What is Cushing’s Disease?

Clinical signs, tests, and treatment

 

What is Cushing’s Disease?

Cushing’s disease (otherwise known as hyperadrenocorticism), is caused by overproduction of the hormone cortisol or overuse of corticosteroid drugs like prednisone.

Most cortisol in the body is made by the adrenal glands. If an adrenal tumor is present, it can over-secrete the hormone. Adrenal tumors are responsible for about 20% of Cushing’s cases in dogs, usually larger breeds.

A tumor located in the brain (pituitary gland) can also stimulate the adrenal glands to produce more cortisol than normal.

Cushing’s Disease Symptoms in Dogs

Diagnosing Cushing’s disease is not always an easy process. Symptoms are often somewhat nebulous and are seen as other diseases as well. Classic signs of Cushing’s disease, however, are:

• Increased appetite

• Increased thirst and urination

• Skin problems

• Recurrent infections

• Panting

• Muscle weakness

• A pot-bellied appearance

• Neurologic changes in advanced pituitary-dependent hyperadrenocorticism.

It is important to keep in mind that not every dog’s case of Cushing’s disease has every listed symptom.

What to expect at the vet's office

Your vet may proceed with diagnosing a dog with Cushing’s disease when a patient exhibits particular yet suspicious signs, like:

• Run a blood chemistry panel, complete blood cell count, a urinalysis, or any other lab work (heartworm test or fecal exam) that might be called for based on a dog’s physical exam and/or history. The results should either point toward or away Cushing’s, i.e. elevated alkaline phosphatase levels and a stress leukogram.

• With a sample of urine, your veterinarian can run a cortisol: creatinine ratio test. If the results are normal, Cushing’s disease is extremely unlikely. If they are elevated, Cushing’s disease is possible, but not a definitive diagnosis, as other diseases can produce the same result.

• Identify most (but not ALL) cases of Cushing’s disease and determining whether the adrenal or pituitary gland form of the disease is present (which also determines treatment) is done with a combination of an ACTH stimulation test, low dose dexamethasone suppression test (LDDS), high dose dexamethasone suppression test, and/or abdominal ultrasound.

Treatment for Cushing’s Disease

Medications: Dogs with Cushing’s disease caused by a tumor in their pituitary glands are generally treated with either mitotane (Lysodren) or trilostane.

Surgery: Cushing’s disease that is caused by a tumor in the adrenal gland is best treated by surgically removing the tumor.

If a dog’s symptoms are not too serious (i.e. he/she is panting more but is otherwise normal), treatment may not be necessary unless the problems become worse over time. Close monitoring of dogs undergoing treatment for Cushing’s disease is essential. The goal is to suppress cortisol production enough to keep pets healthy, but not so much that a new, opposite problem arises: hypoadrenocorticism, otherwise known as Addison’s disease.

Dogs with Cushing’s disease can be expected to live three years or even longer, after diagnosis with an appropriate treatment and a dash of luck, but while this is a condition that can often be successfully managed, it is only rarely cured.

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Homemade Slime: Toxicity and Health Risks for Pets

There has been a rise in a love of crafting homemade slime in households. While not a threat to creativity, some ingredients in slime pose a threat to our beloved pets.

Table Salt

This is often the most concerning ingredient in many slime recipes. Pets can develop salt toxicity or hypernatremia. Depending on the amount of salt ingested symptoms can range from GI upset to Central Nervous System signs such as lethargy, tremors, seizures, coma, and death. Signs of toxicity can be seen at 2 g/kg , or 0.13 tablespoons/kg of body weight. To put this into perspective, a 10lb dog (4.54 kg) could began to show signs of toxicity after ingesting just over 0.5 tablespoons of table salt. For that same 10 lb dog a fatal dose is possible at 1.5 tablespoons of salt ingested. Some slime recipes do not contain a particular amount of salt but just instructions to continue adding salt until the desired consistency/texture is achieved. This can make it difficult to gauge the amount of salt in the finished product. Some homemade slimes contain epsom salt instead of table salt. It would generally take more epsom salt than table salt to cause toxicity but this is still an ingredient that should not be ingested in large amounts as significant GI signs can result.

School glue

This is a common ingredient that does not usually hold significant potential for toxicity. When ingested GI irritation (vomiting, diarrhea, anorexia) is possible.

