Thursday, March 10, 2011

Viva Has Cushing's

Viva's story is shared with us by my good friend @Kenzo_HW. Check out his blog, it's got awesome information on Hovawarts, tracking, nose work and lot's of other great stuff.

Helping Viva to get better and improve health is a lot like peeling the layers of an onion. 

Just when we think all bases are covered and all issues addressed, we find out we are looking at yet another layer.

The warning signs have been around all the time. 

High liver numbers returned from her very first blood-work. Not as high to worry about, treat or investigate further. But high enough to keep on monitoring her regularly just in case.

The first external signs came about one month ago. Viva was slowing down on our daily work-out. 

We gave her some rest, an additional acupuncture session - maybe she was in pain ? - but to no avail. She rapidly became more lethargic, and stopped playing and ear-nibbling with Kenzo, her favorite past-time!

We did a round at our vets and found out her spondylosis had not gotten worse, but her liver numbers had exploded. 

High liver numbers could be caused by just about anything and further testing was needed. We were in for a couple of painstaking weeks of further testing, investigating, and discussing theories.

Our regular vet started suspecting Viva of having Cushing's disease after some additional testing. 

Although not all the signs have been adding up. She turned out to be spot on.

Cushing's disease, or hyperadrenocorticism, is an overproduction of cortisol hormone.

It can be caused by over-stimulation of the adrenal glands due to a tumor on the pituitary gland or a tumor on the adrenal gland itself.

Most dogs develop Cushing's because of a tumor on the pituitary gland, causing over production of ACTH hormones which in turn stimulates an overproduction of cortisol. 

While the tumor itself is usually benign, Cushing's is a life-threatening condition affecting inner organs like kidneys and liver.

Some of the most common signs are hair-loss, a pot-belly, lethargic behavior, incontinence, and being overly interested in food and water. Apart from being lethargic, Viva had none of those signs. Yet she always had been overly interested in food and water as a former obese dog.

Testing Viva for Cushing's sounded like a wild-goose chase, but I am happy to have followed our vet's gut feeling on this one.

To diagnose Cushing's we started with a urine test to measure cortisol levels. They were sky high. Next was an ACTH stimulation test, which was conclusive. Now it was final, Viva has Cushing's. The diagnosis was actually a huge relief, a month had already passed and I was so worried for Viva being in discomfort for so long and not being able to help her.


We started treating Viva with Vetoryl (Trilostane). Already after 5 days Viva was feeling better! Kenzo got his first ear-nibble in a month, which we celebrated with the whole family that day. It was awesome to witness.

Vetoryl is a very aggressive medicine, that messes with the hormone level. Administering the correct doses is extremely important, as Viva can die if we administer either too much or too little.

Viva will need Vetoryl for the rest of her life. 

The doses can vary over time, and Viva has to be tested quarterly to ensure the doses is correct. Those quarterly tests include an ACTH stimulation test and 3 different blood-work tests.

The onion

We are three layers down: allergies, spondylosis and Cushing's. Maybe we are done, maybe we are not. Yet another lesson Kenzo and Viva taught me.

Health is not a shopping list with items you can check off and wrap up.

Related articles:
The Many Faces Of Arthritis: Viva Has Spondylosis
Alternative Treatment Of Arthritis: Viva's Update

Hypo- versus Hyperadrenocorticism

Further reading:
What Exactly is Cushing's Disease
Symptoms of Cushing's Syndrome
Testing: Laboratory Hints Suggesting Cushing's Syndrome
Testing: Confirming Cushing's Syndrome
Classifying Cushing's Syndrome: Pituitary vs Adrenal
Trilostane, New Drug Treatment for Dogs with Cushing's Syndrome


  1. read this sad story on kenzo's blog :(

  2. Hi Georgia. Well, it's not completely sad, she's responding to the medication well, so that's good. As long as her cortisol levels can be kept at optimum levels she should do well.

  3. Hi,

    I'm fairly familiar with Cushing's and the drug she's been put on. I'm sure Trilostane will have her up and feeling herself in no time. :)

  4. Yeah, she started feeling good quite fast :-)