Cushing's Disease in Dogs

5 min read

Treatment for Cushing's Disease in Dogs


Treatment for Cushing’s disease that develops due to corticosteroid medication overuse is fairly straightforward. Dogs should be slowly weaned off of these medications while under a veterinarian’s care. Removing these medications too quickly can lead to a life-threatening condition called an Addisonian crisis.


Dogs with mild symptoms associated with pituitary-dependent Cushing’s disease may not need immediate treatment but should be closely monitored to determine when it would be beneficial. In general, treatment should start when a dog develops symptoms that are potentially dangerous and/or troublesome to the pet or owner.


These might include high blood pressure, an increased urine protein:creatinine ratio (evidence of kidney damage), recurrent infections, urinary accidents, having to get up in the middle of the night to urinate, exercise intolerance and excessive panting.


Once the decision to treat a dog’s pituitary-dependent Cushing’s disease has been reached, a veterinarian will likely prescribe trilostane (Vetoryl). This drug can have serious side effects, so dogs taking it should be closely monitored. Trilostane may interact with other common dog medications, so it is important to discuss all medications and supplements with your veterinarian.


When a patient is diagnosed with an adrenal tumor, chest radiographs and possibly a CT scan or MRI should be taken to examine the body for any possible metastatic spread of the disease. If no metastases are seen, the dog is often given a medication (trilostane) for a few months to shrink the tumor, followed by surgery to remove it.


Living with and Managing Cushing's Disease


If your dog is being treated with trilostane for Cushing’s disease, you need to be prepared to continue treatment for the life of your pet. You will need to be observant for any adverse reactions to these powerful medications.


Typical signs of an adverse reaction are lack of energy, weakness, lack of appetite, vomiting, diarrhea and sometimes difficulty walking. If any of these side effects do occur, you should contact your veterinarian immediately and discontinue medication under their supervision.


Because of the cost and risks associated with use of trilostane, it is often recommended to under-treat rather than over-treat your dog. It is imperative to closely monitor cortisol levels in the blood, as your dog can become very ill if the levels drop too low.


Your veterinarian will schedule regular follow-up visits to monitor for the adverse effects of trilostane and make sure that your dog continues to receive an appropriate dose. Schedules vary, but you should be prepared to see your veterinarian several times a year once the maintenance phase of therapy has been reached.


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