How to know if your dog has Cushing’s Disease and Diabetes

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How to know if your dog has Cushing’s Disease and Diabetes.

What is Cushing’s
Cushing’s Disease (or syndrome) occurs when the adrenal glands produce excess amounts of cortisol, also known as cortisone. Cushing’s is also known as hyperadrenocorticism. Hyper = above normal; adreno = relating to the adrenal glands; corticism = relating to the cortex & cortisol production. So, Cushings is a disease of elevated cortisol production by the adrenal cortex. Cushing’s is much more common in dogs than in cats, so this page focuses on Cushings in dogs.

Dogs have two adrenal glands, which are are small pea-sized glands located next to the kidneys. The adrenal glands produce several types of hormones that are involved in regulating many of the body’s processes including control of blood potassium and sodium concentrations, water metabolism, protein, fat and carbohydrate metabolism, stress response, regulation of blood pressure, and to a small extent sex hormone levels.

The outer portion of the adrenal gland is called the cortex and it produces corticosteroids (cortisol and corticosterone) and mineralocorticoids (aldosterone). Cortisol is involved in the metabolism of carbohydrates, fat, and protein. Aldosterone is involved in regulation of mineral and water balance. The inner portion of the adrenal gland is called the medulla and it produces epinepherine, which during a stress response, raises blood glucose levels, blood pressure, and cardiac output.

Production of cortisol by the adrenal gland is controlled by the pituitary gland, which is a small gland located at the base of the brain. The pituitary gland produces adrenocorticotropic hormone (ACTH) which stimulates the adrenal cortex to produce corticosteroids (cortisol). Additionally, the hypothalamus, a small structure in the brain, secretes corticotropin-releasing hromone (CRH) which signals the pituitary gland to produce ACTH. When enough cortisol is produced, it in turn goes back to the pituitary and hypothalamus and tells them to stop producing ACTH and CRH. In technical terms this is called a negative feedback system. The hypothalamus produces CRH which tells the pituitary gland to produces ACTH. The ACTH tells the adrenal glands to produce cortisol, which returns back to the hypothalamus and pituitary to turn off CRH and ACTH production.

Cushing’s is one of the most common endocrine diseases of middle-aged and older dogs. Most dogs are 9-10 years old when diagnosed, but it can occur in younger dogs. Larger dogs and females tend to be more affected than smaller breeds or males.

Reasons why the balance between ACTH and cortisol can be upset:

Pituitary gland tumor- also called Pituitary Dependent Hyperadrenocorticism (PDH)– This is the most common type of Cushings and it is found in about 85% of all cases. A tumor in the pituitary gland causes an increased production of ACTH, which in turn tells the adrenal cortex to produce more cortisol. The pituitary tumor can be very tiny or large and it can be benign or malignant. Poodles, terriers, German shepherds, Dachshunds, beagles, and boxers are more commonly diagnosed with PDH than other breeds.
Adrenal gland tumor – A tumor in one or both adrenal glands can cause an excess production of corticosteroids, which causes Cushing’s. The tumor can be tiny or large and it can be benign or malignant.
Iatrogenic – Iatrogenic means the disease has resulted from a complication of medical treatment. When a dog is given corticosteroids to treat another medical condition such as allergies, the excess corticosteroids can overload the body and result in Cushing’s symptoms.

Clinical signs of Cushing’s
Not all of these signs may be present, but as the disease progresses, they may become more pronounced or more signs may be seen. How common the sign is is shown for many of the items.

Increased appetite (polyphagia) – 80-95% will show this sign.
Increased drinking (polydypsia) and urination urination (polyuria) – due to interference with production of antidiuretic hormone. 80-90%.
Muscle weakness, lethargy, lack of activity – excess cortisol causes protein breakdown (catabolism) which leads to muscle weakness. 75-80%
Obesity, bloated abdomen, and “potbelly” – due to an increase of fat in the abdomen, increase in liver size (hepatomegaly), cronically full bladder, stretching of the abdominal wall, and the abdominal well becoming weaker. 90-95%
Panting – due to increased fat in the rib area (thorax), muscle weakness, and increased abdominal contents exerting pressure on the diaphragm. A “common” sign.
Poor hair coat, thinning hair (usually on the sides), hair does not regrow . “Common”.
Skin infections – due to excess corticosteroids suppressing the immune system.
Thin skin, flaky or greasy skin & bruising – many processes that control skin structure and health are effected.
Fasting hyperglycemia (elevated blood glucose) – seen in 40-60% of dogs.
Insulin resistance – seen in up to 85% of dogs

So as you can, some of the signs of diabetes and Cushing’s are identical.

