefore, it is best to use such drugs in limited courses or low doses, if there is no alternative.

Symptoms

Breeds that are at increased risk for Cushing's syndrome include:

• all poodle breeds
• breeds of small terriers (Yorkshire, toy terrier, etc.)
• dachshunds
• german shepherds
• hound breeds
• Labrador Retriever
• boxers
• boston terriers

However, Cushing's syndrome can develop in any breed of dog. The median age of onset is 10 years, but dogs can develop the syndrome at a much younger age. Symptoms may include:

• lethargy
• excessive thirst
• frequent urination, incontinence
• increased appetite
• severe shortness of breath
• hair loss, mainly on the body, but not on the head and paws (usually without itching)
• skin thinning
• Sagging belly and muscle loss

These symptoms may not be seen in all dogs, but the vast majority of affected dogs will have noticeable changes in their thirst and urination soon after the onset of the disease. Changes in the skin and muscles tend to occur a little later.

Diagnostics

If your dog is showing any of these symptoms, it's best to make an appointment with your veterinarian as soon as possible. Left untreated, Cushing's disease can cause further complications such as diabetes mellitus. If you think your dog has started to drink noticeably more, then you can measure how much water he is drinking. This information will be of great help to the veterinarian. Use a measuring cup at the start of the day to record the exact amount of water you put into your dog's bowl. Then, at the end of the day, you will be able to determine the amount of water that is left in it, and you will only have to calculate the water that the dog drank. If your dog is very thirsty, then you may need to refill the bowl. Water consumption should not normally exceed 100 ml per kg of body weight in a 24 hour period. Keep in mind that your pet may start drinking more water if you change his diet to dry, but excessive water intake will still help confirm that the flow is still too high. Also, a sample of your dog's urine collected on the morning of the appointment can be a useful test for the veterinarian. Unfortunately, however, there is no single diagnostic test that can guarantee 100% diagnosis with a urine sample alone, so the veterinarian will have to perform several other tests. A blood test is usually used to rule out any other diseases that may be causing the symptoms. Your dog may also need an abdominal ultrasound.

Treatment

1. Pituitary-dependent Cushing's syndrome: for treatment, you will need to take a drug containing the active element trilostane. Treatment is aimed at suppressing the production of cortisol. Drugs usually require daily intake throughout the life of the dog. Symptoms generally decrease fairly quickly, often within the first 2 weeks of starting treatment. The dog will need regular checkups and blood tests to make sure the medication is working and not causing any side effects or complications. A blood test is usually done after 10 days of taking the drug, after 4 weeks, and then every 3 months. The prognosis of treatment is usually good.

2. Adenoma or adenocarcinoma of the adrenal cortex: Treatment of dogs with adrenal disease is more complex. Often in these cases, treatment is best initiated with the help of a qualified veterinarian, at least in the initial stages of treatment. Basically, there are three treatment options: surgery to remove the adrenal tumor, treatment with mitotane to suppress adrenal function, or treatment with drugs to reduce the symptoms of the disease. The prognosis is quite variable and depends on the extent of the tumor. Your veterinarian should be frank with you about all treatment options and the pros and cons associated with them.

3. The development of Cushing's syndrome due to medication: in most cases, the symptoms disappear after a simple discontinuation of the drug. However, it is very important that discontinuation be gradual and under veterinary supervision, as abrupt discontinuation can be dangerous and even potentially fatal. Never stop taking the drug without first discussing with your veterinarian.

Cushing's syndrome in dogs is a pathology in which the pituitary gland ceases to control the production of a special hormone, cortisol, by the adrenal glands. Its excess leads to the fact that the dog's body begins to work at its limit, is quickly depleted, and the disease often ends in the death of the animal. At an early stage, it is impossible to make a diagnosis based on symptoms alone. If your pet does not behave as usual for some time, feels unwell and does not get better - do not expect a miracle, consult a doctor.

The adrenal glands, at the signal of the pituitary gland and under its control, produce cortisol. The hormone cortisol is the stress hormone. It is responsible for increasing blood pressure and producing blood sugar. In a stressful situation, when a dog has to spend a lot of energy on defense or attack, such a state is justified. She becomes stronger, faster and more resilient. But at this moment, other body systems (digestive, genitourinary, immune) do not receive sufficient nutrition and blood supply. If this does not last long, the animal suffers without consequences and is easily restored.

