Cushing’s Disease in Boston Terriers

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Is your Boston Terrier drinking and peeing excessively? Are they slowing down because of their old age, or is this what I call Cushing’s disease? In this article, I’m going to discuss what’s Cushing’s disease in Boston Terriers, along with its symptoms, effects, treatment, and prevention. 

Cushing’s Disease in Boston Terriers

Cushing’s disease comes from a tumor that causes a dog’s body to produce too much of the cortisol hormone. Cortisol is a steroid hormone that helps a Boston Terrier respond to stress and pain, monitor sugar levels, fight infections, and control weight. 

Graphic image of a Boston Terrier and the word disease with a text explaining what is Cushing Disease in Boston Terriers

Excessive cortisol production means your Boston Terrier has a hormonal imbalance, which affects its body’s ability to function properly. As a result, your pet may experience neurological or behavioral issues.

Causes of Cushing’s Disease

Also known as hyperadrenocorticism, this excessive secretion of cortisol will cause production problems of crucial hormones that regulate a Boston Terrier’s body functions. These are three reasons why a Boston Terrier may get Cushing’s disease.

A Tumor On The Pituitary Gland

About 80 to 90% of dogs with Cushing’s disease have a tumor on the pituitary gland at the brain’s base or what I call pituitary-dependent hyperadrenocorticism (PDH). The tumor, often benign and small, affects the brain and surrounding structures.

Smaller breeds, such as Boston Terriers, are more susceptible to getting tumors in the brain or hyperplasia, which is an increase in cell number in the pituitary gland. 

Boston Terrier with Cushing's disease

A Tumor on the Adrenal Gland 

While tumors on the adrenal glands are more common with large dog breeds, it’s equally important to know that a tumor can cause the gland to secrete too much cortisol. Adrenal-dependent hyperadrenocorticism impacts 15 to 50% of dogs, forming either non-cancerous or malignant tumors on top of the kidneys. 

An Overuse of Steroid Medications

Iatrogenic Cushing’s syndrome happens if a Boston Terrier has taken steroids or excessive amounts of glucocorticoids for a long time. Oral and injectable forms of steroid-containing medication may trigger this problem. Thus, such medications require a prescription and approval from a veterinarian. 

Symptoms of Cushing Syndrome in Boston Terriers 

When the hormones become out of balance, the most evident symptoms of Cushing’s disease are concurrent drinking of large amounts of water and excessive urination. As the disease progresses, Boston Terriers may suffer muscle and joint problems, causing them to feel weak. 

Furthermore, these warning signs may not be noticeable at first, as you think a Boston Terrier is just manifesting the actions of an old dog.

  • Hair loss
  • Recurring skin infections
  • Enlargement of the belly or pot-bellied appearance 
  • Increased hunger 
  • Excessive panting 
  • Lethargy 

Effects of Cushing’s Disease

While not entirely painful, Cushing’s disease in Boston Terriers may trigger other health problems.

  • High blood pressure: Remember that the syndrome uses cortisol, which affects a dog’s response to mood. With excessive cortisol, your Boston Terrier may easily experience irritability, anxiety, and hypertension. 
  • Kidney infections and bladder stones: As the disease elevates blood pressure, it also suppresses a Boston Terrier’s immune system, resulting in kidney and bladder infections.
  • Diabetes: Hyperadrenocorticism produces too many steroids, which cause insulin resistance. 

Life Expectancy of Boston Terriers With Cushing’s Disease 

Two years is the average survival time for a dog with Cushing’s disease, although some may live beyond that. However, this doesn’t automatically mean that a dog will die because of the syndrome. Since the disease usually occurs in senior dogs, most would die of causes related to aging. 

Diagnosing Cushing’s Disease in Dogs 

Cushing’s disease can be quite complex to diagnose because it has the same symptoms as other conditions. This is why it’s essential that you inform the veterinarian of all the things that seem different about your Boston Terrier. 

Dog lying on the floor

Nevertheless, these are various tests veterinarians can use to determine if your Boston Terrier has the syndrome or not.

Urine Cortisol Creatinine Ratio 

The Urine Cortisol Creatine Ratio plays a key role in diagnosing because a Boston Terrier with a normal UCCR is free of Cushing’s disease. Meanwhile, a Boston Terrier with abnormal UCCR needs further testing to confirm the diagnosis.

Low-Dose Dexamethasone Suppression Test 

The Low-Dose Dexamethasone Suppression test is a relatively sensitive yet specific screening that helps determine whether a Boston Terrier has pituitary-dependent or adrenal-dependent Cushing’s disease. It looks at blood samples of how a Boston Terrier’s body works with dexamethasone, a man-made version of cortisol. 

