My dog has high cortisol but seems normal. Is it Cushing's? Treat?

Cushing's or Hyperadrenocorticism is a fairly common endocrine disease in dogs. It can be caused by a bit of overactive tissue in the brain (in the pituitary gland, which is the master ruler of hormone secretion in the body) or a mass in an adrenal gland (sits by the kidneys, secretes hormones as directed by the pituitary gland). Basically what happens is an excess of a hormone in the body, usually a steroid called cortisol, if it is traditional Cushing's. This then causes some symptoms in the pet, blood work changes, and sometimes other changes like high blood pressure. I suspect based on the value that you report that this was a liver enzyme elevation call ALP. This very commonly occurs in pets that have Cushings, but is not specific for Cushing's and elevation can be caused by other disease processes. This value does not correlate with severity of disease as many dogs have a high value. It sounds like your vet is on the right track by recommending an ultrasound to look at the adrenal glands and also the rest of the abdominal organs to rule out other disease processes. Ultimately Cushing's Disease has to be diagnosed by some sort of endocrine testing which your vet may recommend as well. Treatment if then based on what type of Cushing's disease is present. I hope this helps and thank you for using Petco Pet Education Center, formerly Petcoach!

Thank you for posting the results! I'm not sure what you are reading regarding diagnosing early and late, it is not so much of an issue with Cushing's. In really really advanced cases there can be a lot of damage done to other body systems but it is usually caught on way before that stage. And your dog is not there. From your results I can see that the post result is a two fold increase from the high end of normal. This makes me think the disease has likely been rumbling away for some time. Like I say the most important determination of progression of the disease are the clinical signs. If your dog is getting coat change and a pot belly then it's been going on for a few months. The acth stimulation test is not perfect but it is highly suggestive of Cushing's in this case. If your dog has clinical signs I would get your vet to start therapy with vetoryl which should make a huge difference. It's not too late to start treatment.

It is common for people to decide not to treat their dog for Cushing's disease. Unfortunately, the treatment is expensive and has side effects. The biggest concerns with Cushing's disease are the side effects of the disease (drinking more, urinating more, etc) and the potential for the dog to develop other infections from a suppressed immune system. So, I recommend that a dog with Cushing's disease be closely monitored at home for any changes in clinical signs and have them evaluated in case the dog is developing a secondary infection. That will often mean checking urine samples on a regular basis to make sure a urinary tract infection isn't hiding. I have attached more information on Cushing's disease below. https://www.veterinarypartner.com/Content.plx?P=A&S=0&C=0&A=635 At almost 15 years old, if Bullwinkle has other health problems, then Cushing's disease may or may not shorten his life. But the most important thing is to closely monitor him and make sure any infections are treated right away. Good luck! I hope that was helpful. Thanks for using PetCoach.

There are studies that show it does not affect their life span ! It is a disease of symptoms and can be frustrating to live with. It will cause an increase in drinking and urination which can lead to accidents, it causes thin skin and a pot belly appearance with weight gain a muscle loss. In severe cases it can lead to a skin infection and calcifying of the skin

My biggest concern is that your vet is talking about hyperadrenocorticism also known as Cushing's disease. This is what I think of when you discuss those symptoms, liver enzyme elevations and adrenal issues. Cushings is where they produce too much cortisol in their system. You can do a test to rule this in or out. You can have your vet do a low dose dexamethasone test OR a ACTH stimulation test. If it comes up positive then you can treat with the disease with a daily medicine called trilostane to help the symptoms. But you cannot cure cushings. I hope this helps and will help guide you in a conversation with your vet if this is actually what your vet thinks is going on.

Hi there and thank you for posting your question. The medication used to treat Cushing's disease can cause some pretty serious problems if not monitored appropriately. Unfortunately, the blood testing to monitor Cushing's is expensive. For the first two to three months I will perform this particular test called the ACTH test to monitor the response to treatment and to make sure that the medication is not causing the reverse problem called Addison's disease. If the dog is well regulated I might spread out the blood test to once every 6 months to ensure that the values are regulated. Of course, this is something that you will have to discuss with your veterinarian who is ordering this blood test up every few weeks. Every doctor is different with how they monitor their patients, so not all of us will recommend the exact same plan for every patient. I hope this helps guide you in the right direction. Please let me know if you have any further questions or concerns and I would be more than happy to help you further.

Poor Nemesis. Sometimes pets will need the medication adjusted. I recommend to call your veterinarian and ask if another test is needed to evaluate the blood levels in his body. The test is called an ACTH stimulation test. It has been found that 50% of dogs with Cushing’s disease will also have a urinary tract infection that can only be detected with a urine culture. I recommend to have this test done as well as this will cause constant drinking and urination. Other conditions such as thyroid disease, diabetes or kidney disease can also cause these signs. You must start ruling them out. Best of luck.