home Audience 12 Endocrine system of cats. Causes of hyperadrenocorticism in cats. Prognosis for the treatment of hyperadrenocorticism in cats

Endocrine system of cats. Causes of hyperadrenocorticism in cats. Prognosis for the treatment of hyperadrenocorticism in cats

Cushing's syndrome is an endocrine disease caused by a dysfunction of the combined dysfunction of the pituitary gland and adrenal glands and the system of their relationship with the predominance of hypercortisolism. The disease is more common in aging animals, and since dogs and cats live longer than other species, the pathology occurs more often in them.

Etiology. Hypercortisolism: excessive secretion (increased synthesis of cortisol and hydrocortisone) occurs due to damage to the hypothalamus and pituitary gland or directly to the adrenal cortex. In the vast majority of cases, spontaneous hypercorticism in dogs occurs as a result of hyperstimulation of the adrenal cortex due to excessive production of ACTH in the pituitary gland, and this occurs with a pituitary adenoma and excess ACTH. In addition, the cause of hypercortisolism can be a hormonally active tumor of the adrenal cortex - glucosteroma: a benign tumor is small, a malignant tumor is large, thus increasing the number glandular tissue, producing hormones.

Pathogenesis. The synthesis of glucocorticoids (cortisol, hydrocortisone, etc.) by the adrenal cortex occurs under the control of the hypothalamus and adrenocorticotropic hormone (ACTH) of the pituitary gland. Corticoliberin. synthesized in the hypothalamus, stimulates the formation and release of ACTH. Increased synthesis of ACTH leads to bilateral hyperplasia of the adrenal cortex and increased synthesis of corticosteroids, primarily cortisol. Cortisol itself influences the formation of ACTH and corticoliberin. With hypertrophy or adenoma of the hypothalamus or pituitary gland, the secretion of corticoliberin and ACTH increases, and the concentration of cortisol in the blood increases. With adenoma (glucosteroma) of benign or malignant adrenal cortex, the secretion of glucocorticoids also increases. Hypersecretion of cortisol is accompanied by an increase in insulin secretion, stimulation of glycogenesis with excessive formation of adipose tissue. Violation fat metabolism is considered one of the main pathogenetic links of hypercortisolism and, in particular, glucosteroma. There is a violation of protein metabolism, skin nutrition, and its damage. With Cushing's syndrome, deep degenerative processes develop in bone tissue ending in osteoporosis.

Glucocorticoids inhibit the processes of hydroxylation of calciferol, converting it into active forms vitamin D, which leads to a decrease in the absorption of calcium from feed. At the same time, there is an increase in the excretion of calcium in the urine, a decrease in the content of organic matter of bone tissue (collagen, mucopolysaccharides), and a decrease in activity alkaline phosphatase, poor saturation of the bones with calcium and other mineral elements. Osteomalacia and osteoporosis develop. Impaired calcium excretion by the kidneys can lead to nephrocalcinosis, the formation of kidney stones and pyelonephritis. Glucocorticoids promote sodium retention in the body and accelerate the release of potassium, the development of hypokalemia and muscle weakness.

Symptoms The leading place in the symptoms of the disease is occupied by obesity or redistribution of fat, skin lesions and muscle weakness. In most cases, the disease manifests itself in excessive deposition of adipose tissue in certain areas of the body - in the subcutaneous layer of the abdomen, shoulder girdle, sacrolumbar region, and thighs. The skin is dry, thinned and easily wounded, hyperpigmented, cold to the touch, pyoderma (pustular lesion) is observed in the corners of the lips and other areas, and bedsores are observed in the places of protrusions. The hairline is sparse, with areas of alopecia. Muscle tone is weakened (myopathy). Sick animals show signs of osteoporosis (curvature of the limbs, spine, fracture of ribs, tubular bones, etc.). The general state is depressive, the animals are indifferent to their surroundings. X-rays reveal osteoporosis of the ribs and tubular bones.

Diagnostic criteria. Selective sites of fat deposition. Characteristic changes in the skin and hair (thinning, dryness, hyperpigmentation, cold snap, alopecia, etc.). Muscle weakness (myopathy). Signs of osteodystrophy with a predominance of symptoms of osteoporosis, the presence of bone fractures.

Laboratory tests in the blood reveal lymphocytopenia, eosinopenia, neutrophilic leukocytosis, hypokalemia (below 16 mg/100 ml, 4.10 mmol/l). Confirmation of the diagnosis is an increase in the blood levels of ACTH and corticosteroids (cortisol). Characteristic pathomorphological changes are found in the hypothalamus, pituitary gland and adrenal cortex. X-rays of the bone reveal lesions characteristic of osteomalacia and osteoporosis. It is possible to use the results of an adrenal gland scan.

At differential diagnosis They mean hypocortisolism and other endocrine diseases.

Treatment. Treatment is aimed at normalizing the production of ACTH and cortisol, restoring metabolic processes in bone tissue, function correction of cardio-vascular system, kidneys and other organs. Normalization of ACTH and cortisol production is achieved by removing tumors in the hypothalamus, pituitary gland or adrenal glands and using medication.

Drug treatment includes the use of drugs that suppress the secretion of ACTH and cortisol: cloditan (mitotane), bromocreptine, cyproheptadine hydrochloride, etc.

Chloditan (mitotane) is an inhibitor of adrenal cortex function. Suppresses the secretion of corticosteroids, blocks the steroid effect of ACTH, and can cause destructive changes in normal and tumor tissue of the adrenal glands. Give orally to dogs at a dose of 25 mg/kg 2-3 times a day for 2-3 weeks until cortisol in the blood decreases to a level of 50-100 nmol/l. Then switch to a dose of 50 mg/kg (once a week). Monitor the health of the animal. The drug is available in tablets of 0.5 g.

Bromocretin (parlodel, bromergon, pravidel) is a synthetic activator of defomin receptors, suppresses the secretion of the anterior pituitary hormone prolactin, reduces the secretion of ACTH, suppresses physiological lactation. The drug for Cushing's syndrome is given to dogs and cats initially in a daily dose (approximately 0.1 mg/kg body weight), then the dose is halved and after 2-3 weeks a maintenance therapeutic dose of 0.05 mg/kg is prescribed. The course of treatment is 6-8 weeks.

Cyproheptadine hydrochloride (peritol, adekin, cyprodine, etc.) has antihistamine (blockade of H[-receptors), antiserotonin (blockade of S-receptors) and anticholinergic (blockade of M-cholinergic receptors) effects. Inhibits the biosynthesis of somatotropin and ACTH, enhances the secretion of the pancreatic gland. Used for many allergic reactions, Cushing's syndrome, pancreatitis. Produced in the form of tablets of 4 mg, syrup in bottles of 100 ml (1 ml of the drug contains 0.4 mg). Prescribed orally to horses, cattle at a dose of 0.04-0.06 mg/kg, sheep, goats and pigs - 0.07-0.08 mg/kg, dogs - 0.09-0.1 mg/kg 3 times a day day. The course of treatment is 2-4 weeks.

Ketoconazole (oranozole, nizoral, fungoral) is an antimycotic drug (KRKA company, Slovenia). Available in tablets of 200 mg. Indicated for Cushing's syndrome in dogs due to the fact that the disease is accompanied by skin lesions, possibly of fungal origin. Dogs are prescribed orally at a dose of 10 mg/kg during the first week, 20 mg/kg during the second week, 30 mg/kg during the third week 2 times a day.

For pituitary adenoma, which provokes Cushing's syndrome in dogs, N. Grange (2005), in addition to the use of dexamethasone and imitoton, used the method of radiotherapy using an electron accelerator; total dose 36 Gy.

Normalization of metabolism in the bone is achieved to a certain extent by improving the absorption of calcium from the intestine, fixing it with the bone matrix, and restoring the organic component of bone tissue.

Derivatives of vitamin D3, in particular Oxidevit or the drug a-DrTeBa, or fat- or water-soluble vitamin D preparations, help to increase calcium absorption. Oxidevit can be administered orally to dogs in an estimated daily dose of 1-1.5 ng/kg, and fat- or water-soluble drugs vitamin D - orally at a dose of 500 IU/kg body weight.