Diagnosis and Testing
Diagnosis of Cushing’s can be complicated and difficult. It is important to determine the type of Cushings (adrenal, pituitary, or iatrogenic) so that the appropriate treatment can be undertaken.

Routine lab tests are usually performed – complete blood count, biochemistry, urinalysis – and abnormalities in these tests may suggest Cushing’s.
An abdominal x-ray may show an enlarged liver or adrenal gland changes.
An abdominal ultrasound is often performed to evaluate liver and adrenal glands.
A urine test measuring cortisol to creatinine ration is sometimes performed, but it is not a very specific test because many health problems can cause abnormal test results. This is a screening test only – a negative result rules out Cushing’s. A positive result does not confirm Cushing’s and more tests will need to be performed.
More definitive diagnostic testing looks at adrenal gland function. Cortisol levels in the blood are measured before and after a drug that would normally effect cortisol levels is given. Two commonly used tests are the ACTH stimulation test and the Low-dose dexamethasone suppression test. During the ACTH stimulation test, a pre-test blood sample is taken, then a dose of ACTH is given. After 2 hours, cortisol levels are measured again. If the cortisol levels are higher than expected, Cushing’s may be diagnosed. Dexamethasone is a cortisone-type drug that provides negative feedback on the pituitary gland to turn off ACTH production, and that in turn causes a decrease in adrenal cortisol production. In a normal animal (non-Cushing’s) a dip in cortisol would be seen 8 hours after giving dexamethasone. If a pituitary tumor exists, no drop in cortisol level is seen during the low-dose dexamethasone test. During a high-dose dexamethasone suppression test, cortisol levels will be suppressed in about 75% of dogs with PDH and will not be suppressed in the remaining 25% of dogs with PDH or in 100% of dogs with an adrenal tumor.
For detailed information about the tests used to diagnose Cushing’s, see http://www.marvistavet.com/html/confirming_cushing_s.html

Diabetic animals can pose a special problem when testing for Cushing’s.
As you can see, diabetes and Cushing’s share many of the same signs (increased drinking, urination, eating, lethargy, enlarged liver). Uncontrolled diabetes can lead to complications that in turn cause increased cortisol levels and signs that are identical to Cushing’s. Testing and diagnosis of Cushing’s in a non-diabetic dog can be complicated, and it can be extremely complicated in a dog that has diabetes. The situation is even worse for a stressed or poorly controlled diabetic because stressed diabetics and Cushing’s dogs can have similar blood panel abnormalities and blood chemistry abnormalities. Plasma ACTH levels, the ACTH stimulation test results, and low-dose dexamethasone suppression test results can be abnormal in a stressed DM dog; the high-dose dexamethasone suppression test results can be abnormal in an unregulated DM dog. There are clinical signs that help distinguish the two disease so your general vet and specialist must consider the “whole picture” of your dog’s physical condition and test results.

Treatment
Cushings caused by a pituitary gland tumor (PDH). Surgery to remove a tumor in the pituitary gland is very risky and is rarely performed. Controlling the growth of the tumor may be attempted with radiation. Medication is used to control this type of Cushings.

The drug most commonly used is o,p’DDD, also know as Lysodren or mitotane. This drug works by destroying the cortisol-producing cells in the adrenal cortex. Careful monitoring is required during treatment to be sure that too much drug is not given and too many adrenal cortex cells are not killed. Too much drug would result in too little cortisol being produced (resulting in Addison’s disease, the opposite of Cushing’s). Treatment involves an “induction” or “loading” phase where Lysodren is given on a daily basis. This loading phase rapidly brings the some of the Cushing’s symptoms under control. Owners are usually instructed to closely monitor their dog’s eating and drinking. When drinking is normal (about 50-60 mL water per pound body weight per day) induction is complete and the “maintenance” phase begins. In maintenance, Lysodren is given two to three times a week to keep the cortisol levels within acceptable levels. ACTH stimulation tests are repeated every three to four months to ensure adequate control and dosing.

