Wednesday, August 20, 2008

Cushing's Disease can stump even the experts. . . .

. . .I use Google "alerts" to keep up with about umpteen different topics. Yes, I do have my shoes off so I COULD probably count high enough to give an accurate number, but I don't have the energy. Anyhow, it stands to reason one of the topics is "Cushing's". You'd think that would be pretty straight-forward, but did you know there are a lot of famous (and not-so-famous) folks with the last name of Cushing's? And towns called Cushing's?

One of the titles of an article that had a brief summary that was in Sunday's list (and I just now read) was Cushing's disease can stump even the experts Dr. David Gordon. Just exactly like that. Punctuation (and lack of) perzactly like that.

So, of course I read it. (My comments are in italics)

Q. My vet says my dog, Sheila, may have Cushing's syndrome or Cushing's disease. I tried looking this up on the Internet, and it is so complicated, I cannot really understand it. Not only that, but Sheila does not really show any of the signs that are described. Can you explain what is going on?

Ruh-roh, r'Elroy.....there is the word "dog". I started to click the "x" to close the window. But I was intrigued, so I read on.

Don't worry; you are not alone. Cushing's disease, or hyperadrenocorticism, is
one of the most complex diseases involving the endocrine system that we face.
Now, that's the truth, and it doesn't matter the genus and species of mammal named here. Homo sapien works fine, too.

I will try explain what is going on with Sheila. First, a little background:

Nothing is quite as complex nor quite as elegantly simple as the body's endocrine system. The endocrine system comprises glands in our bodies that help regulate all of our bodily processes through hormones.

Yeppers...true, true, true for the higher level of primates, too.

When the endocrine system is working perfectly, our bodies are like finely tuned machines, capable of carrying out hundreds of chemical reactions simultaneously without a glitch. When the system goes awry, however, nothing can make you feel worse. Also, since the endocrine system's effects are so widespread, it is not unusual to see effects of endocrine disease in many parts of the body.

We all require a very intricate balance among all of the hormones our body produces. Cushing's disease may be causing Sheila's body to produce too much of a certain kind of hormone. This can cause a wide variety of symptoms and/or problems.

(Are you SURE you are talking about a dog, Dr. Gordon?)

These symptoms can be vague and varied and tend to appear gradually and get progressively worse, making it easy to mistake Cushing's disease for normal aging. In addition, many of the symptoms are not unique to Cushing's and could reflect a number of other health concerns.

The most common symptoms include:

  • increased or excessive water consumption
  • Where's my water bowl?

  • increased or excessive urination
  • Yeah, I know where that other "bowl" is, too.....

  • house-training accidents in previously house-trained dogs [insert humans]
  • increased or excessive appetite
  • food stealing or guarding, begging, trash dumping, etc.
  • I know those....see my post on hunger and overeating as a Cushie....

  • a sagging, bloated, pot-bellied appearance
  • weight gain or the appearance of weight gain, due to fat redistribution
  • Oh, boy, that sure sounds familiar... (See article on What is Cushing's Disease?)

  • loss of muscle mass, giving the appearance of weight loss (ditto)
  • bony, skull-like appearance of the head (nope...this one doesn't fit for me)
  • exercise intolerance, lethargy, general or hind-leg weakness
  • new reluctance to jump up on things or people
  • Lethargy, weakness...ditto... no jumping on anything, from anything, or to anything.... Hind legs or whatever!

  • excess panting, seeking cool surfaces to rest on
  • OMG...he followed me up my steps. It had to be before my surgery in Dec. 2006, so he's been "researching" for a while!

  • symmetrically thinning hair or baldness on torso
  • other changes in the coat like dullness, dryness
  • slow hair regrowth of hair after clipping
  • thin, wrinkled, fragile and/or darkly pigmented skin
  • easily damaged/bruised skin that heals slowly
  • Wa'al....thinning hair on many areas, but the chin got the leftovers...... Skin definitely wrinkled and fragile....bruising..... Move over, Rover......
  • hard, calcified lumps in the skin
  • In all seriousness, I had these and until this moment did not realize they may have been due to the Cushing's. Although just a slight hyperbole, I told some friends I thought I'd had at least a zillion pop up for me to scrape off after my surgery. For months....and months....