In Cushing's disease, the pituitary gland in dogs ceases to control the production of cortisol. It enters the bloodstream in larger quantities than necessary, many times over. The body is in a state of constant stress, all systems work for wear and tear, which leads to exhaustion and early aging.

The disease develops in different ways: sometimes the deterioration of the dog's condition occurs slowly, and sometimes rapidly.

Most often, animals get sick after 7 years, but in some cases Cushing's syndrome is also diagnosed in young pets. Dachshunds, terriers, boxers, basset hounds are more susceptible to this disease.

Types of disease

The disease is classified according to the cause of the disease, the symptoms in all cases are the same:

1. Iatrogenic Cushing's syndrome occurs due to the fact that the treatment of any disease of the dog was carried out with hormonal drugs haphazardly, and without control. They contained a hormone similar to cortisol. With regulatory therapy, the level of the hormone is lowered, but in the future the adrenal glands may stop producing it. You will have to inject cortisol in the form of injections until the last days of the pet.
2. Genetic Cushing's syndrome is more common in young dogs. Its reasons are unknown.
3. A type of disease that occurs due to a brain tumor of any kind. The neoplasm is located either inside the pituitary gland, or nearby. As the tumor grows, the pituitary gland is compressed and stops working. Signals to the adrenal glands stop coming. With this type of disease, cortisol enters the blood in excess, or is not produced at all.
4. A disease associated with dysfunction of the adrenal glands. The signal comes from the brain, but the adrenal glands do not carry it out. The cause may be neoplasm or toxic poisoning.

Symptoms

With Cushing's syndrome in dogs, some symptoms do not appear immediately. Primary signs:

• intense thirst. The animal drinks water avidly - often and a lot;
• profuse urination. The pet does not have enough walks two or three times a day, as before. Sometimes he stops asking and leaves puddles anywhere;
• the dog begins to smell like urine;
• increased appetite, the pet eats a lot and does not eat up;
• promiscuity in food. Because of the increased appetite, he even eats the food that he previously refused.

If a dog has such signs and does not go away, this is already a reason to think and contact a veterinary clinic for an examination. If treatment is not started, the disease progresses. The appearance of the pet and its behavior is changing:

• severe and sudden weight loss, regardless of the fact that the entire portion is eaten and the dog asks for a supplement;
• a strong increase in the abdomen;
• atrophy of all muscles, including the abdominal ones, due to which the stomach begins to sag;
• hair loss. Baldness occurs on the abdomen, sides and partially on the back. Bald patches are formed symmetrically. Hair does not fall out on the head, paws and tail.
• the formation of purple stripes on the skin of the abdomen. The skin becomes thinner, with minor damage, wounds and erosion are formed. There is no itching, the dog does not itch;
• frequent fractures due to thinning of the bones;
• after some time, the females stop estrus, and the testicles atrophy in males.

A characteristic external sign of Cushing's disease is a dog with thin paws, a sunken sternum and a strongly sagging large belly. Symmetrically bald body, skin in places with small cracks.

In addition to these symptoms, the pet experiences changes in behavior, and mental disorders may occur. Secondary diseases appear: diabetes mellitus, gastritis, jumps in blood pressure, arrhythmia.

More recently, a perky, beautiful pet becomes like an old, feeble dog. Outwardly aging, all body systems are aging.

Diagnostics

A qualified specialist can determine the diagnosis by external signs, but a laboratory examination is indispensable. Diagnosis in the veterinary clinic is carried out in order to accurately determine the disease and establish its cause. It depends on which course of treatment will be chosen. Diagnostics includes:

• general blood analysis;
• biochemical blood test;
• urinalysis to find out if the protein content is normal;
• x-ray and ultrasound to determine if there is a neoplasm in the adrenal glands, the degree of their mineralization, liver enlargement, bone porosity;
• examination to detect violations in the work of the pituitary gland;
• dexamethasone tests, which measure the functioning of the adrenal glands.

It is impossible to establish Cushing's disease only by determining the level of cortisol in the blood. The hormone can increase with other pathologies, or with external influences on the mental state of the dog. For some excitable pets, going to the veterinary clinic is the most stressful, so at the time of taking the analysis, the level of cortisol may be elevated.