Shaving cream, hand soap, dish soap, shampoo and most hand lotions

These ingredients cause not much more than GI irritation but variations in ingredients are possible that may increase the risk for toxicity. For example, there are shampoos and lotions that contain cocoa bean (Theobroma Cacao) extract which is an ingredient of concern for chocolate toxicity.

Boric Acid

Generally, in acute (one time) doses, this is a GI irritant that can cause vomiting, diarrhea, abdominal pain, or anorexia.

Saline Contact Lens Solution

While some contact lens solutions are just saline, in addition to the salt concern, many (usually the ones used to make slime) contain Boric Acid or Borate which is a GI irritant.

Laundry detergent

Laundry detergent, when ingested, can be a GI irritant or for some products even cause corrosive injury to the oral cavity and GI tract. Mixed into a product like a slime it would be diluted and less likely to cause corrosive injury but if not well mixed and if an area of concentrated laundry detergent came into contact with the GI tract there would still be potential for injury.

Toothpaste

Many kinds of toothpaste contain xylitol which can pose significant toxicity risk for dogs.  Depending on the dose ingested, xylitol can cause profound hypoglycemia (low blood sugar) and in higher doses liver failure. Both of these levels of toxicity can be life-threatening for your dog.

Liquid Starch

Most liquid starches contain ingredients that would be expected to cause GI irritation at most when ingested in a slime mixture.

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There are other concerns in addition to toxicity when our pets ingest slime. Large amounts of slime could pose a risk for a foreign body obstruction or blockage in the GI tract.

When slime contains decorative additives such as sequins, tinsel, or glitter, injury to the GI tract is also possible. Tinsel is of particular concern as if long enough strands (more than a couple of inches long) are ingested, linear foreign body (a condition where string type materials can cause injury to the GI tract by bunching it up and causing blockage or necrotic damage)is possible.

Another concern is that slime is by nature slimy, and viscous. If your pet vomits this material back up there is a risk for aspiration of the product into the lungs which can quickly become a life threatening situation.

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How do we prevent our pets from ingesting homemade slime?

1. When the slime is not in use keep it somewhere that is not accessible to your pet.

2. Keep your pets out of areas where slime is in use.

3. Teach your children not to walk away from their slime project without putting it somewhere that is inaccessible to pets.

4. Store the slime making ingredients out of reach of your pets at all times.

5. Slime ingestion is also harmful for wildlife. Please dispose of your used slime responsibly.

What should you do if your pet ingests slime?

1. Do not attempt to induce vomiting at home or treat your pet in any other way without advice from your veterinarian or an animal poison control center. Some at home treatments can do more harm than good.

2. Call your veterinarian or Pet Poison Helpline.

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People Foods to Avoid Feeding Your Pet

This week is National Poison Prevention week and we are bringing you a list of the top toxic people foods to avoid feeding your pet. If you suspect your pet has eaten any of the following foods, please note the amount ingested and contact your veterinarian or poison control.

Alcohol

Alcoholic beverages and food products containing alcohol can cause vomiting, diarrhea, decreased coordination, central nervous system depression, difficulty breathing, tremors, abnormal blood acidity, coma and even death. Under no circumstances should your pet be given any alcohol. If you suspect that your pet has ingested alcohol, contact your veterinarian or Poison Control immediately.

Avocado

Avocado is primarily a problem for birds, rabbits, donkeys, horses, and ruminants including sheep and goats. The biggest concern is for cardiovascular damage and death in birds.  Horses, donkeys and ruminants frequently get swollen, edematous head and neck.

Chocolate, Coffee and Caffeine

These products all contain substances called methylxanthines, which are found in cacao seeds, the fruit of the plant used to make coffee, and in the nuts of an extract used in some sodas. When ingested by pets, methylxanthines can cause vomiting and diarrhea, panting, excessive thirst and urination, hyperactivity, abnormal heart rhythm, tremors, seizures and even death. Note that darker chocolate is more dangerous than milk chocolate. White chocolate has the lowest level of methylxanthines, while baking chocolate contains the highest.

Citrus

The stems, leaves, peels, fruit and seeds of citrus plants contain varying amounts of citric acid, essential oils that can cause irritation and possibly even central nervous system depression if ingested in significant amounts. Small doses, such as eating the fruit, are not likely to present problems beyond minor stomach upset.

