Atypical Cushing’s, also called atypical hyperadrenocorticism, is a disorder that affects your pet’s endocrine system, which controls hormone levels in the body.

Imagine the endocrine system as a delivery service that sends hormones through the bloodstream to carry out various normal and necessary body functions. These hormones help manage functions such as the immune system, inflammation, sleep/wake cycle, and help the body handle stress.

The hypothalamus is known as the brain's control center. It signals the pituitary gland, which then tells the adrenal glands to produce the hormone cortisol. Cortisol in the blood is closely regulated to maintain homeostasis (the state in which the body’s systems are in balance). When there is too much cortisol in the blood, this is called Cushing’s disease (hyperadrenocorticism). 

Atypical Cushing’s is different. Blood cortisol levels are normal with this condition, but sex hormones are elevated. An elevation in blood cortisol levels is only characteristic of typical Cushing's. The adrenal glands produce an excess of different hormones in both disorders, but the symptoms are very similar.

Diagnosis

Both dogs and cats can get Atypical Cushing's, but it is much more common in dogs. This condition is one of the rarest forms of Cushing's disease, and the cause is unknown. One of the first clues that your dog has this disorder is how your pet looks or behaves. The affected pet may have a potbelly appearance with alopecia (hair loss) and increased thirst and urination. They may also have episodes of restlessness with changes in behavior.

Regular endocrine tests for typical Cushing’s usually come back normal in these dogs; blood cortisol levels are normal. For confirmation of Atypical Cushing's disorder, sex hormone levels are evaluated before and after giving medication to stimulate the adrenal glands. This helps show whether sex hormones are too high. More specific adrenal hormone panels can also be run for further confirmation. Imaging tools like ultrasound, CT scans, and MRIs are used to analyze the size and orientation of the adrenal glands. 

Treatment

Treatment is tailored to each patient, depending on the cause of the hormonal imbalance. In many cases, the excess of hormones produced by the adrenal gland can be medically managed by suppressing its function. If a tumor on the adrenal gland is the cause and has been confirmed with advanced imaging techniques, surgery may be recommended to remove it. If surgery is not an option, medications like trilostane or mitotane may be prescribed to prevent the adrenal glands from overproducing hormones. Independent of the chosen treatment option, cortisol levels should be monitored every three months to ensure effective treatment.

Prognosis

Your pet’s prognosis is based on how well the condition and symptoms can be managed. With early detection and appropriate treatment, your pet can live a happy and healthy life.