By Dr. Becker
I met Mazie Grace in August 2009, when she was eight years old and suffering with recurrent urinary tract infections and inflammatory bowel disease (IBD)-related issues.
Fortunately, we were able to get both issues under control by eliminating the carbs in her diet that were causing Mazie’s GI and bladder inflammation, decreasing mucosal resiliency and triggering opportunistic infections. Mazie’s mom must travel quite a distance to see me, so she comes in annually and works with her local veterinarian between visits to maintain Mazie’s health.
Mazie Develops Atypical Cushing's Disease
In June 2010, Mazie’s mom noticed she was panting more, drinking more water, and had gained weight. I suggested we check her adrenal function, so we completed an ACTH stim test and sent the paired serum samples to the University of Tennessee’s Veterinary Diagnostics Lab. The endocrinologist reported that Mazie had moderately increased adrenal activity (page 1). Specifically, her sex hormones were notably high, even though she was spayed (her hormone secreting tissues were removed).
Those of you who are regular visitors to Mercola Healthy Pets know I often discuss the pros and cons of elective surgeries, including spaying and neutering. It’s a big topic, and researchers continue to identify new concerns about how these procedures impact animal health.
In Mazie’s case, her diagnosis was atypical Cushing's disease, or atypical hyperadrenocorticism.
The Challenge: Getting Mazie's Hormones Under Control
When a dog’s main sex hormone-secreting tissue is removed during a spay or neuter procedure (removal of ovaries or testes), the last remaining tiny piece of tissue that can secrete a small amount of sex hormones is the inner layer of the adrenal gland, called the zona reticularis.
This tiny layer of androgen producing cells was never meant to supply the body’s entire requirement of sex hormones, but that’s what can happen to some animals after desexing surgery. Over time, the adrenal glands may begin to over-secrete sex hormones to keep up with the body’s demand. This is what was happening in Mazie’s body, and was responsible for the hot flashes she was having.
We started Mazie on high lignan flax hulls (this is NOT flaxseed or flax oil). High lignan flax hulls actually help the body to quiet down sex hormone production. A year later Mazie’s numbers were improved (page 2). We continued the protocol, but the lab report the following year showed her baseline cortisol was higher, even though her estrogen levels had improved.
It’s not uncommon for dogs with atypical Cushing’s disease to, with the passage of time, begin over-producing cortisol as well. Mazie didn’t have full-blown Cushing's disease yet, but we wanted to address her elevated cortisol levels before they climbed any higher. So in addition to the high lignan flax hulls, I also prescribed a supplement with phosphatidylserine, along with 6 mgs of melatonin at night, both of which help reduce cortisol production.
Mazie’s July 2012 report (page 3) showed her estrogen levels were within normal range, but her baseline cortisol was higher and her aldosterone levels (another adrenal hormone that regulates electrolytes) were also higher.
I suggested we complete an abdominal ultrasound to make sure Mazie did not have an adrenal tumor. Thankfully, she didn’t. In addition to her natural hormone support, I added a Chinese herb called Long Dan Zie Gan Tang for additional cortisol control. I suggested Mazie’s mom recheck her cortisol levels in 6 months with her local vet, and they were normal (page 4).
At this year’s exam, Mazie was in beautiful shape. Her physical exam was unremarkable and her mom had no abnormal symptoms to report. We were both ecstatic when the endocrinologist reported her adrenal panel was normal (page 5). This means the protocol Mazie is on is controlling her adrenal issues beautifully.
Adrenal Disease Isn't Curable, But It's Quite Manageable
Adrenal disease isn’t curable, but as you can see from Mazie’s story, it can be managed successfully enough that the animal’s body has no physiologic stress from the condition.
As Mazie ages, I am sure her protocol will change. I frequently find that aging dogs require a change in their adrenal protocols as often as every four to six months once they reach their geriatric years.
I believe the “art of medicine” is changing supportive protocols as often as necessary to keep up with each unique body’s aging process. As pets age, their bodies change dynamically and oftentimes, dramatically. Fine tuning protocols as changes occur is key in maintaining an excellent quality of life and slowing down disease progression.
In Mazie’s case, her adrenal function is considered “normal” now because she’s being managed in way that resonates with her body’s current metabolic demands. This will change in the future, and her protocol will also change. Her mom is committed to doing whatever it takes to keep Mazie as happy and healthy as possible for the rest of her life.