It is possible to use drugs containing fluorotridine and osein. Tridine in tablet form is produced by Rotta-karm. One tablet contains 150 mg of calcium ions (in the form of calcium gluconate and citrate), 5 mg of fluoride ions (in the form of L-glutamine monofluorophosphate). The drug is intended to replenish calcium deficiency and fix it in bone tissue. In medicine it is indicated for primary osteoporosis. Contraindicated in osteomalacia, impaired renal function, during growth, pregnancy, lactation, hypercalcemia and hypercalciuria.

Ocein (Corberon) is a drug containing 20 mg of sodium fluoride in 1 tablet. In medicine, it is prescribed orally to normalize metabolism in bone tissue, correct the imbalance between the growth and resorption of bone tissue, and reduce bone fragility. Used in individual doses for a long time. The contraindications are the same as for tridin. Shipped from Germany.

Surgical treatment consists of removing a tumor of the pituitary gland or hypothalamus, one or even two affected adrenal glands. In these cases, carry out postoperative treatment by the means indicated above.

If you have any idea about medicine, then you almost certainly know the danger that hormonal disorders bring with them. Even in a first-class clinic, one cannot always hope for improvement. Unfortunately, there is often no talk of a complete cure. Alas, our pets did not escape these misfortunes either. There is Cushing's syndrome in cats, which we will consider in this article.

It's called extremely rare pathology, which occurs when an animal’s adrenal glands produce excessive amounts of cortisol. An excess of this hormone causes complex consequences, among which the most notable are:

Major behavioral changes. In this case, for the time being, the complacent cat may even rush at its owners!

Severe weakness, apathy.

Important! In cats, this pathology is less common than in dogs, but its consequences are much more severe, and this disease is much less treatable. But this is not a reason to give up without a fight!

Read also: Glomerulonephritis - kidney disease in cats

However, in the latter case, the cat will die faster from functional disorders in the functioning of the liver, so there is simply no time left for the development of the syndrome. Another theory is that some animals have a genetic predisposition. Considering the extreme rarity of this pathology, the assumption may well turn out to be correct.

Do we treat or cripple?

No matter how much doctors and veterinarians talk about the dangers of uncontrolled use of hormonal drugs, it is rare that an animal owner listens to them. Everyone considers themselves at least Parcelsians, and therefore easily and naturally follows the advice of “experts” from the Internet. “Treat” the cat hormonal ointment from the pharmacy? Yes Easy! But you don’t need to be surprised later that your pet has “something wrong” with his health.

As you might have already guessed, problems with the pituitary gland may well be provoked by the uncontrolled use of various “drugs” without a veterinarian’s prescription. The particular danger of hormonal disorders of this class is that they do not develop suddenly and not immediately. “Healing” your cat’s eyes hormonal drops a couple of years ago, you would not connect Cushing's disease in cats with this fact. And the veterinarian will only have to be tormented by guesses about what exactly caused the appearance of the disease in this particular case.

Natural causes

But maybe you shouldn't blame yourself? There are many cases when this pathology manifests itself quite natural reasons! True, this applies exclusively to middle-aged and elderly animals. What is this connected with? The fact is that a ten-year-old cat in human terms is a very old woman. And old people, as you know, very often suffer from cancer.

Read also: Tuberculosis in cats: symptoms, treatment and risk of transmission to the owner

So, the possibility of a tumor (quite possibly even benign) appearing near the pituitary gland cannot be ruled out. Compression of this organ can lead to different consequences, among which is Cushing's syndrome.

How does it manifest?

In principle, we have already described some symptoms at the very beginning of the article, but now is the time to talk about them in more detail. You should be especially wary if your pet exhibits the following:

The cat constantly drinks and pees.

At the same time, the animal exhibits a brutal appetite, but its weight remains the same, although its belly grows. Of course, this can also be attributed to pregnancy, but if you have a cat, it is still unlikely...

Over time, the cat loses mobility, its muscles become weak and flabby.

The condition of the coat is constantly deteriorating: it becomes thin and brittle, and the skin loses its elasticity. The last sign is so serious that in some animals, with the slightest mechanical impact, deep abrasions and cracks form.

Please note that the combination of all these symptoms

Based on materials from the website www.icatcare.org

Hyperadrenocorticism- a rare disease in cats that develops when the adrenal glands (located near the kidneys in abdominal cavity) a hormone called "cortisol". Excessive levels of cortisol can lead to a variety of problems, including aggressiveness, weakness, and skin changes. Although hyperadrenocorticism in cats is much less common and much less treatable than in dogs, successful treatment is still possible.

Causes of hyperadrenocorticism in cats.

Most often the cause of the disease is abnormal work pituitary gland, which is located at the base of the brain. The pituitary gland, along with many other hormones, controls the production of cortisol by the adrenal gland. In some cases, the disease is associated with pathology of the adrenal glands themselves. Another cause of hyperadrenocorticism can be the use of large doses of cortisol-like hormones for a long time, which is sometimes necessary to treat certain diseases.

Iatrogenic hyperadrenocorticism.

The term "Iatrogenic hyperadrenocorticism" is used to describe the disease caused by drugs with high levels of cortisol-like hormones. These drugs can be corticosteroids (often used for inflammation and allergies), as well as progesterone-type drugs (progestogens), which are sometimes used to control reproductive cycle in cats, and also potentially have cortisol-like effects. With long-term use, such medications have the same effect on the cat’s body as natural disorders of the adrenal glands.

Natural hyperadrenocorticism.

Cortisol is a hormone produced by the adrenal glands, two small glands located directly next to the kidneys. Excess cortisol production can be caused by an adrenal tumor or, more commonly, tumors affecting the pituitary gland (a small gland at the base of the brain). The pituitary gland produces many different hormones, including adrenocorticotrophic hormone (ACTH), which stimulates the adrenal glands to produce cortisol. If pituitary tumors lead to excessive ACTH production, this in turn causes the adrenal glands to enlarge and produce excess cortisol.

If hyperadrenocorticism is caused by an adrenal tumor, the disease is called adrenal dependent, and if it’s a tumor of the pituitary gland - pituitary-dependent. Adrenal-dependent diseases account for less than 15% of cases of natural hypdrenocorticism, of which about half of the cases are caused by malignant tumors (adrenal carcinoma). Most cases of disease caused by pituitary tumors are caused by very small benign neoplasms(microadenomas).

Symptoms of hyperadrenocorticism in cats.

Natural hyperadrenocorticism is rarely observed in cats, and the iatrogenic form of the disease is also relatively rare, since cats are quite tolerant of high doses of corticosteroids.

Natural hyperadrenocorticism most often develops in middle-aged and elderly cats; cats are more susceptible to the disease than cats. Cortisol can cause many changes, so Clinical signs diseases vary widely. Symptoms may be mild at first, but usually get worse over time. The most commonly observed symptoms are:

Excessive fluid intake (polydipsia) and urination (polyuria);
Increased appetite;
Abdominal enlargement;
Apathy;
A loss muscle mass and weakness;
Poor condition of the coat;
Hair loss;
Curling of the tips of the ears;
Thin and brittle skin;

In some cats, the skin can become so thin and fragile that it bruises and cracks very easily. Wounds may also be slow to heal.

Many cats with hyperadrenocorticism also have diabetes because excess cortisol interferes with the action of insulin. This can cause your cat to become thirsty and urinate more frequently. Hyperadrenocorticism may also make it difficult to control a cat's diabetes. In fact, hyperadrenocorticism should be suspected in any diabetic cat that has difficulty controlling it.

Diagnosis of hyperadrenocorticism in cats.

Diagnosis of the disease is quite labor-intensive and usually requires multiple blood tests, urine tests, and diagnostic imaging (X-ray or ultrasound).

