Hearing your dog has Cushing’s disease—it’s one of those moments that knocks the wind out of you. At first, it’s small stuff. They’re drinking more water, maybe losing some hair. You chalk it up to age. But then the vet calls it by name. And suddenly, very little change feels heavier.

Cushing’s means their body is making too much cortisol. That stress hormone we all need in small doses? Now it’s flooding their system. So their body starts changing—weight gain, that rounded belly, that look in their eyes that tells you they’re not quite themselves. And they can’t tell you any of it. That’s the part that gets you.

It’s easy to feel lost at first. You sit in the exam room, hearing all these new terms, seeing numbers and scans, wondering how it all fits together. Suddenly, simple things—like watching them nap or taking a walk—feel different. You start asking yourself: Are they okay? How do I help? What does this mean for the time we have left?

But even with all that weight, this isn’t a goodbye. Not yet. Not if you stay ahead of it. Plenty of dogs live well for years after being diagnosed. It comes down to working with your vet, adjusting your routine, paying closer attention. Sometimes it’s daily meds. Maybe new food. Maybe just a softer pace.

The goal isn’t to fix everything. It’s to make each day more gentle. Familiar. Comfortable. Because your dog’s still in there—the one who’s been your shadow for years. They’re just asking for a little more help now. To stay near. To notice. To keep loving them the way they’ve always loved you.

This guide was written to sit quietly with you while you figure it all out. We’ll cover what this disease really is, what signs to track, what care looks like, and most of all—how to give your dog more good days. You’re not in this alone. And neither are they.

Defining Hyperadrenocorticism in Dogs

When a dog has Cushing’s disease, their body starts making too much cortisol. It’s a hormone that normally helps with stress and balance, but too much of it wears them down. Over time, you’ll see changes—more water, a bigger belly, or just less energy.

But once you understand what’s happening, you can start helping them feel better, one small step at a time.

Recognizing Early Symptoms of Cushing's in Dogs

Spotting Cushing's early can make a big difference. Keep an eye out for these common signs:

• You might’ve seen your dog drinking water like they just ran a marathon—even when they’ve been resting all day. And then, more bathroom breaks. Sometimes at odd hours. It’s not just a “they’re getting older” thing. It’s their body trying to handle what’s happening inside.

• The appetite? That can change too. Some dogs suddenly act like they haven’t eaten in days, constantly begging, constantly hungry. It’s not greed—it’s their system sending mixed signals.

• And then there’s the belly. That soft, round look that seems to come out of nowhere. It’s not weight gain from overeating. It’s deeper than that. Their abdominal muscles are weakening. Fat shifts around. They don’t look like themselves, and that can be hard to see.

It's easy to dismiss these symptoms as normal aging changes, but it's always best to consult with your vet if you notice any of these signs. Early detection can lead to better management and improved quality of life for your dog. Don't hesitate to seek professional advice; it's always better to be safe than sorry.

Impact of Untreated Cushing's Syndrome

Leaving Cushing's untreated can lead to some serious complications. The constant overproduction of cortisol can wreak havoc on your dog's body. 

Here's what can happen:

• Diabetes mellitus: High cortisol levels can interfere with insulin, leading to diabetes.

• High blood pressure: This can strain the heart and kidneys.

• Increased risk of infections: Cortisol suppresses the immune system, making your dog more vulnerable. Recognizing early symptoms of Cushing's is crucial.

• Blood clots: Cushing's can increase the risk of developing dangerous blood clots.

• Organ damage: Prolonged exposure to high cortisol can damage the liver, kidneys, and heart.

Ignoring Cushing's isn't an option. It's a progressive disease, and the longer it goes unmanaged, the more damage it can cause. Early intervention is key to minimizing these risks and ensuring your dog lives a happier, healthier life.

Initial Veterinary Assessment for Cushing's Disease

So, you think your dog might have Cushing's? The first step is always a visit to the vet. They'll do a thorough physical exam, checking everything from your dog's weight to their coat condition. They'll also ask a bunch of questions about your dog's history and any weird stuff you've noticed, like increased thirst or peeing more often. This initial assessment is super important because it helps the vet decide which tests are needed to confirm if it's really Cushing's. It's like detective work, piecing together clues to get to the bottom of things.

