Dog Diseases, The Most Commonly Misdiagnosed Canine Diseases including Cushing`s Disease and Addison`s Disease

 

 

Not all dog diseases are easy to diagnose. The following are examples of commonly misdiagnosed dog diseases:

·         Addison’s disease (hypoadrenocorticism)

·         Cushing’s disease (hyperadrenocorticism)

·         Ehrlichosis infection

·         Hypothyroid disease

·         Laryngeal Paralysis

·         Lyme infection (Borreliosis)

·         Myasthenia Gravis

·         Portosystemic Shunt

 

Let’s consider the first two misdiagnosed diseases, Addison’s and Cushing’s, and the other misdiagnosed canine diseases in other Caring for Pets discussions.

Cushing’s Disease and Addison’s Disease

Cushing’s and Addison’s, are problems with the adrenal glands. With Cushing’s disease, the adrenals secrete too much cortisol and with Addison’s disease, the adrenals secrete an insufficient amount of cortisol.

Breeds genetically predisposed to develop Cushing’s disease

Some dog breeds are more likely than others to develop Cushing’s disease; for example, the Poodle, Dachshund, Boston Terrier, Boxer, Beagle, and Sheltie are more likely to have Cushing’s disease. My Sheltie-Collie mix, Sam, had Cushing’s disease.

Breeds genetically predisposed to develop Addison’s disease

Some dog breeds are more likely to develop Addison’s disease; for example, the Great Dane, Portuguese Water Dog, Bearded Collie, Standard Poodle, Nova Scotia Duck Toller, Leonburger, Westie, Rottweiler, Basset Hound, and Labrador Retriever. Terriers are also predisposed to develop Addison’s disease and in my experience, the Soft Coated Wheaten is high on this list.

Symptoms of Cushing’s disease

Dogs with Cushing’s disease may have the following symptoms:

• hair loss, especially over flanks
• thin skin that is prone to infection
• ravenous appetite
• pot belly caused by enlarged liver
• increased drinking and urinating (PUPD)
• weakness, lethargy, and loss of muscle mass

Symptoms of Addison’s disease

Dogs with Addison’s disease may have the following symptoms:

• poor appetite
• vomiting
• diarrhea
• weakness, lethargy
• increased drinking and urinating (PUPD)
• trembling and collapse

 

Why is Addison’s difficult to diagnose?

Addison’s is difficult to diagnose because the symptoms come and go, being most obvious when the dog is stressed. Dogs can be stressed if there is construction or loud noise, fighting in the family, or if family members travel. When dogs with Addison’s disease are not stressed, they often appear normal.

How is Addison’s disease diagnosed?

Blood and urine tests are used to diagnose Addison’s disease. We’re looking for abnormal electrolytes so that sodium (Na) and potassium (K) are present in the wrong proportions, with sodium abnormally low and potassium, high. Sometimes blood glucose is also low and calcium (Ca) is high. When sodium is low, the blood pressure can be low (hypotension). With hypotension, blood flow through the kidneys is inefficient and wastes are not cleaned from the blood and the dog has increased blood urea (BUN). Dogs with Addison’s disease can also have anemia, and, change in the electrical activity in the heart (abnormal EKG), abnormal heart size (microcardia), and abnormal esophageal size (megaesophagus). Chest x-ray would help diagnose the small heart and enlarged esophagus.

Why is Cushing’s disease difficult to diagnose?

I don’t think Cushing’s disease is difficult to diagnose, but it can be expensive to diagnose because multiple tests are necessary, including urinary cortisol:creatinine ratio, ACTH stim test, low dose dex test (LDDT), and abdominal ultrasound. If families choose not to spend money for testing, then we can suspect Cushing’s disease based on symptoms.

How is Cushing’s disease diagnosed?

Cushing’s disease is diagnosed with elevated cortisol in the urine, protein and bacteria in the urine, elevated liver enzymes (ALP), increased blood pressure (hypertension) with possible retinal haemorrhage, increased liver size (hepatomegaly), and occasionally with adrenal tumor.

Treating Cushing’s disease without a barrage of tests

Some veterinarians are willing to treat a pet for Cushing’s based on symptoms, but other veterinarians are not.

Veterinarians practicing only conventional medicine are especially likely to require a full barrage of tests because they treat Cushing’s disease with meds such as mitotane (Lysodren), which have serious side effects. Holistic veterinarians, who can prescribe TCM herbal formulas, supplements, homeopathy, and diet changes, may be more willing to treat dogs symptomatic for Cushing’s without full barrage of tests. I diagnosed my dog Sam with Cushing’s disease at 12 years of age based on his symptoms, blood tests, and LDDT. Sam had elevated AP, LDDT positive for pituitary-dependent Cushing’s disease, chronic bacterial cystitis, thin skin, hair loss, muscle loss, pot belly, ravenous appetite, and PUPD. Sam was treated with TCM herbal formula Si Miao San and diet and he did well for two years, passing away at 14 years of age.

Cushing’s and Addison’s are Endocrine Diseases, as is Hypothyroidism

The endocrine system is a series of glands that make materials (hormones) that influence other cells.  Some endocrine glands influence cells in their own vicinity and other glands influence cells at a distance by sending hormones through the blood.  The adrenals make corticoid hormones (glucocorticoids  and mineralcorticoids) that circulate through the blood and influence cells throughout the body and diseases of the adrenals, such as Cushing’s and Addison’s, called endocrine diseases.

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