Conditions that mimic Cushing's syndrome in dogs often present with similar signs like increased thirst, urination, appetite, hair loss, and a pot-bellied appearance. Major mimics include diabetes mellitus, kidney disease, hypothyroidism, liver disease, and chronic infections like urinary tract infections or pyometra.

What can be misdiagnosed as cushings?

Pseudo-Cushing state

Some people have an abnormal amount of cortisol that is caused by something unrelated to Cushing's syndrome such as polycystic ovarian syndrome, depression, pregnancy, and obesity. This is called pseudo-Cushing state.

What looks like cushings but isn't?

Pseudo-Cushing syndrome (PCS), or, as it has been renamed, "non-neoplastic hypercortisolism," [1, 2] is a group of conditions associated with clinical and biochemical features of Cushing syndrome but in which the hypercortisolemia is usually secondary to other factors.

What is the difference between Addisons and Cushings in dogs?

The main difference lies in hormone levels, with Addison's being too low and Cushing's being too high. Accurate diagnosis depends on hormone testing, like ACTH stimulation for Addison's and LDDS for Cushing's.

Which can have similar effects as Cushing syndrome?

Symptoms such as fatigue and weight gain can have many different causes. Cushing's syndrome may be mistaken for other conditions that have many of the same signs, such as polycystic ovary syndrome or metabolic syndrome. Your doctor will first want to rule out other conditions.

Dog Cushings Disease. Dr. Dan covers symptoms, diagnosis, and treatment of Cushing's disease

What are the early signs of Addison's in dogs?

Clinical signs

• Lethargy.
• Loss of appetite.
• Vomiting.
• Diarrhea.
• Weight loss.
• Increased thirst and urination.
• Trembling.
• Weakness.

What can falsely elevate cortisol?

Patients treated with prednisone, prednisolone, and 6-methylprednisolone (especially higher doses) may show falsely elevated concentrations of cortisol. Patients with 21-hydroxylase deficiency may have elevated 21-deoxycortisol levels that can give rise to falsely elevated cortisol results.

How to rule out Cushing's disease?

Cushing syndrome

1. Urine and blood tests. These tests measure hormone levels and show if the body is making too much cortisol. ...
2. Saliva test. Cortisol levels typically rise and fall during the day. ...
3. Imaging tests. ...
4. Inferior petrosal sinus sampling.

Can Cushing's disease be misdiagnosed in dogs?

There is not a simple test that can diagnose Cushing's disease in dogs. Since the symptoms are similar to other conditions, it can take time to diagnose. Dogs with other health issues are also more likely to test positive, even if they do not actually have Cushing's disease.

What are the red flags of Cushing's syndrome?

Symptoms of Cushing's syndrome

a red, round face – the redness may be harder to see on brown or black skin. skin that bruises easily and stretch marks on your tummy, hips, breasts and under your arms. muscle weakness, particularly at the top of your arms and legs. low sex drive (loss of libido)

Is there always a tumor with Cushings?

Approximately 10% of patients with Cushing's syndrome have an adrenal tumor, most commonly a benign adrenal nodule or bilateral adrenal hyperplasia that is producing excess cortisol directly. Adrenal cancer produces excess cortisol about 50% of the time, but it is a very rare tumor.

Can a dog have Cushing's without a tumor?

In dogs, Cushing's disease occurs naturally and is either pituitary-dependent or adrenal-dependent. About 80% to 85% of Cushing's is pituitary-dependent, meaning it's triggered by a tumor on the pituitary, a pea-sized gland at the base of the brain.

What is a pseudo Cushing's disease in dogs?

Also known as Alopecia X, pseudo-Cushing's is identified by symmetrical alopecia (hair loss) on the trunk of the body, thighs, or neck, along with darkening of the skin where hair is lost. The coat's color may change as well. The condition does not cause itching.

What is an alternative to Vetoryl for dogs?

Vetoryl remains the gold standard for most dogs with Cushing's disease due to its effectiveness and relatively manageable side effect profile. However, alternatives like Lysodren, ketoconazole, selegiline, or cabergoline may be appropriate in specific situations.

Are dogs with Cushing's always hungry?

Yes, an increased appetite (polyphagia) is a hallmark symptom of Cushing's disease in dogs, often appearing alongside excessive thirst (polydipsia) and urination (polyuria), as high cortisol levels directly stimulate hunger and affect metabolism. While not every dog will show extreme hunger, it's a very common sign, along with a pot-bellied appearance, thinning hair, skin issues, and lethargy, that warrants a vet visit. 

What labs are abnormal with Cushing's?

24-hour urinary free cortisol level.

Levels higher than 50 to 100 micrograms a day for an adult suggest Cushing's syndrome. The normal upper limit varies in different laboratories, depending on which measurement technique is used.

What are the signs of adrenal gland problems in dogs?

Dogs with atypical Addison disease can have low blood levels of cortisol but normal levels of sodium, potassium, and chloride. Signs of Addison disease include repeated episodes of vomiting and diarrhea, loss of appetite, dehydration, and a gradual loss of body condition. Weight loss is often severe.

What causes high cortisol but not Cushing's?

Pseudo-Cushing syndrome (PCS), also known as nonneoplastic hypercortisolism, is due to physiological hyperactivation of the hypothalamic-pituitary-adrenal axis. Causes of PCS include depression, eating disorders, extreme physical stress, obesity, insulin resistance, and chronic alcoholism [1].

What is a pseudo-Cushing's disease?

Pseudo-Cushing's syndrome or non-neoplastic hypercortisolism is a medical condition in which patients display the signs, symptoms, and abnormal cortisol levels seen in Cushing's syndrome.

What can throw off a cortisol test?

Your provider may tell you to stop taking certain medicines that can affect the test, including:

• Antibiotics.
• Anti-seizure medicines.
• Medicines that contain corticosteroids, such as hydrocortisone, prednisone, and prednisolone.
• Estrogen.
• Oral birth control (contraceptives)
• Water pills (diuretics)

What breeds of dogs are prone to Addison's disease?

While any dog can get Addison's disease, certain breeds have a higher genetic predisposition, including Bearded Collies, Standard Poodles, Great Danes, Nova Scotia Duck Tolling Retrievers, Portuguese Water Dogs, and West Highland White Terriers, with Rottweilers, Soft Coated Wheaten Terriers, and Leonbergers also being overrepresented. It's an endocrine disorder where adrenal glands don't produce enough hormones, often striking young to middle-aged female dogs.
 

What are the red flags of Addison's disease?

Red flags for Addison's disease include extreme fatigue, unexplained weight loss, darkening skin (hyperpigmentation), salt cravings, low blood pressure (causing dizziness), abdominal pain, nausea, vomiting, and diarrhea, which can worsen into a life-threatening adrenal crisis with severe pain, confusion, and shock. These symptoms often develop slowly but can appear suddenly during stress or illness, requiring immediate medical attention.

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