Morbus Cushing

How did I originally come to write this text? When I got my first Whippet seven years ago, I had informed myself extensively about the breed. The Whippet was perfect for me, not least because the average life expectancy at that time was stated as 14-16 years. In the literature on the breed only testicular defects and perhaps still here and there heart problems were mentioned with regard to diseases. Today - after some years of research - I have the impression that this picture of the healthy breed of that time seems somewhat faded today. Unfortunately, some other diseases have now also reached the Whippet.


What is the reason for this? On the one hand, there is certainly much better diagnostics to be applied here, which makes it possible to recognize diseases and also to treat with greater success. On the other hand, the information available today is very different to 10 or 15 years ago' the Internet and social networks make it possible to share information quickly. In former times someone with a sick dog simply no longer appeared at shows and was thus "out of sight out of mind", today comfort and help is asked for on Facebook or with other (online) self-help groups and the disease becomes public. Another view is the increasing environmental issues, which can be a possible factor in many diseases. So the question arises: have diseases increased or are people now simply more open to the subject?


I think both is the case. An open approach to a problem or circumstance that could become a concern is, in my opinion, the basic prerequisite for responsible action, both as an owner and as a breeder. Even if cases of Whippet disease are still rather rare in relation to the total population compared to other breeds, they should not be denied as "individual cases". Beware the beginnings...! Each dog owner can make his own contribution to the topic of transparency in health issues. Recently, the TWA (formerly TheWhippetArchives, now Breedarchive, can be found at ) provided the facility to enter health-related information for your own dog. This enables every visitor of the profile or that of a direct relative to call up the entered data via the "health analysis" function. However, the database for health-related information is still very new and therefore not yet meaningful. Nevertheless, every user should enter their health information to make breeding decisions easier, and better informed. It is not only a matter of informing breeders of the diseases that have occurred, but also positive entries such as health checks which help to create a complete picture of the dog concerned


Unfortunately, I have also come across Cushing's disease more frequently in TWA than before. There have also been some cases in my personal environment. In exchange with the Whippet owners concerned, the idea for this report on the subject of "Cushing" was born. Unfortunately, the disease is not curable, not lethal, but nevertheless a huge concern for both dog and owner.


Let's start with some medical information about Cushings:


The official name of Cushing is actually the Cushing syndrome due to a Morbus Cushing or also called hyperadrenocorticism. The latter already clearly reflects what the disease is all about, namely an increased release of the stress hormone cortisol (hyper = too high, corticism = cortisol release). The Cushing syndrome is a disease that is more common in older dogs and affects bitches rather than males. The age of the dog at the time the disease is noticed is usually around eight years. The symptoms are therefore often initially attributed to age. They can mimic an early aging process so that Cushing is often overlooked in the early stages.


The disease is usually caused by a tumour of the pituitary gland (pituitary hyperadrenocorticism) or by a tumour in the adrenal glands (adrenal hyperadrenocorticism). The third cause can be the treatment of other diseases with corticosteroids (cortisone) (iatrogenic hyperadrenocorticism), which can cause the symptoms of the Cushing disease. However, the Cushing symptoms should disappear after the discontinuation of the cortisone. A Primary Cushing, however, does not disappear by itself!

85% of Cushing's diseases in dogs are caused by a pituitary tumour (pituitary hyperadrenocorticism). This type of tumour is usually benign, quite small (usually does not even have pinhead size) and slow-growing. However, the tumour continuously sends signals to the adrenal glands to produce the stress hormone cortisol. In a healthy dog, this signal is no longer emitted once the necessary level of cortisol has been reached; the glands then stop producing hormones until they receive a new signal to resume cortisol production. In a Cushing dog, this signal interruption does not occur and cortisol is released far beyond the required level. This is therefore comparable to long-term cortisone medication. This health situation is not conducive to long term health


The adrenal tumour (adrenal hyperadrenocorticism) is more rare, but the mode of action is ultimately the same: a continuous production of cortisol. If the tumour is located on the adrenal gland, can be localised (for example by CT) and is operable, a cure by surgery is possible in a few extremely rare cases (see also information on good links on the Internet below (in German only)).


Since a tumour can be blamed for the disease in the primary Cushing's cases, it cannot be said that the disease is hereditary. However, as with cancer, it can be assumed that there are certain family accumulations or genetic dispositions.


