Cushing's syndrome in cats symptoms. Hormonal failure in cats: a list of possible diseases leading to a violation (symptoms, treatment)

Cushing's syndrome is an endocrine disease caused by impaired function of the combined dysfunction of the pituitary and adrenal glands and the system of their relationship with the predominance of hypercortisolism. The disease is more common in aging animals, and since dogs and cats live longer than other species, the pathology occurs more often in them.

Etiology. Hypercortisolism - excessive secretion (increased synthesis of cortisol and hydrocortisone) occurs due to damage to the hypothalamus and pituitary gland or directly to the adrenal cortex. In the vast majority of cases, spontaneous hypercortisolism in dogs occurs as a result of hyperstimulation of the adrenal cortex due to excessive production of ACTH in the pituitary gland, and this occurs with pituitary adenoma and excessive ACTH. In addition, the cause of hypercortisolism can be a hormonally active tumor of the adrenal cortex - glucosteroma: a benign tumor is small, a malignant tumor is large, thus increasing the amount of glandular tissue that produces hormones.

Pathogenesis. The synthesis of glucocorticoids (cortisol, hydrocortisone, etc.) by the adrenal cortex occurs under the control of the hypothalamus and adrenocorticotropic hormone (ACTH) of the pituitary gland. Corticoliberin. synthesized in the hypothalamus, stimulates the formation and release of ACTH. Increased synthesis of ACTH leads to bilateral hyperplasia of the adrenal cortex, an increase in the synthesis of corticosteroids, primarily cortisol. Cortisol itself affects the formation of ACTH and corticoliberin. With hypertrophy or adenoma of the hypothalamus or pituitary gland, the secretion of corticoliberin and ACTH increases, and the concentration of cortisol in the blood increases. With adenoma (glucosteroma) of a benign or malignant adrenal cortex, the secretion of glucocorticoids also increases. Hypersecretion of cortisol is accompanied by an increase in insulin secretion, stimulation of glycogenesis with excessive formation of adipose tissue. Violation of fat metabolism is considered one of the main pathogenetic links of hypercortisolism and, in particular, glucosteroma. There comes a violation of protein metabolism, nutrition of the skin, its defeat. With Cushing's syndrome, deep dystrophic processes develop in the bone tissue, ending in osteoporosis.

Glucocorticoids inhibit the processes of hydroxylation of calciferol, converting it into active forms of vitamin D, which leads to a decrease in the absorption of calcium from feed. At the same time, there is an increase in urinary excretion of calcium, a decrease in the content of organic matter in bone tissue (collagen, mucopolysaccharides), a decrease in alkaline phosphatase activity, and poor saturation of the skeleton with calcium and other mineral elements. Osteomalacia and osteoporosis develop. Violation of calcium excretion by the kidneys can lead to nephrocalcinosis, the formation of kidney stones and the appearance of pyelonephritis. Glucocorticoids contribute to the retention of sodium in the body and the acceleration of potassium excretion, the development of hypokalemia and muscle weakness.

Symptoms. The leading place in the symptoms of the disease is occupied by obesity or redistribution of fat, skin lesions and muscle weakness. In most cases, the disease manifests itself in excessive deposition of adipose tissue in certain areas of the body - in the subcutaneous layer of the abdomen, shoulder girdle, sacro-lumbar region, and thighs. The skin is dry, thinned and easily injured, hyperpigmented, cold to the touch, pyoderma (pustular lesions) is observed in the corners of the lips and other areas, and bedsores in the places of protrusions. The hairline is sparse, with patches of alopecia. Muscle tone is weakened (myopathy). Sick animals show signs of osteoporosis (curvature of the limbs, spine, fracture of the ribs, tubular bones, etc.). The general condition is depressive, the animals are indifferent to the environment. X-rays reveal osteoporosis of the ribs, tubular bones.

diagnostic criteria. Selective sites of fat deposition. Characteristic changes in the skin and hairline (thinning, dryness, hyperpigmentation, cold snap, alopecia, etc.). Muscle weakness (myopathy). Signs of osteodystrophy with a predominance of symptoms of osteoporosis, the presence of bone fractures.

Laboratory in the blood establish lymphocytopenia, eosinopenia, neutrophilic leukocytosis, hypokalemia (below 16 mg / 100 ml, 4.10 mmol / l). Confirmation of the diagnosis is an increase in the blood content of ACTH and corticosteroids (cortisol). Find characteristic pathomorphological changes in the hypothalamus, pituitary gland and adrenal cortex. On radiographs of the bone, lesions characteristic of osteomalacia and osteoporosis are established. It is possible to use the results of an adrenal scan.

