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🐾

EYE DISORDER IN DOGS And natural home remedies

Your pet's eyes are one of the more important and sensitive parts of their anatomy. There are a number of different eye disorders.

Common eye disorders

Conjunctivitis (red eye or pinkeye),

Epiphora(excessive tearing)

Uveitis 

KCS (dry eye)

Glaucoma

Cataract 

Corneal ulceration and PRA (progressive retinal atrophy).

Eyelid or eyelash abnormalities

Conjunctivitis 

Conjunctivitis, also called pink eye, is a common condition in dogs. 

It is defined as inflammation of the red, conjunctival tissue around your pet's eye. It is the most common cause of red eye in dogs and cats.

The most common causes of conjunctivitis are bacterial conjunctivitis, bacterial infection of the tissue around the eye, and allergie .Other more serious causes include glaucoma (swelling in the eye) or an ulcer on the cornea (erosion on the surface of the eye).

Sings When You Need To Run To The Veterinarian 

1. Pet’s eye infection is painful, with your pet rubbing an eye;
2. if the cornea appears to be indented  or layered; 
3. and if the entire eye becomes cloudy;

Treatment of Conjunctivitis in Dogs 

Treatment depends on  cause of the conjunctivitis. Allergic conjunctivitis is most commonly treated with eye drops  containing steroids. Sometimes oral steroids and antihistamines are also recommended if there is systemic inflammation. Prevention is most important with allergic conjunctivitis, so it’s best avoid allergens affecting your dog. Allergic skin testing, flea preventatives, environmental changes, and food trials may be recommended by your veterinarian.  

Bacterial conjunctivitis is treated with topical antibiotics, though sometimes oral antibiotics and anti-inflammatory medications may also be used depending on how serious is an infection. Viral conjunctivitis is often treated with time and oral antioxidants to boost the immune system, and sometimes with either oral or topical anti-viral medications.  

Dogs diagnosed with eyelid or eyelash abnormalities will require surgical correction Dogs diagnosed with chronic dry eye will require lifelong medications to stimulate tear production. Dogs with immune-mediated medical issues will need medications that affect the immune system both orally and topically, for their entire life.

Home Remedies 

There are many home remedies for conjunctivitis 

EYE, TEARS. The lubricated eye tears used for people can be effective for minor infections . First wipe any discharge away from the eyes with clean sterile cloth apply two to three drops in the affected eye three times a day 

TEA -has tannins ,it is anti-inflammatory and antimicrobial . Cup of strong black tea ,place three to four drops in the affected eye three times a day . It should be made fresh every day.Could be used also Camomile and Green tea for topical eye infection .

HONEY is as an effective antibacterial, and a good home remedy to combine with the tea.  Local, organic honey, mixing in 1 teaspoon of honey with 1 cup of black, green or chamomile tea. Apply 3-5 drops to affected eye 3 -4 times daily. 

• In my professional opinion when it comes to minor topical eye infections , i found this  very helpful.It’s ok to try out some natural remedies first ,before you run to the veterinarian.

As you can see also dr. Johns recommended that natural treatments ,he showed on video the procedure how to make that remedy at home 

https://youtube.com/shorts/_mddkg8y-10?si=uqAf4yqZIp-SLFWI

How Long Does Conjunctivitis in Dogs Last

Some forms of-conjunctivitis can resolve on their own in dogs with  healthy immune systems. Dogs usually need therapy to avoid chronic changes.

The duration of clinical signs depends on the cause. With good treatment, bacterial conjunctivitis is usually resolved within 5 to 7 days. Viral conjunctivitis can take up to 3 to 4 weeks for full resolution.   

Allergic conjunctivitis will stay until the underlying allergen is eliminated. Chronic dry eye and immune-mediated disorders are often lifelong and need continued therapy. 

Written by Imrana Sljivo DVM

Resources: 

https://www.petmd.com

https://beyondpets.com/pet-health-plus/conjunctivitis-in-dogs/

What Is Diabetes in Dogs?

Diabetes is a Disorder Characterized by Elevated Levels of Blood Glucose (blood sugar) . 

Lack of insulin production causes diabetes.Elevated blood sugar levels can cause serious health problems.
Undiagnosed or diagnosed diabetes in dogs can turn into a medical emergency called DKA diabetic ketoacidosis.
Vomiting diarrhea decreased appetite ,lethargy  are sings of urgency.You need to call your vet 
immediately if you notice these symptoms. 

How long do dogs live after being diagnosed with diabetes?

Dogs with diabetes can do well and continue to live relatively normal lives with insulin therapy and diet changes.

Can you treat diabetes in dogs without insulin?

No. Insulin is a lifelong part of treatment in a diabetic dog.

Types of Diabetes in Dogs

There are primarily two types of diabetes in dogs:

• Type I—Known as insulin-dependent diabetes and is like Type I diabetes in humans. This is the most common type to occur in dogs.
• In Type I diabetes, insulin-secreting cells in the pancreas are destroyed, causing an absolute lack of insulin. 
• This is happening because autoimmune disease or recurrent pancreatitis 
• These dogs needs insulin supplementation for the lifetime 
• Type II—Known as noninsulin-dependent diabetes and is like Type II diabetes in humans. This form of diabetes is typically related to obesity but it’s very rare in dogs 
• In Type II diabetes, the pancreas may produce less insulin, and the body’s cells respond poorly to the insulin that is secreted. This leads to higher glucose  in blood and less glucose entering the cells .