Interpreting Endocrine Diagnostic Screening Tests

Okay, so the vet suspects Cushing's and orders some tests. Now comes the fun part: interpreting the results! These tests, like the ACTH stimulation test and the low-dose dexamethasone suppression test (LDDST), measure how your dog's adrenal glands are working. Understanding these results can be tricky , even for vets. Sometimes the results aren't clear-cut, and that's where things get a bit more complicated. It's not always a straightforward yes or no answer, and other factors might need to be considered. It's important to have a vet who knows their stuff when it comes to interpreting these tests. If you are looking for blood tests, your vet can help.

Advanced Testing for Cushing's Syndrome in Dogs

Sometimes, the initial tests aren't enough to give a clear diagnosis. That's when advanced testing comes into play. This might include things like an abdominal ultrasound to look at the adrenal glands or an MRI to check the pituitary gland. These tests can help determine the cause of Cushing's – whether it's a tumor on the adrenal gland or a problem with the pituitary gland. They can also help rule out other conditions that might be causing similar symptoms. It's like getting a more detailed picture to help guide treatment decisions.

Advanced testing is not always needed, but it can be really helpful in tricky cases. It's all about getting the right information to make the best decisions for your dog's health. The goal is to get a clear diagnosis so that the right treatment plan can be put in place.

Here's a quick rundown of some advanced tests:

• Abdominal Ultrasound: Checks for adrenal gland tumors.

• MRI: Examines the pituitary gland.

• High-Dose Dexamethasone Suppression Test: Helps differentiate between pituitary and adrenal causes.

Trilostane for Dogs: A Primary Treatment Option

Trilostane is often the first choice for managing Cushing's in dogs. It works by inhibiting the production of cortisol in the adrenal glands. It's generally well-tolerated, but it's important to understand the potential side effects and monitoring requirements. Your vet will likely start with a low dose and adjust it based on your dog's response.

• Regular blood tests are needed to monitor cortisol levels.

• The dosage might need tweaking over time.

• Some dogs experience side effects like vomiting or diarrhea, but these are usually mild.

Trilostane is a prescription medication, so you'll need to work closely with your vet to determine the right dosage and monitoring schedule for your dog. It's not a cure, but it can significantly improve your dog's quality of life by controlling the symptoms of Cushing's.

Mitotane Therapy for Cushing's in Dogs

Mitotane, also known as Lysodren, is another medication used to treat Cushing's disease. It works by destroying the cortisol-producing cells in the adrenal glands. It's a more potent drug than trilostane and requires careful monitoring due to the risk of side effects. The treatment typically involves an initial induction phase followed by a maintenance phase. 

Here's a quick comparison:

Managing Pituitary-Dependent Hyperadrenocorticism

Most cases of Cushing's in dogs are pituitary-dependent, meaning the problem originates in the pituitary gland. Medical management aims to control the excessive cortisol production caused by a tumor in the pituitary gland. While surgery to remove the pituitary tumor is an option, it's not always feasible or available. Therefore, medications like trilostane and mitotane are commonly used. It's important to remember that managing pituitary-dependent hyperadrenocorticism is a long-term commitment.

• Regular veterinary check-ups are essential.

• Be prepared for potential adjustments in medication.

• Monitor your dog closely for any changes in behavior or symptoms.

While medical management is often the first line of defense against Cushing's, surgery can be a viable option in specific cases, particularly when dealing with adrenal tumors. It's a more invasive approach, but it can potentially offer a more definitive solution compared to long-term medication. However, it's not without its risks and requires careful consideration.

Adrenal Gland Removal for Cushing's Disease

Adrenalectomy, or the surgical removal of the adrenal gland, is primarily considered when a dog has an adrenal tumor causing Cushing's. This is especially true if the tumor is cancerous (malignant), as surgery can prevent or slow down the spread of the disease. The procedure involves removing the affected adrenal gland, which stops the overproduction of cortisol. The success of adrenalectomy depends on factors like the tumor's size, location, and whether it has spread to other tissues. Post-operative care is intensive, and dogs will need careful monitoring and hormone replacement therapy, at least temporarily, as the remaining adrenal gland adjusts. It's a big surgery, but it can significantly improve a dog's quality of life if the tumor is successfully removed. If your vet recommends adrenal gland removal, make sure you understand the risks and benefits.

Pituitary Gland Surgery for Canine Cushing's

Surgery on the pituitary gland, called hypophysectomy, is a less common but potentially curative option for pituitary-dependent Cushing's. This type of surgery is highly specialized and typically performed at referral centers with experienced veterinary neurosurgeons. The goal is to remove the tumor on the pituitary gland that's causing the overproduction of ACTH, which in turn stimulates the adrenal glands to produce excess cortisol. The surgery is delicate because of the pituitary gland's location at the base of the brain.