A healthy dog’s cortisol level should go down over the next few hours after getting a dexamethasone injection. If it fails to drop, it may indicate a tumor is not responding to the medication.

Adrenocorticotropic Stimulation Test 

The Adrenocorticotropic Stimulation Test is another screening method, although it won’t know if the disease is pituitary-dependent or adrenal-dependent. Instead, it measures how well the adrenal glands work in response to a hormone called ACTH, which prompts the glands to produce cortisol. 

A Boston Terrier with the normal adrenal response should only have a slight increase in cortisol level. If the blood samples from the ACTH Stim show high numbers, this confirms Cushing’s disease.

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Treatment for Cushing’s Disease in Dogs 

Treating Cushing’s disease in Boston Terriers mainly depends on the underlying cause. Treatment options include: 

Surgery

Surgery is less likely to happen for the pituitary-dependent CD because the gland is a pea-sized body attached to the brain. It is a highly sensitive part that controls the growth, development, and function of other glands. 

Meanwhile, adrenal-based SD commonly uses surgery to remove the tumor in an adrenal gland since this part is next to the kidneys, and therefore, easier to reach. However, surgery may become more complicated in malignant tumors that grow aggressively or metastasize to other parts of a Boston Terrier’s body. 

On the other hand, if the surgery is successful, a Boston Terrier’s appetite and water consumption should return to normal in a few weeks. Normal growth of fur should follow in the coming months. 

Oral Medication

While Medication does not completely treat Cushing’s disease, it can make your Boston Terrier’s life more comfortable by getting the symptoms under control. It is the usual treatment plan for Boston Terriers with pituitary-dependent Cushing’s. This is also an option for an adrenal-dependent Cushing’s Disease where surgery can’t remove the tumor. 

Boston Terrier

A Boston Terrier can still live a normal life with medication, although your pet will need it for the rest of its life. Depending on the prognosis, a veterinarian may use trilostane as medication for two to 2.5 years to help normalize or lower cortisol concentrations. 

Suppose a veterinarian decides to pursue some form of chemotherapy. In that case, a Boston Terrier may survive up to one year with the help of mitotane, an oral chemotherapeutic agent that reduces a tumor’s growth.

Radiation

While radiation may help shrink the size of a pituitary tumor, this treatment is only effective on small tumors to reduce the effects of Cushing’s disease. Definitive radiation therapy in dogs with pituitary masses shows an 87% survival rate for two years

Discontinuation of Steroid Dosage 

If a Boston Terrier has an iatrogenic Cushing’s syndrome, you should gradually decrease steroid dosage until you can stop it eventually. It would be best to consult a veterinarian as this may cause a relapse in the primary disease the steroid was initially used to treat. 

Routine Check-Ups

You will need to schedule regular check-ups and blood tests to determine if the treatment is working. Careful monitoring is vital when your Boston Terrier is taking oral medication to make sure the drugs don’t destroy the adrenal cortex completely and only help the cortisol stay normal.

You still need to keep a close watch on your Boston Terrier as the veterinarian will most likely ask you about behavioral changes. Call the clinic right away if you notice a return of common symptoms such as abnormally frequent urination, lethargy, troubled breathing, and decreased appetite. 

Euthanization

Cushing’s disease is a condition that requires long-term treatment and management after diagnosis. If medication isn’t improving your Boston Terrier and only causes constant pain and neurological health impacts, it might be time to make the tough decision of euthanizing your pet. 

You know your Boston Terrier the most, and letting your pet go may be an option if you think the syndrome is causing adverse effects on its quality of life. Euthanization is an extremely difficult decision to make, so take your time when considering this option. 

Ways to Prevent Cushing’s Disease

While there is no straightforward way to prevent your Boston Terrier from getting Cushing’s disease, a proper diet can help manage the signs of the syndrome. 

Feed your Boston Terrier with low-carbohydrate, high-protein dog food. The pathway of glucocorticoids or steroids impacts the inflammatory process in the adipose tissue, which stores energy in the form of fats. High carbohydrate foods can exacerbate that inflammatory process. 

Cushing’s syndrome and diabetes have overlapping symptoms. As a precaution, both conditions may benefit from reduced sugar intake. 

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Conclusion

Cushing’s disease may come from steroid medication, as well as a tumor on a Boston Terrier’s pituitary or adrenal glands. Surgery, medication, radiation, and checkups are treatment options. A change in lifestyle, diet, and exercise may not totally prevent the disease, although these measures can help keep your Boston Terrier healthy. 

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