In differential diagnosis, hypocorticism and other endocrine diseases are meant.

Treatment. Treatment is aimed at normalizing the production of ACTH and cortisol, restoring metabolic processes in bone tissue, correcting the function of the cardiovascular system, kidneys and other organs. Normalization of the production of ACTH and cortisol is achieved by removing tumors in the hypothalamus, pituitary gland or adrenal glands and using the drug method.

The drug method of treatment includes the use of drugs that suppress the secretion of ACTH and cortisol: chloditan (mitotane), bromocreptine, cyproheptadine hydrochloride, etc.

Chloditan (mitotane) is an inhibitor of the function of the adrenal cortex. Suppresses the secretion of corticosteroids, blocks the steroid action of ACTH, can cause destructive changes in normal and tumor tissue of the adrenal glands. Give inside to dogs at a dose of 25 mg / kg 2-3 times a day for 2-3 weeks until cortisol in the blood decreases to a level of 50-100 nmol / l. Then switch to a dose of 50 mg / kg (once a week). Monitor the health of the animal. The drug is produced in tablets of 0.5 g.

Bromokreptin (parlodel, bromergon, pravidel) - a synthetic activator of defomin receptors, suppresses the secretion of the hormone of the anterior pituitary gland prolactin, reduces the secretion of ACTH, suppresses physiological lactation. The drug for Cushing's syndrome is given to dogs and cats at first in a daily dose (approximately 0.1 mg / kg of body weight), then the dose is halved and after 2-3 weeks a maintenance therapeutic dose of 0.05 mg / kg is prescribed. The course of treatment is 6-8 weeks.

Cyproheptadine hydrochloride (peritol, adekin, cyprodine, etc.) has antihistamine (blockade of H[-receptors), antiserotonin (blockade of S-receptors) and anticholinergic (blockade of M-cholinergic receptors) action. Inhibits the biosynthesis of somatotropin and ACTH, enhances the secretion of the pancreatic gland. Used for many allergic reactions, Cushing's syndrome, pancreatitis. Produced in the form of tablets of 4 mg, syrup in vials of 100 ml (in 1 ml of the drug 0.4 mg). Assign inside to horses, cattle at a dose of 0.04-0.06 mg / kg, sheep, goats and pigs - 0.07-0.08 mg / kg, dogs - 0.09-0.1 mg / kg 3 times a day. day. The course of treatment is 2-4 weeks.

Ketoconazole (oranozol, nizoral, fungoral) is an antimycotic drug (Krka, Slovenia). Produced in tablets of 200 mg. It is indicated for Cushing's syndrome in dogs due to the fact that the disease is accompanied by skin lesions, possibly of fungal origin. Dogs are administered orally at a dose of 10 mg/kg during the first week, 20 mg/kg during the second week, 30 mg/kg during the third week 2 times a day.

With pituitary adenoma, which provokes Cushing's syndrome in dogs, N. Grange (2005), in addition to the use of dexamethasone and imitotone, used the method of radiotherapy using an electronic accelerator; total dose 36 Gy.

Normalization of bone metabolism is achieved to a certain extent by improving the absorption of calcium from the intestine, fixing it with a bone matrix, and restoring the organic component of bone tissue.

Derivatives of vitamin D3, in particular oksidevit or a-DrTeBa preparation, or fat- or water-soluble vitamin D preparations, contribute to an increase in calcium absorption. vitamin D - orally at a dose of 500 IU / kg of body weight.

Perhaps the use of drugs containing fluorotridine, osein. Tridin in the form of tablets is manufactured by Rotta-karm. One tablet contains 150 mg of calcium ions (in the form of calcium gluconate and citrate), 5 mg of fluoride ions (in the form of L-glutamine monofluorophosphate). The drug is designed to compensate for calcium deficiency and fix it in the bone tissue. In medicine, it is indicated for primary osteoporosis. Contraindicated in osteomalacia, impaired renal function, during growth, pregnancy, lactation, hypercalcemia and hypercalciuria.

Osein (Corberon) is a drug, 1 tablet of which contains 20 mg of sodium fluoride. In medicine, it is prescribed orally to normalize bone metabolism, correct the imbalance between the growth and resorption of bone tissue, and reduce bone fragility. Used in individual doses for a long time. Contraindications are the same as for tridine. Supplied from Germany.

Surgical treatment consists in removing a tumor of the pituitary or hypothalamus, one or even two affected adrenal glands. In these cases, postoperative treatment with the means indicated above is carried out.

Cushing's syndrome in animals is called an endocrine pathology, which develops as a result of a violation of the combined activity of the pituitary and adrenal glands. This leads to increased production of adrenal hormones and the development of hypercortisolism. Most often, aging dogs and cats face the disease.