Anipryl or L-deprenyl is another drug that is used to treat pituitary-dependent Cushing’s. It was approved for use in the United States in 1997. Anipryl is used to treat cognitive dysfunction in dogs and has shown to be effective in clinical trials in controlling Cushing’s in about 70% of dogs. The drug works by influencing dopamine concentrations (a chemical used to by brain cells to communicate with each other), which in turn influences production of ACTH by the pituitary gland. The effectiveness of this drug is controversial, but since the side effects are less severe than those of Lysodren, it is used in some dogs, especially those who are older or have multiple health problems. Anipryl does not involve an induction or loading phase.

Ketoconazole is another drug used to treat PDH or dogs who have adrenal gland tumors. It works by blocking production of cortisol in the adrenal gland. It has the potential to damage the liver.

Cushings caused by an adrenal gland tumor may be treated surgically or with Lysodren or Ketoconazole. Surgery is difficult and may have many complications. Removal of the adrenal gland may require life-long supplementation with glucocorticoids and mineralocorticoids (both normally produced by the adrenal gland).

Iatrogenic Cushing’s – treatment requires slowly discontinuing the cortisone that is being given. This must be done in a controlled manner so that other problems do not occur. The disease that is being treated with cortisone will probably recur. If damages has been done to the adrenal glands, that will need to be addressed.

Special considerations for treating diabetics
With a possible diabetic and/or Cushoid animal there are three different scenarios that can occur:

Your animal may be both diabetic and have Cushing’s. As the Cushing’s is brought under control your animal’s insulin needs will be greatly reduced. Therefore it’s very important to monitor your animal’s blood glucose until the correct maintenance dose is determined so an overdose of insulin doesn’t happen.
You can read Kiri’s story – she lived with diabetes, Cushing’s and hypothyroidism for over 6 years.
Your animal may only have Cushing’s. The increased blood glucose levels may be a side effect of the Cushing’s and once the Cushing’s is brought under control there may be no need for insulin anymore.
Your animal may only be diabetic. The Cushing’s tests may have been altered by one of the previously mentioned causes, resulting in false positive results.

Questions to ask your vet
With a diabetic it is very important to take every means possible to stabilize them on their insulin before a Cushing’s test is even tried. Some questions to ask your vet:

If your animal is unregulated–ask your vet at what amount of insulin they would consider your animal to be needing to bring the glucose levels under control.
If your animal has only been on one type of insulin, are they willing to try another type.
Would a change in food, feeding schedule, or amount of food make a difference.

Resources and References

The Cushing’s Pet Forum
Mar Vista Animal Medical Center Cushing’s Informational Web Site and information on Tests for Confirming Cushing’s
Canine Hyperadrenocorticism, Diabetes Mellitus, or Both? Kirsten Zwicker DVM et. al.
Dog Owner’s Guide: Cushing’s Disease
Pocket Companion to the Fourth Edition of Textbook of Veterinary Internal Medicine 1995. Stephen J. Ettinger.
U.C. Davis School of Veterinary Medicine Book of Dogs. 1995. Mordecai Siegal, editor.

http://www.caninediabetes.org/pdorg/cushings.htm

How to Hold a Dachshund Properly

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http://www.wikihow.com/Hold-a-Dachshund-Properly

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How to Hold a Dachshund Properly

Two Methods:Holding a Dachshund SafelyKnowing What to Avoid

Dachshunds (also known as “wiener dogs”) are known for their long body, short legs, and floppy ears. While these adorable dogs make great household companions, their unusual proportions can make them delicate — their long spines are especially sensitive. This means that extra care must be taken to support the dog’s back as you pick it up, hold it, and set it back down.[1]
Method 1 of 2: Holding a Dachshund Safely