Coconut and Coconut Oil

When ingested in small amounts, coconut and coconut-based products are not likely to cause serious harm to your pet. The flesh and milk of fresh coconuts do contain oils that may cause stomach upset, loose stools or diarrhea. Because of this, we encourage you to use caution when offering your pets these foods. Coconut water is high in potassium and should not be given to your pet.

Grapes and Raisins

Although the toxic substance within grapes and raisins is unknown, these fruits can cause kidney failure. Until more information is known about the toxic substance, it is best to avoid feeding grapes and raisins to dogs.

Macadamia Nuts

Macadamia nuts can cause weakness, depression, vomiting, tremors and hyperthermia in dogs. Signs usually appear within 12 hours of ingestion and can last approximately 12 to 48 hours.

Milk and Dairy

Because pets do not possess significant amounts of lactase (the enzyme that breaks down lactose in milk), milk and other dairy-based products cause them diarrhea or other digestive upset.

Nuts

Nuts, including almonds, pecans, and walnuts, contain high amounts of oils and fats. The fats can cause vomiting and diarrhea, and potentially pancreatitis in pets.

Onions, Garlic, Chives

These vegetables and herbs can cause gastrointestinal irritation and could lead to red blood cell damage. Although cats are more susceptible, dogs are also at risk if a large enough amount is consumed. Toxicity is normally diagnosed through history, clinical signs and microscopic confirmation of Heinz bodies.

Raw/Undercooked Meat, Eggs and Bones

Raw meat and raw eggs can contain bacteria such as Salmonella and E. coli that can be harmful to pets and humans. Raw eggs contain an enzyme called avidin that decreases the absorption of biotin (a B vitamin), which can lead to skin and coat problems. Feeding your pet raw bones may seem like a natural and healthy option that might occur if your pet lived in the wild. However, this can be very dangerous for a domestic pet, who might choke on bones, or sustain a grave injury should the bone splinter and become lodged in or puncture your pet’s digestive tract.

Salt and Salty Snack Foods

Large amounts of salt can produce excessive thirst and urination, or even sodium ion poisoning in pets. Signs that your pet may have eaten too many salty foods include vomiting, diarrhea, depression, tremors, elevated body temperature, seizures and even death. As such, we encourage you to avoid feeding salt-heavy snacks like potato chips, pretzels, and salted popcorn to your pets. 

Xylitol

Xylitol is used as a sweetener in many products, including gum, candy, baked goods, peanut butter, and toothpaste. It can cause insulin release in most species, which can lead to liver failure. The increase in insulin leads to hypoglycemia (lowered sugar levels). Initial signs of toxicosis include vomiting, lethargy and loss of coordination. Signs can progress to seizures. Elevated liver enzymes and liver failure can be seen within a few days.

Yeast Dough

Yeast dough can rise and cause gas to accumulate in your pet’s digestive system. This can be painful and can cause the stomach to bloat, and potentially twist, becoming a life threatening emergency. The yeast produce ethanol as a by-product and a dog ingesting raw bread dough can become drunk (See alcohol).

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Poison Prevention Tips

• Be prepared for an emergency. Keep the national, free Poison Helpline number at your fingertips by saving the number in your mobile phone: 1-800-222-1222

• Practice safe storage habits. Always store medicines and hazardous substances up, away, and out of sight of children. Keep these substances in their original, child resistant containers.

• Read and follow all labels and directions. Review medicine and product labels before you use them, especially before giving medicine to children.

• Detect invisible threats. Have a working carbon monoxide detector in your home

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Pet Dental Care for Cats and Dogs

Your pet’s teeth should be checked at least once a year by your veterinarian for early signs of a problem and to keep your pet’s mouth healthy.

Symptoms of Dental Health Issues

Have your pet’s teeth checked sooner if you observe any of the following problems.

• bad breath

• broken or loose teeth

• extra teeth or retained baby teeth

• teeth that are discolored or covered in tartar

• abnormal chewing, drooling, or dropping food from the mouth

• reduced appetite or refusal to eat

• pain in or around the mouth

• bleeding from the mouth

• swelling in the areas surrounding the mouth

Some pets become irritable when they have dental problems, and any changes in your pet’s behavior should prompt a visit to your veterinarian. Always be careful when evaluating your pet’s mouth, because a painful animal may bite.

