How to Treat Hypertension in Dogs with Cushing's Disease

Anthony Carr, DMV, DACVIM (SAIM), professor at University of Saskatchewan, discusses treatment options for hypertension that developed as a complication of Cushing’s disease.

Interview Transcript (slightly modified for readability)

“We do know that hypertension is a very common complication of Cushing’s disease, depending which study you look at and [based on] research we’ve done as well. Probably upwards of 60% to 70% of dogs who have Cushing’s will have some degree of hypertension. Although, generally, in the mild to moderate range, very few dogs will have blood pressure in excess of 180 millimeters of mercury cytosolic. There are exceptions to that but those are often dogs [that] have adrenal tumors, or other underlying disease that leads to elevations. In a dog that’s older, which is what most dogs are going to be with Cushing’s, that degree of elevation probably has very little [clinical] significance, especially when the average life expectancy of a dog treated for Cushing’s is probably 3 to 4 years. So, that is very unlikely causing damage.

However, there are certain reasons to control blood pressure, and that is if they have coexisting disease that could be worsened by hypertension. The two things I really look for are preexisting renal disease; proteinuria not as the only factor, but especially if they’re azotemic, then I think you need to control their blood pressure; and if they have preexisting cardiac disease, because that increase in the blood pressure means increased workload for the heart.

Generally, if blood pressure is under 180, I won’t necessarily treat these dogs; however, if it’s above that I will. I will treat it in the range of 160 to 170 if they have underlying renal disease or underlying cardiac disease.”