Diagnosing and monitoring Cushing disease in dogs requires a series of tests that can be stressful for affected animals, and appropriate test selection and humane monitoring protocols minimise welfare impact during the diagnostic process.
Cushing disease diagnosis imposes welfare costs through the repeated handling, restraint, and venipuncture required for confirmatory testing. Dogs in the diagnostic phase may undergo 3-6 or more blood samples over several weeks, combined with hormone injections and periods of waiting at the veterinary clinic. For anxious dogs, this repeated clinic exposure compounds the stress of the underlying disease. Post-diagnosis monitoring every 1-4 months involves a lifetime of regular testing to maintain safe treatment levels. The welfare cost of monitoring is offset by the welfare benefit of detecting both under-treatment (continued Cushing symptoms) and over-treatment (potentially fatal Addisonian crisis). Minimising the number of tests required through good clinical judgement, using home monitoring tools where available, and employing anxiolytic protocols for highly stressed dogs reduces the monitoring welfare burden without compromising diagnostic quality.