• Pre-operative assessment is critical.

• Post-operative care is intensive.

• Success rates vary depending on the surgeon's experience and the tumor's characteristics.

Pituitary surgery can be a good option for dogs with pituitary-dependent Cushing's, but it's important to weigh the potential benefits against the risks and costs. Not all dogs are good candidates, and the procedure requires a skilled surgical team and dedicated post-operative care.

Considerations for Surgical Treatment

Before opting for surgery, several factors need careful consideration. The dog's overall health is paramount; they need to be stable enough to withstand a major surgical procedure. The type of Cushing's (adrenal-dependent vs. pituitary-dependent) significantly influences the surgical approach. Diagnostic imaging, like CT scans or MRIs, is essential to assess the tumor's size, location, and any potential spread. The availability of experienced surgeons and specialized facilities is also a key factor. Finally, the cost of surgery can be substantial, and owners need to be prepared for the financial commitment. It's important to have a detailed discussion with your veterinarian and a veterinary surgeon to determine if surgery is the right choice for your dog. Remember that medical treatment options are also available.

While conventional treatments like trilostane or mitotane are often the first line of defense against Cushing's, there's growing interest in alternative and supportive therapies to help manage the condition and improve a dog's quality of life. These approaches can be used alongside traditional medications or, in some cases, as a sole treatment under careful veterinary supervision. It's all about finding what works best for your individual dog and their specific needs.

Exploring Alternative Treatments for Cushing's

Alternative treatments for Cushing's in dogs are gaining traction, especially for pet owners seeking a more holistic approach. Some options include melatonin, HMR lignans, and SDG lignans (flaxseed hull). These are often used by veterinarians and pet parents who are so inclined. It's important to note that the effectiveness of these treatments can vary, and they should always be discussed with your vet before starting. Regular monitoring is key to assessing how well your dog is responding to any alternative therapy. For example, some owners have found success with  CBD oil to help manage symptoms.

Dietary and Lifestyle Modifications for Dogs with Cushing's

Diet and lifestyle play a huge role in managing Cushing's. A diet low in fat and high in fiber can help manage weight and blood sugar levels , which are often affected by the disease. Regular, moderate exercise is also important to maintain muscle mass and overall fitness.

Here are some things to consider:

• Protein : Ensure adequate protein intake to support muscle mass.

• Fiber : High-fiber diets can help with weight management and regulate blood sugar.

• Fat : Limit fat intake to prevent pancreatitis, a potential complication of Cushing's.

• Exercise : Regular, gentle exercise can help maintain muscle mass and improve overall well-being.

Creating a stable and stress-free environment is also crucial. Stress can exacerbate Cushing's symptoms, so minimizing stressors in your dog's life can make a big difference. This might include providing a quiet, comfortable resting place, maintaining a consistent routine, and avoiding situations that trigger anxiety.

Addressing Complications of Cushing's Syndrome

Cushing's can lead to a range of complications, and managing these is a critical part of supportive care. Common issues include skin problems, urinary tract infections, and diabetes. Addressing these complications promptly can significantly improve your dog's comfort and overall health. 

Here's how:

1.  Skin Infections  : Regular bathing with medicated shampoos can help manage skin infections.

2.  Urinary Tract Infections  : Ensure your dog has access to fresh water and monitor for signs of infection, such as frequent urination or straining.

3.  Diabetes  : Work with your vet to manage blood sugar levels through diet and, if necessary, insulin therapy.

Regular Monitoring After Cushing's Treatment Begins

Once your dog starts treatment for Cushing's, regular monitoring is super important. It's not a one-and-done deal; it's more like a continuous process of checking in to see how things are going. This usually involves frequent vet visits, especially in the initial stages of treatment.

Here's what you can expect:

• ACTH stimulation tests: These tests help your vet assess how well the medication is controlling cortisol production. They're typically done a few weeks after starting treatment and then periodically after that.

• Bloodwork: Regular blood tests are needed to monitor your dog's overall health and to check for any side effects from the medication. This includes looking at liver enzymes, kidney function, and electrolyte levels.

• Physical exams: Your vet will want to see your dog regularly to check for any changes in their physical condition, such as muscle mass, skin changes, or increased thirst and urination.

