Cushing’s Disease in the Dog- Surgical and Radiation Treatment

Cushing's Disease in the Dog- Surgical and Radiation TreatmentThis article summarizes the various treatment options available for Cushing’s Disease in Dogs using surgery and radiation. Click here to learn about treatment options for Cushing’s Disease using medications.

Surgical Removal of Adrenal Tumor

In cases of Cushing’s disease secondary to adrenal cancer without evidence of invasion into nearby tissues or spread to distant tissues (metastasis), surgical removal of the offending gland may cure the dog.  However, surgery comes with significant risk – only 80% of dogs survived to discharge after surgery in one study (Anderson CR, et al. Surgical treatment of adrenocortical tumors: 21 cases (1990-1996). JAAHA 2001;37:93-97).  It may be necessary to supplement with cortisone (prednisone) for several weeks after surgery while the remaining adrenal gland returns to normal function.

Surgical Removal of the Pituitary Gland

Though not performed routinely in the United States, surgical removal of the pituitary gland is the treatment of choice for PDH in humans and has been performed in dogs with excellent results.

Radiation

In dogs with PDH, radiation therapy can be targeted at the pituitary gland at the base of the brain.  This is especially true when pituitary tumors become big enough to compress other parts of the brain and cause neurologic signs, such as change in behavior, seizures, or blindness.  However, many dogs with Cushing’s disease treated with radiation do not improve for several months and require medical therapy with Trilostane or Lysodren in the interim while some require those medications for long periods.  Tumor size is the key factor that determines if radiation will be effective for PDH involving neurologic abnormalities, with larger tumors decreasing life expectancy after radiation treatment.  In addition, treatment can be very expensive and requires days or weeks of therapy at a specialty veterinary hospital.

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Dr Roger Johnson and Dr Derek Calhoon

Roger K. Johnson, DVM, Diplomate ACVIM (internal medicine) is a board-certified veterinary internal medicine specialist. His professional interests include cardiology as well as using advanced diagnostics to help his patients. His particular favorites include echocardiography, abdominal ultrasonography, and endoscopy. Derek Calhoon, DVM is a veterinary general practitioner.

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