CUSHING’S DISEASE IN DOGS: SYMPTOMPS AND TREATMENT
WHAT IS CUSHING’S DISEASE IN DOGS?
Cushing's disease (Cushing’s syndrome) is a condition in dogs caused by excessive production of adrenal hormones, mainly cortisol1. It typically results in an increase in appetite, water consumption and urination. Other common signs may include lethargy, poor skin and coat health, bloated belly and persistent bladder infections2.
CUSHING'S DISEASE FOR DOGS: SYMPTOMS
An increase in cortisol levels leads to an increase in appetite and food intake. As a result, excess fat may build up within the abdominal organs. In combination with reduced activity and weakening of the abdominal muscles, this may cause the belly of the dog to become bloated. Cushing’s also entails skin and coat health issues as well as frequent urination and bladder infections2.
The most frequent symptoms are3:
- Increased appetite
- Pot-bellied abdomen
- Increased thirst
- Frequent urination
- Persistent bladder infections
- Hair thinning and hair loss
- Skin thinning resulting in bruising
- White scaly skin patches
- Skin infections
- Constant panting
The symptoms may start gradually, but intensify to the point of causing discomfort3.
CUSHING’S TYPES AND CAUSES
There are three causes of Cushing’s: (1) pituitary tumor, (2) adrenal tumor and (3) prolonged intake of steroids1.
Pituitary dependent causes are the most common ones, affecting 85-90% of all dogs with Cushing’s. A pituitary gland tumor causes the pituitary gland to overproduce the hormone ACTH, which in turn stimulates the adrenal glands to overproduce some hormones, including cortisol2.
Adrenal dependent causes are the second most common ones, affecting 10-15% of the diagnosed dogs. An adrenal gland tumor causes the adrenal glands to overproduce adrenal hormones, including cortisol2.
The third cause is a fairly rare one and happens when the dog has been given steroids for a long period of time to treat another condition2. This type of Cushing’s has been given a few names: Iatrogenic Cushing’s, Alopecia X or Pseudo-Cushing’s. It typically occurs in young dogs (ages 1 to 5) with plush coats, such as Pomeranians, Poodles, Samoyeds, Alaskan Malamutes, and Siberian Huskies6.
TREATMENT FOR CUSHING'S DISEASE IN DOGS
It is important to determine what is the cause of the Cushing’s disease as the treatment will depend on the cause. This requires taking your dog to the Vet for testing. Tests include ACTH stimulation test, low-dose dexamethasone suppression (LDDS) test, endogenous ACTH levels test, a high-dose dexamethasone suppression (HDDS) test, a urine cortisol-creatinine ratio test and abdominal ultrasound examination2.
Medications are the best treatment option for dogs with Cushing’s syndrome caused by pituitary gland tumors1, as surgery is not performed on these tumors4. If the tumor is small and the secretion of cortisol by the adrenal glands can be managed with medications, the dog will continue to live fairly normally as long as it takes the medication for Cushing’s. If the tumor grows and affects the brain, causing neurological signs to appear, the prognosis is less favorable2.
The prognosis and treatment of Cushing’s disease caused by adrenal gland tumors depend on the tumor. If the tumor is benign, a successful surgical removal of the tumor will typically cure the dog. If the adrenal tumor is malignant, however, the prognosis is poor. When (1) a surgical operation is not possible due to other conditions or old age or (2) the tumor spreads beyond the adrenal glands, medications remain the only viable treatment option1.
Unless the tumor causing the Cushing’s disease can be removed operatively (as in the case with small adrenal tumors), there is no cure. When the tumor is benign/small, however, control is possible through lifelong administering of medications2.
The most popular medications for Cushing's disease in dogs include trilostane (brand name Vetoryl®) and mitotane (brand name Lysodren®). Selegiline hydrochloride (brand name Anipryl®), and ketoconazole (brand name Nizoral®) are also used as medications for Cushing's in dogs, although they are not considered as effective as trilostane or mitotane2. As with all medications, there are some risks with these too (including damage of the adrenal gland, causing Addison disease - a condition in which the adrenals cannot produce enough cortisol)4.
If the Cushing’s is caused by a prolonged administration of steroids, the steroid should be gradually discontinued under the supervision of the Vet. It is likely that the steroids have negatively affected the adrenal glands, necessitating hormone replacement therapy. Unfortunately, the discontinuation of the steroids may cause the reappearance of the original condition they were treating2.
ARE THERE NATURAL REMEDIES FOR CUSHING'S DISEASE IN DOGS?
Because the diagnosis and treatment of Cushing’s disease can be inconclusive and expensive, while the treatment can be fraught with adverse side effects, many caregivers turn to alternative or complementary therapies. According to an article by CJ Puotinen and Mary Straus, published in the Whole Dog Journal: “Holistic vets are likely to try natural treatments first and turn to symptom-suppressing conventional therapies later instead of the other way around”6.
There are many natural supplements and ingredients sold to help the dogs Cushing's. My research shows that the combination of lignans and melatonin is the only one that has more solid, scientific backing.
