Understanding Cushing's Disease in Shih Tzus: A Comprehensive Guide

Cushing's disease in Shih Tzus is a serious health issue that requires prompt attention.

This condition is caused by an overproduction of cortisol, a hormone produced by the adrenal gland.

Shih Tzus are more prone to Cushing's disease due to their breed characteristics, such as a short, compact body and a flat face.

Cushing's disease can lead to a range of symptoms, including weight gain, thinning of the skin, and a pot-bellied appearance.

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Cushing's disease is a serious health issue that affects some Shih Tzus, characterized by an overproduction of cortisol in the body.

Cortisol is a hormone that helps the body respond to stress, but excessive levels can lead to a range of problems.

This condition is often caused by a benign tumor on the pituitary gland, which is located at the base of the brain.

The tumor produces excess adrenocorticotropic hormone (ACTH), which in turn triggers the adrenal glands to produce too much cortisol.

Symptoms of Cushing's disease in Shih Tzus may include weight gain, particularly in the midsection, and a pot-bellied appearance.

Other symptoms may include thinning of the skin, hair loss, and a dull coat.

Shih Tzus with Cushing's disease may also experience increased thirst and urination, as well as a range of other health issues.

In severe cases, Cushing's disease can lead to life-threatening complications, such as kidney disease and heart problems.

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One of the most common symptoms of Cushing's disease in Shih Tzus is increased thirst and urination. This is because cortisol causes the body to retain more water, leading to an increase in the amount of urine produced.

As a result, Shih Tzus with Cushing's disease may break housetraining after years without an accident. This can be frustrating for owners, but it's essential to remember that it's a symptom of the disease.

Increased appetite is another common symptom of Cushing's disease in Shih Tzus. This is because cortisol stimulates appetite, leading to overeating and potential weight gain.

Some Shih Tzus may appear chubby around the belly, but thin in the limbs due to muscle weakness and muscle breakdown caused by cortisol.

Here are some common clinical signs of Cushing's disease in Shih Tzus:

If you spot any of these symptoms in your Shih Tzu, contact your vet immediately.

Diagnosis of Cushing's disease in Shih Tzus typically starts with a physical exam and routine screening tests such as a complete blood count (CBC), chemistry profile, and urinalysis.

These tests help assess the changes that may have occurred secondary to Cushing's disease and evaluate the overall health of the patient.

A CBC may reveal a stress leukogram, a specific pattern in the white blood cell numbers.

A chemistry profile can show an elevation in a liver enzyme called ALP.

Urinalysis may indicate a lower urine concentration and protein in the urine.

Several blood tests can help diagnose Cushing's disease, including the ACTH stimulation test and the low-dose dexamethasone suppression (LDDS) test.

These tests measure the cortisol response to a stimulant or a hormone suppressing medication, respectively.

An abdominal ultrasound can be used to assess the size and shape of the adrenal glands, especially if an adrenal tumor is suspected.

A urine cortisol to creatinine ratio is a measure of the amount of cortisol secreted into the urine, which can be used as a screening tool.

However, a definitive diagnosis of Cushing's disease may require multiple tests, including blood tests and imaging studies.

A thorough examination and history, as well as baseline blood and urine testing, will give your veterinarian an idea that Cushing's may be present.

Imaging such as X-rays and abdominal ultrasound can also be helpful in diagnosing Cushing's disease.

Magnetic resonance imaging (MRI) is typically the most effective diagnostic testing tool for Cushing's disease, but it can be costly.

It's essential to work closely with your veterinarian to determine the best course of testing and treatment for your Shih Tzu.

Treatment for Cushing's disease in Shih Tzus involves medication to decrease the amount of cortisone produced by the adrenal glands. Most veterinarians treat both adrenal- and pituitary-dependent Cushing's disease with medication.

