C O L D  R I V E R  V E T E R I N A R Y  C E N T E R

Cushings disease in a dog

CASE REPORTS

• Allergies in a dog

• Allergies in a cat

• Arthritis

• Colitis. otitis

• Cushings disease

• Ear infections

• Feline chronic renal failure

• Heartworm

• Inflammatory bowel disease

• Kennel cough

• Kidney failure, disc disease

• Lymphangitis

• Lymphoma

• Oral papillomas

• Vestibular disease

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Gus is a sweet 13 year-old neutered Welsh Terrier who developed the classic signs of hyperadrenocorticism or Cushings syndrome. He was drinking more, urinating more, had a voracious appetite, disturbed sleep, a distended abdomen, became obese, and developed thin skin and hair coat. His health deteriorated after being treated with oral steroids (prednisone) for allergies and then topical steroids (prednisolone acetate eye drops) following cataract surgery. This case report details how home food and nutritional therapy brought him back to good health without medications, and cured him of allergies!

Adrenal hypertrophy

Gus had undergone cataract surgery in July, 1999. Chronic corticosteroid therapy had made him a rotund 34 pounds, panting and constantly thirsty. An abdominal ultrasound exam in September, 1999 revealed a large left adrenal gland of 3.3 cm with multiple small cysts at the cranial pole. The right adrenal was not visualized. There was sludging of bile in the gall bladder and the liver was markedly enlarged. Several hyperechoic nodules were noted throughout the liver parenchyma.

Surgery, an option

With a possible diagnosis of Cushings disease, Gus had a series of tests to measure his output of cortisol hormone. An adrenocorticotropic hormone or ACTH stimulation test was normal, but endogenous ACTH was low (< 10 pg/ml). His urine cortisol/creatinine ratio was high at 41 supporting a diagnosis of hyperadrenocorticism. Gus either had adrenal-dependent hyperadrenocorticism or more likely, iatrogenic hyperadrenocorticism from his medications. His primary veterinarian consulted with several specialists about the treatment options: surgery in the case of an adrenal tumor, chemotherapy to obliterate the overactive adrenal gland, or watch and wait. Gus's caregiver called us to see what alternative therapy could do. 

Nutritional consult begins

We met Gus only through a phone consultation with his caregiver in November, 1999. She was willing to try anything reasonable that would save her dog from the adverse effects of glucocorticoids. He had been on allergy desensitization injections, was still on prednisone, and still had itchy paws. We requested copies of his medical records and recommended a thyroid profile.  

The thyroid results arrived 2 weeks later. As we suspected, Gus was also hypothyroid. With the blood tests and urinalysis we prepared a BioMedical Profile (nutritional analysis). The BMP outlined specific nutritional therapy to treat Gus's liver disease (steroid hepatopathy), thin skin, weak abdominal muscles, high cholesterol, and low thyroid. The results of his response to nutritional therapy are summarized in the table below. We also recommended a diet of fresh, whole foods as the history suggested a dietary intolerance (food allergy). Good food choices included green leafy vegetables, liver, shellfish, sardines, berries, avocado, sesame seeds, and psyllium seed. 

After three months of nutritional therapy, Gus was responding very well and loved the people food. He still had a voracious appetite however and was eating stool (coprophagia). We have observed this in many patients with B-vitamin deficiencies. By now the caregiver had seen an enormous improvement in Gus's health, not seen since he was a youngster. She wanted to discontinue the other medications that he had always been given such as monthly heartworm preventive and pesticides for tick exposure. We prescribed homeopathic heartworm nosode, and a natural preventive for Lyme disease.

Gus continued to do well in 2000, and had annual re-checks and BioMedical Profiles to monitor his progress and revise the nutritional treatment plan. When his progress hit a plateau we suspected that a dietary component was still triggering some inflammation in his liver. We recommended a food allergy IgE test. When the test results came back, we found Gus was allergic to milk, soy, corn, wheat, beet, carrot, potato and yeast. A hypoallergenic diet was recommended for three months to desensitize him.

Gus's exam at CRVC

Gus lives 2 hours south of CRVC, so office calls are infrequent. He recently made an office call and we were thrilled to see his thick, healthy coat and happy disposition. He is now a healthy dog at 28 pounds. He is playful, active, and generally doing great- with no allergies!

Acupuncture

On physical exam in July, 2001 we observed muscle tremors in his hind legs whenever he got excited. We found muscle spasm (trigger points) along his lumbar muscles and increased sensitivity over acupuncture association points for the adrenal glands (Triple Heater), BL-21. We treated acupoints for the adrenal dysfunction, trigger points for referred pain, and injected a solution of nutrients and antioxidants* into the acupuncture point, Bai Hui (in the lumbosacral space) for the apparent source of his weakness. Later we discovered that radiographs taken in 1999 had also diagnosed spondylosis at the lumbo-sacral junction. We further recommended massage for home care, and acupuncture with Gus's local veterinarian.

* Vitamin B12, glutathione, superoxide dismutase, and a homeopathic remedy for intervertebral disc disease, Discus Compositum (BHI-Heel Co.)

Serum chemistry profiles

    *These values are at one end or outside of the reference range for dogs.

 William Konrad Kruesi, D.V.M.  /2001