Q. My dog was just diagnosed with Cushing’s disease. I wanted to know the different types of treatments, and what one you would suggest. Thanks so much.
A. Cushing’s disease is diagnosed when the body produces too much cortisol, which is a steroid hormone. There are two types of steroid hormones: anabolic (which athletes may take to build up muscle mass) and catabolic (which tend to break down muscle). Cortisol is a catabolic steroid, and one of the signs is a bulging abdomen due to the breakdown of the muscles of the abdominal wall.
Cortisol is secreted by part of the adrenal gland, near the kidney. The gland can become overactive due to an increase in the size of the adrenal gland itself, or increased stimulation of the adrenal gland by the pituitary gland in the brain. About one-third of the dogs diagnosed with Cushing’s disease have a benign tumor of the pituitary gland in the brain. Different blood tests and an ultrasound of the abdomen can help determine which kind of Cushing’s disease your dog has.
Once your dog is diagnosed with Cushing’s disease, there are two main treatment options: Lysodren, which helps destroy part of the adrenal gland, or Anipryl, which helps shut down the pituitary, which in turn reduces the stimulation of the adrenal gland.
Lysodren has been shown to be the most effective treatment for Cushing’s disease. However, it’s a powerful drug with potential side effects, and your dog will have to monitored carefully while it is taking it. It also can be fairly expensive, and often is a lifetime treatment.
The other medication, Anipryl, has had only variable results in treating Cushing’s disease, although the side effects may be fewer.
I would recommend Lysodren, but be sure to carefully follow up with your veterinarian on recheck exams and blood tests. Accept the fact that it will be expensive to treat, knowing that it should definitely extend your dog’s life, and it should be of reasonably good quality.
Jon Geller, DVM