It's really important to keep up with these appointments and to communicate openly with your vet about any concerns you have. They can adjust the medication dosage or recommend other supportive therapies as needed.

Assessing Treatment Effectiveness in Dogs

So, how do you know if the treatment is actually working? It's not always obvious, and it can take some time to see noticeable improvements. One of the first things you might notice is a decrease in excessive thirst and urination. Your dog might also start to regain some of their energy and appetite.

Here are some key indicators that treatment is effective:

• Improved clinical signs: Look for a reduction in the symptoms that led to the diagnosis in the first place, such as decreased panting, less abdominal swelling, and improved skin condition.

• Normal cortisol levels: ACTH stimulation tests should show that cortisol levels are within the normal range. This indicates that the medication is effectively controlling hormone production.

• Stable bloodwork: Blood tests should show that liver enzymes, kidney function, and electrolyte levels are within normal limits. This helps ensure that the medication isn't causing any significant side effects.

It's also important to remember that treatment goals may vary depending on the individual dog. In some cases, the goal may be to completely eliminate all symptoms, while in others, it may be to simply improve the dog's quality of life. Open communication with your vet is key to setting realistic expectations and adjusting the treatment plan as needed.

Managing Recurrence of Cushing's Symptoms

Even with successful treatment, there's always a chance that Cushing's symptoms could come back. This can happen for a variety of reasons, such as changes in the dog's overall health, the development of resistance to the medication, or the progression of the underlying disease.

If you notice that your dog's symptoms are returning, it's important to contact your vet right away. They may recommend additional testing to determine the cause of the recurrence and to adjust the treatment plan accordingly. This could involve increasing the medication dosage, switching to a different medication, or exploring other treatment options.

Here are some things you can do to help manage recurrence:

• Monitor your dog closely: Pay attention to any changes in their behavior, appetite, or physical condition. The sooner you catch a recurrence, the easier it will be to manage.

• Keep up with regular vet visits: Regular checkups and blood tests can help detect any early signs of recurrence.

• Follow your vet's instructions carefully: Be sure to give your dog their medication as prescribed and to follow any other recommendations your vet makes.

Remember, Cushing's disease is a chronic condition that requires ongoing management. With careful monitoring and proactive treatment, you can help your dog live a happy and comfortable life, even with Cushing's.

When to Treat Versus Watch and Wait for Cushing's

Deciding whether to treat canine Cushing's or simply monitor your dog can be tough. It really boils down to how much the symptoms are affecting your dog's and your own quality of life. Are they just mild annoyances, or are they seriously impacting daily routines? If the symptoms are significantly reducing quality of life, treatment is generally recommended.

Here's a quick rundown of things to consider:

• Severity of symptoms: How bad are the increased thirst, urination, and appetite? Are they manageable, or are they causing major disruptions?

• Presence of complications: Has your dog developed secondary issues like diabetes or skin infections? These often warrant treatment.

• Overall health: Does your dog have other health problems that might make treatment riskier? This needs careful consideration.

Sometimes, the best approach is to address any existing complications and keep a close eye on things. Regular check-ups and monitoring can help you catch any worsening symptoms early on.

Evaluating Quality of Life in Dogs with Cushing's

Assessing quality of life is super important when dealing with Cushing's. It's not just about the test results; it's about how your dog is actually doing. Is your dog still enjoying walks, playing, and interacting with the family? Or is he mostly just sleeping, eating, and drinking excessively?

Consider these factors:

• Energy levels: Is your dog lethargic and unwilling to exercise?

• Appetite and thirst: Are these excessive to the point of being disruptive?

• Behavior: Has your dog's personality changed? Is he more irritable or withdrawn?

• Physical comfort: Is your dog experiencing pain or discomfort due to complications like arthritis or skin issues?

If your dog's quality of life is significantly diminished, treatment is likely the best option. However, if the symptoms are mild and your dog is still enjoying life, a "watch and wait" approach might be reasonable.

Client Education and Expectations for Cushing's Treatment

One of the biggest things is understanding what to expect from treatment. Cushing's isn't usually curable, but it can be managed. The goal of treatment is to control the symptoms and improve your dog's quality of life, not necessarily to eliminate the disease entirely.

Here are some key points to discuss with your vet:

• Treatment options: Understand the pros and cons of each option, including potential side effects and costs.

• Monitoring: Regular blood tests are essential to monitor your dog's response to treatment and adjust the dosage as needed.

