Molly is a 9-year-old Miniature Poodle, who up until now has led a happy, healthy and fairly uneventful life. She is up to date with her vaccinations and has regular preventative parasite treatment. Recently her owners, Mr and Mrs Smith, have noticed that she is drinking and urinating more than usual; and initially wonder whether a urinary tract infection could be the culprit. However, she has also started to lose a lot of fur from her sides, is lethargic and her tummy looks a little swollen, so they book in a trip to the vets.
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After gathering a detailed history from the owners, their vet performs a thorough examination of Molly, from nose to tail. The vet agrees that Molly’s drinking was definitely abnormal; filling up her water bowl three times a day rather than the usual one is a significant change. The hair loss and swollen tummy are also picked up on. The vet expresses their concern that Molly could be affected by something called Cushing’s disease, but needs to run some tests to get more information. Obviously, Mr and Mrs Smith have plenty of questions – they’ve never heard of this disease, what is it? What tests do you need to run? Can it be treated? Luckily, Molly is in very capable hands and their vet can answer all their questions.
What is Cushing’s?
Molly’s vet explains that Cushing’s disease is an endocrine disorder that causes excess cortisol to be released by the body. Cortisol is important for helping the body regulate its metabolism, but in excess can have harmful side effects.
Symptoms include, but are not limited to:
- Drinking and urinating more
- Excessive hunger
- Hair loss on the trunk
- Pot-belly
- Lethargy
- Excessive panting
Cushing’s can originate from two different locations.
Pituitary dependant
In the majority of cases (80-85%), the disease will be caused by a small benign tumour on the pituitary gland. The pituitary gland sits at the base of the brain and is responsible for releasing a hormone called ACTH, which in turn causes the adrenal gland to produce cortisol. The tumour causes an excessive amount of ACTH to be released, and therefore an excessive amount of cortisol to be released.
Adrenal dependant
Less frequently, a tumour within the adrenal gland itself can cause an excessive release of cortisol. These tumours are more likely to be cancerous.
Diagnosis
Molly’s vet initially suggests they take a blood sample and a urine sample and do a general screening of both. Blood results show elevations in some liver enzymes and increased blood sugar level. The urine is very dilute. Both of these continue to make the vet suspicious of Cushing’s disease so next they get permission from Mr and Mrs Smith to run some further blood tests to truly see if there is an excess of cortisol in Molly’s body.
The vet also offers Mr and Mrs Smith the option of further investigating whether Molly has adrenal or pituitary disease, using further blood tests and diagnostic imaging – they decline at this time.
Treatment
Now confident that Molly is affected by Cushing’s disease, the vet recommends she start on some medication, which will help decrease the amount of cortisol produced by the adrenal glands and will help regardless of whether the condition is pituitary or adrenal dependant. The vet explains that the drug is generally well tolerated, but in some cases, animals can experience vomiting, diarrhoea and lethargy, and that Mr and Mrs Smith were to contact the practice straight away and stop the medication if any of these were noticed.
Molly has to have blood tests at 10 days, 4 weeks, 10 weeks and then every 3 months after first starting the medication to ensure that it is controlling the condition appropriately. Mrs Smith also keeps a diary of Molly’s to monitor Molly’s improvement over time, and is pleased to see positive changes in Molly’s symptoms and general wellbeing.
How is Molly doing now?
Now 6 months down the line, Molly is back to her normal self and is happily taking her daily medication – her fur has even grown back and is looking very well indeed. Mr and Mrs Smith are exceptionally pleased with Molly’s progress and are regimental with making sure she has her regular blood tests (now every 3 months) to ensure that condition remains well controlled. While they know Molly will never be fully cured of the disease, they are happy in the knowledge that she has a good quality of life – and that their insurance is covering the bills!
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