Winter 2021 Newsletter_Digital | Page 5

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Pet Health Watch with Dr . Main What ’ s Cushing ’ s Disease ?

Cushing ’ s disease otherwise known as hyperadrenocorticism is characterized by several common clinical symptoms . These signs include increased urination and thirst , increased hunger , hair loss and thin skin , potbellied appearance , and panting .

This condition results from increase production of cortisol from the adrenal glands . As many older dogs exhibit some of these symptoms , Cushing ’ s disease is often being considered as a possible diagnosis for our patients .
Typically there is a step wise progression of exam and testing that leads to the diagnosis of Cushing ’ s disease . In the early stages of diagnosis for Cushing ’ s disease ; patient history , exam findings , and basic blood and urine results are used to determine if more specific tests should be completed .
The following are five findings that would point toward a patient having Cushing ’ s disease .
The first finding is called a stress leukogram . This refers to the interpretation of the complete blood count . The complete blood count known as a CBC is part of most basic blood panels . This is the counting of white and red blood cells as well as platelets . Typically patients with Cushing ’ s disease will have lower than normal lymphocyte counts and higher than normal platelets counts .
The second finding will be elevated liver enzymes . The liver enzyme alkaline phosphatase ( AP ) is produced primarily in the liver . But when cortisol levels increase , the cortisol induces the AP to become higher . And this increase in AP is found in about 90 % of patients with Cushing ’ s disease .
The third finding is mild elevation in blood glucose known as hyperglycemia . Cortisol increases the production of glucose from the liver and also blunts the effect of insulin in some patients . About 35 % of patients with Cushing ’ s disease will have hyperglycemia .
The fourth finding is elevated cholesterol known as hypercholesterolemia . Cortisol increases the breakdown of fat and adipose tissue , releasing fats into the blood stream . Approximately 90 % of Cushing ’ s patients will have hypercholesterolemia .
The final finding is the presence of dilute urine . The increased level of cortisol interferes with the kidney , and the kidney is no longer able to save water . This inability of the kidney to reabsorb water leads to water loss in the urine ; and the need to drink more water to replace the water that is being lost . This occurs in 90 % of patients with this disease .
If your elderly pet is panting , has hair loss , and is drinking and urinating more than usual , then he or she could have Cushing ’ s disease . Start by letting your veterinarian know of these symptoms and collecting samples for basic blood and urine tests .
If several of the above findings are present then specific testing for Cushing ’ s disease should be completed . This would include further blood testing and likely abdominal ultrasound .
If Cushing ’ s disease is diagnosed then treatment should be considered . This disease is not cured , but managed , and can require intensive monitoring . Having said that , in the right cases , very satisfying results can be accomplished by the veterinarian and client working together .