The symptoms of Cushing's are diverse. They occur slowly and increase slowly and are therefore noticed only very late, usually only when several symptoms come together. Unfortunately - as already mentioned above - the diagnosis is quite difficult and often veterinarians treat only the issues shown in the Blood Values. These are mostly thyroid dysfunctions or kidney diseases.

The first symptoms observed are:


Excessive drinking

  • Increased urine production (possibly puddles in the house)
  • Increased appetite and greed, food theft, excessive hunger
  • hair loss to baldness, especially on hind legs and belly, shaggy coat
  • thin, wrinkled or darkly coloured skin or also parchment-like, translucent skin
  • abrasions, slow and poor wound healing
  • Calcareous deposits (greyish firm knobs) in the skin
  • Faintness and weakness
  • muscle wasting

If these symptoms occur, you should always have Cushing in the back of your mind when the dog is presented to the vet.


With advancing illness the dog often shows a hanging belly, gains (not least because of the increased appetite) substantially in weight along with simultaneous muscle atrophy in the legs Fatigue, aversion to running, general weakness (not being able to get on the couch any more) and excessive panting are often attributed to old age, but are all symptoms of the disease. In addition, there is an increased susceptibility to infections, especially urinary tract and skin infections. In addition, diabetes, pancreatitis or thrombosis / embolisms are often the secondary diseases.


The good news: Cushing's is treatable and the dog often regains an improved quality of life when he receives medical care. But a cure is almost impossible.

The treatment depends on the general health and the age of the patient. In very old dogs, which for example receive cortisone to alleviate severe arthritis or in allergy sufferers, the disease improves because the body itself produces the cortisone that is otherwise given orally. So if you treat against the Cushing, the allergy or arthritis gets worse again. In these exceptional cases, it may be better to live with Cushing.


However, it is usually recommended to get a clear diagnosis by an ACTH test as well as the low-dose and the high-dose dexamethasone suppression test. Unfortunately, both the diagnosis and the treatment is very difficult in many cases, owners may choose not to treat due to high costs and difficulty stabilising


A life-long drug treatment with Trilostan, known under the brand names Vetoryl and Modrenal, is indicated in most cases. The active ingredient Trilostan is in most cases the most suitable drug on the market for Cushing's patients because it inhibits steroid synthesis in the adrenal glands. If the medication is discontinued, everything is theoretically as before and the adrenal gland is not destroyed (which would result in Addison's disease - the antagonist to Cushing's disease with too low cortisol levels). Support from Cushing's herbs or Cushing's Complex can help to keep the Vetoryl dose quite low. Unfortunately, the drug - especially in dogs of small breeds - sometimes has no or only limited effect. Finding the right dose for the dog is unfortunately complex, lengthy and cost-intensive. But once this is found, the dog is much improved. In most cases the coat grows again. In some cases, weight gain is also reduced. A strict diet is also a prerequisite for this, however, because the dog eats everything and anything


However, an untreated Cushing's disease is rarely an option. If left untreated, the disease leads to increased susceptibility to infection, skin tumours, loss of coat, hypothyreosis, chronic pancreatitis, heart failure, blood clots and liver or kidney failure. Ultimately, these secondary diseases then lead to the early death of the beloved four-legged friend.


However, Cushing patients have a good chance of regaining their quality of life. Even if the treatment is expensive and time-consuming, this approach is worthwhile! The first step is to get a reliable diagnosis when the first symptoms appear (and not only to treat on differential diagnoses and lose time). Nowadays, self-help groups on the Internet enable a good exchange of information. Here you can also get good advice about cheaper sources of supply for the expensive medications. However, one should not forget that the Internet allows everyone - even the unqualified - to write a comment, post or article.


 In addition, there is also good online reading on the subject, for example under the following links:


As I said, I'm an interested dog owner, but not a vet. In this respect I would like to point out that this article is logically not a doctoral thesis and in case of suspicion please contact a competent veterinarian immediately!


But what does life with a Cushing dog look like in practice?


The stories of the affected Whippets and their people known to me show that all the cases are different but have the Cushing's diagnosis in common.


