To diagnose Cushing’s disease in dogs, your veterinarian will discuss with you symptoms that you have noticed and perform a complete physical exam looking for specific physical attributes like a distended belly which is related to the disease. They will then run a CBC (Complete blood profile), Serum Biochemistry Profile and probably test a stool sample and urine specimen.

     For a full-blown diagnosis, it could run you upwards of $1,500. Or, there is a more cost-effective way to mostly rule out Cushing’s Disease. It is a simple urine test called the urine cortisol to creatinine ratio test, or the UCC. A fresh urine specimen is taken in the morning and can determine if your dog is excreting an abnormally high amount of cortisol in his urine. Dogs that have cortisol within the normal range do not have typical Cushing’s Disease.

      An Abdominal Ultrasound or X-Ray will help confirm the presence of a tumor

Urine Cortisol: Creatinine Ratio. If this first tests results are normal, then no further testing for  Cushing’s disease is required. Dogs with high urine Cortisol: Creatinine Ratios, will require further testing.

 

     The next test will be a Low-Dose Dexamethasone Suppression Test (LDDST) and requires you to leave your Dog at the Vets for the day.  A blood sample is taken to measure a dog’s baseline cortisol level, and then dexamethasone is administered in a small amount by injection. Blood cortisol levels are measured four and eight hours after the injections. In a healthy dog, the dexamethasone injection inhibits secretion of a hormone that stimulates cortisol secretion, which leads to a decrease in circulating cortisol levels. In a dog with Cushing’s disease, cortisol is not suppressed.

    For a Pituitary tumor the most commonly used drugs are Trilostane (Vetoryl) and Mitotane (Lysodren),  Another drug used for a Pituitary Tumor which is considered not as effective as Trilostane or Mitotane is called Selegiline Hydrochloride (Anipryl), which is used to mainly treat canine cognitive dysfunction. Developed originally as a drug called Eldepryl for Parkinson’s patients, the active ingredient Selegiline increases the concentration of a chemical called dopamine, which stimulates dopamine receptors in the brain and thereby assists in many cognitive processes.

     It’s amazing how a drug intended for human Parkinson’s Disease is now a drug helping dogs with Cushing’s Disease think, act and focus like their younger selves. Because Anipryl is so cognitive focused, dog owners have made statements like, “It has brought my dog back.” But again, along with the good with Anipryl comes a laundry list of side effects.