Routine blood tests can help rule out the most common causes of clinical signs, after which more specialized tests are required to identify hyperadrenocorticism. Among them:

Measurement cortisol levels in urine. The test can be used as a screening test to exclude hyperadrenocorticism, since high cortisol levels cannot confirm the diagnosis.
ACTH stimulation. This test measures cortisol levels in blood samples before and after injections of synthetic ACTH (adrenocorticotropic hormones). If elevated cortisol concentrations are detected, the diagnosis is confirmed.
Screening test with dexamethasone. In this test, cortisol levels in the blood are measured before and after an injection of dexamethasone (a powerful corticosteroid that normally suppresses the production of cortisol). If the cat's cortisol production does not decrease, this can be considered confirmation of hyperadrenocorticism.
Measurement ACTH concentrations in blood. It is carried out to determine the type of disease - adrenal-dependent or pituitary-dependent.
X-ray and ultrasound. Ultrasound examinations can be especially useful, as they allow you to determine the size of the adrenal glands, assess whether the enlargement has affected one or both adrenal glands, and clarify the type of dependence of the disease.

Unfortunately, there is no simple test to accurately diagnose hyperadrenocorticism in cats, so a series of tests and tests, sometimes repeated, must be performed.

Treatment of hyperadrenocorticism in cats.

Iatrogenic hyperadrenocorticism is usually treated by gradually reducing the dose of corticosteroids or progestogens taken. May require searching alternative medicines to control, for example, allergies.

In the case of natural hyperadrenocorticism, a choice of several treatment options is possible, however, drug therapy is most often preferred.

Drug therapy with trilostane. Many drugs are used to suppress adrenal cortisol production, but few work well in cats. Trilostane, which inhibits cortisol production and is widely used in dogs, is also effective in treating cats, which is why it is used most often. The tablets are given once or twice a day, the dose is determined depending on the cat's reaction to them. Clinical signs, even with successful treatment, decrease very slowly.
Surgical adrenalectomy. Surgical removal of the adrenal glands may be in a good way if only one adrenal gland is affected (for example, with benign tumor one adrenal gland).
Hypophysectomy. Removing the pituitary gland, although technically possible, is a very difficult and high-risk operation. Usually not recommended, and is only available in specialized centers.
Radiotherapy. For pituitary tumors, radiation therapy can sometimes combat hyperadrenocorticism, although the availability of such treatment is currently limited.

Prognosis for the treatment of hyperadrenocorticism in cats.

Hyperadrenocorticism is serious illness with unclear prospects. The disease itself is rarely cured, but with the right treatment support, many cats respond positively and can live for many months or even years with an excellent quality of life. If the cause of the disease is a malignant adrenal tumor, the prognosis inevitably worsens.

Cushing's syndrome is an endocrinological pathology caused by an increased level of one of two hormones in the blood:

cortisol produced by the adrenal glands;
ACTH hormone, which is produced by the pituitary gland.

Normally, cortisol is responsible for regulating blood pressure, blood clotting and reduces inflammatory processes. It is often called the stress hormone. In critical situations, a powerful release of cortisol promotes instant mobilization of strength.

The functions of the adrenal glands are closely related to the pituitary gland. It is also a gland, but is located in the brain. For proper operation The adrenal glands produce adrenocorticotropic hormone (ACTH) in the pituitary gland, which moderates the concentration of cortisol.

The reason for this pathological condition- excessive amounts of cortisol in the blood of an animal with constant long lasting influence on the body.

Normally, it promotes blood clotting, regulates blood pressure, and has an anti-inflammatory effect. In critical situations, its powerful release into the blood allows you to quickly mobilize the body.

The work of these endocrine glands, in turn, depends on the influence of the pituitary gland. The pituitary gland is also a gland that is located in the brain and regulates the functioning of the entire body.

For proper functioning of the adrenal glands, the pituitary gland secretes adrenocorticotropic hormone (ACTH), allowing the concentration of cortisol to be maintained at normal levels. Violation of this interdependent system leads to the occurrence of this endocrinopathy.

Other names of the pathology: Itsenko-Cushing syndrome, hyperadrenocorticism, hypercortisonemia.

Causes

Genetically determined causes have not been sufficiently studied. The rest are usually divided into the following forms:

Cushing's disease (spontaneous hyperadrenocorticism) caused by pituitary adenoma or hyperplasia;
(glucosteroma), caused by an adenoma or carcinoma of one or two adrenal glands;
Iatrogenic hyperadrenocorticism, can occur with excessive intake of hormones from the outside (long-term treatment with corticosteroid drugs).

Possible consequences

Because of high concentration In the blood of cortisol, the animal’s body is in a state of constant readiness to withstand adverse effects. This leads to rapid wear and tear of the body, depletion of its energy reserves and early old age.

Risk group

Cushing's syndrome is a pathology due to which the pituitary gland secretes cortilosis in huge quantities. Cortilosis is an essential hormone, and it is this hormone that exists to combat stress. The physiological mechanism of cortilosis is very difficult and long to describe, since a huge number of different reactions take place there. You just need to know that thanks to cortilosis, a dog can resist negative impacts external environment.

What is the problem if this hormone is one of the most important for life. For a dog, this amount of cortilosis secretion exceeds all norms. Cortilose is secreted so much that even an elephant would have enough of this amount of such a hormone. The pituitary gland is required to control this hormone, but the fact of the matter is, for some inexplicable reasons, it simply stops paying attention to the huge secretions of cortilosis in the dog’s body, as a result of which the dog simply begins to become exhausted. If your pet has Cushing's syndrome, the pet will have to face the following problems:

These are not even the main problems of Cushing's syndrome. The main problem is that many dogs simply die much earlier than they should. For example, many animals barely live to be three years old with this syndrome; it is also worth noting that the body of a dog that is 12 years old will be practically no different in its condition from the body of a dog that died from Cushing’s syndrome. With Cushing's syndrome, the dog's entire body begins to work faster and faster, thereby exhausting all its biological reserves.

It can be said that this syndrome simply slowly depletes the dog's body, thereby killing it. And the saddest thing is that those cases when pets live to the age of four are considered a miracle. In general, Cushing's syndrome wears out a dog's body at a tremendous speed.

Cushing's syndrome in dogs or hyperadrenocorticism is one of the most common organ diseases endocrine system in dogs (it rarely occurs in cats), which occurs when the hormone cortisol is excessively produced by the adrenal glands (located in the abdominal cavity) or adrenocorticotropic hormone by the pituitary gland (located in the brain). Therefore, there are three types of Cushing's syndrome in dogs:

Pituitary hyperadrenocorticism - associated with increased release of adrenocorticotropic hormone (ACTH) by the pituitary gland and in most cases the cause of this is a neoplasm of this organ (usually a pituitary adenoma);
Primary adrenal hyperadrenocorticism is caused by a unilateral or bilateral tumor of the adrenal glands, sometimes by a structural change - adrenal hyperplasia, which occurs for an unknown reason;
Iatrogenic hyperadrenocorticism is a secondary change that leads to long-term treatment large doses a hormonal drug from the group of glucocorticoids.

Cushing's syndrome can occur in middle-aged and older dogs of any breed, but it is more common in poodles, dachshunds, small terriers and boxers. It has also been found that adrenal tumors are more likely to form in large breeds dogs weighing more than 20 kg. Both males and females can suffer from Cushing's syndrome.

Sheltie dog with Cushing's syndrome

This disease occurs in dogs after their pituitary gland begins to produce cortisol in excess. This hormone is very important. Normally, it is a means of protection against stress. IN emergency situations thanks to it, the animal’s body is completely mobilized to protect itself from the external environment.

That is, the body needs cortisol, but not in the quantities produced by the gland in Cushing's syndrome. The pituitary gland ceases to control the process of hormone production. As a result, the animal develops various disorders:

Mental and behavioral disorders.
Constant thirst and frequent urination. At the same time, urine has such a pungent odor that it is almost impossible to be near it.

IN severe cases this disease can lead to the death of the pet. The cause of death lies in the wear and tear of the body, which has been in a state of complete mobilization for a long time.

When performing autopsies on young animals that died from Cushing's syndrome, veterinarians note that the condition internal organs equivalent to dogs dying of old age.