  • susceptibility to infections, especially of the skin and urinary tract (check)
  • diabetes, pancreatitis, seizures (not yet, thankfully)
  • Usually, increased water intake and urination or changes in the coat prompt an owner to have his dog evaluated by a veterinarian, as dogs with Cushing's seldom appear suddenly and dramatically ill.

    I wish my owner had noticed. I suspect I'd been diagnosed much faster by the vet....

    An estimated 80 percent to 85 percent of dogs with Cushing's have been shown to have increased water consumption, drinking from two to 10 times normal amounts (normal is considered 1 ounce of water per pound of body weight per day). Also:

  • Eighty-five percent-100 percent have skin and coat changes.
  • Eighty percent-90 percent show increased appetites.
  • Ninety percent-95 percent have a pot-bellied appearance.
  • Considered a disease of middle and old age, Cushing's typically appears in the form of symptoms sometime after 6 or 7 years of age. It is estimated that most dogs display some symptom(s) of the disease for one to six years before Cushing's is suspected and diagnosed. Certainly, it is harder to ignore a dog that urinates throughout the house or a dog who is balding than it is to overlook an older dog who is gradually slowing down on walks.
    Oh, bless ' takes a long time for them, too. Let's see, that's 42-49 doggie-to-human years. I feel for ya, Sheila...

    Adding to this problem is the difficulty in diagnosing the disease. Veterinarians use at least four or five different tests to try to diagnose the disease, because not one test accurately diagnoses Cushing's in all cases. In fact, it is very unusual to get a definitive diagnosis of Cushing's disease without running several of the tests.
    DITTO! DITTO! DITTO!! DOUBLE DITTO!! (How in the heck do they do a UFC on a dog? )

    I don't have the space here to elaborate on these tests, but your veterinarian may have talked to you about some of them. The tests are very important in distinguishing the source of the excess hormone production, which could be either the pituitary gland (in the brain) or the adrenal glands (located near the kidneys). Each type of Cushing's disease is treated differently.

    Hey, Doc Gordon...wanna do a blog on "survive the journey: canine trails...." or sumthin' similar?

    Once a pet has been definitively diagnosed, treatments are available to control the excess hormone production. Consistent dosing and drug monitoring are very important. Although Cushing's disease can be expensive to diagnose and a little
    costly to control, Sheila should be able to live a long and high-quality life.
    No transsphenoidal surgery for Sheila, eh? How come there aren't any good drugs for us? (Canine transsphenoidal that would take one long nose-picker endoscope.)



    1. OMG Robin, you had me laughing like crazy! I think Dr. Gordon has been following us all up our steps!!! ROTFLMAO!!!!

    2. Thanks Robin - good out take on this - and great sense of humor. If you can't laugh about this, what the hell can you do?

    3. Oh, y'all...I'm glad you saw the humor, too. I got so tickled and couldn't help myself!

    4. Well, Sheila might be a pretty lucky dog if she gets a diagnosis! But how do they know the drugs are affective for the dogs, Sheila can't tell them how she feels.
      And since Dr. Gordon seems to have a take on the complexity of the disease, maybe he'd like to help the humans now!

    5. I have a dog with Cushing's - she was diagnosed about 20 months ago and is going fantastically well on treatment.

      I think with Cushing's that this is one area where the dogs have it good (better anyway) - more likely to be suspected and diagnosed (because its more common) and the treatments seem to be much more satisfactory although veterinary competence in treating the condition is, er, highly variable shall we say!

      If the treatment is well managed a Cushing's dog will live out its normal life-span with a good quality of life and some even seem to live to a particularly ripe old age. The damage done by Cushing's in dogs also seems to be more reversible than it is in humans.

      I'm one of the moderators at If you are interested in Cushing's in dogs drop in and have a look around.

    6. Very good read. Thanks for the post.

    7. This comment has been removed by a blog administrator.

    8. Thanks! I am much encouraged by the support and knowledge, and hope that my dog will be able to live a quality life with good care!

    9. That went right over your head, eh, anonymous?



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