Boston Terrier Cushing's: Causes, Diagnosis, and Management

Boston Terrier Cushing's is a serious health issue that affects many of these adorable dogs. Cushing's disease is caused by a benign tumor on the pituitary gland, which leads to an overproduction of cortisol in the body.

Boston Terriers are particularly prone to Cushing's due to their brachycephalic skull structure, which can lead to pituitary tumors. According to research, Boston Terriers are 4-6 times more likely to develop Cushing's than other breeds.

Symptoms of Cushing's in Boston Terriers can be subtle at first, but they can quickly progress to more severe issues if left untreated. Common signs include excessive thirst and urination, weight gain, and thinning of the skin.

Boston Terriers with Cushing's may also experience increased appetite, vomiting, and diarrhea.

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Cushing's disease is a serious medical condition that's common in middle- to older-aged dogs.

It's caused by excess cortisol levels, which can affect multiple organ systems and lead to potentially dangerous complications.

Cushing's Disease is the common name given to a hormonal condition called hyperadrenocorticism.

Dogs with Cushing's have overactive adrenal glands that produce too much of the stress hormone, cortisol.

This excess cortisol can have significant effects on a dog's body, making it a condition that needs to be taken seriously.

Boston Terriers with Cushing's disease can be a bit tricky to spot, but there are some common signs to look out for.

One of the earliest signs of Cushing's disease in Boston Terriers is excessive thirst and peeing. This is because the excess cortisol causes the body to produce more urine.

You might also notice your Boston Terrier panting more than usual. This is another common symptom of Cushing's disease.

As the condition progresses, you may notice a pot-bellied appearance, which is caused by the redistribution of body fat. This can be a distinctive sign of Cushing's disease in dogs.

Hair loss is also a common symptom of Cushing's disease in Boston Terriers. This can be due to the thinning of the skin, which makes it more prone to hair loss.

Here are some common symptoms of Cushing's disease in Boston Terriers:

Keep an eye out for these symptoms, and if you notice any of them in your Boston Terrier, it's always best to consult with a veterinarian for proper diagnosis and treatment.

Diagnosing Cushing's disease in Boston Terriers requires patience and a combination of tests. A veterinarian will start with a physical exam and ask about symptoms and any medications the dog is taking.

Diagnostic testing can take time, as no one test can definitively diagnose the condition. Initial blood work tests like a CBC, chemistry panels, or urinalysis are often done first. These tests can show evidence of Cushing's disease, such as elevated liver enzymes and high cholesterol.

The diagnostic tests of choice for diagnosing Cushing's disease are a low-dose dexamethasone suppression test (LDDST) and an ACTH stimulation test. These tests can help determine if the dog has Cushing's disease and if it's pituitary-dependent or adrenal-dependent.

Here are the diagnostic tests used to diagnose Cushing's disease:

Additional tests like imaging (abdominal ultrasound, CT, and MRI) may be done to identify pituitary or adrenal tumors.

Cushing's disease in dogs is often caused by a benign tumor in the pituitary gland, which secretes ACTH and stimulates the adrenal glands to produce cortisol.

This type of tumor is the most common cause of Cushing's disease in dogs.

Dogs who receive corticosteroids to treat another medical condition may develop iatrogenic Cushing's disease, meaning the medication is causing the symptoms rather than a pituitary or adrenal gland tumor.

Corticosteroids like prednisone can affect the body in a similar way to cortisol, leading to symptoms that are typically reversible by discontinuing the medication under a veterinarian's supervision.

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Certain breeds, including Poodles, Yorkshire Terriers, and Dachshunds, may be predisposed to Cushing's disease due to genetics.

Pituitary gland tumors, adrenal gland tumors, and breed disposition are common causes of Cushing's disease in dogs.

Tumors in the pituitary or adrenal glands can lead to excessive production of cortisol steroids, disrupting normal function and affecting multiple organ systems.

An overgrowth of cells in the pituitary gland or a tumor in one of the adrenal glands can cause too much cortisol to be produced, leading to Cushing's disease.

In rare cases, Cushing's disease in dogs can be caused by over-use of steroid medication, known as iatrogenic Cushing's disease.

Diagnosing hyperadrenocorticism in dogs requires patience, as no single test can definitively diagnose the condition. A veterinarian will start with a physical exam and speak with you about the symptoms present and when they started.

The veterinarian will also ask about any medications your dog is currently taking. If Cushing's disease is suspected, diagnostic testing can be done. Two main tests are used to diagnose Cushing's disease in dogs.

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Initial blood work tests, such as a CBC, chemistry panels, or urinalysis, are often used as a starting point. These tests can show evidence of Cushing's disease, like elevated liver enzymes, decreased BUN levels, and high cholesterol.

An abdominal ultrasound may be recommended to assess organs like the liver, kidney, and adrenal glands. This can help identify any tumors or abnormalities. Measuring the urine's cortisol-to-creatinine ratios can also point toward Cushing's disease, but other causes of elevated cortisol-to-creatinine ratios will need to be ruled out.

A low-dose dexamethasone suppression test (LDDST) and an ACTH stimulation test are the diagnostic tests of choice for diagnosing Cushing's disease. These tests can help determine if your dog has Cushing's disease and whether it's pituitary-dependent or adrenal-dependent.