Veterinary medicine distinguishes several types of the syndrome, each of which is easily diagnosed, but requires special comprehensive treatment and prevention.

Cushing-Itsenko disease

It occurs as a result of primary damage to the stem and subcortical (hypothalamus, limbic zone of the brain) formations. If the primary lesion is not noticed in time, then the pathological foci spread to the adrenal cortex and pituitary gland.

Hypercortisolism develops. When examined in dogs, a basophilic pituitary adenoma is discovered, which intensively produces adrenocorticotropic hormone. This entails rapid growth of the adrenal cortex and, as a result, increased production of cortisol.

Cushing-Itsenko syndrome or glucosteroma

As a result of adrenal dysfunction, dogs can develop a hormonally active (intensively growing) tumor of the adrenal cortex. It is formed from the zona fasciculata and promotes excessive secretion of hormones. Mainly glucocorticoids. With this form of the syndrome, a more pronounced secretion (production) of the hormone is observed. It is caused by prolonged and rapid proliferation of the adrenal cortex, the growth of adenomas, which, if left untreated, can develop into cancer.

The formation of a pituitary adenoma is the cause of Cushing's disease in 15% of cases, the development of a tumor - in 80%. However, about half of neoplasms in dogs are benign.

Iatrogenic Cushing's syndrome in dogs

Acquired form of the disease. It occurs during long-term treatment of an animal with drugs containing corticosteroids. They are prescribed to suppress a fairly large number of diseases in dogs, and therefore the symptoms of the disease are less pronounced.

We have already learned that Cushing's disease is the result of excess cortisol production, or ACHT. Moreover, only prolonged high levels of hormones in the blood lead to imbalance. But why does cortisol begin to be produced in excess? There are two reasons:

The appearance of a tumor (adenoma) in the pituitary gland, which begins to produce excessive amounts of ACTH. Being in close relationship, the adrenal glands begin intensive synthesis of the hormone cortisol. This form of the disease is called “pituitary hyperadrenocorticism” and occurs in 80-90% of dogs. Typically, the tumor develops slowly and does not make itself felt for years.
The formation of a hormonally active tumor (glucosteroma) in the adrenal cortex, which leads to the proliferation of glandular tissue and increased production of cortisol. This form of the syndrome is called primary adrenal hyperadrenocorticism and occurs in 10-15% of dogs. As a rule, a tumor in the adrenal glands is malignant and develops quite quickly.

These two causes relate to spontaneous hypercortisolism. However, there is another one that leads to the occurrence of this disease. Iatrogenic syndrome resulting from long-term treatment animal with hormonal drugs. For example, Dexafort, Prednisolone, Metipred, Dexamethasone, etc.

The cause of the failure is a tumor of the adrenal glands or pituitary gland (both malignant and benign). In 85% of cases in dogs, Cushing's syndrome is caused by a pituitary tumor.

Cushing's syndrome can occur in

any breed, but most often susceptible to it

Boxers,

Mostly dogs older than seven years of age are affected.

What causes hyperadrenocorticism? This is perhaps the most popular question that dog owners ask veterinarians. Even veterinarians do not know the real cause of this disease, which is why it is impossible to cure it, because there are a huge number of inconsistencies due to which doctors could not figure it out.

The only peculiarity that doctors noticed when studying Cushing's syndrome is that cats almost never experience this disease; for them, this case is one in a million, while dogs encounter Cushing's syndrome quite often. Why cats constantly avoid this disease, while the pituitary gland in dogs cannot control the release of the hormone in huge quantities, doctors could not understand.

Although scientists have been trying for many years to identify possible reasons the development of the disease is still far from being fully clarified. In some cases, veterinarians simply cannot determine the cause of the malfunction of the pituitary gland.

Nevertheless, scientists have identified several of the most common causes of pathology:

Hormonally active tumors in the pituitary gland.
Glandular tumors affecting the adrenal cortex.
Incorrect drug treatment using steroid drugs.
Significant age of the animal.
Overweight.
Genetic reasons.

Scientists have also identified several forms of this disease. The division into forms is determined by the reasons for the development of pathology.

Cushing's disease. In dogs, symptoms of this pathology appear when tumors appear in the pituitary gland: adenoma or hyperplasia. This form of the disease is the most common and is detected in 80% of cases.
Cushing's syndrome. It is also often called glucosteroma. The cause of this pathology is dysfunction of the adrenal cortex caused by a tumor. Because of it, a large amount of glucocorticoids are released into the blood, which disrupt the functioning of the pituitary gland.
Iatrogenic Itsenko-Cushing syndrome. This form of pathology develops as a reaction to the excessive introduction of hormonal agents such as prednisolone and dexamethasone into the animal’s body. Typically, these medications are prescribed to dogs for serious colds and allergic reactions. This type of disease goes away quickly after stopping the medications.

If symptoms of Cushing's disease appear after starting treatment hormonal agents, then the supply of these medications cannot be abruptly interrupted. It is necessary to gradually reduce the daily dosage of the drug until the symptoms disappear completely.

Reasons for development and varieties

When studying this disease, researchers tried to understand what types there are and whether they exist at all? There are indeed varieties of Cushing's syndrome, and it has also turned out that sometimes the owners are the provocateurs of this syndrome. What is the first variety, and what causes it?

It is also worth noting that there are even predispositions to this disease, that is, those breeds of dogs in which this disease occurs most often. This list includes 3 breeds: terriers, boxers and dachshunds.

If any of the readers of this article have anything to do with medicine, then they can say that a syndrome is a complex of signs and symptoms. They can often vary from case to case. Based on this, scientists have long suggested that Cushing's pathology can be divided into several categories. The researchers were right, as there are indeed different types. Let's look at them in a little more detail.

First, iatrogenic Cushing's syndrome in dogs. What it is? This - shining example the fact that the care of the owners can sometimes backfire on the pets themselves. The fact is that this term refers to a disease that arises due to an excess of... hormones. More precisely, those of them that are similar to endogenous (internal) cortisol. Where can they even come from if the adrenal glands of the body itself are “responsible” for the production of such substances?

And the whole point is that synthetic substances of this nature are part of many hormonal medicines. Good owners, without consulting a veterinarian, begin to “treat” their pets with them. The result is Cushing's syndrome. What is especially offensive is that due to such “therapy” the pituitary gland of dogs sometimes completely loses the ability to produce endogenous cortisol.

What other reasons are there? As we have already said, they are not clear in all cases. For example, the mechanism of occurrence of genetically determined “Kushiga” has been practically not studied. But there are also clearer cases. They are associated with tumors, not only malignant, but also quite benign.

Finally, do not forget about the damage to the adrenal glands themselves. Even if the pituitary gland is absolutely healthy, it will not be able to influence the excessive release of cortisol in the event of a tumor or toxic lesion.

Main features

Is it possible to somehow determine whether a pet is beginning to develop Cushing's syndrome or has already developed? During research, several symptoms of Cushing's syndrome were identified; they can be identified by the following signs:

As mentioned earlier, the pet begins to constantly drink water, and urination also works constantly. If you notice that your pet has a surprisingly strong thirst with urination, then you should pay attention to this. Don't forget that some dog breeds just naturally drink a lot. Hyperadrenocorticism in dogs is quite difficult to determine based on this symptom.
Hair begins to fall out and the coat degrades. With Cushing's syndrome in dogs, the skin becomes quite brittle, as a result of which they simply begin to lose it. This happens quite quickly, for a dog to be completely hairless, it will take from two weeks to a month, it all depends on the breed of the dog, because some breeds are very susceptible to this disease, while others are quite resistant to it. This symptom looks very scary, and you will definitely notice if your dog begins to lose its fur.
The pet begins to lose a lot of weight, and her physique also changes. If a dog previously had a good weight, then it can lose weight very quickly in a short amount of time. Enough strange symptom is that their body loses weight, but their stomach becomes even fuller. After concluding this fact, the researchers noticed that in some cases pets do not lose weight, but get fat; they could not give any explanation for this. In general, the only thing we can say with certainty is that with a very rapid change in weight, a pet may have hyperadrenocorticism.
It is also worth noting that with hyperadrenocorticism, dogs not only drink a lot, but also begin to eat constantly. They don’t eat as much as they drink water, but still, their diet almost doubles, they just start eating everything they see. The most interesting factor is precisely that with a huge diet, they can even lose weight rather than gain weight. But often dogs still gain weight after constant power supply large amount of food, this weight will not be more than 15% of the dogs' original weight.

