Can anemia and Cushing's disease occur together in Shih Tzu dogs?

Cushing's or Hyperadrenocorticism is a fairly common endocrine disease in dogs. It can be caused by a bit of overactive tissue in the brain (in the pituitary gland, which is the master ruler of hormone secretion in the body) or a mass in an adrenal gland (sits by the kidneys, secretes hormones as directed by the pituitary gland). Basically what happens is an excess of a hormone in the body, usually a steroid called cortisol, if it is traditional Cushing's. This then causes some symptoms in the pet, blood work changes, and sometimes other changes like high blood pressure. I suspect based on the value that you report that this was a liver enzyme elevation call ALP. This very commonly occurs in pets that have Cushings, but is not specific for Cushing's and elevation can be caused by other disease processes. This value does not correlate with severity of disease as many dogs have a high value. It sounds like your vet is on the right track by recommending an ultrasound to look at the adrenal glands and also the rest of the abdominal organs to rule out other disease processes. Ultimately Cushing's Disease has to be diagnosed by some sort of endocrine testing which your vet may recommend as well. Treatment if then based on what type of Cushing's disease is present. I hope this helps and thank you for using Petco Pet Education Center, formerly Petcoach!

Thank you for reaching out about Jake. I think you will need to send us another post on Petco Pet Education Center, formerly Petcoach and be more specific about your dog's problems. You can attach blood results or x-rays to your question. Anaemia as well as Cushing's disease are chronic problems in dogs and there may be several aspects of the diseases you may want to ask. Regarding your questions: dogs with Cushing's disease usually do not suffer from anaemia, so my initial feeling is that these problems are not related. Anaemia is caused by either failure to produce red cells (bone marrow diseases), blood loss (internal or external bleeding) or excessive damage of the red cell (autoimmune diseases, splenic diseases). Other causes of anaemia in dogs, like iron deficiency are very uncommon. Will ideally need to see blood results of your dog or at least the type of anaemia he suffers from to give you more specific answers.

Some common symptoms of Cushings's are panting, increased thirst/urination, but these are also common symptoms of many diseases. Bloodwork and endocrine testing can help to ferret that out. Neurologic symptoms can sometimes be present with Cushing's if there is a larger tumor in the pituitary gland but seizures can also be caused by other things as well so an MRI is typically required. CT can sometimes be used if a pituitary mass is strongly suspected. Itchy feet is typically caused by allergies which may also be associated with secondary infection. Next steps are to see your vet for an exam, bloodwork, and endocrine testing. Abdominal ultrasound and blood pressure measurement are also typical next steps. I hope this helps and thank you for using Petco Pet Education Center, formerly Petcoach!

I'm sorry to hear about Chi Chi's recent issues. Vomiting and an anal gland abscess/rupture may cause some changes on the blood panel, but not typically ALP. When you have a significantly elevated ALP and normal ALT it is highly suggestive of Cushing's disease. Cushing's can be diagnosed with a few different tests, these tests involve taking blood, injecting a substance then taking blood again to see the body's ability to respond. I think it would be wise to have her checked. If she dies have Cushing's thankfully it is treatable with medication but this will be for life.

I'm sorry that Miller is not feeling well. We certainly see an increase in ALKP as an early sign of Cushing's disease, but ALT is not as commonly elevated. I am attaching a handout with more information about Cushing's disease below. https://www.veterinarypartner.com/Content.plx?P=A&S=0&C=0&A=1551 The most common test that we will use to diagnose Cushing's disease is called a Low Dose Dexamethasone Suppression Test. I am attaching a handout below that discusses the specific tests we use for Cushing's disease. https://www.veterinarypartner.com/Content.plx?P=A&S=0&C=0&A=636 However, an abdominal ultrasound is also an excellent test to evaluate the adrenal glands to look for evidence of Cushing's disease. So, I would discuss with your veterinarian if they would recommend doing further blood testing first or an abdominal ultrasound. That answer will likely depend on what Miler's lab work looks like when it is rechecked in 2 weeks. Good luck! I hope that was helpful and you can figure out what is going on with Miller. Thanks for using PetCoach.

Interesting question! Cushings can be a very difficult condition to manage and can in itself give low thyroid readings (as can any illness such as urinary tract infections common in cushings patients). This syndrome is known as euthyroid sick syndrome where although the thyroid my be capable of working it is not as active as expected - this occurs in almost 50% of cushings patients. True failure of the thyroid gland is also possible but much more rare. Extensive testing may be required in order to differentiate the two conditions but if confirmed, thyroid medication can be given alongside cushings medication

Just based on the information you described, I would probably consider testing for Cushing’s disease first, but it is possible to have both conditions so I would do the additional thyroid testing at the same time or soon after. Good catch!