Author: Jae-seung Yeo, Chief Director (Chief Director of 24H UN animal medical center, Director of Companion Animal Cardiovascular and Renal Center, Internal Medicine Director of 24H UN animal medical center)
This content was prepared in compliance with relevant laws including the Medical Law.
How Should You Approach Diabetes and Cushing's Syndrome in Elderly Dogs in Busan Right Now?
Q. My elderly dog is suspected of having both diabetes and Cushing's syndrome. How should I manage this in Busan?
When both diabetes and Cushing's syndrome are suspected in an elderly dog, diagnosis and management are far more complex than with a single disease. Cushing's syndrome (hyperadrenocorticism) is an endocrine disease that occurs when cortisol hormone is over-secreted. This excess cortisol continuously elevates blood glucose and can trigger or worsen diabetes. According to Health Kyunghyang Companion Animal Health Story, Cushing's syndrome progresses gradually and is easily mistaken for aging, and if left untreated can lead to serious complications affecting multiple organ systems.
When both diseases are concurrent, insulin dosage adjustment differs from cases with diabetes alone. Starting with a detailed examination at an animal medical center equipped with an interdisciplinary consultation system of internal medicine and diagnostic imaging is the first step. The AAHA 2018 Diabetes Management Guidelines also recommend using multiple comprehensive evaluation items rather than blood glucose levels alone when diagnosing canine diabetes.
Because individual hormone levels and blood glucose responses vary, it is difficult to determine management direction based on a single clinic visit result. If your pet is showing signs of abnormality now, the key is to first find a 24-hour comprehensive animal medical center where endocrine internal medicine consultation and detailed examination are available.
Why Should Diabetes and Cushing's Syndrome in Elderly Dogs Be Managed Together?
The two diseases are closely interconnected. Cortisol assists in stress response when in appropriate amounts, but when over-secreted, it impairs insulin function and continuously elevates blood glucose levels. In other words, Cushing's syndrome can be a cause of diabetes development or worsening, and if only diabetes is treated while Cushing's is neglected, blood glucose stabilization may be difficult regardless of insulin dosage adjustments.
According to Health Kyunghyang materials, neglecting Cushing's syndrome increases the risk of complications such as diabetes and pancreatitis. Clinical literature indicates that Cushing's diagnosis is not confirmed by a single test, and multiple tests must be conducted in stages to differentiate other diseases with similar symptoms such as diabetes, renal failure, and hypothyroidism.
Particularly, Cushing's medication dosage adjustment is very important. Clinical cases note that there may be risks if medication is arbitrarily discontinued or changed without regular hormone monitoring. The concurrent presence of both diseases and treatment priority are determined by veterinarians based on individual status, and self-directed medication adjustment should be avoided.
If these symptoms persist for more than 2 weeks, consider detailed examination
✓ Dog drinks significantly more water than usual (polydipsia)
✓ Urine output noticeably increases (polyuria)
✓ Appetite suddenly increases significantly (polyphagia)
✓ Abdomen appears bulging or muscles seem reduced
✓ Hair falls out sparsely or skin color changes
✓ Panting becomes more severe than before
✓ Weight loss accompanied by lethargy
How 24H UN animal medical center Approaches Long-term Endocrine Management
According to materials from the Seoul National University College of Veterinary Medicine Animal Hospital internal medicine department, endocrine diseases are diagnosed and managed through basic blood and urine tests, X-ray and ultrasound, as well as specialized hormone tests. Representative endocrine diseases such as diabetes, hyperadrenocorticism (Cushing's), and hypothyroidism share similar symptoms including polydipsia, polyuria, appetite changes, and skin abnormalities. Therefore, a systematic interdisciplinary diagnostic process that follows each stage is important.
Since its founding in 2016, the 24H UN animal medical center has operated an integrated consultation system of internal medicine, diagnostic imaging, and health screening center in the Busan area. For chronic endocrine disease patients, it provides one-stop access from blood tests, ultrasound, and hormone testing through regular follow-up management.
| Stage | Key Content |
|---|---|
| ① Initial Visit·Basic Examination | Understanding overall status through blood tests, urine tests, X-ray, and abdominal ultrasound |
| ② Hormone Detailed Examination | ACTH stimulation test, cortisol levels, blood glucose curve measurement |
| ③ Interdisciplinary Diagnosis | Integrated evaluation of adrenal size, tumor presence, and insulin resistance through internal medicine and diagnostic imaging consultation |
| ④ Customized Treatment Plan | Cushing's medication dosage setting + insulin prescription + dietary adjustment individualization |
| ⑤ Regular Monitoring | Periodic re-confirmation of blood glucose curve and cortisol levels, dosage re-adjustment |
According to relevant clinical materials, endocrine diseases are chronic conditions occurring in the thyroid, adrenal glands, and pancreas, and most require long-term management through continuous monitoring and customized treatment. The 24H UN animal medical center works with guardians to establish long-term management plans based on continuous communication with the attending veterinarian. We inform you that treatment effectiveness varies depending on individual status, age, and concurrent diseases.
