Cushing's disease in dogs caused by steroids

The most common test used to diagnose Cushing’s disease in dogs is the low-dose dexamethasone suppression test (LDDS). A blood sample is taken to measure a dog’s baseline cortisol level and then a small amount of dexamethasone is administered by injection. Blood cortisol levels are measured four and eight hours after the dexamethasone is given. In a normal 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.

It may not be necessary to do an all day test to monitor how well the Lysodren is working. Once we know that Cushing's disease is present we usually use the ACTH response test to monitor the response to treatment. It is usually possible to do this test in an hour (although some vets recommended two hours). Many of our clients come, let us draw the blood and give the ACTH and then walk their dog around our clinic property for an hour or go on a short errand and return. This test takes less time than a dexamethasone suppression test which is usually thought of as the best way to diagnose Cushing's disease and is the initial test that many dogs get, for that reason.

This disease hits close to home for me since my own horse Prophecy was diagnosed with it at the age of 9 using the morning and night cortisol levels testing method. I have had him on pergolide since that time, which was about four years ago. His symptoms at the time of diagnosis were for the most part very mild and very subtle. He had many episodes of "ain’t doing right,” laziness in the arena and a mild case of laminitis. His owner at that time, having had a dog with Cushing’s disease, asked me to test him. I’m happy to report that he is symptom free today. However, to be on the safe side, I’m starting Prophecy on higher dose vitamin E supplements and will test him using low-dose dexamethasone suppression combined with TRH stimulation. If he tests positive with that method, I will seriously consider trilostane for him.

The drug's most common side effects are poor or reduced appetite, vomiting, lack of energy, diarrhea, and weakness. Occasionally, more serious side effects, including bloody diarrhea, collapse, severe sodium/potassium imbalance, and destruction of the adrenal gland may occur, and may result in death. In 2014, with input from CVM, the manufacturer updated the information about patient monitoring and side effects on the package insert. Although not proven to be caused by Vetoryl, some additional side effects reported to CVM and now included on the package insert are adrenal insufficiency, shaking, elevated liver enzymes and elevated kidney tests.

Cushing's disease in dogs caused by steroids

cushing's disease in dogs caused by steroids

The drug's most common side effects are poor or reduced appetite, vomiting, lack of energy, diarrhea, and weakness. Occasionally, more serious side effects, including bloody diarrhea, collapse, severe sodium/potassium imbalance, and destruction of the adrenal gland may occur, and may result in death. In 2014, with input from CVM, the manufacturer updated the information about patient monitoring and side effects on the package insert. Although not proven to be caused by Vetoryl, some additional side effects reported to CVM and now included on the package insert are adrenal insufficiency, shaking, elevated liver enzymes and elevated kidney tests.

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