Treatment

It is no longer possible to completely restore the health of a dog and the functioning of the body, just as it is impossible to restore youth to an old person. Therapeutic measures are aimed at lowering the level of cortisol, improving the functioning of the organs, and in some cases, removing the neoplasm. You cannot refuse treatment. The disease will progress and lead to death.

Therapeutic measures and supportive therapy improve the general condition of the pet and prolong its life by at least 2.5-3 years, which is a long time for a dog.

Surgical measures

If the tumor is found in the adrenal gland, surgical measures are taken to remove it. It is important that the neoplasm is benign and there are no metastases in other organs.

Operations to remove neoplasms in the brain are not carried out in our country. The veterinarian may prescribe drugs that stop its growth. At the same time, they may suggest surgery to remove both adrenal glands in order to stop the production of hormones. In the future, continuous administration of cortisol in the form of injections and hormone replacement therapy is required.

Surgery may not be possible for all dogs. In some cases, the pet may be weakened due to age, or have other serious illnesses. In such cases, the operation will be ineffective and worsen the general condition of the animal.

Medical treatment

Another method of treatment is the appointment of drugs to reduce cortisol levels and normalize it. It is important to prevent a decline below normal or a cessation of production, which happens with a progressive disease.

Drugs should not be taken without a doctor's prescription. It is important to correctly calculate their dose, which is affected by the general condition of the dog, age, weight. The intake of hormonal drugs is carried out under the supervision of a doctor. In the course of treatment, the composition of the blood is examined, an ultrasound examination is performed. With any changes, the dose is changed.

In addition to hormone therapy, restorative treatment is carried out, which is aimed at reducing pressure, normalizing the work of the heart, gastrointestinal tract, and strengthening the immune system.

One of the signs that the dog is on the mend is a decrease in appetite and lack of thirst.

There are no preventive measures to prevent Cushing's disease. Only the iatrogenic variety of this disease can be prevented. Just do not self-medicate the animal, especially when it comes to taking hormonal drugs.

Cushing's syndrome, or hyperadrenocorticism, is a common disease in veterinary practice that is characteristic of dogs. It is associated with a disorder of the hormonal system and is most often diagnosed in individuals in middle or old age. The most susceptible to the development of this pathology are large breeds of dogs, as well as poodles, dachshunds and terriers, regardless of gender. How to cure this disease?

Causes of Cushing's Syndrome in Dogs

The mechanism of the development of the disease is associated with prolonged exposure to the body of an excessive amount of cortisol, a hormone that has anti-inflammatory and immunosuppressive effects. It is produced by the adrenal glands, and the process of its production is controlled by a substance called ACTH on the principle of reverse reaction. When cortisol is deficient, it is produced in large quantities and stimulates the adrenal glands, which begin to actively release cortisol, and the intensive production of the hormone suppresses the effects of ACTH, as a result of which its synthesis decreases.

In Cushing's syndrome, the mechanism of cortisol production is disturbed, it is produced in excessive amounts and has a detrimental effect on the body, affecting the work of almost all organs and systems. The cause of the pathology is neoplasms that appear in the brain or adrenal glands and disrupt the production of the hormone.

Pathology of adrenal origin occurs in older dogs, whose average age is 11-12 years

There are three types of Cushing's syndrome in dogs:

• pituitary form of the disease. A tumor that appears in the pituitary gland (most often an adenoma) synthesizes an excessive amount of ACTH, as a result of which intensive production of cortisol begins in the adrenal glands. This form occurs in 85–90% of four-legged patients, the neoplasm progresses slowly, and symptoms may develop over several months or years.
• Primary adrenal form. The cause of the disease is neoplasms of the adrenal glands, which appear on one or both sides and produce an excessive amount of cortisol. Pathology occurs in 10-15%, and in half of the cases the tumor is malignant, so the symptoms appear faster, sometimes for several weeks.
• Iatrogenic hyperadrenocorticism. Secondary change, which leads to long-term treatment with large doses of a hormonal drug from the group of glucocorticoids. In rare cases, the disease has a genetic origin and is diagnosed in young individuals.

Symptoms

Cortisol affects all organs and systems, so the manifestations of the disease can be different. The most common signs include:

• strong thirst and frequent urination (even if the dog is accustomed to going to the toilet on the street, if the genitourinary organs are affected, he will defecate at home);
• increased appetite;
• hair loss before the appearance of bald patches, which are most often localized on the trunk, tail and neck;
• no estrus in bitches;
• decreased activity and mobility, constant fatigue and drowsiness;
• rapid weight gain, but fat is located in the neck and chest, the stomach increases in volume and sags.