If you have a dog that is used as a guard, then with such an illness it will be useless for its previous position, because during training they are simply depleted at a tremendous speed. As mentioned earlier, at first the pets will simply become exhausted during training, after which they may simply stop listening to your commands, because their body will not be up to training. They also simply begin to lose potency due to this disease; in males, complete atrophy of the testes may occur.

It is also worth noting that the bones of dogs become extremely fragile with hyperadrenocorticism; they develop a bone disease, which is called osteoporosis of the skeletal bones. Dogs should not receive blows or any other stress, because this can simply cause them to get serious injury, after which they will be able to rehabilitate themselves with great effort.

Diagnosis and treatment

And now the most important thing is, can this disease be cured? The answer is yes, but first you will need to have your pet diagnosed so that doctors can be sure that your pet has hyperadrenocorticism. You will have to do a lot of research for your dog, it is not that easy and takes a lot of time.

Ketoconazole is used as a drug to combat Cushing's syndrome. This drug was created to suppress the production of hormones, it was not created for this disease, so your pet will have to increase the dose by 3 times, after which the drug will have an effect. The drug is an excellent way to fight the disease; it has virtually no side symptoms and it is not that expensive, but the disadvantage of this medicine is that it is useful only in the early stages of the disease; in advanced stages of hyperadrenocorticism it is practically useless.

There is also a drug called trilostane, which is called much more effective than ketoconazole. There are two disadvantages to using this medicine, the first is large quantities side effects, so it should be used only as directed by a doctor in order not to accidentally harm your pet. The second disadvantage is the price; trilostane is far from the cheapest medicine, given the fact that you will have to buy it several times.

And also, it happens surgery, which can help your dog if a tumor appears in the pituitary gland area. There are various therapies, such as treating this disease with herbs, but these are just a waste of time and money because they have been tested and do not help pets at all.

As you already understand, it is still possible to cure Cushing’s syndrome, but to do this you need to immediately contact a veterinarian who can prescribe a course of therapy. Your pet will be prescribed the medications needed to use, and then you will simply need to administer those medications. As a rule, ketoconazole or trilostane is prescribed, it all depends on the stage of the disease; at an early stage, it is possible that ketoconazole will help the dog, at a later stage, trilostane cannot be avoided.

Now let’s look at the symptoms that more or less accurately indicate the presence of this particular disease. Here they are:

As we said, thirst and constant urination.

Wool and skin deteriorate catastrophically, which is especially noticeable in dogs of long-haired breeds. Hair falls out, and deep cracks and erosions appear on the skin, the occurrence of which can sometimes be caused by even a slight mechanical impact! This happens because the skin becomes brittle and “fragile”.

The dog’s physique changes greatly: it loses weight, but at the same time the volume of its abdomen increases. However, in some cases, sick dogs, on the contrary, become hideously fat (this is easily noticeable in the photo).

Almost all animals with “Cushing’s” begin to literally “eat everything.” Distinctive feature- no more than 15-20% gets fat. All others, with a “pig” diet, only lose weight.

If a hunting or service dog gets sick, even minimal physical activity instantly causes severe exhaustion and fatigue. Of course, it becomes completely impossible to use such animals in their previous work. Another symptom is severe problems in the sexual sphere. The bitches, even if they are in the most reproductive age, estrus completely disappears. In male dogs, if the pathology is not treated at all, complete atrophy of the testes may occur.

Osteoporosis of the skeletal bones is very common, causing them to become noticeably thinner and more fragile. Any blow, any mechanical force can lead to a severe fracture. Occasionally, dogs with this pathology exhibit involuntary, rhythmic contractions of the limbs. This phenomenon can be observed both on all paws and only on the hind paws.

Symptoms and treatment

The hormone cortisol affects the functions of the dog’s entire body, so Cushing’s syndrome affects almost all systems:

Other glands also change their normal production of hormones, so the kidneys, liver and skin may be affected. The syndrome develops gradually, but the first symptoms you may notice are the following:

excessive appetite;
increased thirst and, as a result, frequent urination;
alopecia (appearance of bald patches in the kidney area).

Associated symptoms include urinary incontinence and rapid obesity. In this case, excess weight is localized not in the subcutaneous tissue, but in the chest, neck and abdomen. The effect of a “saggy belly” occurs.

After baldness in the kidney area, alopecia appears on the back, neck, chest and even tail. If you look closely at the skin, you will notice small bumps that are hard to the touch (calcinosis). The skin becomes thinner, dry and cold to the touch. Bedsores and pyoderma (pustular lesions) may occur.

Next, muscle weakness (myopathy) develops and the stomach sags even more. The dog becomes drowsy, depressed, lethargic. You may notice a lack of coordination, as well as sudden changes in mood and behavior. Sometimes infections in the genitourinary system can occur.

The disease affects the animal's reproductive system. In females, the sexual cycle may be disrupted and estrus may disappear. In males, atrophy of the testes is possible. The animal may suffer from gastritis, pressure drop, osteoporosis (curvature of limbs, fractures of tubular bones).

Given the widespread effect of cortisol on the functioning of the entire body, Cushing's syndrome affects the immune, nervous, reproductive, genitourinary, reproductive, cardiovascular and musculoskeletal systems. Kidneys, skin, and liver may be damaged. Other glands also change the normal production of hormones.

The disease develops gradually, so you should know the main symptoms of Cushing's syndrome in dogs:

increased thirst and urination;
excessive appetite;
deterioration of the coat with the appearance of bald patches.

Other signs can also be observed developing disease. Along with an increased urge to urinate, urinary incontinence appears. The dog gains excess weight, and the fat leaves subcutaneous tissue and is localized mainly in the neck, abdomen and chest.

As the fur deteriorates, hair loss begins and alopecia (symmetrical bald patches) appear in the kidney area. Further, baldness spreads over the entire back area, to the chest, neck and tail. Hyperpigmentation and calcification may be seen on the skin.

There is muscle weakness and a sagging belly as a result. In females, the reproductive cycle is disrupted, up to the disappearance of estrus, and in males, atrophy of the testes is possible.

The dog becomes lethargic and sleepy. Unbalanced behavior may be noticed. In the case of pituitary adenoma, loss of coordination and depression are possible.

How associated with the disease, the following symptoms of Cushing's disease in dogs are observed: pyoderma, thromboembolism, signs of secondary diabetes mellitus, the genitourinary system is exposed to infections. The animal may experience changes in blood pressure and signs of gastritis.

Cushing's disease in dogs is accompanied by osteoporosis with possible fractures, a disorder of the cardiovascular system.

Diagnostics

Severe symptoms of the disease can be diagnosed by visual examination. TO additional methods Diagnosis in a dog includes general and biochemical tests blood and urine.

The next step will be to conduct functional tests associated with the administration of dexamethasone and the hormone ACTH. Judging by the body's reactions to these drugs, the functioning of the adrenal glands is assessed.

To do this, an ultrasound of the abdominal cavity is performed, which will reveal possible availability neoplasms or enlargement of the adrenal glands. Radiography will detect their mineralization and identify possible increase liver, characteristic of Cushing's syndrome.

To identify tumors in the pituitary gland or adrenal glands, MRI and CT are used where this type of diagnosis is available. Cushing's syndrome causes irreversible consequences, because... affects all systems and organs.

Treatment

Treatment for Cushing's syndrome in dogs can be surgical or medical. If a tumor of one of the adrenal glands is detected in the absence of metastases, it is removed.

Surgical removal of both affected adrenal glands is possible, after which further lifelong replacement therapy in the form of taking glucocorticoids and mineralcorticoids.