The goal of therapy is to render the adrenal gland incapable of over-producing cortisol, without dropping it too low. Medications like Lysodren/mitotane, Trilostane (Vetoryl), and Anipryl (selegiline) are commonly used to treat Cushing's disease in dogs.

Lysodren acts directly on the over-grown cells of the adrenal gland, causing them to die off. It requires careful monitoring and can have severe side effects. Trilostane, on the other hand, works by stopping the production of cortisol in the adrenal glands.

Trilostane is the only FDA-approved drug for the treatment of Cushing's disease in dogs. It's often the first drug chosen by veterinarians due to its safety and efficacy. However, it can have side effects such as poor appetite, vomiting, and diarrhea.

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Anipryl is FDA-approved to treat Cushing's disease in dogs, but only for certain cases caused by a pituitary tumor. It's less effective than Trilostane and can have unpredictable side effects.

Nystatin (ketoconazole) is an oral antifungal medication that suppresses the adrenal gland and is rarely used to treat Cushing's disease. It's less effective than other medications and can have side effects such as vomiting and diarrhea.

Treatment options depend on the type of Cushing's disease present. For pituitary tumors, Trilostane and Mitotane are commonly used. For adrenal tumors, major abdominal surgery is usually required, but medication can also be an option.

Here are some key treatment options to consider:

It's essential to work closely with your veterinarian to determine the best treatment plan for your Shih Tzu. Regular monitoring and adjustments to medication may be necessary to ensure the best possible outcome.

The prognosis for most Shih Tzus with Cushing's disease is excellent, particularly those diagnosed prior to complications such as insulin resistance and kidney issues.

With close monitoring and adjustments to medications, the impact of Cushing's disease on lifespan will be minimal. This is especially true for dogs diagnosed early on.

Regular follow up with an experienced doctor is crucial to managing Cushing's disease. This can be done through routine check-ins.

Patients taking Lysodren require regular monitoring, with blood tests every one to two weeks during the loading phase. This is essential to ensure the medication is working effectively.

Once on maintenance therapy, patients taking Lysodren need to return for an ACTH stimulation test as often as monthly for the first 3-4 months. This helps track hormone levels and adjust treatment as needed.

If patients are doing well, they can be followed every 6 months or so to recheck their hormone status. This is a great way to stay on top of their condition.

Patients taking Trilostane are on a similar schedule for blood test monitoring. This ensures their hormone levels remain stable and under control.

Complications of Cushing's disease in Shih Tzus can be serious, with high blood pressure, blood clots, and infections being common issues. Dogs with Cushing's are also prone to skin problems and lower urinary tract problems.

In most cases, Cushing's disease in Shih Tzus is pituitary-dependent, which means it's triggered by a tumor on the pituitary gland at the base of the brain. This type of tumor causes the overproduction of adrenocorticotropic hormone (ACTH), leading to excess cortisol production.

Dogs with adrenal-dependent Cushing's have a tumor in one or both adrenal glands that produces excess cortisol. This type of Cushing's disease makes up about 15% to 20% of cases in Shih Tzus.

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Complications can be a real challenge for dogs with Cushing's disease. High blood pressure is a common complication, which can lead to a range of health issues.

Dogs with Cushing's are prone to blood clots, which can cause stroke-like episodes. This can be a life-threatening condition if not treated promptly.

Infections are another complication that can arise in dogs with Cushing's. Skin problems are also a common issue, which can be painful and uncomfortable for the dog.

Lower urinary tract problems can also occur in dogs with Cushing's, often due to infection or the formation of bladder stones.

Cushing's disease in dogs can be triggered by two main types of tumors: pituitary-dependent and adrenal-dependent.

About 80% to 85% of Cushing's cases are pituitary-dependent, meaning a tumor on the pituitary gland causes the overproduction of ACTH, which then stimulates the adrenal glands to produce excess cortisol.

A tumor in one or both adrenal glands is responsible for the remaining 15% to 20% of Cushing's cases, directly producing excess cortisol.

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