✓ Ownership of university hospital-level blood test, ultrasound, and X-ray precision equipment
✓ Operation of consultation system by internal medicine and diagnostic imaging specialties
✓ 365 days, 24 hours year-round — emergency response possible during nights, early mornings, and holidays
✓ Communication-centered consultation sharing detailed test results and treatment plans with guardians
✓ Operation of customized regular checkup programs for elderly dogs and cats
Things to Check Before Procedure
These are items that guardians can check in advance to help with diagnosis.
Symptom Observation Checklist
✓ Did water intake suddenly increase (1.5 times or more compared to usual)
✓ Does the dog urinate frequently or have urinary accidents
✓ Did appetite increase excessively
✓ Did the abdomen become noticeably swollen
✓ Does hair fall out sparsely or has skin color changed
✓ Did panting suddenly become severe
✓ Have eyes become cloudy (cataracts — signal of diabetes complication)
✓ Has weight decreased or does the dog sleep for extended periods in lethargy
According to Health Kyunghyang materials, early symptoms of Cushing's syndrome (polydipsia, polyuria, abdominal distension, alopecia, etc.) are similar to aging, causing delayed early detection in many cases. Additionally, the Health Kyunghyang elderly companion animal endocrine section emphasizes that because endocrine system diseases are very difficult for guardians to discover themselves, continuous monitoring through regular checkups is important. Cushing's syndrome is commonly reported in individuals over 10 years old, and certain small dog breeds such as Poodles, Shih Tzus, Dachshunds, and Maltese are known to have genetic predisposition.
Precautions and Limitations
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The above checklist is for reference only; do not confirm disease through self-diagnosis.
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Do not purchase or administer diabetes or Cushing's syndrome medication without veterinary prescription — it is dangerous.
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Insulin injection dosage varies by individual blood glucose response, so consult with your veterinarian.
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Cushing's medication can cause complications if dosage is too high or too low.
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Treatment effectiveness varies depending on individual status, concurrent diseases, and age.
Guide for Nearby Area Guardians
Guardians from Namgu, Suyeong-gu, Haeundae-gu, Yeonje-gu, Dongrae-gu, Geumjeong-gu, Busanjin-gu, and Saha-gu in Busan, as well as nearby areas such as Yangsan, Gimhae, Changwon, and Ulsan can visit us. Those looking for endocrine consultation at Busan Suyeong-gu veterinary hospitals or internal medicine for elderly dogs in Busan Haeundae or Cushing's and diabetes consultation in Busan Yeonje-gu should visit the 24H UN animal medical center. We also welcome visits from those in the Yangsan and Gimhae areas seeking endocrine and elderly dog internal medicine consultation. Even if an emergency occurs during travel, emergency veterinarians are on-site 24 hours, 365 days.
We Will Consult with You Step by Step
Start your consultation for elderly dog endocrine disease at 24H UN animal medical center. We will consult with you step by step.
Situations where both diabetes and Cushing's syndrome are suspected can cause great worry and confusion for guardians. As emphasized by the AAHA 2018 Diabetes Management Guidelines, canine diabetes is a condition where the goal is to maintain a stable daily life through consistent management rather than a cure. The same applies to Cushing's syndrome — if proper management is implemented, your pet can maintain a sufficiently comfortable daily life.
There is no need to make all decisions right now. First start with basic screening to accurately understand the current status, then together with your attending veterinarian, develop a management plan based on the results.
✓ Daeyeon-dong, Namgu, Busan | 365 days, 24 hours year-round
✓ Emergency veterinarian on-site during nights, early mornings, and holidays
✓ One-stop consultation with internal medicine, diagnostic imaging, and health screening center collaboration
✓ Detailed sharing of test results and treatment plans with guardians
Questions You Might Have
Q1. What makes it more difficult if diabetes and Cushing's syndrome are both present?
Corticol over-secretion due to Cushing's syndrome impairs insulin function and continuously elevates blood glucose. Because of this, when both diseases are concurrent, insulin dosage setting becomes more complex than with diabetes alone, and situations arise where insulin dosage must be re-adjusted as Cushing's treatment progresses. This is why an interdisciplinary consultation system capable of managing both diseases is necessary.
Q2. Must Cushing's syndrome medication be taken for life?
Cushing's medication therapy often continues for life. However, in some cases such as adrenal tumors, surgical approaches may be considered. If medication is too high or too low, complications can develop, making regular hormone monitoring and dosage adjustment through periodic monitoring extremely important. Any discontinuation or change must always be discussed with your veterinarian first.
Q3. For elderly dog diabetes, do I need to give insulin injections directly at home?
Insulin injections are often administered directly by guardians at home. The injection dosage and frequency are determined according to the attending veterinarian's prescription, and injection methods can be learned through guardian education at the hospital. In the initial stages, blood glucose curve confirmation through hospital visits is conducted concurrently, so it is important to communicate closely with your veterinarian rather than making independent judgments.
Q4. Are there criteria for finding a veterinary hospital in Busan capable of long-term endocrine disease management?
Endocrine diseases are chronic diseases requiring long-term follow-up management. When choosing a hospital, check whether it owns precision equipment such as blood tests, hormone tests, and ultrasound, whether interdisciplinary consultation between internal medicine and diagnostic imaging is possible, whether it can respond in nights and emergency situations, and whether it shares test results and management plans sufficiently with guardians.
This content was prepared in compliance with Article 32 of the Veterinary Act, and specific matters should be discussed with a professional.