Polydipsia is a condition where water intake is over 100 ml/kg of body weight during the day.

Polyuria - urine production over 50 ml/kg of body weight during the day.

Skin, especially on the ventral side of the abdomen, thins and loses elasticity

In the later stages, rashes on the skin where there is no hair, signs of diabetes mellitus, infections of the genitourinary system, changes in blood pressure, disorders of the digestive system, and osteoporosis are possible. With serious damage to the body, a four-legged patient has neurological symptoms - depression, impaired vision and coordination of movements, convulsions.

What is dangerous disease

Since Cushing's syndrome most often develops in older individuals, the owners attribute the symptoms of the disease to the respectable age of the pet and do not go to the veterinarian, which is why the pathology is detected in advanced stages.

Cortisol refers to the so-called stress hormones that prepare the body for the effects of negative factors and keep it in constant tension, due to which internal reserves wear out quickly, and vital functions are disrupted.

The presence of neoplasms also contribute to serious health problems - they cause circulatory disorders, intoxication and other pathologies leading to unpleasant consequences for the animal.

Often, at the time of diagnosis, all abnormalities are already present.

Diagnostics

Diagnosis of Cushing's syndrome is not difficult for an experienced specialist, as it has specific symptoms. To confirm the diagnosis, determine the form and stage of the disease, assess the condition of the internal organs, laboratory and instrumental studies are needed, which are carried out in a veterinary clinic:

• General blood analysis. A clinical blood test reveals an increased concentration of red blood cells, white blood cells, hemoglobin and glucose. Indicators are a sign of pathological processes in the body and serve as confirmation of the presence of Cushing's syndrome.
• Biochemical analysis. In blood samples, high levels of cholesterol, alkaline phosphatase, and changes in protein content are found. One of the main signs of the disease is a high concentration of cortisol.
• Analysis of urine. Among other organs, Cushing's syndrome affects the urinary system, as a result of which an increased amount of protein is found in the urine.
• X-ray examination. An x-ray is performed to determine the degree of damage to internal organs - an increase in the liver, a decrease in bone density, in some dogs pathological changes are observed in the walls of the bronchi and adrenal glands.
• ultrasound. Ultrasound diagnostics is prescribed for both mild and severe forms of the disease to detect benign and malignant neoplasms, as well as pathological processes in the adrenal glands.
• functional tests. The essence of the study is the introduction into the body of small doses of ACTH and dexamethasone (an analogue of corticosteroid hormones) and assess the reaction of the adrenal glands.

Based on a comprehensive diagnosis, the doctor makes a diagnosis and prescribes appropriate therapy.

In Cushing's syndrome, the coat is thinning, the head, paws and tail are usually the last to be affected.

Treatment

The tactics and treatment regimen depend on the form, stage and cause of the disease. The goal of therapy is to normalize the production of cortisol without causing a natural synthesis of its formation, stabilize the hormonal background, eliminate damage to internal organs and improve their work.

With neoplasms localized in the pituitary gland, Cushing's syndrome is treated with medications. The number of drugs that are used in the treatment of the disease include Vetoril, Trilostan and Ketoconazole, the dosage is determined individually depending on the condition and characteristics of the animal's body. In severe cases, surgery is performed, but pituitary surgery in dogs is associated with a high risk of mortality and associated complications.

If the pathology is caused by tumor processes in the adrenal glands, most often doctors remove both organs, after which the pet is prescribed lifelong hormone replacement therapy. If it is impossible to carry out surgical treatment, the disease is treated medically with the help of hormone synthesis blockers in the adrenal cortex - Mitotan and its analogues belong to the group of such drugs.

The complexity of the conservative treatment of Cushing's syndrome in dogs is that the drugs used to combat the pathology are not commercially available and cause a large number of side effects, so veterinarians usually recommend surgical treatment.

If the pathology is caused by taking hormonal drugs, as a rule, it is enough to stop therapy to eliminate the symptoms, but it is necessary to stop the use of drugs gradually so as not to provoke unpleasant health consequences.

To reduce the risk of complications and side effects, the dog requires strict supervision and a special diet - light, but nutritious foods containing a sufficient amount of nutrients.

