Bichon with Cushing’s Disease – Happy Bichon


Bichon With Cushing's Disease

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What is Cushing’s disease in Bichon Frise Dog?

One of one the Most Remarkable Things about owning a Bichon Frise. Is the amount of Boundless energy this Breed of Dogs Contains. Our Dogs have continued a state of Playfulness even until Later Years in Life.

Cushing’s disease also known as Cushing’s syndrome. Cushing’s disease is a condition in which the adrenal glands overproduce certain hormones. The medical term for this disease is hyperadrenocorticism. Literally translated, “hyper” means overactive, “Adreno” means adrenal gland, and “corticism” refers to the outer part of the adrenal gland. It is a fairly common condition in middle-aged and older dogs.

Dogs normally need some steroids for their bodies to function properly and they are produced by the adrenal gland, which sits next to the kidney. The adrenal gland is sent a message to produce cortisol by the pituitary gland, which sits at the base of the brain. If a dog gets a growth on either of these glands, this can send hormone production into overdrive which leads to a number of symptoms. Decrease or excessive production of these substances, especially cortisol, may be life-threatening.

What is Cushing Disease
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Part 3

What are the causes of this disease in Bichon Frise?

There are three types of Cushing’s disease, each of which has a different cause. Identifying the cause is important because each type is treated differently and each has a different prognosis.

1.   Pituitary gland tumor:

The most common cause of Cushing’s disease(85%-90% of all cases) is a tumor of the pituitary gland(which is located at the base of the brain).

The tumor may be either benign or malignant. The tumor causes the pituitary gland to overproduce a hormone(ACTH) that stimulates the adrenal glands to produce cortisol.

The tumor may be microscopic or large. Depending on the size of the tumor, clinical signs other than those of Cushing’s disease may be present.

Generally, if the activity of the adrenal gland can be controlled, many dogs with this form of Cushing’s disease can live normal lives for many years as long as they take their medication and stay under close medical supervision. If the pituitary tumor grows, it will affect the brain, often resulting in neurological signs and giving the dog a less favorable prognosis. This happens in approximately 15% of these patients.

These large, benign growths of the pituitary are called macroadenomas and are typically larger than 1 cm in diameter.

Tumors less than 1cm in diameter are called microadenomas and rarely cause neurological symptoms.

2.   Adrenal gland tumor:

Cushion’s disease may be the result of a benign or malignant tumor of the adrenal gland( adenoma or carcinoma, respectively). If the tumor is benign, surgical removal will cure the disease. If the tumor is malignant, surgery may help for some time, but the prognosis is much less favorable.

3.   Excessive cortisol from prolonged use of steroids:

The third type of disease is called Iatrogenic Cushion’s disease. It is caused when there is excessive administration of an oral or injectable steroid. Although the steroids were usually given for a legitimate medical reason, in this case, their excess has become detrimental. many times the Bichon Frise Breed has a susceptibility to skin allergic Conditions. _ AKA Hotspots. Many times a Vet will prescribe Steriods to help with the Skin irritation.

7 Warning signs of Cushing’s Disease in Bichon Frise Dog:

Cushion’s disease is one of those diseases that are extremely difficult to detect because the symptoms can be linked to such a wide number of different ailments. Find out here some specific warning signs to look out for as your dog ages.

1.   Increased thirst and urination:

The onset of Cushing’s disease can be a long, slow process. One of the first signs of this disease is excessive thirst and urination. You may find that you are refilling your dog’s water bowl more often. They may be asking to go outside more frequently. Paired with this, you may find that your well-trained dog is suddenly having an accident in the house.

Cushing’s is a disease more often found in older dogs, and as such, at its onset, these symptoms can sometimes be confused with urinary tract infections or even the senility that can come with old age. Additionally, increased thirst could also be a sign of kidney disease. If increased thirst and urination are paired with any of the symptoms below, you may want to ask your veterinarian to run diagnostic tests.

2.   Increased Appetite and Weight Gain, Especially with a potbellied Appearance:

Higher levels of cortisone will increase a dog’s appetite. For this reason, they may eat more, and as a result, gain weight. This weight gain can make it hard for your dog to move around, jump up on furniture, or even climb the stairs.

Cortisone will also cause a dog’s abdominal ligaments to relax and their liver to become bloated causing a pot-bellied appearance.

As with urinary incontinence, these effects of Condition can be confused with other issues early dogs commonly face, including arthritis. If you are suspicious of Cushing’s ask your vet to feel your dog’s abdomen to see if their liver is enlarged.

Sometimes the result of this simple hands-on exam will encourage your doctor to do further testing to either diagnose or rule out the onset of Cushing’s disease.

3.   Panting:

Panting is normal if a dog has exerted themselves, during times of stress, or if they are hot. However, if your dog appears to be panting more than usual, and if this occurs in conjunction with the other signs mentioned here, it could be an indication of Cushing’s.