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1
Place one hand under the chest. Picking up a dachshund is different than the way you’d pick up other breeds, but it’s not especially hard once you learn the right method. Start by slipping a hand under the dog’s upper body to support his chest and ribcage. Don’t lift up yet.
Spread your fingers out so that you support as much of the dog’s upper body as possible. The wider the area you can spread his weight over, the gentler it will be on his spine.
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Place your other hand under the dog’s rump. Gently slip your free hand under the dog’s rump — either directly behind it or just in front of the dog’s rear legs to support its lower body. Get ready to lift up.
Here, again, it is best to spread your hand to give the widest base of support possible.
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Slowly lift the dachshund, keeping its body level. Now, simply lift the dog up. As you go, try to keep the dog’s lower body from hanging or drooping beneath its lower body. A little bending is fine, but you’ll want to keep the dog’s back as flat as possible to keep from putting stress on it.[2]
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Continue to support the dog’s back as you hold it. As you move around or play with your dachshund, make sure its lower back is well-supported at all times. Dachshunds aren’t like other dogs — letting their lower bodies dangle is uncomfortable to them and can contribute to painful back problems (like slipped and ruptured discs) over time.[3]
Luckily, with a little practice, this should become second nature after a while. Eventually, it will feel “wrong” to pick the dachshund up in the incorrect way.
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Transition to a “cradle” hold if you wish. As long as the dachshund’s back is well-supported and its body is fairly straight, it doesn’t really matter how you choose to hold it. If you’d like the convenience of being able to hold your dachshund with one arm, try shifting to this alternate hold once you’ve picked it up correctly by following the steps above:
Gently shift the dog’s weight so that it comes to rest on the forearm of the arm that you were using to support its rump. Use your full forearm to support its weight.
Tuck the dog against your body for added support and comfort. This should feel a little like how you would cradle a baby or hold a football.
Use your free arm when needed to help the dog balance and keep it from squirming or wriggling free.
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6
To set the dachshund down, slowly lower it to the floor. If you’ve had experience with other dog breeds, you may be used to “dropping” or gently heaving them back to the ground when you’re done holding them. With dachshunds, instead, you’ll want to lower the dog all the way to the ground before letting go. As always, keep its back well-supported as you lower it down.
Ideally, you’ll want its feet to be touching the ground before you let go. As you’ll read below, even a drop of a few inches can put stress on the dachshund’s back and joints.[4]

Method 2 of 2: Knowing What to Avoid

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1
Don’t pick up a dachshund by his upper body. Many are accustomed to picking up dogs as if they were human babies by putting one hand under each of the dog’s “armpits.” However, this is unsafe for dachshunds. This puts an unnatural stress on the dog’s back — its spine simply isn’t built to support its long body without any other support.[5]
In general, you will want to avoid any sort of hold that supports only half of the dog’s body length. This is true even if the dog is already standing on one set of legs — like, for instance, if he is propping himself up on his hind legs while looking over the top of a sofa. In this case, you’ll want to lean down so that you can support his rump before picking him up.
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2
Never drop the dachshund back onto the ground. As noted above, dogs should be set down gently, not dropped. A dachshund’s legs are very short compared to other dog breeds’. This means that they can’t bend very far to absorb the shock of hitting the ground, which puts most of the impact stress on the leg joints and back. Getting rid of the dog’s “fall” eliminates this danger.[6]
Don’t trust your dog’s body language here. Dachshunds don’t know that their skeleton can’t support falls, so they may be perfectly willing to jump out of your hands. Even if this doesn’t cause them immediate pain, it can lead to painful problems if continued in the long term.
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Never make a dachshund bend or twist when you pick him up. Dachshunds’ long, slender spines are especially vulnerable to injury, which is why it’s so important to keep their bodies straight when you pick them up. You will definitely want to avoid any activities that put a twist or bend in the dog’s back, as this increases the stress on it and can contribute to conditions like slipped discs.
For example, one way you might accidentally do this is by scooping the dachshund up suddenly when it doesn’t expect it. If you startle your dog, it may wriggle or twist out of one of your hands, putting an unnatural bend in its spine as it hangs. Make sure your dog is calm and aware of you before you attempt to pick it up.
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Don’t ignore any signs of distress from the dog. Dachshunds, like all dogs, are generally pretty smart about letting you know when they are in pain. If your dog looks or sounds uncomfortable when you pick it up, it probably is, so set it back down and re-evaluate the way you’re holding it before you try again.
Some signs of pain in dogs are obvious, like yelping, whimpering, etc. However, others a little more subtle. The following are nonverbal signs that a dog may be uncomfortable:[7]

Trembling (without another explanation, like coldness)
Trying to get away
Unnatural amounts of affection or aggression
Holding the mouth closed (rather than having a natural, “happy” look)

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Show family and friends how to hold dachshunds properly before letting them play. Nothing’s more frustrating than when you take the time to learn how to hold your dachshund properly, only for well-meaning relatives to come over and treat it like an ordinary dog. To avoid problems, be sure to educate any visitors about the proper ways to hold your dog before they play with it.
This is especially true for children, who can sometimes be too rough with dogs by accident. It’s a wise idea to supervise children when they first interact with your dachshund until you’re confident that they know how to play safely.