For pituitary adenoma, it is possible to use drugs that suppress the production of cortisol. Unfortunately, such drugs are very expensive and inaccessible. Conservative treatment involves the use of drugs Mitotan, Lysodren, Chloditan, L-deprenyl, Ketoconazole, Cyproheptadine.

The course of treatment is prescribed based on the clinical picture, localization of the pathological focus and constant monitoring of the dog’s condition.

As an additional alternative treatment you can use the homeopathic drug Hormel, which generally normalizes the functioning of hormonal system and is compatible with conservative treatment.

The main indicator of correctly chosen treatment tactics is reducing the amount of water consumed by the dog. The animal will also need regular monitoring of its condition using blood tests and ultrasound.

Treatment results may vary and depend on many factors, including how attentive and responsible the dog’s owner is.

Despite different types diseases, external clinical signs are similar, and the main ones can be noticed by any owner in their pet. These include: increased thirst and urination (polydipsia and polyuria), increased appetite (polyphagia) - a good appetite- this is a sign of the dog’s health, but its increase may indicate an emerging problem and the owner should pay attention to this sign and once again consult with his pet’s doctor; obesity may be characteristic skin changes(alopecia without signs of itching, thinning and inelasticity of the skin, comedones), as well as muscle weakness/wasting, sagging abdomen (“pot-bellied” appearance), disruption of the reproductive cycle in females and atrophy of the testes in males, noisy and rapid breathing, neurological signs.

Dachshund dog with Cushing's syndrome

Dog with Cushing's syndrome with calcification of the skin

Hyperadrenocorticism develops slowly, so it may not manifest itself for a long time. In this case, the disease can only be detected through a laboratory blood test to determine the level of cortisol in the blood.

Clinical manifestations appear in the later stages of the disease. The following symptoms appear:

The dog develops extreme thirst.
The dog urinates frequently but little by little.
The coat becomes dry and brittle. Observed increased loss. First, the hair falls out in clumps in the abdominal area, and later it can become completely bald.
The animal is depressed and tries to move less.
The abdominal muscles weaken, causing it to sag.
The fat layer becomes thinner. At the same time, muscle atrophy occurs.
The cyclical nature of sexual behavior is disrupted. Males don’t want to mate, and females go out of heat.

Dogs with Cushing's disease may experience mental health problems, but this is rare. Much more often, sick pets get tired quickly and move little. They have a significant decrease in reflexes.

Sometimes animals exhibit involuntary convulsive movements. Typically, cramps affect the hind legs.

A blood test of sick pets gives the following picture:

The number of lymphocytes is reduced. Cells are destroyed under the influence of steroid hormones.
Thrombocytosis.
Increase in the number of neutrophils.
Alkaline phosphatase is increased.

Based on symptoms alone, veterinarians are rarely able to diagnose accurate diagnosis. Therefore, sick animals are subjected to additional research methods.

The symptoms of the disease described by veterinary medicine are the same for both the syndrome and Cushing-Itsenko disease. They distinguish only the severity and intensity of manifestation of individual symptoms. At mild form obvious symptoms are expressed moderately - they do not bother the animal much. And in severe (advanced stage of the disease) form, in addition to clearly expressed clinical symptoms Complications are often observed:

pathological bone fractures;
severely progressive muscle weakness;
the appearance of hypertensive kidney syndrome;
cardiovascular disorders.

The clinical picture is as follows. On the background general weakness animal is observed:

rapid weight gain. This is the first symptom that dog owners pay attention to. With advanced Cushing's syndrome, a specialist diagnoses obesity (fat is deposited in the abdomen, neck and chest);
the presence of excruciating pain in joints and bones;
formation of violet-red stripes on skin in the area of the abdominal wall;
a sharp decrease in muscle mass, muscle atrophy;
profuse hair loss in the chest, back and abdominal wall;
pathologies of the cardiovascular system (left ventricular hypertrophy);
blood pressure surges;
gastritis;
subsequent development of either bulimia or polydipsia.

Experts also distinguish between two forms of the disease: progressive and torpid. In the first case, both the syndrome and Cushing's disease proceed very quickly, in the second, the disease has a protracted form (the dog can be ill for several years).

Breeds that are at increased risk of developing Cushing's syndrome:

all poodle breeds
breeds of small terriers (Yorkshire, toy terrier, etc.)
dachshunds
german shepherds
hound breeds
Labrador Retriever
boxers
boston terriers

Diagnostics

To establish a diagnosis, the veterinarian uses several examination methods:

inspection;
blood and urine tests;
functional tests;
Ultrasound, MRI and radiography.

You can also visually determine signs of osteoporosis and the presence of a bone fracture.

The second stage is general and biochemical tests of the animal’s blood and urine. Laboratory tests determine the content of ACTH and cortisol, which indicate changes in the pituitary gland, hypothalamus and adrenal cortex. A general blood test establishes hypokalemia, red blood cell content, lymphocytopenia, hemoglobin level, neutrophilic leukocytosis, eosinopenia. Biochemical research determines changes in protein fractions, increased alkaline phosphatase and liver transaminases.

The third stage is conducting functional tests that allow you to assess the function of the adrenal cortex. Their essence is simple: first, the basic level of cortisol in the blood is determined, and then a small dose of ACTH or dexamethasone is administered. Next, doctors monitor changes in the concentration of the hormone.

After confirming Cushing's syndrome, the doctor needs to accurately determine the source of the pathology - the pituitary gland or adrenal glands. To do this, an ultrasound of the abdominal cavity is performed. It will show the structure of organs, help compare the left and right adrenal glands, and see tumors. X-ray reveals mineralization of organs, enlarged liver, and bone lesions due to osteoporosis, which are characteristic of the syndrome.

MRI and CT are used to detect pituitary adenoma. But this device is not always available in veterinary clinics.

Diagnosis of Cushing's syndrome in dogs is quite complex and consists of several types of tests:

blood tests - clinical and biochemical;
special tests for cortisol levels in the blood;
functional tests confirming that increased level hormone is caused specifically by Cushing's syndrome;
Ultrasound of the adrenal glands.

Once the excess level of the hormone is confirmed by blood tests and tests, you need to find out which organ provokes this pathology - the adrenal glands or the pituitary gland. This is what is being done for ultrasonography. The owner should take into account that the drugs for tests and the ultrasound procedure are quite expensive. But this is a small thing compared to the cost of treatment if the diagnosis is confirmed.

After examining the dog, the doctor will prescribe general tests blood - clinical and biochemical, and urine analysis to identify accompanying pathologies, a survey ultrasound/X-ray of the abdominal cavity, as well as more specific tests - a blood test for the hormone - cortisol, but the determination of the level of cortisol in the blood is done under the influence of drugs.

To clarify a preliminary diagnosis, veterinarians resort to various methods diagnostics The most commonly used are ultrasound and x-ray.

The latter is needed to detect salt deposits on the mucous membranes of the trachea and bronchi. In addition, X-ray examination can reveal an enlarged liver and a distended abdominal wall. This characteristic symptoms for Cushing's syndrome.

Ultrasounds are typically used to examine the adrenal glands. Using ultrasound, doctors can evaluate the condition of the glands and determine the presence or absence of tumors.

Various tomographs are used to use the pituitary gland and hypothalamus.

An ACT test is required. First, the dog's blood cortisol level is determined, and then an injection with ACTH is given. After 60 minutes, the cortisol level is re-determined. The disease is confirmed if the hormone level after injection exceeds 600 nmol/l.

As you might have guessed, identifying this disease is only possible in conditions veterinary clinic. The signs of pathology that we have just examined may well correspond to other ailments. Moreover, they can also be of hormonal origin. Not the most fun prospect, right?

It is not difficult to identify the disease at any stage and diagnose the animal, since the syndrome is an easily diagnosed ailment with a clearly pronounced clinical picture. The diagnosis is made based on a visual examination of the dog and data laboratory research. At the same time, both the symptoms and laboratory data for both forms of the disease will be virtually identical.

