Frequently asked questions about Cushing’s disease in a dog

Transsphenoidal hypophysectomy surgery (pituitary gland removal) for a pituitary tumor causing Cushing’s disease in a dog

The Pituitary Surgery Service at the WSU Veterinary Teaching Hospital is committed to providing the very best surgical care for your dog or cat. The board-certified veterinary team is led by pituitary surgical specialist Dr. Tina Owen (’92 DVM), who was one of the first veterinarians in the United States to perform transsphenoidal hypophysectomy surgery. The team also includes veterinary neurologist Dr. Annie Chen-Allen, critical care specialist Dr. Linda Martin, and internal medicine specialist Dr. Sarah Guess along with neurology residents and veterinary technicians specializing in surgery, neurology, anesthesia, and critical care. The surgery team works collaboratively with board-certified veterinarians specializing in radiology, anesthesia, and oncology to offer our patients the best treatment options.

Pituitary surgery frequently asked questions

What are the treatment options for a dog diagnosed with Cushing’s disease?

Medication and radiation therapy are two common ways to treat Cushing’s disease in dogs, but these treatments only manage symptoms and will not cure the disease. The only treatment option that addresses the pituitary tumor directly is a surgery called transsphenoidal hypophysectomy. Roughly 85% to 95% of dogs that have the pituitary tumor removed through this procedure no longer have a hormonal imbalance caused by the tumor or neurological symptoms. WSU is one of only a handful of veterinary hospitals in the country performing transsphenoidal hypophysectomies.

Read What is Cushing’s disease?

How much does transsphenoidal hypophysectomy surgery cost?

The estimate is $17,000 to $20,000 for uncomplicated surgery and hospitalization (covers approximately two weeks at WSU without complication).

Is this procedure currently being done anywhere else?

It is our understanding WSU is currently the only facility in the United States offering this procedure. The procedure is also done in the Netherlands, Australia, Japan, and the United Kingdom.

Where is your veterinary hospital located?

Our hospital is located on the Washington State University campus.

WSU Veterinary Teaching Hospital, 205 Ott Road, Pullman, Washington

Is there a cost for a phone consultation?

There is no charge for phone consultation. We do, however, for those interested, accept and appreciate any donation to the pituitary fund in lieu of a charge for phone consultations. Please call the WSU Veterinary Teaching Hospital at 509-335-0711.

Is my dog too old for transsphenoidal hypophysectomy surgery?

Age is not a disease, and all pets are examined for health by several departments (including but not limited to Cardiology, Radiology, and Internal Medicine) prior to surgery to ensure they are good candidates. The average age of patients undergoing this surgery is 10 to 14 years old.

What is my pet’s prognosis with surgery?

Prognosis is very dependent on tumor size, and the larger the tumor the worse the prognosis. Mild pituitary enlargement typically carries a remission rate of 92% and a recurrence of approximately 28%. Long-term survival rates after hypophysectomy for pituitary tumors causing Cushing’s disease at 1, 2, 3, and 4 years are 86%, 79%, 74%, and 72% respectively.

What is the survival/mortality rate of the surgery?

The mortality rate is 8%-10% for dogs with small to moderate sized tumors. For larger tumors the mortality rate is about 20% but can be as high as 30%.

What is the timeline to expect during a visit?

  • Monday: Initial consultation and preliminary diagnostics. The patient can go to the hotel with the owner this night.
  • Tuesday: MRI, localization procedure, and CT for surgical planning. The patient stays in the hospital this night.
  • Wednesday: Surgery to remove the pituitary tumor.
  • The patient is in ICU the remainder of the hospitalization. There are frequent visits by the owner, dependent upon recovery from surgery.
  • If all is going well, the patient initially spends the day and then overnights with the owner in the hotel room usually starting on the Sunday or Monday after the procedure. During the hotel stay, the owner becomes familiar with the medications, the timing of the medications, and monitoring their pet.
  • The patient is usually discharged the later part of the second week when everyone is comfortable with the management.

Can work-up and imaging can be done locally before coming to WSU?

Yes, all work-up and imaging should be done and sent to WSU before scheduling pituitary surgery (or it can be done at WSU if we are the closest center). Most pets are coming from a fair distance away. We try to make sure before travel we have done all diagnostics needed to ensure your pet is a good candidate for surgery. There are several diagnostics we either do here or repeat here as needed prior to the anesthesia and surgery.

What should I bring for my pet when I travel to Pullman?

  • Food
  • Blankets or bed

What kind of brain imaging is needed?

An MRI is preferred but a CT is acceptable.

Can you give me a brief overview of the surgery?

  • The surgery is an open mouth procedure with an incision through the soft palate to approach the base of the skull.
  • A small hole is drilled in the base of the skull to approach the pituitary fossa, the area where the pituitary gland resides.
  • The pituitary fossa is surrounded by the blood supply to the brain.
  • The pituitary gland/tumor is removed using neurosurgical instrumentation.

Are there medications we must give after surgery?

The normal pituitary gland is removed when the pituitary tumor is removed. The pituitary gland produces several hormones to keep various systems functioning in the body. Fortunately for animals, there are usually only two medications that will be required lifelong to replace the loss of those hormones.

  • A physiologic dose of steroid, typically prednisone, will be given lifelong.
  • Thyroid supplementation, thyroxine, will be given lifelong.
  • Anti-diuretic hormone or DDAVP (vasopressin) will be required initially. This may be transient and given for 1-4 months post-operatively. Half of all patients, however, may require this medication lifelong.

What are the complications associated with surgery?

There are complications associated with the surgery, anesthesia, and secondary to the removal of the pituitary gland. Should you decide on surgery, you will be given a compiled list of complications. We will discuss these complications in more detail with you during the initial phone consultation.

Where can I send our records and information?

Chris Dumas, a licensed veterinary technician, at christopher.dumas@wsu.edu.

Who can I call with more questions?

Chris Dumas, a licensed veterinary technician who works with the pituitary surgery team and Dr. Tina Owen, can help answer your questions. Chris can be reached at 509-432-4742 (text or phone) between 8 a.m. and 5 p.m. (PST) or christopher.dumas@wsu.edu.