Symptoms of Diabetes in Dogs

Symptoms of diabetes in dogs are:

      

1. Increased thirst 
2. Increased urination
3. Increased appetite 
4. Weight loss 
5. Lethargy
6. Dehydration
7. Cataract 

If you don’t treat your dog’s diabetes, the effects of disease are severe and can be also fatal.

These are secondary and long-term effects 

• Seizures-hypoglycemic seizures 
• Liver disease-Fatty liver 
• Diabetic ketoacidosis (DKA)—DKA is a life-threatening complication of diabetes. When the body break down fat for energy and create ketones blood becomes acidic.
• Hyperglycemic hyperosmolar syndrome (HHS)—HHS is a life-threatening complication of diabetes that occurs when the blood sugar is too high for too long, leading to severe dehydration and disorientation.
• Diabetic neuropathy—Neurologic damage that causes paralysis,but rarely 

Causes of Diabetes in Dogs

Diabetes in dogs can have a few causes. Most dogs have Type I diabetes.Type I diabetes is most likely caused by immune system mistakenly attacking insulin-producing cells in the pancreas, leading to loss of insulin secretion.

Other causes of diabetes are 

• Genetics
• Increased hormone levels (progesterone, growth hormone and cortisol)
• Cushing’s disease 
• Chronic pancreatitis
• Obesity and high-fat diets

Females and middle-aged to senior dogs have a higher risk of diabetes, as well as dogs that are obese. Dog breeds that are predisposed to diabetes include:

• Alaskan Malamute
• Australian Terrier 
• Bichon Frese
• Carin Terrier
• Keeshond
• Labrador Retrive
• Miniature Schnauzer
• Miniature Dachshund 
• Norwegian Elkhound
• Poodle
• Pug
• Samoyed 
• Tibetan Terrier
• Yorkshire Terrier

How Veterinarians Diagnose Diabetes in Dogs

To diagnose diabetes, veterinarians must find persistent high blood and urine glucose values.

Your dog  may also have the following tests:

• Blood chemistry and complete blood count (CBC)
• Urinalysis
• Fructosamine
• Radiography
• Thyroid tests
• Cushing’s testing
• Abdominal ultrasonography
• Pancreatitis blood testing

Treatment of Diabetes in Dogs

Diabetes treatment in dogs primarily includes insulin and diet changes.

Insulin is the main treatment for diabetes ,for dog can be very expensive yearly ,because they need to get insulin two times a day ,so maybe it’s good idea to get an pet insurance .

Most dogs tolerate insulin injections very well. 

Diet therapy is most important, you should feed your dogs the same thing, around the same time every day. Consistency is key and leads to better and faster regulation of blood sugar in dogs.

Prescription diets are available for diabetic dogs. This diet contain high fiber with appropriate fat, protein, and carbohydrate to maintain blood-sugar levels.

You should ask your veterinaria which food is best for your pet.

Recovery of Diabetes in Dogs

Dogs with diabetes require lifelong monitoring and treatment. Insulin and diet control are typically needed for life.

Initially after diagnosis, your dog may need frequent vet visits to help your vet determine the best insulin dose for treatment to control your pet’s blood sugar. 

After that, if your pet is well regulated, vet visits may be every three to six months and will  include some blood tests to ensure their diabetes is well controlled.

Never change your pet’s insulin dose without the consultation with your vet.

If your dog is not eating or they’re vomiting, call your vet to determine if you should give their insulin. If they are experiencing any signs of low blood sugar, such as weakness or tremors/seizures, you should call vet immediately.

If your dog is showing a breakthrough of clinical signs such as increased drinking, tell your vet. 

Prevention of Diabetes in Dogs

Diabetes in dogs is not preventable, but there are some things pet owners can do .

All dogs should be seen their vet every year for a exam and blood tests 

Senior dogs, typically over the age of 6, should be taken to the vet every six months. This can help to detect changes well before they become serious.Dogs can get treatment or have lifestyle changes before they become sick.That can help them to have better quality of life and longer life. Very important is a high quality food and  regular exercise .

Written by Imrana Sljivo DVM🐾

References and sources:

Blois SL, Dickie E, Kruth SA et al: “Use of Insulin Glargine in Dogs with Diabetes Mellitus.” Vet Rec 2012 Vol 170 (2) pp. 52.

Mattin M, O’Neill D, McGreevy PD et al: “An epidemiological study of diabetes mellitus in dogs attending first opinion practice in the UK.” Vet Rec 2014 Vol 174 (14) pp. 349.

Fall T, Hamlin HH, Hedhammar A, et al: “Diabetes mellitus in a population of 180,000 insured dogs: incidence, survival, and breed distribution.” J Vet Intern Med 2007 Vol 21 (6) pp. 1209-16

Tilley LP, Smith FWK. “The 5-Minute Veterinary Consult : Canine and Feline.” Lippincott Williams & Wilkins; 2005

Veterinary Information Network®, Inc. VINcom. Published online June 29, 2005. Accessed April 4, 2022. http://www.vin.com.

https://www.hillspet.it/dog-care/healthcare/dog-diabetes-mellitus?