In all these cases, Cushing appeared between the ages of 5 and 8 and turned the lives of everyone involved upside down. Almost all of them had in common an odyssey from vet to vet, from one (wrong) diagnosis and (wrong) treatment to the next, until it was really clear "the dog suffers from Cushing". In general, the veterinarians did not even consider the disease in a 5-6 year old dog of the Whippet breed. Too untypical in this context.


The symptoms were also different in almost all of them and did not manifest themselves until later in the course of the disease to the typical visual and symptomatic overall picture of Cushing's disease. If in one dog hair loss and a supposed muscle weakness of the beloved Whippet was noticeable first, it was with the other the fat belly and with the next the increased drinking and peeing. So the first veterinarian guessed first of all on thyroid malfunctions (which can justify for example also a hair loss and was supported also by blood values - only unfortunately the values with greyhounds are deviating to the reference values of other races...). While drinking and peeing more and more, the first guess was kidney failure or diabetes (because the symptoms are similar here too) and the dog was treated with strong medication and diets, which, however, did not bring any success. Another veterinarian falls in despair in regard to the blood values of liver, kidney and pancreas and treated them for other differential diagnoses. And so in almost all of these cases it took from a few months up to two years until the correct diagnosis was reached. Time that could have been used effectively in the early treatment and time in which organs were possibly damaged, unnecessary medication was given and immense sums of money were spent on blood tests, veterinarians, alternative practitioners and medication.


For the diagnosis I had exchanged myself also with a veterinarian, who told me and this also regretted that a correct diagnosis is not easy and straight forward in the case of Cushing. There is not just THE one and only test that you simply apply and have a reliable result. Rather, there are many individual factors that confirm the diagnosis: First of all, there is an initial suspicion that exists due to one or more of the symptoms mentioned above. This is followed by an initial blood test, which may not cover all the necessary parameters, so that Cushing remains undetected. One person informed me that in her case a blood test for cortisol combined with pancreatic value provided a first indication. In another case, however, this test result was too unspecific. Only when the cortisol value provides an indication, the low-dose / high-dose dexamethasone suppression test is also positive and then the dose of Vetoryl also provides an improvement in the cortisol value then a reliable diagnosis can be assumed.


As mentioned above, this diagnosis does not mean an immediate death sentence, but it does demand a lot from the affected person. The dog must be put on the correct medication and must be closely monitored (regularly during the initial period of adjustment at four-week intervals, later at least once every six months). The dog must also be given his medication at more or less fixed times, which is not as easy in terms of timing, organisation or the willingness of the patient to cooperate as it sounds at first sight. While one dog simply swallows the medicine with its dry food, the capsule may not even be able to "be put into the dog" in another case.


In addition, the drug is not available in minimal doses. In this case, the drug would have to be "encapsulated" by a pharmacy, because both overdose and underdose are problematic. The right adjustment is therefore complex and demanding.


Life with the dog also becomes more difficult in other respects, because for a sick dog it is extremely difficult to get a suitable care taker, to reliably give the medication - be it for the holiday or should the dog owner have to go to hospital. In addition, stress for the dog should be avoided, which in turn significantly limits some leisure activities. The latter also applies to the usual activity with dogs. While a healthy dog can easily participate in any hiking tour, a sick dog - especially with Cushing - is not in a position to do so. This makes everyday life much more complex, especially when keeping several dogs - which is often the case with Whippets - because the Cushing patient needs limited exercise, while the healthy part of the pack demands its corresponding degree of exercise.


In order to achieve the highest possible restoration of the old quality of life and to make life as normal as possible, it is essential to diagnose the disease as early as possible. The experience of the cases known to me, shows that it is ultimately due to the attention and perseverance of the whippet owners that the dog was not given up, that also the search for the cause, the diagnosis of the disease was not given up. In this respect, I hope that no-one reading this report has these symptoms in their whippet. However, should changes in the dog become noticeable or the Whippet perhaps shows any of the symptoms mentioned, then I hope that this report has helped and perhaps contributed to the correct diagnosis being quickly made. Dog and owner may then not need to travel the long road to treatment. If you suspect a Cushing's disease, please contact your vet and ask for tests. Even if a whippet at five years of age is not a typical candidate for Cushing it is unfortunately not excluded - as practice shows. The sooner a correct diagnosis is made, the less costs, effort and suffering arise from the directly correct treatment. In this sense: stay alert and persistent - for the benefit of your Whippet!



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