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Cushings Syndrome

Cushing's syndrome results from chronic excess cortisol in the bloodstream. It exists in two main forms: pituitary-dependent (PDH, 85% of cases) caused by a pituitary tumor, and adrenal tumor (AT, 15% of cases). An atypical form involves normal cortisol but elevated sex hormones.

Key Facts

  • 85% pituitary-dependent, 15% adrenal tumor in both dogs and cats
  • Atypical Cushing's shows normal cortisol but elevated sex hormones
  • Dogs: excessive thirst/urination, pot belly, skin/hair changes, muscle weakness, ravenous appetite
  • Cats: 80% also develop diabetes-mellitus; only 10% of dogs do
  • Adrenal tumors have 50% chance of malignancy
  • Screening labs show stress leukogram, elevated alkaline phosphatase, elevated cholesterol
  • Confirming tests: low-dose dexamethasone suppression test (90% accuracy), ACTH stimulation test, urine cortisol:creatinine ratio
  • Discriminatory tests to classify type: high-dose dexamethasone suppression, endogenous ACTH level, ultrasound imaging of adrenal glands
  • Treatment: trilostane or mitotane (medical), surgery for adrenal tumors
  • Species: dogs and cats (rare in cats)

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