A natural approach to Cushing’s disease in dogs includes nutrition, glandulars, herbs, acupuncture and more, addressing all facets of the disease with no side effects.

Today’s dog parents go online to search for the safest and most effective therapies for their canine companions. However, hyperadrenocorticism or Cushing’s disease is among those common disorders that must be explained thoroughly to dog owners who wish to make informed decisions on how to best treat their four-legged family members. This article looks at why a natural approach is an effective option for dogs with hyperadrenocorticism.

THE CONVENTIONAL APPROACH TO CUSHING’S

Although often helpful, today’s conventional option for hyperadrenocorticism comes with side effects that can be complicated to manage, and even deadly. Trilostane is currently the most used pharmaceutical for this condition. It acts by blocking receptor sites to decrease cortisol in the dog’s body.

The side effects of inadequate cortisol can include vomiting, diarrhea, weakness, and even collapse. This means a fair amount of monitoring is required when using this treatment protocol. Patients on Trilostane typically survive less than two years.

Before using this treatment, the attending veterinarian must confirm a Cushing’s diagnosis. Sometimes the diagnostics are difficult to implement. The Cortrosyn gel used to perform the one-hour ACTH stimulation test is expensive, difficult to handle and store, and sometimes not available. The eight-hour low-dose dexamethasone suppression test utilizes readily available medication but is difficult to use in dogs with severe anxiety or aggression issues, or at veterinary facilities with inadequate kennels. Add to this the likelihood of false negative testing.

Most, but not all, dogs with Cushing’s have an elevatedSAP/alkaline phosphatase level. Veterinarians commonly“chase” this test result, trying to figure out why it is elevated in an otherwise normal dog, or a dog with Cushing’s signs but normal follow-up testing. For these individuals, early intervention with a natural approach is ideal.

NATURAL APPROACH PHILOSOPHY

The natural approach addresses all facets of Cushing’s, including the entire Hypothalamic-Pituitary-Adrenal (HPA) dysregulation. It also has no side effects. Many canine patients have signs consistent with HPA dysfunction long before Cushing’s testing becomes positive. Wouldn’t it be nice to implement a treatment strategy at the early onset of this insidious disorder, even before testing becomes confirmatory?

GLANDULAR THEORY

Glandular therapies are supplements made from the glands, organs, or tissues of healthy animals, and administered in tablet, capsule, or powder form. The purpose is to maintain or repair the corresponding tissue or organ in the patient’s body.

• Pituitary-dependent hyperadrenocorticism begins in the pituitary gland with the overproduction of ACTH. Trilostane does not address this, but the natural approach utilizes the glandular theory and adds supplements that contain pituitary.
• The overabundant ACTH tells the adrenal to overproduce cortisol. This is what causes the excessive thirst and urine volume, sometimes ravenous appetite, pot belly, thin coat and skin seen in Cushing’s patients. Providing the body with adrenal gland in the diet directly addresses the adrenal imbalance.
• Elevated cortisol adversely affects the liver. The natural approach uses liver-supportive glandular, super foods and herbals.

EMOTIONAL BALANCE — CORTISOL IS A STRESS HORMONE

We should consider the deepest level of “dis-ease”, including the contribution made by emotional imbalance. After all, cortisol is a stress hormone. When I inquire about the history of my Cushing’s patients, I find that an unusually large number suffered a grief incident prior to the onset of their disease, such as the death of their person or another pet in the home. For this situation, I use essential oils because of their multi-purpose natural chemistry. Aromatherapy affects the amygdala, the memory center of the brain, and hormonal physiology. Select oils can calm the mind, lower cortisol, and detoxify the liver!

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CASE REPORT

Molly was a 12-year-old poodle who was dumped at the local shelter after “mom” died and “dad” didn’t want to wipe up her urine puddles anymore. A holistic vet rescued Molly and began a healing journey for her. Initially, she wore a pink coat to hide her bald, hyperpigmented body, but daily detox soaks and fresh food like raw bones helped make her happy and beautiful again. Molly lived to be almost 18 years old!

