When To Put A Dog Down With Cushing’s Disease: (A Must Read)

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Cute labrador puppy asleep during examination at the veterinary

Cushing’s disease in dogs is commonly believed to be a terminal ailment. Now, this is a hard situation to face if your dog is suffering from the same. It becomes harder when you come to know that your beloved pet may not have much time to spend with you now.

You can make out that something is wrong when your pet starts drinking more water than usual and, consequently, urinates more often than before. Although these symptoms can also be of a kidney disorder or diabetes, they can also be of Cushing’s disease.

As a caring pet owner, you will instantly go for a diagnosis to treat Cushing’s disease for restoring your dog’s health and ensuring a better quality of life. When the prescribed treatment has stopped working effectively and all other options have been tried out, you seriously cannot see your dog in this suffering.

Thus, you ask, “Am I supposed to put down my pet suffering from this disease? Well, there is no specific time prescribed for euthanizing the different Cushing’s disease dog breeds on humane grounds. If the ailment is advanced, you may choose to decide.

Most owners prefer euthanizing when their dogs stop responding to the medication of the ailment. This is when the symptoms may begin to take a toll on your pet who can start feeling anxious. In short, the life of your pet starts to deteriorate.

To prevent further anxiety and suffering, a few owners euthanize their dogs. On the other hand, the rest of them choose to wait for some more days to take a caring decision of letting the dog live happily as far as possible.

So, are you and your family also thinking about when to put down your furred friend with this disease? Well, do not decide in haste. Who knows your dog can probably live well for the next two to three years? To decide, you need to know about the disease, how it can reach an advanced state, what are its medications, and what is the expected lifespan of the affected dog.

Overview of Cushing’s Disease

Sick dog with bandages lying on bed

Regarded as a lifelong condition, Cushing’s disorder occurs when the body of your dog starts producing excessive quantities of cortisol or cortisone, which is much more than what the body can handle.

As the adrenal glands produce this stress hormone, the disorder is often known as ‘hyperadrenocorticism.’ These small glands reside on each kidney.

Typically, the pituitary gland responds to stress by creating the AdrenoCorticoTropic Hormone (ACTH).  This kindles the adrenals to generate more stress hormones. In the state of Cushing’s, very high levels of the stress hormone tend to exist continually.

Due to the increased level of cortisol in the body, problems can crop up. In a healthy state, the adrenal glands perform some important functions such as regulating stress, blood pressure, glucose, body weight, tissue structure, and metabolism. So, when it loses its healthy state, a lot can go wrong quickly.

The disease strikes in one of the following three forms, according to the vets:

  • Pituitary-dependent: Here, the source of the disease is the pituitary gland existing at the brain’s bottom. In this form, a tumor is developed just above this gland due to which there is too much production of ACTH. This hormone then spreads throughout the body. After reaching the adrenal glands, it influences them to make more cortisol than usual. A pituitary tumor is a major cause, resulting in 80% to 85% of the cases.
  • Adrenal-dependent: Here, the source of the disease is the set of adrenal glands. A dog with Cushing’s disease in this form has a tumor in one or both of these glands due to which the glands overproduce cortisol. This form of Cushing’s disease accounts for the remaining 15% to 20% of the cases.
  • Iatrogenic: Here, the root cause is the intake of steroid medications for a long period. It is a rare form of Cushing’s disease in dogs.

What Are the Causes of Cushing’s Disease in Dogs?

Keeping the three forms of this disease in mind, following are the main causes:

  • Malfunctioning of the pituitary gland or adrenal glands
  • Reaction to corticosteroids (medicines) used for treating other ailments in dogs

In 80% of dogs hit by this ailment, the most common indicator of this dysfunction is a malignant tumor in the pituitary gland. Thus, it is a severe ailment that needs to be diagnosed and treated soon.

Which Dog Breeds Develop the Disease of Cushing’s?

The dogs that are highly susceptible to this disease are adult dogs, those that are six years old and above. Those having stress issues are at more risk.

The gender of a dog hardly affects this hormonal condition. However, the race does affect, as some breeds are more susceptible than others. Due to the malfunctioning of the pituitary, the Maltese Bichon, Poodles, Boston Terriers, Bobtails, and the Dachshunds may develop this condition.

Due to the improper functioning of the adrenal glands, the disease may develop in the Yorkshire terriers, Dinmonts and Dandie terriers, German Shepherds, and in the Dwarf Poodles.

Other dogs who may also be inclined are the Labrador Retriever, Boxer, Australian Shepherds, and Cocker Spaniels. A Cushing’s disease dog breed can be small or big, male or female, and can be young or old.

Yes, it is worth keeping in mind that dogs of any age, breed, size, and gender can suffer from Cushing’s ailment. Make sure to watch out the symptoms and consult your vet if there is any kind of abnormal behavior in your dog.