The reasons

As a rule, increased synthesis of adrenal hormones (cortisol and hydrocortisone) is associated with damage to brain structures such as the hypothalamus or pituitary gland. Also, the cause of the formation of this syndrome may be the pathology of the adrenal cortex itself. We are talking, for example, about hormone-dependent tumors of this organ.

Disease pathogenesis

Normally, the synthesis of cortisol and hydrocortisone is regulated by the hypothalamus and pituitary adrenocorticotropic hormone. The hypothalamus produces corticoliberin. This substance is responsible for stimulating the formation and release of adrenocorticotropic hormone. As a result of an increase in the synthesis of this hormone, a bilateral growth of the adrenal cortex develops. This is manifested by an increase in the production of corticosteroids. With an increase in the level of cortisol in the blood, there is an increase in insulin production and excessive formation of adipose tissue. Therefore, we can assume that the development of Cushing's syndrome in dogs and cats is based on a disorder of fat metabolism. There is also damage to the skin and bone apparatus. This is accompanied by the development of osteoporosis.

An increase in the content of corticosteroids leads to an acceleration of the formation of active forms of vitamin D. As a result, the absorption of calcium from feed is reduced. In this case, the bones are poorly saturated with calcium and other minerals. This leads to the development of osteomalacia and osteoporosis. It is also possible to form calcium kidney stones. This is due to a violation of its excretion from the body. Also at the heart of the development of this syndrome is a decrease in potassium levels and subsequent muscle weakness.

Clinical picture of the disease

In most cases, Cushing's syndrome in animals is manifested by obesity, skin pathology and muscle weakness. As a rule, the localization of fat deposits are the thighs, the subcutaneous layer of the abdomen, the shoulder girdle, the sacro-lumbar region. There is thinning and hyperpigmentation of the skin. It is also possible her pustular lesion. The weakening of muscle tone is characteristic. In sick dogs and cats, curved limbs and spine are detected. The tendency to frequent fractures of the ribs and tubular bones is also determined. The radiographic sign of this pathology is the phenomenon of osteoporosis.

Diagnostics

A blood test reveals a decrease in the level of lymphocytes and eosinophils. The potassium content is also reduced. To confirm the diagnosis, it is planned to study the level of corticosteroids and adrenocorticotropic hormone.

Treatment of the disease

The main goal of treatment is to optimize the production of adrenal and pituitary hormones. Hormone-dependent tumors are subject to removal. As drug therapy, drugs are used that suppress the secretion of cortisol and adrenocorticotropic hormone. We are talking about bromocriptine, hydrochloride, etc.

To optimize bone metabolism, calcium absorption from the intestinal wall is improved. For this, derivatives of vitamin D3 (oxidevit) are used. To increase the level of calcium in the bone apparatus, drugs with fluorotridine and osein are prescribed. The main indication for their use is osteoporosis.

Hormonal disorders pose a serious danger to the life and health of the animal. It is to such violations that Cushing's syndrome in cats belongs. Although dogs are more likely to suffer from this ailment, it sometimes affects members of the feline family. Hyperadrenocorticism (Cushing's syndrome) is much more severe and more difficult to treat than in dogs or other pets.

What is Cushing's Syndrome?

Cushing's syndrome is a condition in which the adrenal glands produce too much of the stress hormone cortisol. Its excessive concentration leads to such serious consequences as: weakness, apathy, aggression, partial hair loss, changes in skin color and structure, and death. This disease develops slowly, and symptoms appear rather late. Curing a sick cat is very difficult, but possible.

Cats with Cushing's syndrome are shedding hair.

What causes this syndrome

Hyperadrenocorticism can be caused by excessive use of drugs containing corticosteroids. Their use in the form of tablets and injections, for a long time, is very dangerous for the health of the animal. Artificially administered hormone cortisol quickly accumulates in the tissues, which leads to disruption of the entire body.

Important. You should never uncontrollably use hormonal drugs (ointments, injections). All medicines must be prescribed by a veterinarian, and only when absolutely necessary.

natural causes

Most often, middle-aged and elderly animals suffer from this disease. A pituitary tumor leads to the appearance of the disease, as a result of which a large amount of ACTH (adrenocorticotropic hormone) is formed. It, in turn, stimulates the adrenal glands, which produce cortisol.

Cushing's syndrome can develop due to neoplasms on the adrenal glands.

The natural cause includes oncological or benign neoplasms on the adrenal cortex, which causes increased production of glucocorticoids. The adrenal glands, however, do not respond to the signal from the pituitary gland and continue to produce large amounts of corticosteroid hormones.

