Wednesday, September 18, 2024

Advice About How to Treat a Dog with Cushing’s Disease


In my previous article I talked about Cushing’s Syndrome  in general,also I mentioned some conventional treatments and possibilities .

Today i want to say more about natural remedies and  healthy food that you can give to your pet to help them overcome more easily the issue.


Some people say that poor-quality commercial food diet  including diets high in fats and low in proteins can also contribute to Cushing’s in dogs.In some cases especially if your dog has mild pituitary-dependent Cushing’s maybe the conventional treatment is not really urgent 

 

Dogs with mild pituitary-dependent Cushing’s should be closely monitored .Some veterinarians recommend a natural, anti-inflammatory diet and herbal therapy for treatment 


What You should Consider Before Taking Any Step to Treat your Pet’s condition 

  • Talk to your veterinarian before you change your dog’s diet.
  • Notify your veterinarian before you start your dog on any herbal or natural supplements.
  • If you choose not to treat your dog immediately, closely monitor for any worsening symptoms


What Are Natural Treatments for Dogs with Cushing’s?

Many vets and owners have found natural treatments that can help with Cushing’s symptoms. Most of the natural treatments are herbal or dietary supplements, including:

  • Fish oil
  • Dandelion
  • Magnolia bark
  • Si Miao San
  • Ginkgo biloba
  • Melatonin
  • Nettle
  • Rosehips
  • Clover
  • Burdock
  • Milk thistle
  • Homeopathic pituitary extract
  • Homeopathic formic acid
  • Kelp
  • Clover
  • Garlic
  • Apple cider vinegar
  • Phosphatidylserine supplements 
  • Dog food for Cushing’s

For dogs with food-induced Cushing’s, some experts recommend adrenal enzyme blockers, taken a few hours before meals.

Some also recommend acupuncture, which can help regulate the endocrine system and thus help Cushing’s symptoms.


Dietary Changes for Dogs with Cushing’s Disease


Certain dietary changes can also help reduce your dog’s Cushing’s symptoms. They include:

  • Food high in protein
  • Food low in fat
  • Food low in fiber
  • Food  with low purine levels (avoid organ meats)
  • Food low in carbohydrates
  • Food low in calcium
  • Food rich in lignins (including whole grains, nuts and seeds, legumes, fruits, and vegetables)


Specific Food that is Good for Dogs with Cushing’s


carrots -peas -green beans -potatoes -broccoli -celery -lettuce -bok choy -spinach -brussels sprouts -mushrooms -green peas -zucchini
beef -chicken without skin or bones -fish (except sardines) -shellfish -salmon -kidneys -liver -eggs


Raw Diet for Dogs with Cushing’s


Many believe that feeding a dog a raw diet can help with a number of health problems, including Cushing’s disease symptoms. Since your dog’s natural ancestral diet before domestication included raw protein, he is carnivore and he already has the enzymes to break down the bacteria, and you may find general health improvements.

Advantages of a raw diet include:

  • Increased energy levels.
  • Improved skin and coat.
  • Stronger teeth and bones.
  • Improved muscle strength.
  • Better digestion.

Of course there are always some cones 

Concerns of a raw diet could be :

  • Additional supplementation may be necessary, to ensure that your dog’s diet is balanced over the long term specifically calcium and phosphorous.
  • Bacteria in raw meat can get your dog sick if their body doesn’t properly protect against it (in some cases, a dog may not build up the immunity).
  • Proper cleaning after feeding your dog to avoid contamination.
  • Two studies led by a team at the University of Bristol have found dogs who are fed on a diet of raw meat were more likely to excrete antibiotic-resistant bacteria Escherichia coli (E. coli) in their poop . Previous research has shown that there is the potential for bacteria to be shared between dogs and their owners through everyday interaction, leading the researchers to suggest that raw feeding is not the safest dietary choice, and that, if chosen, owners should take extra precautions when handling raw meat and be especially careful to clean up after their dog. 

While a raw diet may not significantly affect Cushing’s symptom ,it can help health overall. In particular, high protein in a raw diet might be  helpful for dogs in danger of losing muscle mass .


What other food You should Give If Your Dog Is on a Raw Diet

If you have your dog on a raw diet, you should follow certain recommendations to help him maintain his health, such as:

  • Introduce a raw diet step by step , so his body has a chance to build up the needed enzymes to destroy bacteria in raw meat.
  • Include raw vegetables, eggs, and small amounts of fruit and starches.
  • Stick to only high-quality meat and proteins.
  • Feed your dog small amounts of dairy products, including possibly a probiotic yogurt with active cultures.



Written by Imrana Sljivo DVM 🐾


Resources 

Evidence that faecal carriage of resistant Escherichia coli by 16-week-old dogs in the United Kingdom is associated with raw feeding' by Oliver Mounsey, Kezia Wareham, Matthew B. Avison, Kristen K. Reyher et al. in One Health


Sunday, September 15, 2024

Cushing's syndrome


This disease is endocrine pathology characterized by an excessive presence of glucocorticoids in circulation.