Is a dachshund right for you and your family?

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Is a dachshund right for you and your family?

Curious, lively, charming, and brave, the Dachshund is similar to a terrier in his demands to be in on everything.

This comical clown loves to play games and has a great sense of humor. He is a loyal little dog, very attached to his family, and he firmly believes that sleeping under the bedcovers is in the Dachshund Bill of Rights.

Dachshunds attract devoted followers who would never consider having any other breed. Indeed, Dachshunds are often kept in pairs, which is A-OK with them, since they seem to recognize and prefer being with other “wiener dogs”.

They’re usually good with other family pets, too, though they can be jealous when they want attention and they can be possessive of their toys. You need to put a firm stop to the first signs of jealousy or possessiveness so that these don’t become bad habits.

Though the Dachshund makes a great house dog, he does need his daily walks (on-leash! Dachshunds are chasers who will take off! — and plenty of companionship. Loneliness will lead to excessive barking.

You’ll also hear his sharp, persistent bark when people approach, for most Dachshunds are alert watchdogs who do not take kindly to strangers intruding on their domain. Again, you need to put a stop to overt signs of suspiciousness, lest this progress to nastiness.

Though bright and clever, Dachshunds like to do things their own way. In other words, they’re stubborn. Cheerful praise and treats should be offered freely, as Dachsies are proud little dogs who resist force. They become irritable when pushed too far, and they may respond defensively (growling or snapping) if jerked around, handled harshly, or teased.

Other behavioral problems? Well, the Dachshund’s hunting and tunneling instincts may lead to holes being dug in your garden. Also, housebreaking may go slowly, as many Dachshunds don’t like to go outside in cold or wet weather. A covered potty yard is recommended, if possible.

In general, Miniature Dachshunds are more active than the larger Standard Dachshunds. Comparing the three coat varieties:

Wirehaired Dachshunds tend to be the most energetic, the most mischievous, and the most obstinate (probably stemming from their strong terrier heritage).
Longhaired Dachshunds tend to be the quietest and sweetest-natured (probably stemming from their spaniel heritage).
Smooth Dachshunds are most apt to attach themselves to one person and are often more aloof with strangers.

But remember, these are just generalities!

If you want a dog who…

Comes in a variety of smallish sizes, coats, and colors
Is comical and entertaining
Is loyal to his family
Needs only moderate exercise
Makes a keen watchdog
Is good with other family pets, especially other Dachshunds
Usually lives a long life

A Dachshund may be right
for you.

If you don’t want to deal with…

Stubbornness
Scrappiness toward strange dogs, especially larger dogs
Chasing and hunting instincts (chipmunks, birds, etc.)
Notorious housebreaking difficulties
Potential for excessive barking
Potential for digging holes
Excessive suspiciousness toward strangers when not socialized properly or made to behave
Worries about the serious spinal problems that afflict 1 out of every 4 Dachshunds and can result in paralysis

A Dachshund may not be right for you.

http://www.yourpurebredpuppy.com/reviews/dachshunds.htmlhttp://www.yourpurebredpuppy.com/reviews/dachshunds.html

A Happy Dachshund Hotel

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I wish I lived in the united kingdom so I could send my pups their to stay.

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Welcome to Sausage Dog Hotel, the premier choice for those difficult times when your beloved sausage needs a home away from home.

We provide a full range of services, including long and short term stays, regular day care, walking and much more, all specifically tailored to dachshunds.

Located in Hertfordshire, just south of St Albans, with extensive countryside and woodland right on our doorstep, we are also within easy reach of North London and service a large part of the surrounding area. We are fully licenced by the local authorities, and have insurance policies to cover all our activities – at home, while traveling, and when out walking.

We also offer a pick up & drop off service for those sausages that live further afield and want to come stay with us, and have regular guests from all over the country.

http://sausagedoghotel.com/