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Treating Cushing Disease in Boston Terriers

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A couple of days ago, I had an article on recognizing the symptoms of Cushing Disease in Boston Terriers, today’s post is on treating Cushing Disease.  If your dog has this disease, prompt treatment is vital to the survival of your Boston Terrier.

Treatment

Most veterinarians treat both adrenal- and pituitary-dependent Cushing’s disease with medication. The only way to “cure” Cushing’s disease is to remove the adrenal tumor if the disease is adrenal-dependent and the tumor hasn’t spread, says Stohlman. However, because of the complexity and risks of the surgery, most cases are treated with medication. Surgical techniques to remove pituitary tumors in dogs are being studied, but surgery is not a widely available option.

Although Cushing’s is typically a lifelong condition, the disease usually can be managed with medications. “It’s important for a veterinarian to see the dog regularly and do blood tests,” Stohlman says. “Monitoring the blood helps determine the right dose, which may need to be adjusted periodically.”

Frequent blood tests are usually required in the first few months after starting treatment and then every few months after that, depending on the dog’s response to treatment and tolerance to the medication.

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.”

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Four years ago a new drug was introduced for the treatment of Cushing Disease.  It has increased the survival of dogs with Cushing Disease tremendously.  If you have any experience with this disease, please comment below.

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