To make a diagnosis, the following are required:

General blood test of a dog. When examining the material, it is revealed increased content in plasma of erythrocytes, glucose, leukocytes and hemoglobin. Data indicating the presence of pathological processes in the animal’s body.
Biochemical analysis. In the blood serum, an increase in the level of cholesterol, cortisol and alkaline phosphatase, and changes in protein fractions are detected.
X-ray. Detection of bone osteoporosis, liver enlargement. In some cases, in some dogs, specialists diagnose mineralization of the walls of the bronchi and adrenal glands.
Ultrasound is necessary for both mild forms of the disease and severe ones, since the syndrome occurs with the formation of tumors and adenomas. The study shows enlargement of the adrenal glands, the presence or absence of neoplasms.

For correct diagnosis It is for Cushing's syndrome that special tests are often used - taking small doses of dexamethasone.

If your dog exhibits any of these symptoms, it is best to make an appointment with your veterinarian as soon as possible. If left untreated, Cushing's disease can cause further complications such as diabetes. If you think your dog is starting to drink noticeably more, you can measure how much water he is consuming.

This information will be very helpful to your veterinarian. Use a measuring cup at the beginning of the day to record the exact amount of water you put in your dog's bowl. Then, at the end of the day, you will be able to determine the amount of water that is left in it, and all you have to do is calculate the water that the dog drank.

If your dog is very thirsty, you may need to refill the bowl. Water consumption should generally not exceed 100ml per kg body weight over a 24 hour period. Remember that your pet may begin to drink more water if you change his diet to a dry diet, but excessive water consumption will still help confirm that the consumption is still too high.

A sample of your dog's urine collected on the morning of the appointment may also be a useful test for your veterinarian. However, unfortunately, there is no diagnostic test that can guarantee a 100% diagnosis using a urine sample alone, so your veterinarian will have to run several other tests. A blood test is usually used to rule out any other medical conditions that may be causing the symptoms. Your dog may also need an abdominal ultrasound.

Treatment

Treatment for Cushing's disease in dogs can be medication or surgery. The choice of method depends on where the pathology is localized.

Conservative

Drug therapy is aimed at reducing the production of cortisol and ACTH production, correcting metabolic processes in the kidneys, bone tissue and normalizing the functioning of the cardiovascular system. To suppress the secretion of hormones, the following are usually prescribed: Bromocreptine, Chloditan (mitotane), Ketoconazole, Cyproheptadine.

Chloditan is given to dogs orally for 2-3 weeks, the dosage is 25 mg/kg body weight. Frequency of administration: 2-3 times a day. The drug is prescribed until the cortisol level is within 50-100 nmol/l. Afterwards, secretion is maintained by prescribing a dosage of 50 mg/kg (1 time per day).

Bromocretin (Bromergon) is prescribed to dogs at an initial dosage of 0.1 mg/kg for 1 week. Then the concentration is reduced by half and after 2-3 weeks a maintenance course of therapy is prescribed - 0.05 mg/kg. The total duration of treatment does not exceed 6-8 weeks.

Ketoconazole in tablet form is prescribed not to regulate hormones, but to treat the skin of an animal. The dosage is as follows:

first week – 10 mg/kg (1 time per day);
second – 20 mg/kg (1 time per day);
third – 30 mg/kg (2 times a day).

To normalize metabolism in bone tissue, drugs are prescribed that enhance the absorption of calcium from the intestines. For example, Tridin or Osein.

In any case, the veterinarian sets the dosage and drug based on the characteristics of the disease in the animal. Therefore, it is recommended not to risk the life of your pet and not to self-medicate.

Surgical

An alternative (surgical) treatment for this syndrome is to remove the tumor of the adrenal gland, pituitary gland or hypothalamus, if metastases have not occurred. It is possible to excise the adrenal glands themselves, after which the dog will be on hormone replacement therapy (taking glucocorticoids and mineralcorticoids) for life.

The difficulty is due to the fact that the syndrome usually affects older animals and by that time other diseases surpass it in importance.

Treatment for Cushing's syndrome in dogs depends on whether the tumor is found in the adrenal gland or the pituitary gland. If the adrenal glands are damaged, a surgical operation is performed to remove them - provided that there are no metastases. Since these glands produce the hormones necessary for the body, replacement therapy is suggested. In practice, it looks like this: the dog takes mineralcorticoids and glucocorticoids for life. It's not a big problem

The situation is more complicated when the pituitary gland is affected. With this form of hyperadrenocorticism (another name for the disease),

Drugs are recommended that suppress the production of excess cortisol by the adrenal glands. This point presents the main difficulty. There are no such drugs in domestic veterinary pharmacies; they need to be purchased abroad, and they are very expensive.

Treatment

When talking about the treatment of hypercortisolism, as in other cases, the emphasis is always immediately placed on the fact that the method will completely depend on the form of the disease. However, in this case, the choice of method plays a role exclusively in the situation when it comes to surgical intervention.

In a relationship drug therapy Treatment will depend on the cause of the disease, of which there are only three:

For a long time, the dog took hormones similar in composition to cortisol.
Hypersecretion of adrenocorticotropic hormone (ACTH) by pituitary adenoma.
Hypersecretion of cortisol by the cortex of the adrenal gland affected by a tumor.

Reference. Some experts, when listing the reasons, in addition to those already indicated, additionally name two more: absolutely any brain tumor, which with its volume compresses the pituitary gland and blocks its signals. As well as toxic poisoning of the animal.

In these cases, treatment will be etiotropic: aimed at the root cause of the development of the pathology.

To treat the disease, surgery may be prescribed (for a unilateral adrenal tumor), but drug treatment in the form of tablets is more often used.

In foreign veterinary medicine, studies have been carried out proving that treatment of hyperadrenocorticism prolongs the life of animals significantly. Therefore, timely contact and subsequent cooperation with veterinary specialists will prolong the joy of communication between owners and their pets.

If the disease was caused by a tumor of any gland, then it is completely impossible to cure the dog. However, treatment makes it possible to prolong the pet’s life and relieve it of some pathological symptoms.

The choice of one or another treatment strategy is determined by the results of the study and the reasons that caused the pathology. So, therapeutic assistance appears only in animals with clearly visible symptoms.

If the dog was diagnosed based on laboratory test data, but there are no symptoms of pathology, then therapy is not carried out, since it can significantly accelerate the development of the disease and worsen the animal’s well-being.

As an emergency measure, veterinarians may perform surgery. It's about about tumor removal. Most often it is removed along with the gland.

It is worth noting that when the pituitary gland is damaged, operations are not performed in our country. Veterinarians have too little experience in this area. In addition, surgery on the pituitary gland has the following negative aspects:

It costs a lot.
There are very few qualified specialists, so the result of the intervention is unpredictable.
Lifetime hormone therapy after operation.
There is a high risk of diabetes in the animal.

Veterinarians operate on the adrenal glands much more readily, since the operation is less complicated. Despite this, many animals die after surgery, and survivors experience various hormonal disorders and complications.

Due to the high risks of surgery, drug therapy remains the best treatment option.

Most often, the drug Mitotan is used to stabilize the condition of a four-legged patient. It destroys tumor cells in the adrenal cortex.

This drug should be used according to the following regimen:

The medicine is added exclusively to the feed.
At the beginning of the course, the dosage does not exceed 12 mg of the drug per kg of weight.
Treatment continues until the symptoms of the pathology disappear.
After the symptoms disappear, the medicine is continued to be given to the animal along with food at a dose of 2 mg/kg once every few days.

Mitotane prolongs the life of an animal by several years. However, this medication should be taken for life.

Sometimes Mitotane is replaced with Trilostane. The latter drug acts differently: it suppresses the production of hormones in the adrenal glands.

Trilostane is given to dogs at 6 mg per kg of body weight once a day. After two weeks of therapy, the level of cortisol in the blood is assessed, and the dosage is adjusted upward or downward.

Other drugs can be used for therapeutic purposes, however, their effectiveness is low, so today there are simply no alternatives to Trilostane and Mitotane.

IN last years veterinarians began to practice radiation therapy in the treatment of hyperadrenocorticism in dogs. This technique shows good results, but is not yet widely available, since the mechanism of such therapy has not yet been sufficiently developed.