What Are the Cushing’s Signs and Symptoms?

The biggest impact of the chronic overproduction of stress hormones is on the immune system of your dog, which weakens. This can make the pet more vulnerable to other ailments and infections. It can even harm a few vital organs, compromising the pet’s overall health.

Before you let this happen, it is wise to know the common symptoms of Cushing’s disease. This will help you to take quick remedial actions. Following are the common clinical symptoms to check out in a dog with Cushing’s:

  • Polyuria or increased urination
  • Polydipsia or increased thirst
  • Increased panting
  • Skin issues
  • Swollen belly
  • Obesity
  • Weakness
  • Tiredness
  • Muscle weakness, loss of muscle mass
  • Increased hunger
  • Hair loss, poor quality of hair, baldness
  • Recurring infections
  • Neurologic changes in case of pituitary-dependent Cushing’s disease
  • Testicular atrophy or reproductive cycle mismatches in females

It is worth noticing that not all of these symptoms tend to develop or surface in the affected dog. Dogs with Cushing’s can even show just two of these symptoms, which you are more likely to attribute to other diseases such as hypothyroidism, canine diabetes, or a nervous disorder.

Many times, the tangible symptoms are often linked with the healthy aging of the dog. Thus, the presence of Cushing’s disease can go unnoticed in the early stage. As a result, it becomes tough to detect this ailment early.

However, early detection is indispensable for healthy recovery. Yes, it is possible to recover if this is done. Nevertheless, this is rare because the symptoms typically surface slowly and some years can pass for them to become visible as a whole. This makes it tough for you to find out what is happening.

Moreover, complications can exist, as not all dogs react in the same way to the boosted cortisol levels. Thus, the symptoms and their intensity are likely to differ from one dog to another.

Vet doctor visiting golden retriever dog at home

What Are the Final Stages of Cushing’s Disease in Dogs?

Obvious, intense, and multiple symptoms appear when a dog enters into the advanced or later stages of this condition. Following are these clinical symptoms:

  • Depression
  • Intolerance to exercises
  • Lethargy
  • Expanded liver or spleen
  • Meager hair coat
  • Cold ears, abdomen, and back
  • Extremely thinned urine
  • Extreme weight loss and unobvious thinness

Although pituitary tumors can be brought under control in most cases, they can transform into macroadenomas in some cases. These tumors are larger than 1cm due to which they are likely to put much pressure on the adjacent tissues. This can result in other neurological symptoms.

These are the most extreme cases. In such a situation, you will definitely work with your vet to retain your pet’s comfort as long as possible. This is also when you may want to know when to put the dog down. Fortunately, these are highly uncommon circumstances.

This is because the benign macroadenomas are removable via surgery. Even the malignant tumors are removable but a lot of complications are involved in it. Thus, most vets do not take this risk.

How Cushing’s Disease Is Diagnosed?

Diagnosing any form of this disease is not that easy. This is because the symptoms differ, are vague, and can be along with the symptoms of other disorders. However, an expert vet knows how to diagnose dogs effectively. So, there is no need to worry.

Dog owners are likely to take their dogs for two or more tests, including the blood tests. An ultrasound test is done in some cases to know whether a tumor exists on just one or both adrenal glands.

Above all, the urine and blood of the dog are tested for identifying the markers such as liver-produced enzymes and cortisol levels. One of the indicators is alkaline phosphatase, an enzyme that the liver produces and is studied to be more in dogs with Cushing’s disease.

Furthermore, it is common for these dogs to suffer from one or more urinary tract infections. These are the markers or abnormalities.

If these tests are positive, your vet would then suggest some more specific tests namely, ACTH test and Low Dose Dexamethasone Suppression (LDDS) test. The former is helps in discriminating between the pituitary- and adrenal-based conditions.

Herein, blood is taken for observation and then the dog is given an ACTH shot. This allows the vet to observe the response of the body to ACTH.

On the other hand, the LDDS test is done only when it is clear that the symptoms are not of any other disease. It involves giving synthetic cortisol to your dog and seeing how it reacts to it. The cortisol is known as dexamethasone. Here too, the blood samples are taken first.

This test has come up due to the sensitivity involved in conducting several screening tests. These tests are reliable only if there are symptoms and abnormalities. They are likely to give false-positive results for dogs that are not showing these symptoms.

Moreover, these tests are done at the hospital of a licensed vet that is likely to have a negative impact.  The dog is confined, resulting in the hospitalization stress that alone can give a false-positive result.

Thus, several vets the LDDS test as the most reliable one. However, the issue with this diagnosis is that it is likely to give a false-positive result due to the undergoing stress.

By now, the safest and precise way of diagnosing the disease is the urine test known as the Cortisol Creatinine Ratio test. It is done by considering the urine sample of dogs. According to dogsnaturallymagazine.com, this test has an accuracy rating of 90%.