The condition is very frequent in dogs and rare in cats.  


Racial predispositions ,Dogs that are More Sensitive 

For the pituitary form (Poodle, Dachshund, Boxer, Beagle), German shepherd and

Miniature poodles appear to be frequently affected by adrenal tumors.

Middle-aged or older dogs are also more affected. The pituitary-dependent form can

also affect 1 year old subjects. 

It seems that females are more predisposed than males to develop a neoplastic form of the adrenal gland.

It appears that small breeds <20 kg tend to have the pituitary form; while >20 kg 

adrenal.

More than 80% of dogs show PU/PD

- Decreased central release of ADH

- Interferences with the action of ADH at the level of the renal tubules and loss of tonicity

medulla due to increased renal blood flow

- Accompanying subclinical or manifest diabetes mellitus.


Possible Complication of  this Disorder

Pulmonary thromboembolism caused by a hyperadrenergic state, the clinical signs of this complication are acute dyspnea and orthopnea (dyspneic animal forced to stand) . 


How To Recognize the Cushing Syndrome condition 

Under examination radiographically, plauritic effusion and an increase in the caliber of the pulmonary vessels are observed, above all

the arteries.

We can have:

- Iatrogenic Cushing's;

- Spontaneous Cushing:

Pituitary (80/85%)

Adrenal (15/20%):

▪ Adenomas (40%)

▪ Carcinomas (60%)

From ACTH (ectopic)


Symptoms of the Cushing’s Syndrome 

With direct clinical examination we can detect 

- PU/PD

- Polyphagia (excessive hunger )

- Barrel abdomen

- Muscle atrophy and laziness

- Shallow and frequent breathing/dyspnea

- Gonadal atrophy and anestrus

- Hepatomegaly ( liver enlargement)

- Ectopic calcifications

- Cutaneous signs: bilateral and symmetrical alopecia( area without hair) thinning of the skin,

hyperpigmentation, skin calcinosis, comedones, dry seborrhea, febelectasias, ecchymosis.

The barrel abdomen is caused by the decrease in muscle component and redistribution of body fats (thin skin due to increased catabolism).

The physiological reproductive cycle is altered 

Neurological Symptoms

From a skin point of view, the vascular pattern becomes more visible, the alopecia is mainly localized trunk and neck. If you notice anything like said above ,maybe you should call your veterinarian.


Diagnosis

Often the diagnosis is made only thanks to clinical findings; diagnostic tests

they are often used to evaluate the functionality of the Hypothalamus – Pituitary – Adrenal axis, to confirm

the suspicion and start appropriate therapy.

Other diagnostic tests are ultrasound and laboratory tests and sometimes x-rays.


Collateral investigations

1. RX: Radiological findings : increase in abdominal contrast due to accumulation of fat in the abdomen, hepatomegaly (due to accumulation of steroids), enlargement of the

bladder due to polyuria, dystrophic calcifications of the trachea, bronchi and skin.

A very rare finding  is the presence of a mass of soft tissue or calcification in the adrenal area (neoplasm). Metastases may be present lung carcinomas.

2. Hematological profile Urinalysis

Leukocytosis Hyposthenuria

Neutropenia Possible glycosuria (due to diabetes mellitus)

Lymphopenia Leukocyturia

Eosinopenia

3. Biochemical findings 

> alkaline phosphatase ALP

> cholesterol and triglycerides (lipolysis)

> liver enzymes (ALT, GGT)

> Na + H2o ➔ Hypertension

< K, Ca, P

< urea nitrogen (BUN)

> Blood sugar (due to insulin resistance)

4. Urinalysis: hyposthenuria, glycosuria (due to diabetes mellitus), leukocyturia.

5. Ultrasound:

Pituitary Cushing  Bilateral hyperplasia of both adrenal glands, which appear

increase in volume.

Adrenal Cushing's ➔ Increase in volume of the adrenal gland which is the site of the neoplasm,while the contralateral is often not visible because it is atrophied.

6. Tests

  1. ACTH stimulation test
  2. Low-dose dexamethasone suppression test
  3. Suppression test with high dose dexamethasone 


Therapy to keep your Pet Healthy 

Chronic Cushing's has a deleterious effect, and if left untreated the your pet can die because of changes of immune and cardiovascular system 

1) Trilostane (Modrenal cps 60 mg)

Side effects: Vomiting, rarely diarrhea.

Contraindications: In case of pregnancy or severe hepato-renal dysfunction.

2) Mitotane ( human chemotherapy drug but can be used to treat Cushing in dogs ) 

It’s very similar to Trilostane and has similar side effects 


Other therapeutic options include surgical removal of an adrenal or adrenal tumor

both glands, the latter when we have pituitary cushing; radiotherapy for i pituitary macroadenomas.If you decide to have surgery, you will need to take post-operative care into account pharmacologically to the missing hormones, generally using prednisolone.


Prognosis 

The prognosis depends on the age of your pet, young subjects can survive for up to 6-7 years,

while older about 2 years after diagnosis.



Written by Imrana Sljivo DVM🐾



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