The described disease can be effectively treated medications. But often, after diagnosing the disease, the dog’s life expectancy is 2-2.5 years. This is due to the fact that Cushing's syndrome causes a chain of irreversible consequences - complications affect the musculoskeletal system, cardiovascular and nervous system, reduce the body's resistance to infections, increase blood pressure.

The main goal of the veterinarian prescribing treatment for the disease is to ensure that the production of cortisol by the adrenal cortex is normalized without causing its deficiency in the body. The specialist may prescribe: Lysodren (lysodren), Mitothan (mitotane), Chloditanum (chloditan) or op’DDD. Moreover, for each individual case, treatment and drug (dosage) are prescribed individually.

The first sign that Cushing's treatment was prescribed correctly is a decrease in the amount of water consumed by the dog. However, during a course of drug therapy, the animal may develop complications (vomiting, increased lethargy, refusal to eat), which may indicate the development of concomitant diseases.

1. Pituitary-dependent Cushing's syndrome: treatment will require taking a drug containing the active element trilostane. Treatment is aimed at suppressing cortisol production. The medications typically require daily administration throughout the dog's life. Symptoms generally decrease fairly quickly, often within the first 2 weeks after starting treatment.

The dog will need regular checkups and blood tests to make sure the medicine is working and not causing any side effects or complications. Blood tests are usually performed after 10 days of taking the drug, after 4 weeks, and then every 3 months. The prognosis for treatment is usually good.

Therapeutic measures

Now we get to the most important thing. How can all this be treated, and can it be treated at all? You should immediately warn animal owners that therapy for this disease is expensive and time-consuming, so you will have to be patient.

As for drugs, ketoconazole is often used. Oddly enough, but this... antifungal agent! What do fungi have to do with Cushing's syndrome? In principle, they have absolutely nothing to do with it. The action of the drug is simply based on suppressing the production of adrenal hormones. This is exactly what we need!

Trilostane is much more effective. What is the treatment regimen for Vetoril (another name for trilostane)? It should be prescribed exclusively veterinarian, but in most cases, single (per day) doses of no more than 2.5 mg/kg are used. As an option, the daily amount is divided into two times. Attention!

In some cases, surgery may be prescribed. But this applies only to tumors of the adrenal glands themselves, since the pituitary gland of dogs in our country is practically not operated on. Are there any alternatives? After all, Cushing's herbal treatment for dogs is advertised! That’s right, but this “therapy” doesn’t have any effect. At all.

Forecast and consequences

Considering all of the above, we come to the conclusion that the owner of a dog affected by Cushing’s syndrome has a choice between bad and very bad options. Namely:

if the pituitary gland is damaged, provide your pet with expensive imported drugs;
if the adrenal glands are damaged, perform surgery and use hormone replacement medications for the rest of the dog’s life;
leave the dog alone and let him die a natural death;
put to sleep if you can’t bear to watch him suffer.

If the pituitary gland is damaged, if funds allow, it is possible to purchase medicines abroad. Nowadays, this can be done using online pharmacies. If the owner

faced the problem of Cushing's syndrome, one can only sympathize with him and the animal. But miracles happen, and perhaps the pet will live for several more years, albeit on artificial hormones. Not the best bad way out from this situation.

Risk group

Cushing's disease can occur in dogs of any breed and gender. However, older animals are most often at risk. It has also been established that the breeds most prone to the disease are dachshund, poodle, beagle, boxer, German shepherd, basset hound and the entire group of terriers.

Boxers,

Prevention

There is no prevention for spontaneous Cushing's syndrome. Veterinarians advise regularly examining their pets. Only in this case can you find primary signs pathology even before the symptoms are revealed.

To prevent the development of an iatrogenic type of disease, do not self-medicate, especially with hormonal drugs. Carefully study the information about the composition of the medicine. Do not neglect consultation with a veterinarian, even if you want to cure the most simple illness dogs.

In most cases, this pathology is detected in older dogs. Considering the insufficient knowledge of the etiology of tumors of the pituitary gland and adrenal glands, the development of effective preventive methods seems impossible.

To prevent Cushing's disease, veterinarians advise dog owners to regularly examine their pets. In this case, it will be possible to promptly identify the pathology and begin its treatment, which will prolong the life of the pet.

Treatment for Cushing's syndrome is very expensive and does not provide guaranteed results. Therefore, if the dog is elderly, veterinarians suggest that the owners euthanize the pet. And here each person himself decides the fate of his four-legged friend.

Forecast

Hyperadrenocorticism (Cushing's syndrome) is one of the most common diseases of the endocrine system in dogs and a fairly rare disease in cats. The cause of the disease is increased production hormones of the adrenal cortex, mainly cortisol.

There is a distinction between spontaneous hyperadrenocorticism, which can be caused either by hyperplasia of the pituitary gland or damage to it by a tumor (Cushing's disease), and by a primary disease of the adrenal glands - adenoma or carcinoma of the adrenal gland (Cushing's syndrome). There is also iatrogenic hyperadrenocorticism, caused by excessive intake of corticosteroid hormones from the outside.

Clinical symptoms associated with the multifaceted influence of cortisol on almost everything in life important systems– genitourinary, cardiovascular, nervous, musculoskeletal, reproductive and immune. The liver is also affected, as well as the skin, kidneys and others. endocrine glands. The main signs that the owner of the animal should first pay attention to are severe thirst and frequent urination with urinary incontinence both during the day and at night. Also in the etiology of the disease there is increased appetite, sagging belly, drowsiness, intolerance physical activity and muscle weakness, obesity. From skin manifestations– symmetrical alopecia, calcification and hyperpigmentation of the skin. Disorders of the reproductive cycle and atrophy of the testes occur. More rare neurological signs associated with pituitary tumors are depression, impaired coordination of movements, blindness, anisocoria (inequality in the size of the pupils of the right and left eyes), etc. Concomitant manifestations include secondary diabetes mellitus, pulmonary embolism, genitourinary tract infections, and pyoderma.

When conducting laboratory tests in the blood, the following trends are revealed: high levels of alkaline phosphatase; increased levels of ALT, cholesterol, glucose; erythrocytosis; eosinopenia; lymphopenia; leukocytosis; low level thyroid hormones.

Urine has low density, sometimes proteinuria and pyuria occur. Ultrasound and radiography of the abdominal cavity can reveal the presence of adrenal tumors; in addition, Cushing's syndrome is characterized by hepatomegaly (enlarged liver). To more accurately confirm the diagnosis, humane medicine uses CT and MRI of the pituitary gland and adrenal glands.

The determination of basal cortisol in blood serum is low diagnostic value. Therefore, certain screening tests are performed to confirm the diagnosis. For primary diagnosis, you can use the cortisol/creatinine ratio in urine (if the result is negative, this diagnosis is unlikely).

A small dexamethasone test and a stimulation test with ACTH can accurately detect hyperadrenocorticism. A large dexamethasone test makes it possible to differentiate hyperadrenocorticism of adrenal and pituitary origin.

Treatment for adrenal tumors involves adrenalectomy (surgery to remove the adrenal gland). At conservative treatment drug of choice for doctors veterinary center"Zoovet" is mitotane, it is used for both the disease and Cushing's syndrome. However, dogs with adrenal tumors often require more high doses than in dogs with pituitary hyperadrenocorticism. Alternative Methods Treatment consists of drug therapy with L-deprenyl, ketoconazole (nizoral), cyproheptadine (peritol). In different animals in different studies, treatment results were different (often the effectiveness of therapy did not exceed 25%). Hypophysectomy (surgical removal of pituitary tumors) and irradiation of the pituitary gland are practically not used due to the lack of appropriate technical equipment and the high risk of such therapy.

The prognosis for many animals is good, especially if the animal survives 16 weeks after starting mitotane drug therapy. Survival times in one study ranged from a few weeks to 7 years. The average period is about 2 years. Poor prognosis for pituitary macroadenoma, adrenal adrenocarcinoma with metastases and in animals with neurological manifestations.