4.   Symmetrical hair loss:

A dog with Cushing’s may lose fur, although typically, the fur on your dog’s legs and head will remain intact. Instead, Cushing’s-related hair loss occurs primarily on a dog’s midsection. Hair loss caused by Cushing’s is typically symmetrical occurring evenly on both sides of the dog’s body.

5.   Thin skin that Bruises easily:

Try gently pinching a fold of skin on your dog’s abdomen, near their flank. A dog with Cushing’s may have skin that feels thin to the touch, as opposed to the plumpness of healthy skin.

Of course, if you notice bruises on your dog, you should tell your vet.

6.   Recurrence of infections:

Ear and eye infections may occur more and more frequently in a dog who’s dealing with Cushing’s disease.

7.   A change in behavior:

Bichon Frise with Cushing’s will show a change in behavior, acting more aggressive, or not as calm as they usually are. Behavioral changes can signal a whole host of other health problems as well, so it’s always a good idea to alert your vet.

Diagnosis of Cushing’s disease in Bichon Frise Dog:

To diagnosis Cushing’s disease in dogs, your veterinarian will first take a comprehensive history of your dog and then perform a complete physical exam. Basic lab work like a blood chemistry profile, complete blood cell count, fecal examination and a urinalysis will likely follow.

If based on this initial assessment, your veterinarian suspects that Cushing’s disease is a likely cause of your dog’s symptoms, he or she will then run the tests that are necessary to definitively diagnose the condition.

Urine Cortisol: creatinine ratio:

The first test is often urine cortisol: creatinine ratio. If the test results are normal, then your dog probably does not have Cushing’s disease. If your dog has high urine cortisol: creatinine ratio, then further testing is called for, since may conditions can lead to this result.

Low-dose dexamethasone suppression test ( LDDST ) :

The most common test used to diagnose Cushing’s disease in a dog is the low-dose dexamethasone suppression test(LDDST). A blood sample is taken to measure a dog’s baseline cortisol level, and then a small amount of dexamethasone is administrated by injection. Blood cortisol levels are measured four and eight hours after the dexamethasone is given.

In a normal dog, the dexamethasone injection inhibits the secretion of a hormone that stimulates cortisol secretion, which leads to a decrease in circulating cortisol levels. In a dog with Cushing’s disease, cortisol is not suppressed.

ACTH stimulation test:

It measures how well the adrenal glands work in response to a hormone called ACTH that usually prompts them to make cortisol. The vet will take blood samples before and after your dog gets a shot of ACTH to see how the hormone affected him.

If it seems like your dog could have Cushing’s your vet might want to do an ultrasound scan of his belly. This imaging test will help her see if there’s a tumor on the adrenal glands. That could affect the kind of treatment he needs.  Abdominal ultrasound and chest X-rays can also be useful in determining if the tumor has spread and is malignant.

What is the treatment of Cushion’s disease in Bichon Frise Dog?

As previously mentioned, the treatment depends on which type of disease is present.

1.   Pituitary tumor:

The following are the option for the treatment of pituitary-dependent Cushing’s disease.

Trilostane:

Trilostane is a commonly used drug and the preferred medical treatment for hyperadrenocorticism. Trilostane works by reducing the synthesis of cortisol. It can control the disease but does not cure it. Possible side effects of trilostane include lethargy, vomiting, diarrhea, and a disinterest in food.

Trilostane is given daily for the life of the animal. Your veterinarian will need to perform monitoring tests to make sure the dose is right. These tests are more frequent early in treatment, but then need to be done only once or twice a year thereafter.

Mitotane:

Mitotane is another drug treatment. Mitotane works by causing controlled destruction of adrenal tissue to decrease production and release of cortisol.

Mitotane is given in two phases:

  • Induction phase: A higher dose of a drug is given once daily with food for 7-10 days. During this time a large amount of adrenal tissue is being destroyed.
  • Maintenance phase: A smaller dose of a drug is administered several times a week in this phase to try to maintain the adrenal glands in their suppressed state.

Mitotane has good efficacy but is not a complete fix and studies show that 50 percent of patients relapse to cortisol overproduction within one year.

Mitotane is not recommended for animals with pre-existing kidney or liver disease, and should also be avoided in animals with diabetes.

The side effect of Mitotane:

  • Lethargy
  • Ataxia
  • Weakness
  • Anorexia
  • Vomiting and diarrhea.

Both of these medications require continual monitoring, and your veterinarian will need to draw blood to monitor cortisol and electrolyte levels. It is essential to monitor your dog’s drinking, urination, appetite and energy levels.

Anipryl:

Anipryl is FDA-approved to treat uncomplicated, pituitary-dependent Cushing’s disease in dogs.