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LIFESTYLE IS IMPORTANT

The dog’s lifestyle should not exacerbate his or her Cushing’s. Daily exercise and play are mandatory to alleviate stress and provide ample opportunity for urine elimination. Exercise also promotes the release of endorphins, the feel-good hormones! Cushing’s dogs should never be water restricted, and need to urinate frequently. Providing a doggy door, a diaper or belly wrap, or potty pads may become necessary for longevity and the dog parent’s quality of life. Although diapers can increase the incidence of urinary tract infection, they can also minimize caging and decrease everyone’s stress.

Tell the client to avoid activities, medications, and products that can adversely affect their dog’s emotions, adrenals, and liver, including toxic household cleaners and lawn care products. Many products are endocrine (hormone) disruptors, such as plastics, pesticides, and herbicides. Keep this in mind when determining if a heartworm, flea, or tick preventative is necessary. Common endocrine disruptors include DDT, BPA, PCBs, herbicides, cadmium, lead, triclosan, phthalates, arsenic, and even de-sexing.

The best natural approach is prevention. Keeping dogs intact or providing natural hormone replacements should be considered. Spayed females are at greatest risk for developing hypercortisolism. Avoiding stress and toxins is difficult, but at least an awareness of the importance of doing so can be beneficial.

NATURAL NUTRITION-FRESH FOOD

Natural nutrition is vital to the successful management of a Cushing’s patient. Conventional processed foods contain excessive starch, sodium, and even hidden endocrine disruptors. Starch breaks down into glucose. The more glucose, the more insulin is needed. Cortisol suppresses insulin and may cause insulin resistance. Eliminate processed food and sugars from the dog’s diet, and feed a species-appropriate, fresh, prey-concept menu.

In addition to pituitary-dependent hyperadrenocorticism, as well as primary adrenal tumors that can overproduce cortisol and cause Cushing’s signs, a food-induced hyperadrenocorticism condition can also occur. In some dogs, glucagon inhibitory peptide (GIP) receptors may be found on the adrenal glands. When stimulated by GIP, these adrenal gland receptors produce cortisol. GIP release is stimulated by glucose (starch/sugar) ingestion in the stomach with every meal.

Elevated cortisol and blood sugar levels create anxiety and panting, classic and annoying Cushing’s signs.

• Weight loss usually occurs easily on a low-carb diet, which helps reset hormonal imbalances.
• Hypertension can resolve when excessive salt is avoided. Blood pressure should be measured regularly. Run a bloodproBNP to monitor heart health in Cushing’s patients. Hawthorn berry, taurine, coQ10, l-carnitine and more can be added to a fresh diet to support a healthy heart and circulatory system.
• Hyperpermeability or “leaky gut” often heals with a fresh diet that includes a variety of pro/prebiotics and absorbable minerals from foods like bone broth. Many believe there is an autoimmune component to adrenal disease and a correlation between leaky gut and immune dysfunction. SARDS-sudden acquired retinal degeneration syndrome is often associated with Cushing’s and may be immune-mediated.

I start my clients with a commercial, balanced raw diet for their dogs, and help them graduate to a home-prepared diet, if desired. I recommend avoiding synthetic vitamins and minerals and HPP (High-Pressure Pasteurized), although I make an exception if I feel a dog is significantly immune-suppressed or if there are food-safety concerns in the household. All commercial raw diets are a huge step up the nutritional ladder from the processed kibble that exacerbates this disorder. Remember, no starchy biscuit-style treats either! Use freeze-dried organs as functional treats.

IMPLEMENTING A NATURAL APPROACH TO CUSHING’S

1. Diet

• Start with a fresh, raw, species-appropriate diet based on local access, or a freeze-dried food. Many companies ship frozen food on dry ice. Emphasize the addition of blended, dark leafy greens, especially cruciferous vegetables for “liver-cleansing”.Studies show that orally-ingested sulforaphane from broccoli extracts induces Phase II detoxification enzymes.

