21/06/2025
📑 Cushing’s Syndrome (Hyperadreno- corticism) in Dogs & Cats 🐶🐱
Cushing’s syndrome results from excess cortisol production, affecting multiple organ systems, including metabolism, skin, and electrolyte balance. It is common in dogs but rare in cats.
🔬 Causes of Cushing’s Syndrome:
✅ Pituitary-Dependent Hyperadrenocorticism (PDH) – Most common (85% of cases in dogs)
✅ Adrenal Tumor (ADH) – Less frequent but occurs in both species
✅ Iatrogenic Cushing’s – Long-term corticosteroid therapy (rare)
📌 Clinical Signs:
🐶 Dogs:
🔹 Polydipsia & Polyuria
🔹 Potbelly (abdominal distension) due to muscle wasting
🔹 Bilateral symmetrical alopecia (non-pruritic)
🔹 Thin skin & delayed wound healing
🔹 Recurrent skin infections & calcinosis cutis
🔹 Panting, lethargy, and muscle weakness
🐱 Cats:
🔹 Fragile Skin Syndrome (skin tears easily)
🔹 Severe muscle wasting
🔹 Diabetes mellitus (insulin-resistant)
🔹 Weight loss despite increased appetite
🔹 Polydipsia, polyuria, & poor wound healing
🩺 Diagnostic Approach:
✔️ Low-Dose Dexamethasone Suppression Test (LDDST) – Gold standard for dogs
✔️ ACTH Stimulation Test – Useful in differentiating iatrogenic vs. endogenous
✔️ Urine Cortisol : Creatinine (UC : Cr) Ratio – High sensitivity, but low specificity
✔️ Ultrasound – Identifies adrenal tumors or adrenal size changes
📉 Metabolic & Endocrine Effects:
1️⃣ Calcium & Other Minerals:
🔸 Decreased intestinal calcium absorption (due to vitamin D inhibition)
🔸 Increased renal calcium excretion (calciuresis) → Hypocalcemia risk
🔸 Osteoporosis & bone demineralization due to osteoclast activation
🔸 Hypernatremia & hypokalemia (in some cases, due to mineralocorticoid effects)
2️⃣ Glucose Metabolism:
🔸 Hyperglycemia – Increased hepatic gluconeogenesis & insulin resistance
🔸 Diabetes mellitus (especially in cats)
🔸 Glycosuria – Increased urinary glucose loss
🩹 Dermatological Manifestations:
🔹 Thin, fragile skin (more severe in cats)
🔹 Bilateral symmetrical alopecia (trunk, flanks, perineum, sparing the head & limbs)
🔹 Hyperpigmentation
🔹 Calcinosis cutis – Gritty, ulcerated skin plaques from dystrophic mineralization
🔹 Recurrent pyoderma & demodicosis (due to immunosuppression)
📢 Key Dermatological Clue:
Chronic recurrent skin infections or delayed healing wounds in older pets should raise suspicion of Cushing’s!
💊 Treatment Options:
"In accordance with vet indorsed practices"
📌Key Takeaways for Veterinarians:
✔️ Cushing’s is common in dogs, rare in cats.
✔️ Skin, glucose and calcium imbalances are key diagnostic clues.
✔️ Diabetes in cats + skin fragility = Suspect Cushing’s!
✔️ Early diagnosis and treatment improve long-term prognosis.