Most people have heard of Cushing's disease or Cushing’s syndrome in dogs. Fewer have heard of atypical Cushing's syndrome — and if your dog has been diagnosed with it, you've probably found the information surprisingly hard to come by.
Here's what atypical Cushing's actually is, how it differs from the standard form, and why it responds particularly well to lignans.
Standard Cushing's vs. Atypical Cushing's
Standard Cushing's syndrome (including Cushing’s disease) is driven by cortisol overproduction — usually from a pituitary tumor (about 80–85% of cases) or an adrenal tumor (15–20%). (The special case of Cushing’s syndrome in which the cause is a problem with the pituitary gland is called Cushing’s “disease”, while Cushing’s “syndrome” does not depend on the location of the cause.) Blood tests measuring cortisol confirm it, and conventional treatments like trilostane work by suppressing cortisol production.
Atypical Cushing's is different. In these cases, the adrenal glands are overproducing sex hormones — especially, progesterone, estradiol, androstenedione — rather than (or in addition to) cortisol. The symptoms can look identical to standard Cushing's, but cortisol tests come back normal or borderline. This is why it frequently goes undiagnosed or misdiagnosed.
Symptoms of Atypical Cushing's
The symptoms overlap heavily with standard Cushing's:
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Increased thirst and urination
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Increased appetite
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Pot belly
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Hair loss or coat thinning
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Skin changes — darkening, thinning, visible vessels on the belly
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Lethargy and reduced activity
The key difference: cortisol-based tests (ACTH stimulation, low-dose dexamethasone suppression) don't capture what's happening. A sex hormone panel — testing estradiol, progesterone, androstenedione — is needed to confirm atypical Cushing's. If your dog has classic Cushing's signs but normal cortisol tests, ask your vet about sex hormone testing.
Why Lignans Are Particularly Effective Here
This is an area where lignans have a meaningful advantage over conventional options. SDG lignans work in part by influencing how the body metabolizes steroid hormones — including the sex hormones that are overproduced in atypical Cushing's. Specifically,
Conventional medications like trilostane are designed to suppress cortisol production specifically. In atypical cases where cortisol isn't the primary driver, they're less effective. Lignans address the broader steroid hormone pathway, making them a strong fit for this diagnosis.
Many integrative vets treating atypical Cushing's recommend lignans as a first-line approach, often paired with melatonin.
For more information on SDG (Flaxseed) Lignans and HMR Lignans, click here.
Monitoring Progress
Because atypical Cushing's involves sex hormones rather than cortisol, standard cortisol testing won't tell you if treatment is working. The best indicators are symptomatic improvement — reduced water intake, coat regrowth, improved energy, reduced pot belly — alongside follow-up sex hormone panel testing if your vet recommends it.
Be patient. The hormonal shift takes time. Most owners managing atypical Cushing's with lignans start seeing meaningful change in the 8–12 week window.
More detail from the CID site: Cushings In Dogs — Holistic Treatment Options
Sources:
• Franklin TN Vet — Atypical Cushing's Remedy
• Merck Veterinary Manual — Cushing Disease in Animals
• AKC — Cushing's Disease in Dogs
• Cushings In Dogs — Holistic Treatment Options
• VCA Animal Hospitals — Cushing's Disease in Dogs