Nmb5171's List: Cushing's Disease in Dogs

Vetoryl (trilostane) Capsules, the latest drug approved to treat canine Cushing's, is also the first drug approved to treat both pituitary- and adrenal-dependent Cushing's in dogs. This prescription drug works by stopping the production of cortisol in the adrenal glands. In studies of the drug, the most common side effects were vomiting, lack of energy, diarrhea, and weight loss. Vetoryl should not be given to a dog that

• has kidney or liver disease
• takes certain medications used to treat heart disease
• is pregnant

The safety and effectiveness of Vetoryl were shown in several studies. Success was measured by improvements in both blood test results and physical symptoms (normal appetite and activity level, and decreased panting, thirst and urination).

Only one other drug, Anipryl (selegiline), is FDA-approved to treat Cushing's disease in dogs, but only to treat uncomplicated, pituitary-dependent Cushing's.

Veterinarians have often used a human chemotherapy drug, Lysodren (mitotane), "off-label" to treat Cushing's in dogs. Lysodren destroys the layers of the adrenal gland that produce cortisol. It requires careful monitoring and can have severe side effects.

"Off-label," or "extra-label," means veterinarians can legally prescribe human drugs to animals for uses not listed on the label, or for other species or at different dosage levels from those listed on the label. But because dogs may react unpredictably to human drugs, says Stohlman, it's beneficial to have treatments available that have been studied in dogs and approved specifically for them.

"Treating Cushing's is a balancing act," Stohlman says. "But dogs with the disease can live a good life if they are monitored closely by a veterinarian and the owner is diligent about bringing the dog in for blood work and giving the medication as directed."

Traditional medical treatment is generally necessary though there are supplements and herbs that can help such as fish oil, dandelion and magnolia bark to name a few.  One thing that can be of utmost importance though, is diet.  It is worthwhile to note that Cushing’s Disease is an illness that rarely affects dogs in the wild.  This leads to the assumption that the disease itself is somehow attributable to human intervention.  Namely – diet and medications.

Diet for a dog with Cushing’s Disease should be the optimal diet for canine health – which means a diet of natural ACTUAL food.  The diet should be high in protien, have low levels of fat, low amounts of fiber and a low level of purines.  Protien?  No problem – there is no better natural source of protein than plain old meat.  Remember that commercial kibbles by and large do not contain much meat so often their protien levels are skewed as a result.  The healthiest proteins for a dog are those from natural whole food sources such as actual raw meaty bones.  Keeping fat low is important but remember that dogs need fat for energy so don’t over do it – leaner meats with added veggies will keep your fat levels minimal but adequate.  Finding foods low in purines is slightly more difficult – you find purines in all proteins BUT all are not created equal.  Items like beef and pork liver and kidney as well as sardines and some fishes should be avoided.  Moderate purine foods include chicken, beef (non-organ meat), turkey, tripe, rabbit, pork and lamb.   Organ meats will always have a higher purine amount than non-organ meats with the exception of tripe.  Overall, avoiding most seafood as well as beef and pork liver is key.  Little has been done on the effect of cooking and purines but initial experiments have shown that cooking actually breaks down the purines making them easier to absorb and therefore worse for your Cushing’s dog. (www.WHfoods.com)

Feeding a raw natural diet is your best option with a dog that either has Cushing’s Disease or is showing early

Bloated stomach, hair loss and swayback are among some of the physical characteristics of the disease

symptoms.  The most important reason for this is because you are in total control of what your dog is eating – you don’t have to guess at ingredients and what they mean and how much of a certain item is actually in their food.  Another reason is because any kibbled or processed dog food is going to be cooked and therefore, arguably, have purines that are absorbed more rapidly and more completely than those found in raw meats.  By sticking to lower purine meats like turkey, tripe, chicken or cornish game hen, going easy on amounts of liver or kidney and avoiding fish like sardines, you can feed a healthy diet that will boost your dog’s immune system, lower stress, enhance all bodily functions and not aggravate their disease.  It is fine to feed, in lesser amounts, the moderately higher purine foods such as beef, pork, lamb and rabbit occasionally for variety but adding more than a minimal amount of livers or kidneys would not be advised.

The core to the Cushing  dog’s diet should consist of items like Turkey and Veggies, Just Turkey, Cornish Hen and Veggies, Chicken and Veggies, Just Chicken and our Raw Green Tripe.  To keep organ intake to the bare minimum feed mostly chicken backs, necks or turkey necks and alternate with the mixes above.  Other additions in moderate amounts only to maintain the lowest purine diet that you can.  Adding extra organs would be unwise and remember that RAW is the way to go!   While it may not make the Cushing’s Disease disappear, feeding your dog a food that is going to not aggravate his disease and that you have complete and utter control over will help to keep your dog strong and fighting.  Never giving up is the best thing you can do for your pup!