2. Glandulars

• Standard Process (SP) Canine Adrenal Support or Adrenal Complex

• SP Pituitrophin PMG

• SP Canine Hepatic Support or Livaplex (both contain milk thistle)

• SP Symplex M or Symplex F-replaces missing gonadal influence with orchic or ovarian extract

3. Essential oils*/detox soaks

• This is my favorite tool. I use a moisturizing mineral soap with any of the following oils. It is safe to use as a daily soak if needed, and helps manage secondarily-infected skin, detoxify, and regrow hair by stimulating circulation. Soaking is emotionally soothing for most dogs.

• Lavender angustifolia lowers cortisol and has antimicrobial properties.

• Copaiba is high in beta-caryophyllene, which is anti-inflammatory.

• Nutmeg contains myristicin, which is antioxidant, antimicrobial and more. Use caution as high doses can be psychoactive. One drop diluted in a soak once per week is adequate.

•A blend of blue tansy, fennel, geranium, helichrysum, roman chamomile and rosemary is good for calming, liver detoxification, and improving circulation.*Note: All my safety and efficacy experience with essential oils usage is exclusively with Young Living.

4. Chinese herbals

• To appropriately address underlying Qi/energy imbalance, consider Jing Tang Ophiopogon Powder, Natural Path Si MaioSan, or Wei Ling Tang. TCVM practitioners can choose the appropriate formulation based on the dog’s constitution and tongue and pulse diagnosis, as well as colleagues’ experiences.

5. Acupuncture

• In TCVM, hyperadrenocorticism is most commonly a pattern of Yin deficiency or Qi-Yin deficiency. In the case of excessive appetite, thirst, urine volume, dry coat, thin hair to baldness, and excessive panting with a dry red tongue and thready rapid pulse, needles can be used for Yin Deficiency. Common points used are BL-23/52, KID-3/6/7, SP-6/8/9. A useful herbal formulation is Mai Men Dong, also known as Ophiopogon Powder.

• A Qi-Yin deficiency also includes a pendulous abdomen which maybe due to an enlarged liver, uneven fat distribution, or even fluid related to heart failure. Pulmonary edema may occur, with excessive panting especially at night. The tongue may be paler and the pulseweaker. Common points used are BL-23/26, KID-3/7, HT-7, LIV-3,SP-6, CV-4/6, ST-36. A useful herbal formulation is Rehmannia 11.

6. Hemp

• Hemp products can be beneficial, but purchasing the right product can be confusing. I trust and use SP Canine HempComplex (gel cap) or Animal Essentials Super Hemp (liquid). These are full-spectrum hemp products, not CBD specific.

7. Omega-3 fatty acids

• Fish oil, algae oil, or krill oil supplementation can help lower circulating triglycerides. An appropriate Omega-3-6-9 balance may also help improve dry skin, dull coat, excessive shedding, and inflammatory skin conditions that may accompany hyperadrenocorticism.

8. Other adaptogenic or calming herbals and nutrients

• Lion’s mane mushroom

• Reishi mushroom

• L-theanine

• L-tryptophan-amino acid (found in high levels in turkey; can be a good protein choice for many anxious dogs)

• Catnip

• Valerian

• Passionflower

• Lemon balm

• SP Bacopa Complex has been shown to lower cortisol levels

9. Melatonin promotes sleep, lowers cortisol.

10. Lignans are found in flax hulls and sprouts; they lower cortisol and estradiol.

11. Homeopathics should be used with the help of an experienced classical homeopath to help “peel the onion”; Cushing’s is a complicated disorder to manage.

Many natural approach ingredients work synergistically and can be used in combination if finances permit and the dog will consume them. You can use the alkaline phosphatase (SAP) level as a monitoring tool if it’s elevated. The dog owner should keep a journal to monitor thirst and urine volume as well as appetite and energy

Avoid oxalates and calcium supplementation. Cortisol increases calcium excretion and many of these dogs develop calcium deposits in their skin, as well as calcium oxalate urolithiasis. Choose low-oxalate veggies. If, during a veterinary client discussion, it is deemed necessary to manage a patient’s Cushing’s with conventional medication, keep in mind that the natural approach can be combined with it. Great nutrition, appropriate supplements, and improved lifestyle can minimize the amount of medication needed, and keep the dog on the healthiest track possible.