How does Cushing's syndrome manifest?

At the very beginning of the disease, it is difficult to notice any changes in the cat's body. Symptoms are either mild or absent altogether.

When the disease develops sufficiently, the following symptoms may be observed:

• increased appetite;
• constant strong thirst;
• frequent urination;
• weakness and apathy;
• an increase in the abdomen and loss of muscle mass (dystrophy);
• symmetrical hair loss on both sides;
• unmotivated aggression;
• the skin becomes very thin and bursts at the slightest damage;
• the tips of the ears are bent inward.

Due to the fragility of the skin, any scratches instantly turn into deep, non-healing ulcers. Usually, hyperadrenocorticism in cats is accompanied by diabetes mellitus. After all, a large amount of cortisol in the body interferes with the natural production of insulin.

How the disease is diagnosed

Symptoms of the disease are very easy to confuse with manifestations of diabetes mellitus or other hormonal or neurological disorders. At the slightest suspicion, you should immediately contact your veterinarian.

An ACTH test can measure the level of the hormone cortisol.

To correctly diagnose, you will have to pass several tests. First of all, these are biochemical and general blood tests and urinalysis. In the presence of hyperadrenocorticism, an increase in the number of leukocytes will be observed in the general blood test, and biochemistry will show low calcium, high cholesterol and glucose, increased levels of liver enzymes and phosphatase. Based on the analysis of urine, the ratio of creatinine to cortisol is examined.

Experts recommend conducting an ACTH test, which measures the level of the hormone cortisol in the blood before and after artificial administration of a synthetic form of ACTH. As well as a test for the introduction of Dexamethasone (an analogue of cortisol), to see how the adrenal glands react to it. Such a test allows you to determine what causes Cushing's syndrome - a violation of the adrenal glands or pathology of the pituitary gland.

Useful information about the state of health of the animal is provided by ultrasound and x-ray examination. They allow you to see the presence of tumors, the size and changes of the adrenal glands.

Methods and treatment regimens

There are several ways to treat Cushing's syndrome. For example, if it is caused by taking a large number of hormonal drugs, then a gradual decrease in their dose is practiced, up to a complete cessation.

Drug therapy is used to suppress the production of cortisol. In this case, the specialist may prescribe drugs such as Trilostan or Metyrapone in tablet form, at least 1-2 times a day. The dosage and course of treatment is selected individually, depending on the severity of the disease.

Attention. It is necessary to give a cat such medicines very carefully, and only under the supervision of a doctor.

If a cat has a tumor of the adrenal glands, then surgery may be required to remove them. True, after such a procedure, the animal will need lifelong hormone therapy.

Pathology of the pituitary gland is also treated surgically. This will require the most complicated microsurgical operation to remove the pituitary gland, which is carried out only in high-class specialized clinics. Less commonly, a pituitary tumor is treated with chemotherapy, but the prognosis in this case is not the best.

If Cushing's syndrome is due to a tumor of the adrenal glands, they are removed surgically.

It is impossible to completely cure Cushing's syndrome in a cat, because this is a rather serious disease, often caused by oncological tumors. But there are many cases when competent treatment can extend the life of the animal for several years. It is important that the quality of life does not suffer.

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), which occurs when the adrenal glands produce excessive production of the hormone cortisol (located in 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 Strong smell that it is almost impossible to be near her.

In severe cases, this disease can lead to the death of a pet. Cause lethal outcome lies in the wear and tear of the organism, 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 possible reasons development of the disease until their complete clarification is still far away. 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 drugs 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, it happens surgical intervention, which 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 exercise instantly cause extreme 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 involved in operations the best way treatment remains drug therapy.

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. Generally.

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 was also found that the breeds most prone to the disease are dachshund, poodle, beagle, boxer, German Shepherd, basset hound and the whole 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

ETIOLOGY
- iatrogenic: with abuse and overdose of corticoids;
- hyperproduction of glucocorticoids due to causes:
- pituitary: hyperplasia or tumors of the anterior pituitary gland or hyperproduction of ACTH, which immediately begins to act on the adrenal cortex.
- hyperplasia or tumor of the adrenal glands: unilateral or (albeit rarely) bilateral adrenocortical tumor is stated in 10-20% of cases.

PATHOGENESIS
Increased synthesis or introduction of corticoids into the blood causes a strong imbalance of hormones: adrenal gland-hypothalamus-pituitary gland, which leads to severe mineral metabolism disorders, which manifest themselves in the form of: polyuropolydipsia, amyotrophy, abdominal distension and obesity, skin elasticity disorders.