• Realistic expectations: Be prepared for the possibility that your dog may still experience some symptoms, even with treatment.

• Long-term commitment: Managing Cushing's is a long-term process that requires ongoing monitoring and adjustments.

Open communication with your vet is key to making informed decisions and ensuring the best possible outcome for your dog.

So, we've talked a lot about Cushing's disease in dogs. It's a tricky thing, for sure. But the big takeaway here is that you've got options. Working closely with your vet is super important. They can help figure out what's going on and what the best plan is for your dog. It might be medicine, or maybe something else. The main goal is to make your dog feel better and live a good life. It's not always easy, but with the right approach, you can definitely help your furry friend.

What exactly is Cushing's disease in dogs?

Cushing’s disease in dogs is caused by the overproduction of cortisol, a hormone that regulates stress, metabolism, and immune function. When too much cortisol circulates in the body, it disrupts normal functions and leads to various health problems. It often results from tumors on the pituitary or adrenal glands, which affect hormone balance.

What are the common signs of Cushing's disease in dogs?

Common signs include excessive drinking and urination, increased appetite, a swollen or pot-bellied abdomen, thinning skin, and hair loss. Dogs may also appear tired, lethargic, or weak. These symptoms develop gradually and can be mistaken for normal aging, so early veterinary evaluation is important for accurate diagnosis and treatment.

What happens if Cushing's disease isn't treated?

Without treatment, Cushing’s disease can lead to severe complications like high blood pressure, diabetes, kidney failure, and an increased risk of infections or blood clots. Your dog’s quality of life will steadily decline due to discomfort and fatigue. Long-term, untreated Cushing’s can become life-threatening, making early intervention crucial for health and well-being.

How do vets diagnose Cushing's disease?

Vets typically begin with routine blood and urine tests to detect abnormalities. If Cushing’s is suspected, specific hormone tests like the ACTH stimulation test or the low-dose dexamethasone suppression test are used. These tests help confirm the diagnosis and determine whether the issue stems from the pituitary or adrenal glands.

What are the main ways to treat Cushing's disease?

Treatment usually involves medications like trilostane to reduce cortisol levels and manage symptoms. In certain cases, especially with adrenal tumors, surgery may be recommended. Regular monitoring and follow-up tests are necessary to adjust treatment and ensure the dog remains stable and comfortable over time.

What can I expect after my dog starts treatment for Cushing's?

After starting treatment, most dogs show significant improvement in energy, coat condition, and appetite control. While Cushing’s disease isn’t typically curable, it is manageable with proper care. Ongoing vet visits and medication adjustments help maintain your dog’s health, allowing them to enjoy a comfortable, happy life despite the diagnosis.

What are the 5 P's of Cushing's disease in dogs?

The 5 P’s include: Polyuria (excessive urination), Polydipsia (excessive drinking), Polyphagia (increased appetite), Panting , and Pot-bellied appearance . These signs are among the most common indicators of Cushing’s disease and help vets and owners recognize when further testing is needed to confirm the condition.

What are the neurological signs of Cushing's disease in dogs?

Neurological signs can include disorientation, pacing, circling, head pressing, or seizures. These may occur if a pituitary tumor grows large enough to affect the brain. Dogs may also show changes in behavior, such as increased anxiety or confusion, especially in cases of pituitary-dependent Cushing's disease with intracranial involvement.

How to test for Cushing's disease in dogs?

Testing typically involves hormone-specific diagnostics like the ACTH stimulation test and low-dose dexamethasone suppression test (LDDST) . These help measure how the adrenal glands respond to hormone signals. Additional tests, like ultrasound or MRI, may be used to locate tumors on the adrenal or pituitary glands for a more precise diagnosis.

What are the final stages of Cushing's disease in dogs?

In the final stages, dogs may suffer from muscle wasting, severe lethargy, frequent infections, high blood pressure, and organ damage. Blood clots and diabetes are also common. Without treatment, these complications lead to significant pain and a reduced quality of life, often resulting in the need for euthanasia to prevent suffering.

How does Cushing's disease affect dog behavior?

Dogs with Cushing’s may seem more anxious, restless, or irritable. They may pace, pant excessively, or appear uncomfortable even at rest. Some become food-obsessed due to increased appetite. Behavioral changes are often linked to hormonal imbalances and can be early clues to a deeper medical issue like Cushing’s disease.