Ketoconazole:

Ketoconazole is another drug used for the medical treatment of PDH. It acts by blocking the formation of cortisol in the adrenal gland tumors that will not be receiving surgery or to help control symptoms prior to surgery.

CBD Oil:

Many Bichon Frise parents ask if CBD oil can help treat Cushing’s disease. There are many benefits of CBD oil:

  • Its ability to help ease pain
  • Reduce chronic inflammation
  • Anxiety
  • Control seizures
  • Cardiac benefits
  • Anti-nausea effects
  • Appetite stimulation
  • Anti-cancer benefits

If you feel that your dog is suffering from any of these things, CBD oil may help relieve some of the symptoms. You should speak with your vet about giving your dog anything with CBD to ensure it’s safe for your Bichon Fise.

What is CBD Oil?

CBD, or cannabidiol, is a compound found in cannabis and hemp. It is essential to note that in most cases, CBD does not contain delta-9-tetrahydrocannabinol(THC), the compound that gives marijuana its psychoactive properties. In fact, most CBD products are derived from hemp and not from marijuana.

How does CBD affect dogs?

Currently, there has been no formal study on how CBD affects dogs. What scientists do know is that cannabinoids interact with the endocannabinoid receptors located in the central and peripheral nervous systems, which help maintain balance in the body and keep it in a normal healthy state.

Radiation therapy:

Radiation therapy is not a treatment option to reduce the hormone secretion of the pituitary tumor. Radiation therapy can only reduce the size of the pituitary tumor.

This is beneficial if an animal is experiencing neurological signs because of the size of the pituitary tumor and its pressure on other parts of the brain. However, if no neurological signs are present, radiation therapy is not recommended because it is not effective in controlling the hormone output of the tumor.

Research has shown that after radiation therapy, some dogs will see some temporary improvement in their clinical signs, but will ultimately relapse. Some dogs show no improvement in clinical signs at all. Most dogs end up needing medical therapy ( mitotane or trilostane ) after radiation therapy.

Surgical therapy:

The third option for Cushing’s therapy is hypophysectomy. This procedure is commonly performed in people and involves surgical removal of the pituitary gland. While it is an available treatment for dogs with a microadenoma ( tumor less than 10mm in diameter ), it is seldom performed by veterinary surgeons because it is a highly specialized skill that requires particular instruments.

The surgery begins with a cut into a specific area on the roof of the mouth. The tissue is moved aside and a bone drill is used to remove the thin layer that surrounds the pituitary gland.

The gland is detached and the space left behind is filled with surgical gelatin. Bone wax is then used to close the hole made within the roof of the mouth and the tissue sutured together.

The surgery has an 80 percent remission rate (symptoms subside) and an 11 percent recurrence rate( clinical signs reoccur).

However, despite the removal of the pituitary gland and successful remission of the disease, the patient will need medication supplementation for life.

Treatment of adrenal tumor:

Treatment of adrenal tumors requires major abdominal surgery. If the surgery is successful ( the entire tumor is removed ) and the tumor is not malignant, there is a good chance that the dog will regain normal health. If surgery is not an option, some of these patients can be managed with medication.

Treatment of Iatrogenic Cushing’s disease:

Treatment of this form requires discontinuation of the steroid being given. This must be done in a controlled, gradual manner so that other complications do not occur. Unfortunately, it usually results in a recurrence of the disease that was being treated by the steroid. Because the steroid may have caused adverse effects on the adrenal glands, treatment is also often needed to help replace the hormones that the adrenal gland normally produces.

Natural remedies for curing the Cushing’s disease in Bichon Frise Dog:

There are some natural and homemade remedies for curing the Cushing’s disease:

1.   Dandelion:

Dandelion is known to normalize adrenal gland function in dogs. Stinging nettle is an overall health tonic for humans and dogs, with tones of vitamins and minerals.

2.   Burdock:

Burdock root is a liver detoxifier and blood cleanser, helping to restore balance to stressed bodily systems.

3.   Arsenicum:

Aresenicum treats excessive thirst.

4.   Hepar Sulph:

Hepar sulph heals irritated skin.

5.   Sulfur:

Sulfur improves skin health.

6.   Melatonin:

Melatonin hinders 2 enzymes needed to produce cortisol, which reduces cortisol level.

7.   Lignans:

Lignans impede 2 enzymes( different from melatonin) required to produce cortisol, which decreases cortisol levels.

8.   Milk thistle:

The milk thistle, which is a European medicinal plant. This plant has silymarin that is mainly used by vets for dogs that have liver disease. It is recommended due to its antioxidant capability and its ability to aid bile flow through the liver.

9.   Cushex drops:

Cushex drops are known to be the best. This natural remedy will return adrenal function to normal, as well as balance level of corticosteroid.