A study by Dr. Kelly Fecteau and Veterinary Doctors Hugo Eiler and Jack Oliver recommends lignans and melatonin for Cushing’s disease in dogs4,7. Lignans and melatonin work synergistically to downregulate estrogen production and lower heightened cortisol levels. Lignans and Melatonin are sold as supplements and can help in borderline and mild cases of Cushing’s disease. In more severe cases they may be able to reduce the dog’s dependence on, or dosage of, stronger prescription medications that carry the risk of more serious side effects (damage of the adrenals, Addison disease)5.
While there is only one type of supplemental melatonin, there are two types of lignans: HMR lignans and SDG lignans. The SDG lignans are extracted from flaxseed hulls and can be called flaxseed lignans or flax hull lignans. The HMR lignans are extracted from Norwegian spruce tree. Dogs absorb HMR lignans faster and more completely than SDG lignans3.
It is recommended to give daily 1-2mg of lignans/ pound of dog weight. For example, for a 15lbs dog, give between 15 and 30mg of lignans per day. Lignans are safe, so doses don’t have to be exact4. Because lignans are expensive, many manufacturers would rather include lower amounts, however.
Pet Weight (lbs.)
Lignans / day
Melatonin / day
up to 30 lbs.
31 - 60 lbs.
61 - 90 lbs.
91 lbs. or more
ADDITIONAL BENEFITS OF MELATONIN AND LIGNANS
Melatonin helps dogs in a number of ways - helps regulate hormones, maintains the circadian (sleep-wake) cycle, provides antioxidant benefits and helps regrow fur3. It is recommended to give melatonin in the evening as it may make the dog sleepy.
Lignans have been associated with many positive health effects, whether it’s making your dog’s gut, bones, skin, and hair healthier, or helping with more serious matters like diabetes, cardiovascular and immunity issues in addition to helping with Cushing’s disease8.
Both lignans and melatonin can be given to healthy dogs for overall health benefits.
IS THERE SOMETHING ELSE I CAN GIVE MY DOG TO HELP WITH SKIN AND COAT HEALTH?
The B-vitamin Biotin is an excellent choice when it comes to supporting thinning hair and hair loss. “We find biotin to be very helpful for hair disorders,” says Dr. Wilma Bergfeld. It’s primarily used for alopecia, the medical word for hair loss. “Biotin improves hair growth and helps with inflammation,” she says. “The hair follicle, the skin and the nails all benefit.”9
Omega-3 fatty acids: Omega-3 naturally occurs in foods such as shellfish and flaxseed, but you can also find it in supplements like fish oil. It’s critical to cell health and is thought to make the scalp and hair healthier10.
If you are on a budget and prefer to buy just one of them, Biotin may be more suitable for dogs with Cushing's due to its hair growth support.
DR OSCAR HMR LIGNANS + MELATONIN + BIOTIN FOR DOGS
One can buy lignans, melatonin and biotin in separate supplements but there were no supplements that would combine them in one product. This is what gave birth do Dr. Oscar HMR Lignans + Melatonin for Dogs with Biotin. You can read more about it and order it via this link.
WHAT TO DO IF YOU CONSIDER THAT YOUR DOG HAS CUSHINGS?
If you observe some of the symptoms of Cushing’s in your dog and suspect that it may have the disease, I suggest that you take your dog to the Vet for an examination and testing. Meanwhile, I personally would give the dog a HMR Lignans + Melatonin + Biotin supplement to downregulate the estrogen and cortisol levels to provide some relief to your dog and promote skin and coat health. Given alongside Vet prescribed meds, Melatonin and Lignans can also reduce the dog’s dependence on, or dosage of, stronger prescription medications that carry the risk of more serious side effects5 and Biotin can help with skin and coat health.
1Available at: https://pets.webmd.com/dogs/cushings-syndrome-dogs#1, Accessed Feb 24, 2021
2Available at: https://vcahospitals.com/know-your-pet/cushings-disease-in-dogs, Accessed Feb 24, 2021
3Available at: https://whiteoakvet.com/natural-dog-cushings-disease-treatments/, Accessed Feb 24, 2021
4Available at: https://www.lignans.net/lignansfordogs/, Accessed Feb 24, 2021
5Available at: https://www.cushaway.com/faq/, Accessed Feb 24, 2021
6Available at: http://www.dogaware.com/articles/wdjcushings.html, Accessed Feb 25, 2021
7Available at: https://vetmed.tennessee.edu/wp-content/uploads/sites/4/Melatonin-lignan-article-2011.pdf, Accessed Feb 25, 2021
8Available at: https://bit.ly/2ZQI14C, Accessed Feb 25, 2021
9Available at: https://health.clevelandclinic.org/is-biotin-as-good-as-advertised-for-your-hair-loss/, Accessed Feb 25, 2021
10Available at: https://health.clevelandclinic.org/the-best-vitamins-supplements-and-products-for-healthier-hair/, Accessed Feb 25, 2021