A high-dose dexamethasone suppression test (HDDST) may be necessary in some cases to differentiate between pituitary-dependent and adrenal-dependent disease. This test requires patients to spend at least eight hours in the hospital and can be expensive, so it's usually not taken as a first step in the diagnostic process.

Additional diagnostic tests may be recommended to rule out other conditions and to diagnose any underlying conditions or infections.

Here are the diagnostic tests used to diagnose Cushing's disease, along with their purposes:

A veterinarian may also recommend imaging tests, such as abdominal ultrasound, CT, or MRI, to identify any tumors or abnormalities in the pituitary or adrenal glands.

Boston Terriers with Cushing's disease require careful treatment and management to ensure their safe and effective use of medication.

The medication Vetoryl, a steroid analogue, blocks an enzyme necessary for cortisol production, thus decreasing hormone levels. This is the preferred treatment option for Cushing's disease in dogs.

Regular monitoring is essential to ensure the medication is working effectively and safely. This includes rechecking patients 10 to 14 days after starting therapy and any dose change, with a thorough history, physical examination, serum biochemistry profile with electrolytes, and an ACTH stimulation test.

The ACTH stimulation test is the current gold standard for monitoring Cushing disease, and should be performed 4 to 6 hours after Vetoryl administration.

A low-fat diet is typically recommended for dogs with Cushing's disease, as they generally have high cholesterol. Potential diet options include Royal Canin/Md Adult Low Fat Diet or Hill's Prescription Diet i/d.

Dogs with Cushing's disease should have continued monitoring, such as bloodwork and ACTH stimulation tests, for the remainder of their life to ensure the medication dosage is appropriate and symptoms are controlled.

Here are some recommended monitoring intervals:

Recovery from Cushing's disease requires intensive management, especially in the first few months after diagnosis. Your veterinarian will likely recommend regular ACTH stimulation tests to determine the efficacy of your dog's medication and may adjust the dosage accordingly.

You should expect frequent veterinary visits to monitor your dog's condition, especially in the first few months after diagnosis. Monitoring will involve regular blood work to ensure your dog's kidney and liver are functioning normally, as well as running a urinalysis to check for urinary tract infections.

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The initial treatment requires the most intensive management, with veterinarians recommending ACTH stimulation tests every few weeks until dogs are stabilized. After that, follow-up tests may be done every six months to a year following the initial treatment phase.

Dogs with adrenal tumors that undergo adrenalectomies to remove the tumor may need supplemental medication and additional monitoring. It's essential to follow up with your veterinarian's appointments and contact them if you notice any changes in your dog's symptoms while on medication.

To ensure the medication dosage is appropriate and symptoms are controlled, your dog should have continued monitoring, such as bloodwork and ACTH stimulation tests, for the remainder of their life.

Here's a rough estimate of the monitoring schedule:

Dogs with Cushing's disease generally have high cholesterol and triglyceride content in their blood and benefit from a low-fat diet.

A low-fat diet can help manage the condition by reducing the amount of fat in the blood, which is beneficial for dogs with Cushing's disease.

Dogs with Cushing's disease often require a diet that is specifically formulated to meet their nutritional needs, taking into account their unique health requirements.

Their owners should work closely with a veterinarian to determine the best diet plan for their dog, as it may involve making significant changes to their regular feeding routine.

A low-fat diet can help manage the condition by reducing the amount of fat in the blood, which is beneficial for dogs with Cushing's disease.

Dogs with Cushing's disease may also benefit from a diet that is high in fiber, which can help to lower cholesterol levels and improve overall digestive health.

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Boston Terriers with Cushing's disease require regular monitoring to ensure the safe and effective use of medication. Clear owner communication is essential for this process.

The first recheck should occur 10 to 14 days after starting therapy and any dose change. This recheck should include evaluation of clinical signs with a thorough history, physical examination, serum biochemistry profile with electrolytes, and an ACTH stimulation test.

The ACTH stimulation test is the current gold standard for monitoring Cushing disease. It should be performed 4 to 6 hours after Vetoryl administration.

Dogs being treated with oral medications like trilostane should receive monitoring approximately every three months for the rest of their life. This monitoring interval can vary depending on the dog's needs and any additional medical conditions.

Monitoring based solely on the control of clinical signs, return to a normal physical examination, and outcomes of owner satisfaction may be a better option to save cost. This approach has been investigated in Europe and can be a really great option to save cost.

The following monitoring schedule can be a useful guide:

Note: The cost of medication and monitoring should be discussed with your veterinarian to determine the best approach for your Boston Terrier.

The cost of treating Cushing's disease in Boston Terriers can be a significant concern for many owners. The initial diagnosis and treatment can range from several hundred dollars to over a thousand dollars.

Dogs with Cushing's disease will require daily medications, which can add up over time. Routine blood work and diagnostic testing are also necessary, further increasing costs.

It's essential to discuss financial concerns with your veterinarian before beginning treatment. They can help you understand the costs involved and create a plan to manage them.

Most Boston Terriers can live with Cushing's disease for a while, even without treatment. However, complications often arise after a year or two due to the strain on their circulation and weakened immune system.

With treatment, Cushing's can be controlled, and dogs can have a normal life expectancy.