10.                  Ginkgo Biloba:

This ingredient can support the treatment of Cushing’s disease because it slows down the adrenal hormone release.

11.                  Ophiopogon formula:

It reduces the symptoms of Cushing’s disease, among a long list of others.

12.                  Homemade products:

  • Lean beef mince
  • Cooked brown rice or quinoa
  • Diced or shredded vegetables
  • Eggs
  • Occasionally milk.

Fish oil:

Fish oil has the ability to fight different infectious diseases in dogs.

Natural Remedies for Cushings Disease

What is the recommended diet for a dog with Cushing’s disease?

  • Low-fat foods
  • Low fiber
  • High potassium

Ask your vet about the best dog food to give your dog if they have Cushing’s disease.

Is there a cure?

The only cure for Cushing’s disease is to remove the adrenal tumor if your dog is adrenal-dependant and cancer has not spread elsewhere. However, this can be difficult and risky, so most cases of Cushing’s disease are treated with medication.

Pituitary-dependent dogs do not commonly have surgery because techniques are still under development.

How many days our  Bichon Frise can live with this Cushing’s disease?

This is called the prognosis of the disease. The prognosis for pituitary-dependent Cushing’s disease with treatment is usually good. Some signs will disappear quickly and others gradually. Appetite and water consumption usually return to normal in a few weeks whereas the full return of the fur may take several months.

With pituitary surgery, roughly 85 to 95 percent of dogs who have the tumor removed have hormonal remission, meaning it cures the hormonal imbalance and the symptoms as well as alleviating neurological symptoms.

For dogs with adrenal tumors, surgery can be potentially curative. Treatment of one type of Cushing’s disease, either pituitary development of the other.

This information is not meant to be a substitute for veterinary care. Always follow the instructions provided by your veterinarian.

Management of Cushing’s disease in Bichon Frise Dog:

Checkup:

Treatment for Cushing’s disease in dogs is very specific for each dog so regular checkups are necessary to monitor improvement to treatment as well as checking levels of steroid hormone in the blood to make sure they are with the correct range. The medication can have a side effect in 10-15% of dogs; this can be due to overdosing the drug, reactions to the drug itself or unmasking of other diseases such as kidney disease or arthritis.

Dogs with Cushing’s disease are also more prone to urinary tract infections, diabetes, kidney problems, and high blood pressure which should be regularly monitored and additional treatment may be required.

We recommend that all Cushing’s dogs are seen between 1014 days after starting treatment for a health check and repeat a blood sample to check how well your dog is responding to the medication. If the cortisol level is too high or too low a dosage change would be required and a further check and a blood sample 10-14 days later is required until your dog’s cortisol level becomes stable on the medication. Further checks at 4 weeks and every 3 months thereafter are necessary to monitor the response to treatment and to pick up on the side effects of the medication.

A minimum of 6 monthly checkups is required by law if we are prescribing medications for your dog.

Testing:

Blood test– blood test will look at and track changes in steroid levels and other parameters that may have been abnormal at the time of diagnosis.

Blood testing is required every 10-14 days until the Cushing’s disease is stable, then every 4 weeks, 12 weeks and 3 months depending on your dog’s ongoing health and condition.

There is a special blood test for Cushing’s disease called The ACTH stimulation test- this requires your dog to stay in the hospital for the day.

A blood test is taken 4-6 hours after the last pill was given, then an intravenous injection is given to stimulate cortisol production, another blood test is taken 1-2 hours later. It is very important to have your dog’s blood test at the right time. To monitor the response to medication your dog’s blood should be taken 4-6 hours after the last pill was given.

Urine sampling:

This is helpful to check on kidney function, urine infections and glucose level for diabetes. Bring a urine sample at each check gives us a lot more information on your dog’s health.

Blood pressure monitoring:

Regular blood pressure monitoring would help to identify those dogs with high blood pressure and allow us to start treatment earlier. A blood pressure screen at the first blood test would be helpful in identifying those dogs with problems.

How can we prevent our Bichon Frise Dog from the Cushing’s disease?

We want to prevent having to deal with Cushing’s disease! How can this be done? We should aware of this disease. We should know the signs and causes. Get your dog treated early and avoid long-term side effects!

Is your dog still taking a medicine that can cause an overproduction of cortisol? Try and find alternative medicine or treatments and strengthen his immune system with probiotics or other similar boosters.

Is there a vaccine for Cushing’s disease?

There is no vaccine for Cushing’s disease, as hyperadrenocorticism is an autoimmune condition, not an infection one.

Is Cushing’s disease contagious for humans or other pets?

No, Cushing’s disease is not contagious for other animals or humans.

Summary:

Unfortunately, Cushing’s disease is not preventable. There are no steps that owners can take to prevent it.

Catching the disease early, however, can improve your dog’s prognosis.

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