PECULIARITIES
Breed Predisposition: Poodles, Boxers and Dachshunds are most predisposed.

Clinic:
- alopecia, especially on the body;
- the skin becomes thin, loses elasticity (but the eyeballs do not sink, which is usually observed with dehydration);
- the skin becomes oily, comedones appear;
- pigmentation: diffuse or patchy;
- Tendency to cutaneous calcification;
- polyuro-polydipsia;
- polyphagy;
- amyotrophy and muscle weakness;
- saggy (flabby abdomen), injection of peripheral veins;
- obesity, accompanied by eversion of the elbow joints.

Summary clinic:
1. Seborrhea oleosis;
2. Abnormal behavior, aggression, change in habits;
3. Abnormal size of the testis (testicles) of the scrotum (scrotum);
4. Alopecia (hair loss);
5. Anisocoria (difference in the shape and / or size of the pupils of the eyes);
6. Anorexia (lack of appetite, refusal to eat);
7. Anestrus, no reproductive cycle, inparent estrus;
8. Ataxia;
9. Atrophy in the head, face, jaws, tongue;
10. Atrophy of the hind limbs;
11. Atrophy of the forelimbs;
12. Back atrophy;
13. Quick fatigue during physical. load;
14. Tousled wool;
15. Generalized weakness;
16. Generalized lameness, stiffness of movements;
17. Hepatosplenomegaly, splenomegaly, hepatomegaly;
18. Muscle hypertension, myotonia; At
19. Hyperesthesia, hypersensitivity;
20. Purulent discharge from the skin;
21. Dysmetria;
22. Disorientation, memory loss;
23. Dyspnoe (difficulty breathing, with open mouth);
24. Distension of the abdomen;
25. Flabbiness of head, neck, ears;
26. Hare bouncing;
27. Intra-abdominal masses;
28. Infertility of females, unproductive jumps;
29. Male infertility;
30. Exhaustion, cachexia, neglect;
31. Skin pain;
32. Skin hyperpigmentation;
33. Skin erythema, inflammation, redness, hyperemia;
34. Skin crusts, crusts;
35. Skin papules, Papulosis;
36. Skin pustules, Pustulosis;
37. Skin ulcers, erosions, excoriations;
38. Coma, stupor;
39. Corneal ulcer, erosion;
40. Mydriasis, dilated pupil;
41. Miosis, meiosis, constriction (narrowing) of the pupil;
42. Overweight, obesity;
43. Head pressing;
44. Fainting, syncope, convulsions, collapse;
45. Edema, clouding of the cornea (roots);
46. ​​Petechiae, ecchymosis;
47. Polydipsia, increased thirst;
48. Polyuria, increased volume of urination;
49. Polyphagia, extremely increased appetite;
50. Loss of body weight;
51. Propulsion, inability to rise;
52. Pruritus, scratching the skin;
53. Ptosis of eyelids;
54. Swelling of the skin and subcutaneous tissue;
55. Swelling in the vulva and clitoris;
56. Weak libido or erection;
57. Blindness;
58. Strabismus, strabismus;
59. Dry skin and coat;
60. Thin, atrophied skin;
61. Increased frequency of respiratory movements, polypnea, tachypnea, hyperpnea;
62. Oppression (depression, lethargy);
63. Urinalysis: Glucosuria;
64. Walking in a circle;
65. Cold skin, ears, limbs;
66. Lameness of the hind limbs;
67. Lameness of forelimbs;
68. Scaly skin;
69. Enophthalmos.

Diagnosis:
- computed tomography is used in some cases to establish the exact location of adrenal dysfunction;
- analysis of urine creatinine (urinolysis) ACTH hormone-stimulating tests.
- ultrasonography to establish adrenocortical carcinoma;
- measurement of cortisol in the urine (urinolysis).

TREATMENT
- in iatrogenic Cushing's syndrome: stop inappropriate corticotherapy; replace it with:
Hydrocortison 0.2-0.5 mg/kg/24 hours: in the morning, for 6-8 months;
- in case of tumors and hyperplasia, it is necessary to use drugs that act on the pituitary and adrenal glands:
- Mitotane: with pituitary-dependent hyperadrenocorticism;
- 1-deprenyl (anipryl): for pituitary-dependent Cushing's syndrome.

DEVELOPMENT: prolonged, chronified.
Often complications are associated with Diabetus mellitus, secondary pyoderma and skin calcification; myotonia is a rare complication, mainly in older dogs.

FORECAST: in case of iatrogenic etiology - favorable; in the presence of tumors and hyperplasia of the anterior part of the pituitary gland or adrenal gland - reserved to unfavorable.