Causes of pet dental problems

Although cavities are less common in pets than in people, they can have many of the same dental problems that people can develop:

• broken teeth and roots

• periodontal disease

• abscesses or infected teeth

• cysts or tumors in the mouth

• malocclusion, or misalignment of the teeth and bite

• broken (fractured) jaw

• palate defects (such as cleft palate)

Periodontal disease is the most common dental condition found in cats and dogs. Early evidence of periodontal disease begin by the pet is around 3 years old. If effective preventive measures aren't taken, the disease will worsen. Early detection and treatment are critical. Advanced periodontal disease can cause severe problems and pain that extend beyond your pet's mouth—including in association with the kidneys, liver, and heart muscle changes.

Why does animal dentistry require anesthesia?

When you go to the dentist, you know that what’s being done is meant to help you and keep your mouth healthy. Your dentist uses techniques to minimize pain and discomfort and can ask you how you are feeling, so you accept the procedures and do your best to keep still. Your pet does not understand the benefit of dental procedures, and he or she reacts by moving, trying to escape, or even biting.

Anesthesia makes it possible to perform dental procedures with less stress and pain for your pet. In addition, anesthesia allows for a better cleaning because your pet is not moving around and risking injury from the dental equipment. If radiographs (x-rays) are needed, your pet needs to be very still in order to get good images, and this is unlikely without heavy sedation or anesthesia.

Although anesthesia will always have risks, it’s safer now than ever and continues to improve so that the risks are very low and are far outweighed by the benefits. Most pets can go home the same day of the procedure, although they might seem a little groggy for the rest of the day.

Test yourself.

How much do you know about your pet's dental health?

Take this quiz to find out.

What can I do at home for my pet’s oral health?

Prevention of the most common oral disease in pets consists of frequent removal of the dental plaque and tartar that forms on teeth that are not kept clean. Regularly brushing your pet’s teeth is the single most effective thing you can do to keep their teeth healthy between dental cleanings, and may reduce the frequency or even eliminate the need for periodic dental cleaning by your veterinarian. Daily brushing is best, but it’s not always possible and brushing several times a week can be effective. Most dogs accept brushing, but cats can be a bit more resistant – patience and training are important.

There are many pet products marketed with claims that they improve dental health, but not all of them are effective. Talk with your veterinarian about any dental products, treats, or dental-specific diets you’re considering for your pet, or ask your veterinarian for their recommendation.

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Save on your next flea + tick prevention with Simparica!

New In Stock Alert! We are now carrying a new flea and tick protection option proven to last. Read to the ending for tips on how you will save when you switch to Simparica at River Landings Animal Clinic.

What is Simparica?

Simparica® (sarolaner) Chewables are a safe, monthly flea and tick protection for dogs that start working fast and remain effective all month long.

Simparica starts killing fleas within 3 hours and ticks within 8 hours, and it keeps going strong for 35 days without losing effectiveness at the end of the month.

How does Simparica work?

Simparica is a great tasting chewable tablet given orally once a month. It travels in your dog's blood to safely deliver persistent continuous protection against fleas and ticks from day 1 to day 35*.

*Studies show that Simparica starts killing ticks in 8 hours and is ≥96.9% effective for 35 days against weekly reinfestations of Amblyomma americanum (Lone Star tick), Amblyomma maculatum (Gulf Coast tick), Dermacentor variabilis (American dog tick), and Rhipicephalus sanguineus (brown dog tick).

Why protect against fleas and ticks?

Tick-borne diseases represent a widespread and growing public health hazard to dogs (and their human companions), causing debilitating illness and even death. It only takes one tick to spread disease, so continuous protection is critical to help reduce the risk of infection.

Likewise, it only takes a single "pregnant" flea to start an infestation on a dog or in a home. And although fleas are largely perceived as a mere nuisance, they too can pose health risks to pets and humans.

Why switch to Simparica?

Simparica provides peak protection all month long with no decrease in effectiveness toward the end of the month like some other brands. Comparison charts provided by Simparica on their website.

Save on Simparica!

Purchase 12 doses of Simparica and receive $35 in money-back savings. Purchase 6 doses and get $15 savings. Simply download a special offer voucher and bring it with you to the veterinarian when you purchase Simparica. Then log on to Simparica's website (here) to request your rebate. Your check will be mailed directly to you. It's that simple!

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Don't forget to subscribe to our email newsletter for more recipes, articles, and clinic updates delivered to your inbox (here). Or, you can keep up to date by liking and following our Facebook page (here). We also have additional helpful articles under our tips category (here).