Finding a cure for Cushing’s disease at WSU

Mona McGraw, Jeff Stuncard, and their dog, Keylo.

Pennsylvania residents Mona McGraw and Jeff Stuncard knew time was running out for their 9-year-old Maltese mix, Keylo.

A year-and-a-half prior, the little white dog who had found his way into their backyard seven years ago and never left was diagnosed with Cushing’s disease.

The drugs they had been told were the only treatment option offered some relief for a time, but his symptoms were rapidly worsening. He had the classic signs: hair loss, a pot-bellied appearance, and increased appetite, thirst, and urination.

“I would literally come home to gallons of urine on the floor each day,” McGraw said. “There were times I didn’t know how much more I could take.”

The couple turned to the internet hoping to find a cure. They scoured page after page until coming upon an article about small animal surgeon Dr. Tina Owen and the pituitary surgery team at Washington State University’s Veterinary Teaching Hospital. Owen was the first veterinarian in the United States to offer surgical treatment for Cushing’s disease and is one of only a handful who performs the procedure today.

“I called them the next day and within a couple of months we were driving to Pullman,” McGraw said.

Roughly 100,000 dogs are diagnosed with Cushing’s disease annually in the U.S. About 80% have a form called pituitary dependent hypercortisolism, which is caused by a pituitary tumor that triggers excessive levels of the stress hormone cortisol. When functioning normally, the pituitary, a pea-sized gland at the base of the brain, produces adrenocorticotropic hormone, ACTH, which stimulates the adrenal glands near the kidneys to produce cortisol.

Left untreated, a pituitary tumor can grow large enough to press on the brain and cause neurological symptoms such as difficulty walking or seeing, or other conditions including diabetes or seizures, and death.

Dogs treated with medication usually survive 15 to 24 months. Radiation can also provide some relief, but surgery is the only option that can be curative.

The procedure, called transsphenoidal surgery, also comes with risk. Owen said 8-20% of dogs will die during the procedure or from complications of the surgery, but animals fare better when the tumor is smaller.

“The cases we see most often the tumor has already gotten big and the prognosis is not as good,” Owen said. “Fortunately, in Keylo’s case, his was still smaller.”

Owen works alongside a dedicated team of experts, including Dr. Linda Martin in emergency and critical care, Dr. Annie Chen-Allen in neurology, Dr. Sarah Guess in internal medicine, surgery technician Chris Dumas, and specialists in anesthesia, radiology, and the intensive care unit.

After a short procedure on June 14 to determine the size and location of the tumor, Owen removed Keylo’s pituitary gland and tumor the following day by drilling a hole in the base of his skull through the soft palate in his mouth. The surgery appears to have been a success.

“Based on what we know with the tumor removal and the post-operative CT scan, we feel like we got all the tumor out,” Owen said. “If that’s the case, then he has a normal life expectancy.”

Keylo is back to acting normal and his physical symptoms have improved.

“Dr. Owen and her team saved Keylo,” McGraw said. “The only thing I regret is that I didn’t get him out here a year ago because I didn’t know surgery was an option.”

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