Hyperadrenocorticism or Cushing’s syndrome in cats

Hyperadrenocorticism, or Cushing’s syndrome, is a condition that can manifest in cats when too much cortisol is produced by the adrenal gland, leading to a range of painful and uncomfortable health problems. Cortisol, or hydrocortisone, is a steroidal hormone that occurs naturally in the body and is necessary for good health, and is also sometimes administered as a corticosteroid drug to help to treat a range of other health conditions. However, too much cortisol production or circulation within the bloodstream can lead to the potentially serious condition of Cushing’s syndrome manifesting itself. While Cushing’s syndrome is much more commonly found in dogs than it is in cats, nevertheless, it is a serious condition that all cat owners should be aware of, and able to recognise the signs and symptoms of.

What causes Cushing’s syndrome in cats?

Cushing’s syndrome in cats is caused by the presence of too much cortisol in the blood, which can occur due to an over production of this hormone by the adrenal glands, or because the cat has undergone corticosteroid treatment over a reasonably long period of time. Naturally occurring overproduction by the adrenal glands can be caused by a variety of factors, including adrenal or pituitary gland tumours, or the normal commencement of the body’s shutting down process due to advanced age. Cushing’s syndrome is almost always accompanied by diabetes, and any cat that is diagnosed as diabetic should also be tested for the presence of Cushing’s syndrome on a regular basis as well.

Cats at risk of contracting Cushing’s syndrome

There is no specific breed or type of cat considered to be particularly prone to contracting Cushing’s syndrome, although it usually develops in mature cats, with the risk factors for the condition rising alongside of old age. The condition seems to affect female cats more regularly than male cats, although either sex may ultimately contract the condition. It is not considered to be hereditary or to have any genetically inherited risk factors, and it is neither contagious to other cats nor something that can be vaccinated against.

Prevention of Cushing’s syndrome

There are no currently recognised methods of preventing the development of Cushing’s syndrome in cats, nor any checklist of factors that should be avoided in order to try to prevent the condition from developing. However, medium to long term treatment with corticosteroids is considered to place cats at an elevated risk of contracting the condition, and so long-term usage of this medication should be avoided if there are any other viable alternatives. Cushing’s syndrome and diabetes often go hand in hand, and so to some extent, taking steps to minimise the risk factors for your cat developing diabetes may play a part in warding off the condition. Keeping an eye on you cat’s weight, feeding a balanced diet and helping to keep them active throughout their lives can help to minimise the risk factors for adult onset diabetes in cats.

Symptoms of Cushing’s syndrome in cats

There are a range of symptoms that cats suffering from Cushing’s syndrome might display, and many of them are common to several other diseases and conditions as well, so formal diagnosis of the condition by your vet is vital. Some of the potential signs and symptoms of Cushing’s syndrome in cats might include:

• Drinking a lot of water
• Excessive urination
• Extreme hunger and eating much more food than normal
• Losing a significant amount of weight relatively quickly, or occasionally, gaining weight instead
• An enlarged and painful liver
• Very thin, fragile skin, which can lead to your cat bruising easily and finding it painful to be handled or picked up
• Losing hair from the coat
• Generally losing condition and starting to look uncared for, and losing interest in grooming
• Lethargy and lack of energy
• Vomiting and diarrhoea
• Sometimes, the very tips of the cat’s ears will appear to curl

Veterinary testing including blood panels, urinalysis, cortisol level testing and x-rays and scans may all be used along with other measures to definitively diagnose or rule out the development of Cushing’s syndrome in cats.

Treatment and prognosis

The long-term prognosis for cats with Cushing’s syndrome is not particularly positive, although depending on the cause of the condition, various different treatment methods are available.If the cat has contracted Cushing’s syndrome due to treatment with corticosteroids, stopping this medication and finding an alternative is necessary, to avoid exacerbating the problem. Corticosteroids must be phased out gradually, and if this is begun early enough and managed successfully, the condition may go into remission.If Cushing’s syndrome is caused by a tumour of either the pituitary or adrenal gland, the tumour should be surgically removed or treated if at all possible. Surgical removal of the adrenal glands altogether may be considered, although this is not without problems of its own, and is a relatively complicated surgery. Removal of the pituitary gland is not something that is generally considered to be viable in cats at this time.Treatment for Cushing’s syndrome can be very costly, and even with prompt and aggressive treatment, around 50% of cats with the condition will not survive for more than a year after treatment. As ever, the earlier that diagnosis is performed and treatment is begun, the best chances your cat will have of surviving the disease and recovering, and continuing to enjoy a good quality of life for years to come.