Cushing's syndrome and skin lesions

Our dog was recently diagnosed with Cushing's syndrome with all the usual symptoms (thirsty, hungry, pot belly, hair loss, urinating a lot). She also had dark skin lesions on her back at the time of diagnosis (not painful, just crusty). We can actually rub her back and scrape some of the lesions off. Our vet says this is due to Cushing's and will improve with time. Our dog is now on Vetoryl and her strength, thirst, and hunger issues are being controlled well. The question I have is about the skin lesions. They seem to be spreading across her back, now to her shoulder area, and even her haunch. Definitely not as severe in terms of appearance, but across more of her body. Is this expected and no action is required? The vet did say that in extreme cases, they can perform a procedure to basically excise the lesions. It just feels odd that all her symptoms are reduced except for this one. Any insight or advice from the vets here? Thanks, Auro

Hello - I wouldn't have been expecting that.  What does your vet think that these crusty lesions are?  There are several common skin changes that commonly accompany Cushings disease.  Hair loss, (frequently in association with Demodex mites) can be one.  Another is called calcinosis cutis, which is where crusty calcium deposits are laid down in the skin.  I have seen yeast infections in Cushings patients frequently.  Ringworm etc can also take a hold (try to avoid touching the lesions unless ringworm has been ruled out, and be aware around immunocompromised people).   I am curious that the problem is worsening despite treatment and feel that it is worth consulting your vet again in light of this, in case they should want to test, biopsy or treat further.  If Calcinosis Cutis is what is being seen, that it implies that circulating Calcium levels could upset or implicate the kidneys, so its worth having this case triaged.  (Triage is where you speak to your vet and let them help you to decide the urgency).  Finally, I cannot rule out other skin changes, such as cancer, which are rare but do happen - Cushings disease is often brought about by a stressful event in the body, so occasionally more than one thing is going on at once.  I hope that something here is useful and wish you luck and good answers, moving forward with the case.

As a veterinary assistant, I can provide some insights on the skin lesions associated with Cushing's syndrome in your dog: Skin changes are a common symptom of Cushing's disease. The high cortisol levels can lead to various skin problems, including the dark, crusty lesions you've described. It is not unusual for the skin lesions to persist or even spread to other areas of the body, even as the other Cushing's symptoms improve with Vetoryl treatment. This is because the skin changes can take time to fully resolve. The spreading of the lesions is likely due to the ongoing hormonal imbalance and inflammation in the skin, which may take several months to normalize even as the internal Cushing's symptoms are brought under control. Your vet's recommendation to monitor the skin lesions and only consider excision in severe cases is a reasonable approach. Surgical removal of the lesions is usually reserved for cases where they are very extensive, uncomfortable for the dog, or not responding to medical management. As your dog continues on Vetoryl and the Cushing's is better regulated, the skin lesions should gradually improve and potentially resolve over time, often taking 6-12 months or more. My advice would be to continue the Vetoryl as prescribed, monitor the skin lesions, and consult your vet if they become more severe or concerning. With time and proper management of the Cushing's, the skin changes are expected to improve, even if the process is gradual. ------------------- Edited by slope 1 hour ago

As a veterinary assistant, I can provide some insights on the skin lesions associated with Cushing's syndrome in your dog: Skin changes are a common symptom of Cushing's disease. The high cortisol levels can lead to various skin problems, including the dark, crusty lesions you've described. It is not unusual for the skin lesions to persist or even spread to other areas of the body, even as the other Cushing's symptoms improve with Vetoryl treatment. This is because the skin changes can take time to fully resolve. The spreading of the lesions is likely due to the ongoing hormonal imbalance and inflammation in the skin, which may take several months to normalize even as the internal Cushing's symptoms are brought under control. Your vet's recommendation to monitor the skin lesions and only consider excision in severe cases is a reasonable approach. Surgical removal of the lesions is usually reserved for cases where they are very extensive, uncomfortable for the dog, or not responding to medical management. As your dog continues on Vetoryl and the Cushing's is better regulated, the skin lesions should gradually improve and potentially resolve over time, often taking 6-12 months or more. My advice would be to continue the Vetoryl as prescribed, monitor the skin lesions, and consult your vet if they become more severe or concerning. With time and proper management of the Cushing's, the skin changes are expected to improve, even if the process is gradual. -------------------