Cushing’s Syndrome in Cats This article is verified by a vet

Cushing's Syndrome in Cats

Overweight and lethargy in cats can be indicative of Cushing's Syndrome.

Has your cat developed a large saggy belly, or does its skin seem extremely sensitive to touch? These could be indications of Cushing’s syndrome in cats. Discover why a trip to the vet is essential when suspecting this condition and how you can best support your cat throughout its illness.

What is Cushing’s Syndrome in Cats?

Cushing’s syndrome occurs when your cat’s adrenal glands produce too much cortisol, a stress hormone, leading to an excess in the body.

What Happens If Cushing’s Isn’t Treated?

Cushing’s syndrome in cats, also known as spontaneous hyperadrenocorticism, is rather rare compared to Cushing’s syndrome in dogs. However, because it’s often detected very late in cats, many affected felines present with a severe course including complications.

An untreated Cushing’s syndrome can lead to a cat’s death; thus, upon noticing symptoms, it’s critical to consult a vet without delay.

Symptoms: What Are the Signs of Cushing’s Syndrome in Cats?

Since cortisol plays a role in various bodily functions, the symptoms of Cushing’s syndrome in cats are wide-ranging and commonly include:

  • Poor general health
  • Increased drinking (polydipsia)
  • Increased urination (polyuria)
  • Increased appetite and hunger
  • Excessive grooming
  • Sensitive skin with tearing and non-healing wounds (fragile skin syndrome)
  • Skin that appears thin and darkened
  • Hair loss (especially on the back or tail)
  • Muscle wasting and weakness
  • Increased abdominal girth (pot-bellied appearance)
  • Weight gain
  • Rarely, mite infestation (Demodicosis)

The elevated cortisol levels associated with Cushing’s syndrome additionally weaken a cat’s immune system, making them more susceptible to bacterial and viral infections and inflammatory conditions such as pancreatitis. During the progression of the illness, up to 80% of cats develop diabetes mellitus.

When Should I Visit the Vet?

If you notice several of the mentioned symptoms, it’s crucial to take your cat to the vet as promptly as possible to initiate timely treatment.

Diagnosis: How Is Cushing’s Syndrome in Cats Confirmed?

Diagnosing Cushing’s syndrome is generally challenging. To confirm the diagnosis, your vet will first conduct a clinical general examination followed by various specific tests. A combination of ultrasound and hormone function tests is particularly conclusive.

Blood Test

A blood test reveals changes in blood values typical of Cushing’s syndrome. For instance, 40% of cats show increased levels of the liver enzyme Alkaline Phosphatase (ALP). Many have higher cholesterol concentrations compared to healthy cats.

Ultrasound Scan

This imaging technique allows your vet to inspect the adrenal glands for tumors or enlargement, hinting at Cushing’s syndrome, and to check the liver and other nearby organs for abnormalities.

Hormone Function Tests

Accurate diagnosis of Cushing’s syndrome calls for different hormone function tests:

  • Urine Cortisol-Creatinine Ratio (UCC): Measures cortisol concentration in your cat’s urine, with high levels suggesting Cushing’s. However, the stress of a vet visit can significantly elevate the UCC.
  • Low-Dose Dexamethasone Suppression Test (LDDS): After assessing the normal cortisol levels via a blood sample, your vet administers a cortisol-like drug. In healthy cats, this should reduce the release of ACTH and cortisol. Persistently high cortisol levels indicate Cushing’s syndrome.

Causes: How Do Cats Develop Cushing’s Syndrome?

The clinical signs are a result of abnormally increased cortisol production, with three possible causes:

  • Pituitary-dependent Hyperadrenocorticism: Around 80% of cases involve pituitary tumors causing enlargement of both adrenal cortexes. These are usually benign adenomas that produce ACTH.
  • Adrenal-dependent Hyperadrenocorticism: Twenty percent of cats with Cushing’s syndrome display adrenal cortex tumors, half of which are benign and half malignant, producing cortisol.
  • Iatrogenic: Long-term treatment with glucocorticoids and gestagens, such as corticosteroids like prednisolone or dexamethasone, may induce Cushing’s syndrome.

How Does the Normal Hormone Cycle Work?

The pituitary gland in your cat’s brain controls various hormonal cycles, including cortisol production. When the pituitary’s anterior lobe releases ACTH, it stimulates the adrenal cortex to produce cortisol. An excessive release of cortisol triggers an automatic negative feedback, causing the brain to decrease ACTH secretion. In this way, a healthy cat regulates its blood cortisol levels.

Treatment: What Can Be Done About Cushing’s Syndrome in Cats?

The effective treatment for your cat’s Cushing’s syndrome depends on the underlying cause:

Adrenal Tumor

If your cat has an adrenal tumor, your vet may surgically remove the gland, assuming the tumor hasn’t spread. Post-removal, the other gland compensates for the missing one. However, if both glands are removed, a lifelong prescription of prednisolone and fludrocortisone is necessary.

If surgery isn’t an option, chemotherapy may be helpful, with drugs that suppress adrenal cortex cortisol production. Although only licensed for use in dogs, your vet can prescribe them for your cat.

Pituitary-dependent Cushing’s Syndrome

An experienced surgeon can remove a pituitary tumor. If this isn’t feasible, chemotherapy with trilostane helps. Regular vet visits are then needed to adjust medication dosage based on blood cortisol levels.

Complications with Fragile Skin Syndrome

If your cat already has skin issues with impairments to healing before surgery, a cortisone therapy ensures wounds heal properly post-operation.

Cost: How Expensive Are Diagnosis and Treatment?

Costs vary based on required tests, medication, and any complications. With extensive diagnostics and lifelong medication, Cushing’s syndrome can be quite costly, potentially amounting to several hundred pounds.

Cat having ultrasound scan © Maria Sbytova / stock.adobe.com
Ultrasound exams and hormone function tests are best suited to diagnose Cushing’s Syndrome.

Prognosis: Can Cushing’s Syndrome Be Cured?

Recovery chances depend on the symptoms and severity of the disease. Since many cats with Cushing’s syndrome are presented late to vets and in poor health, they often die shortly after diagnosis or must be put to sleep.

However, with early detection and treatment, a cat has a good prognosis, potentially enjoying a happy life with regular hormone monitoring and medications.

Prevention: Can Cushing’s Syndrome in Cats Be Avoided?

Sadly, many cancers occur spontaneously and are typically unavoidable, which also applies to Cushing’s syndrome. To ensure your cat has the power to fight any illness, support its health as effectively as possible.

This is best achieved by providing species-appropriate nutrition, regular vaccinations, deworming, ample exercise, and avoiding risk factors like obesity.

This article from zooplus Magazine is purely informative. If your pet is experiencing discomfort, contact your veterinarian for diagnosis and treatment.

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Dr Julia Striegl, Veterinarian
autorenbild julia striegl mit hund

I studied veterinary medicine at LMU Munich, where I also finished my PhD in 2012. After that, I was able to gain a lot of experience, for example as a practicing veterinarian and scientific advisor. Particularly important to me is the continuous improvement of animal welfare and farm animal medicine. My greatest concern has always been to act in the best interest of my patients and to provide them with optimal care. In addition to my veterinary knowledge, I am happy to share my experience as a horsewoman and long-time dog owner, as well as a dog sportswoman.


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