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All About Iatrogenic Cushing’s Syndrome

Writer: Canine Cushing's Alliance
Canine Cushing's Alliance
Jul 3
2 min read

Updated: Jul 5

What is iatrogenic Cushing’s syndrome?


Iatrogenic Cushing’s syndrome refers to symptoms of Cushing’s that are caused by the prolonged or excessive use of steroids, such as prednisone, dexamethasone, or steroid eye drops. These medications are frequently prescribed to manage inflammation, allergies, certain cancers, and other health issues. Because they are chemically similar to the cortisol that’s naturally produced in the body, giving a dog too high of a dose or keeping them on steroids for too long can cause urinary incontinence, excessive hunger, and other symptoms of excessive cortisol.


Clinical Signs


The clinical signs of iatrogenic Cushing’s syndrome are similar to the clinical signs of naturally occurring Cushing’s disease. These signs include frequent urination and/or accidents in the house, increased water intake, a ravenous appetite, muscle wasting, an enlarged abdomen, and hair loss.


Diagnosis


Veterinarians diagnose iatrogenic Cushing’s syndrome by evaluating symptoms and the dog’s medical history. They may also use an ACTH stimulation test to help with diagnosis. Dogs with iatrogenic Cushing’s syndrome typically have both baseline and post-ACTH values that are abnormally low, oftentimes less than 1 ug/dL.


Treatment


Treatment may consist of decreasing use of the steroid, gradually stopping its use, or finding an alternative drug. Steroid medications should never be stopped abruptly, and changes in treatment should always be made in consultation with a veterinarian. In many cases of iatrogenic Cushing’s syndrome, the adrenal glands actually shut down natural cortisol production since blood cortisol levels are high due to the medication. Tapering the dose slowly over weeks or months allows the adrenal glands to wake up and resume natural hormone production safely. If steroids are stopped cold turkey, a dog may experience a life-threatening Addisonian crisis due to lack of cortisol.

References



Iatrogenic and Pseudo Cushing’s in Dogs, by Nancy Kerns, Whole Dog Journal


Adrenal Testing in Dogs, by Michigan State University


Cushing’s Disease in Dogs, by Natalee Holt, DVM



 
 
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