The first sign that the therapy is administered correctly is a decrease in the amount of fluid that the animal drinks. But against the background of the use of drugs in a pet, digestive disorders (lack of appetite, nausea, vomiting) can be observed.

Treatment of Cushing's syndrome with homeopathic remedies and folk remedies can only be carried out in combination with drugs prescribed by a doctor - self-medication for this disease can lead to a serious deterioration in the condition of the animal.

Possible Complications

Cushing's syndrome refers to complex endocrine pathologies that have a detrimental effect on all organs and systems, reduce immunity resistance to infectious diseases and contribute to the rapid deterioration of the body. How long a dog will live depends on the stage of the disease, age and general condition of the animal. The life span varies from a few months to 7 years, with an average of 3–3.5 years.

Experts give the most favorable prognosis for benign neoplasms in the adrenal glands, and in cases where the cause of the disease is malignant tumors with metastases and neurological manifestations, there is no hope for a long life. In situations like this, and in older dogs with Cushing's syndrome that may not survive surgery and have comorbidities, veterinarians recommend euthanizing the animal to alleviate its distress.

A high concentration of cortisol in the blood leads to the depletion of the body's energy reserves and early old age.

Prevention

To prevent Cushing's syndrome in a dog, the owner of the animal must carefully monitor its condition, proper nutrition and sufficient physical activity. Independent use of any medications should be excluded, especially if they contain hormonal components - they contribute to endocrine disorders and cause serious pathologies. Regular preventive examinations are important - they are especially necessary for representatives of breeds that are at risk for developing the disease (poodles, boxers, terriers, dachshunds). For any health problems and alarming symptoms, you should contact your veterinarian as soon as possible - in the early stages, Cushing's syndrome and other diseases are better treated.

The basics of diagnosis and treatment of Cushing's syndrome in dogs on video

Cushing's syndrome is a dangerous disease that leads to serious consequences for the health of the dog and shortens the life of the animal. Despite the fact that the probability of a complete recovery is extremely small, with the right therapy and following medical recommendations, the pet can live the rest of his days actively and bring a lot of positive emotions to the owner.

Cushing's syndrome or hyperadrenocorticism is one of the most common diseases in dogs from the endocrine system.

Its cause is increased production of steroid hormones of the adrenal cortex, usually cortisol. The disease can be caused by a tumor of the pituitary gland or its hyperplasia, as well as a disease of the adrenal glands: carcinoma or adenoma.

Most often, older animals older than seven years are sick, although animals from the age of two can suffer from pituitary adrenocorticism. Any breed can get Cushing's syndrome, but boxers, dachshunds, poodles, beagles, and various terriers are most commonly affected.

Symptoms of Cushing's Syndrome in Dogs

Since cortisol affects almost all vital systems, the clinical symptoms of Cushing's syndrome are very multifaceted. They hurt:

• cardiovascular,
• urinary,
• musculoskeletal,
• nervous
• reproductive and immune systems,
• kidneys and other endocrine glands are affected,
• liver (read more)
• leather.

The main sign that deserves attention, and in connection with this, is frequent urination. Not uncommon and urinary incontinence at any time of the day. Also, the animal's appetite can greatly increase, it begins to suffer from obesity, the stomach sags greatly.

At the same time, the dog is drowsy, weak, does not tolerate physical activity, tries not to move. Hyperpigmentation, calcification and symmetrical alopecia appear on the skin (extensive bald patches on the neck, trunk and tail). There are atrophy of the testes and violations of the sexual cycle (). Less common neurological signs:

• impaired coordination of movements,
• depression,
• blindness, etc.

The choice of treatment method depends on where the pathological focus is localized - in the pituitary gland or adrenal glands. If a neoplasm is found in the adrenal gland, the necessary treatment is a surgical removal of the adrenal gland. Unless, of course, metastases have yet been found in the liver and lungs.

With pituitary adenoma, either both adrenal glands are removed, or only conservative treatment is used, in particular, with mitotane. There are also alternative methods of treatment with the help of drug ketoconazole (nizoral), therapy with L-deprenyl, cyproheptadine (peritol).

If, after the animal was treated with mitotane, it survived the 16-week period, then the prognosis for the treatment of Cushing's syndrome is favorable.. On average, these dogs live another two years. In case of adrenal adrenocarcinoma with metastases and pituitary macroadenoma, as well as with neurological manifestations, the treatment prognosis is rather unfavorable.