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Vet Recommended Cushing’s Treatment Options

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Looking for vet recommended Cushing’s treatment for your dog? Dr. Jack Oliver, DVM, former Head of Endocrinology at the University of Tennessee’s College of Veterinary Medicine, developed a protocol for treating Cushing’s disease using lignans and melatonin. His research outlines various treatment options that you can discuss with your vet to determine the best approach for your dog’s specific case. Below is a copy of his published work, which can also be found on the University of Tennessee’s website.

Veterinarian-Approved Cushing’s Disease Treatments

When test results indicate increased adrenal activity, consider the following steps:

1. Diagnostic Procedures

Ultrasound and/or Endogenous ACTH testing can help rule out the presence of primary adrenal tumors.

2. Melatonin Therapy

Melatonin is often used as an initial treatment, particularly if alopecia is present. It is widely available, affordable, and has minimal side effects. Dosage guidelines:

  • Dogs under 30 lbs: 3 mg every 12 hours
  • Dogs over 30 lbs: 6 mg every 12 hours

Standard melatonin (not rapid-release or extended-release) is recommended. It inhibits certain enzymes, helping to lower cortisol levels. Effects may take up to four months, and response time varies between dogs.

3. Melatonin Implants

Melatonin implants are available for both dogs and ferrets and can last 3-4 months. These are particularly effective when used alongside lignans if estradiol levels are elevated.

4. Lignan Supplementation

Lignans, derived from flax hulls (SDG) or Norwegian spruce (HMR), provide phytoestrogenic activity that helps regulate hormonal imbalances.

  • SDG lignan: 1 mg per pound of body weight daily
  • HMR lignan: 10-40 mg per day (depending on dog size)

Avoid flaxseed oil, as its lignan content is too low and may increase triglycerides.

5. Lysodren™ Maintenance Therapy

Lysodren™ is often combined with melatonin and lignan to lower sex steroid levels and suppress cortisol production. Cortisol levels should be closely monitored.

6. Lysodren™ for Cushing’s Disease

A traditional and effective treatment for Cushing’s disease, Lysodren™ helps reduce cortisol, progesterone, and other adrenal hormones. However, estradiol levels may not always decrease.

7. Trilostane (Vetoryl™)

Trilostane is an alternative treatment now available in the U.S. While effective, it can increase 17-hydroxyprogesterone, estradiol, and androstenedione. Lysodren™ may be preferred for atypical cases. Switching between these drugs requires a one-month gap to prevent adrenal complications.

8. Ketoconazole

Used to treat both cortisol and sex steroid increases, typically prescribed at 6-12 mg/kg twice daily, often alongside melatonin and lignan.

9. Selegiline (Anipryl™)

A less commonly used alternative treatment for Cushing’s disease.

10. Hormone Exposure Risks

Topical hormone creams containing estrogen, progesterone, or testosterone may elevate hormone levels and lead to abnormal physical changes such as nipple and vulva enlargement.

11. Ovarian Remnant Syndrome

If estrus signs persist post-spay, an hCG stimulation test and progesterone measurement may be required.

12. Retained Testicle Detection

If cryptorchidism is suspected, an hCG stimulation test and testosterone measurement can confirm diagnosis.

13. Adrenal Panel Testing

Because multiple hormone patterns may be elevated, a full adrenal panel is recommended for a comprehensive diagnosis.

14. Additional Testing and Resources

For further details on testing procedures, submission protocols, and research articles, visit the University of Tennessee’s endocrinology department.

Lignans for Cushing’s Treatment

Types of Lignans

The two primary types of lignans used for Cushing’s disease treatment include:

  • Flax hull (SDG) lignans – derived from flax seed hulls
  • HMR lignan – extracted from the Norwegian spruce tree

Active Ingredients and Absorption

SDG flax hull lignans convert to enterolactone and enterodiol, while HMR lignan converts directly to enterolactone, offering faster bioavailability. Studies indicate HMR lignan provides more systemic bioactivity due to better absorption.

Potential Side Effects

SDG lignans contain fiber, which can increase stool frequency or cause mild diarrhea. HMR lignan has little to no fiber, minimizing this effect.

Safety and Dosage

No adverse effects have been reported for SDG lignans at recommended doses (1 mg per pound of body weight daily). Human studies show HMR lignan is well-tolerated at high doses with no significant side effects.

For more information, read the Linus Pauling Institute’s article on lignans at Oregon State University.

Conclusion

Managing Cushing’s disease in dogs requires a tailored approach, balancing veterinary-prescribed treatments with natural supplements like melatonin and lignans. While medications such as Lysodren™ and Trilostane are commonly used, many pet owners explore natural alternatives to help support their dog’s hormonal balance.

Looking for more information? Lignans for Life is an excellent resource for researching natural supplements like lignans and reading testimonials from pet owners who have used them to help manage symptoms. Always consult your veterinarian before introducing new treatments to ensure they align with your dog’s specific needs.

Frequently Asked Questions

What is the most effective vet recommended Cushing’s treatment?

Many veterinarians recommend a combination of melatonin, lignans, and Lysodren™ or Trilostane, depending on the dog’s specific hormonal profile. Each dog responds differently, so treatment should be tailored to their needs.

How long does it take for Cushing’s treatment to work?

Melatonin and lignans may take up to four months for noticeable improvements. Medications like Lysodren™ or Trilostane may show effects within weeks but require close monitoring.

Is melatonin safe for dogs with Cushing’s?

Yes, melatonin is generally safe and is often the first recommended treatment due to its affordability and minimal side effects. It helps regulate cortisol levels and may improve symptoms over time.

Can I use natural supplements instead of medication?

Natural supplements like melatonin and lignans can be effective, particularly in early-stage or atypical Cushing’s cases. However, more severe cases may require prescription medications like Lysodren™ or Trilostane.

Should I monitor my dog’s cortisol levels during treatment?

Yes, regular cortisol level testing helps assess treatment effectiveness and ensures that medications are not causing excessive suppression of adrenal function.

What’s the life expectancy of dogs with Cushing’s disease?

With proper treatment, many dogs with Cushing’s disease can live happy, fulfilling lives. Understanding Cushing’s disease in dogs’ life expectancy is crucial for setting realistic expectations and planning long-term care.

Is Cushing’s disease in dogs curable?

While there is no outright cure, proper treatment can significantly improve a dog’s quality of life. The goal is to manage symptoms effectively.