First, Merry Christmas!
Cushings disease is, in most cases, an overproduction of cortisol by the adrenal glands. This is in turn caused by a benign but active growth of the pituitary gland just under the brain, which produces a chemical which stimulates the adrenal to grow and to secrete.
We can't easily get at the pituitary gland so when we treat Cushings disease, we address the cortisol but usually not the underlying pituitary problem. That said, in less than 5% of cases there is instead of a pituitary growth, a tumor of the adrenal itself. Indeed, that is more serious but treatment for both ae similar.
After all the testing is done, deciding whether to treat pituitary dependent Cushings depends on several factors, most of all quality of life. the disease cannot be cured and research has shown that while treated dogs suffer reduced signs and symptoms related to Cushings disease the lifespan after diagnosis is unchanged. Therefore, whetehr to treat depends on quality of life. If it is true your dog is suffering no signs, then perhaps treatment can be delayed until signs develop. Signs include increased thirst, increased urination, increased appetite with weight gain, muscle mass loss, potbellied appearance with thin fragile skin and hair loss on the body. Recurrent infections in skin, urinary tract or elsewhere may occur and diabetes may develop. If all of this is absent then treatment may be reasonably delayed. Why delay? Treatment is ongoing, moderately costly to costly (repeated lab testing to monitor closely) has its own side effects and risks ( at least two different drugs in common use) and will only decrease evidence of symptoms. If there are none, well you will see no difference. If on the other hand, signs do exist, well then quality of life is likely to be improved with treatment and by all means pursue it.
Finally, diet has no direct role in controlling or altering the course of Cushing's disease.
Further it is my opinion, that the pet owner will be unlikely to be able to improve on the better commercial diets with home cooking. Invariably an imbalance will be created, one you may never discover because signs of them are subtle and take many years to evidence themselves. Most home cooking books never tell you that. And as I'm sure youve read there seems to be a bias against commercial diets among certain circles. Yet many millions of animals live out their genetically determined lifespans on commercial diets. I believe the home cooking impulse serves people who just need to do something themselves to help. I am a skeptic that they can do so in that way but more importantly, doing no harm should come first.
In closing, we treat pets not lab values so weigh your options carefully. If your pet is truly symptom free, you may have the option of delaying treatment. In an 11 year old dog, the need to treat may never arrive. Also get the dog's blood pressure taken and urine checked for excess protein. Old dogs with Cusghings may have hypertension alone as a sign and that is a reason to treat both Cushings and hypertension.
Good luck and let us know how it turns out.
Arnold L. Goldman DVM, MS
MedHelp and PetDocsOnCall
And Merry Christmas to you! I hope you are having a happy day today.
Thank you for your reply and it was very helpful to me. We have made a Dec 31 appointment with Sam's veterinarian and you have helped arm me with many questions and a better understanding of what she might recommend. I will not resit "no treatment yet" as hard as I thought I might before your response. Sam is truly not showing any symptoms yet, however, I don't know if she took his blood pressure yet or not. I will collect a morning urine specimen to take with us on the 31st (8:45 AM appt).
The same thing happened with my dog before Sam. Luci was diagnosed with kidney failure through a blood testing. Luci was fine and showed no symptoms at that time, however, it wasn't long before she was a very sick doggie.
You can probably understand why I am hoping to get ahead of Cushings and, you are correct, I feel I need to do something to help. Thanks for giving me your opinion of commercial foods vs homemade.
Thanks so much and again, Merry Christmas.
Our dog has all the symptoms but the vet said it is not cushings and the only way to tell what it is would be an MRI. I do not know what the test was he had done. He sent the blood test away and it came back as NOT cushings but gave no other diagnosis.
Hard to say from this. Id have to see the results and understand the diagnostic thought process underway to really comment. Increased thirst and urination can be caused by numerous conditions of a variety of endocrine glands. The dog may have "atypical" Cushings, or may have another condition or illness.
If you do not have confidence the doctor is on the right track, then get a second opinion. Either see a board certified internist (credential is "DACVIM") or see another doctor, let them review the record and if they concur go back to your original doctor and let him/her complete the process. It is your doctor who should be communicating with you sufficiently such that you dont have unwarranted anxiety and unanswered questions. You also have to accept that a diagnostic process may take time, and patience and you should allow them to pursue a diagnosis if the course seems reasonable. But they have to explain it to you.
Dear Dr. Goldman,
I want to thank you for talking with me about Sam especially on Christmas day. He was given a Cushing's test on Dec 31 and I received the call today from his Vet saying that Sam does not have Cushing's. His liver function numbers are a little high and we will continue to check them, but for now all is well. YAHOO!!! Hopefully Sam and I can have another ten years together! :-) I might go before him!
Thank you again. You were most helpful.