 

References:

Cushing’s syndrome—an epidemiological study based on a canine population of 21,281 dogs, www.ncbi.nlm.nih.gov/pmc/articles/PMC6500859/#:~:text=In%20the%20United%20States%2C%20the,et%20al.%2C%202015.

Survival analysis of 219 dogs with hyperadrenocorticism attending primary care practice in England, www.ncbi.nlm.nih.gov/pmc/articles/PMC7146928/.

Fructose-induced inflammation and increased cortisol: A new mechanism for how sugar induces visceraladiposity,https://pubmed.ncbi.nlm.nih.gov/29225114/.

Hypothalamic-pituitary-adrenal axis dysregulation and cortisol activity in obesity: A systematic review, https://pubmed.ncbi.nlm.nih.gov/26356039/.

Modifying influence of dietary sugar in the relationship between cortisol and visceral adipose tissue in minorityyouth,https://pubmed.ncbi.nlm.nih.gov/23929660/.

Glucose ingestion selectively amplifies ACTH and cortisol secretory-burst mass and enhances their jointsynchrony in healthy men,https://pubmed.ncbi.nlm.nih.gov/21752898/.

Stress Recovery Program Part II: The Cortisol-Glucose Connection, www.stmoritzmedical.com/blog/2020/5/12/stress-recovery-program-part-2-the-cortisol-glucose-connection.

The Interaction of Insulin and Pituitary Hormone Syndrome, www.frontiersin.org/articles/10.3389/fendo.2021.626427/full.

Galac S, Kars VJ, Voorhout G, et al. ACTH-independent hyperadrenocorticism due to food-dependent hypercortisolemia in a dog: a case report. Vet J 2007;177(1):141-143.

N’Diaye N, Tremblay J, Hamet P, et al. Adrenocortical overexpression of gastric inhibitory polypeptide receptor underlies food-dependent Cushing’s syndrome. J Clin Endocrinol Metab 1998;83(8):2781-2785.

Supplements – Whole Food Supplements,https://vcahospitals.com/know-your-pet/supplements—whole-food-supplements.

Sudden Acquired Retinal Degeneration Syndrome (SARDS) and Immune Mediated Retinitis (IMR), https://animal-eye-iowa.com/sardsimr/.

Changes in systolic blood pressure in dogs with pituitary dependent hyperadrenocorticism during the first year of trilostane treatment, www.ncbi.nlm.nih.gov/pmc/articles/PMC7848348/.

Broccoli sprout extract induces detoxification-related gene expression and attenuates acute liver injury, www.ncbi.nlm.nih.gov/pmc/articles/PMC4572790/.

What Are Adaptogenic Mushrooms? Benefits, Risks, and Types, www.healthline.com/nutrition/adaptogenic-mushrooms#types-potential-benefits.

An acute, double-blind, placebo-controlled cross-over study of 320 mg and 640 mg doses of Bacopa monnieri(CDRI 08) on multitasking stress reactivity and mood,https://pubmed.ncbi.nlm.nih.gov/23788517/.

Omega’s, www.petmd.com/dog/nutrition/whats-vet-recommended-diet-canine-cushings-disease.

Treatment Option Considerations for Hyperadrenocorticism in Dogs,https://vetmedsp.tennessee.edu/vmc/dls/Endocrinology/Documents/Treatment%20Considerations.pdf.

Pharmacological and Therapeutic Potential of Myristicin: A Literature Review, www.ncbi.nlm.nih.gov/pmc/articles/PMC8512857/.Xie H. Preast V.

Xie’s Veterinary Acupuncture Ch.9 p. 304.

Marsden, S. Essential Guide to Chinese Herbal Formulas.