Just take your dog’s urine at home so that the pet does not feel any kind of stress and bring the sample to the vet’s clinic later that day. The vet will use ultrasound and some urine specific gravity measurements to detect the presence of the disease.

In short, it takes a series of tests, sometimes including even an MRI and a CT scan, to know what has happened to your furry pal.

How to Treat a Dog with Cushing’s Disease?

If a dog with Cushing’s disease is tested positive, the conducted tests reveal the origin or source depending on which your vet will prescribe good and proper medicines. At times, surgery to remove the tumor may also be suggested after considering all the risk factors.

In case the source is pharmacological, you will be immediately asked to stop the medicines causing the disorder. It is highly recommended to go for periodic checkups to your vet and adjust the medicines as per the existing cortisol quantity.

In most cases, handling a dog with Cushing’s disease is manageable with medicines. Although there is no cure for this condition in canines, management options exist due to which your dog can live a long, good-quality life. After diagnosis, your vet can choose the best of these options.

Logically, the type of treatment depends on the type or form of the disease that exists in your dog along with the visible symptoms. If the pituitary-dependent Cushing’s disease dogs show mild symptoms, the treatment too shall be mild or no treatment at all.

Treatment in the form of medicines begins once the symptoms begin to worsen. They aim at bringing the condition under control instead of curing it.

Pets suffering from this disease are usually scheduled for frequent appointments and blood tests to view their reaction to treatment. Based on the reaction, doses are changed.

Normally, the following are the common medicines administered to a pet suffering from Cushing’s disease:

  • Vetoryl or Trilostane as an FDA-approved remedy to stop excessive cortisol production
  • Lysodren or Mitotane as a chemotherapy drug to eradicate the tumor but is rarely prescribed due to its side effects
  • Anipryl or Selegiline as one more FDA-approved medication for treating not so complicated pituitary-dependent disease

Other medicines include Carbex, Nizoral, and Eldepryl. In the beginning, pets having adrenal-dependent Cushing’s disease are put on Lysodren or Vetoryl for two to four months for diminishing the tumor. The remaining part is then removed by a veterinary surgeon.

There are times when surgery cannot be done. For such cases, treatment continues in the form of medicines so that the dog can live a good life before the symptoms wane their quality of life.

Generally, your dog can still live a long and peaceful life. Only in the presence of a big or a malignant tumor, this prognosis changes. The good news is that both the conditions are rare.

What Is the Life Expectancy of a Dog with Cushing’s Disease?

According to the vets, the ultimate lifespan for such a pet to survive is nearly three years. Nevertheless, in some cases of pituitary-dependent condition, it is two years. Dogs with neurological symptoms arising due to a pituitary tumor usually have less lifespan.

Close monitoring by a vet can ensure a good quality of life, which includes regular checkups and proper medications. A span of up to three years is possible with such regular monitoring and suitable treatment as per the cortisol levels.

With some additional care from your side, the pet can live longer. The best combination of treatment and care helps your pet to live comfortably and without pain.

Dogs under supervision are usually peaceful, happy, and free of inflammation. If pet owners can endure excessive urination, they are just normal pets and the probability to suffer from the ailment’s worse symptoms becomes minimal.

The prescribed medicines are capable of handling small tumors for many years. However, the prognosis is not so positive for big tumors. If the adrenal tumor has not yet spread, surgery may be a good remedy. For pituitary-dependent cases, surgery is very rare as such remedies are still under development.

What Happens If Cushing’s is Left Untreated in Dogs? Can Cushing’s Disease Kill My Dog?

Generally, an untreated pet can survive as long as a treated one. However, the pet will have to face the side effects. Only proper treatment does not bring any change in the lifespan but it ensures a better quality of life by improving the symptoms.

So, an untreated dog will experience more symptoms and other complications along with lesser moments of peace and happiness than the one undergoing treatment. Complications such as blood clots and diabetes may occur.

If it is hypoadrenalcorticism, the dog can even face death. Thus, it is wise to discuss with your veterinarian when and how to treat.

So, When Should You Put a Dog Down with Cushing’s Disease?

This is a heartbreaking question. However, the good news is that you can prolong asking this question if you get the treatment and put your dog under a vet’s supervision right from the time you spot one or more symptoms.

Euthanizing your dog with Cushing’s disease is very rare; it is more applicable to untreated dogs. It is only when the condition advances to show the worst symptoms that are just uncontrollable. Well, this is avoidable or can be prolonged with good care and treatment.

As there is no cure, despite prolonged medications and care, your dog may later stop enjoying its life due to deteriorating symptoms. In this case, you should consult a certified vet to take this hard decision.

Most certified vets know how to perform painless euthanize. While this may leave you devastated, it will free your beloved dog from all the worst symptoms. Still, keep in mind that this is rare. A natural death due to this disease is more common.

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