Dog Hyperadrenocorticism and Quality of Life Management

Canine hyperadrenocorticism — Cushing's disease — is a common endocrine disorder in middle-aged and older dogs caused by excessive cortisol production. Effective medical management significantly improves quality of life and extends comfortable lifespan.

Key Facts

Around 80 to 85 per cent of cases are pituitary-dependent, caused by a pituitary micro-adenoma driving excess ACTH secretion
Clinical signs include polyuria, polydipsia, pot-bellied appearance, skin thinning, muscle weakness, and susceptibility to infection
Trilostane is the most widely used medical treatment in Europe, inhibiting cortisol synthesis through adrenal 3-beta-hydroxysteroid dehydrogenase blockade
Mitotane (o,p-DDD) provides an alternative that selectively destroys adrenocortical cells and may offer remission in some dogs
Adrenocortical tumours causing adrenal-dependent Cushing's syndrome are treated with adrenalectomy when surgically accessible

Welfare Considerations

Uncontrolled Cushing's disease causes progressive physical and psychological burden: polydipsia drives restless water-seeking behaviour, skin fragility leads to bruising and wound healing problems, muscle weakness impairs normal activity, and susceptibility to infection causes recurrent health crises. Dogs treated successfully with trilostane typically show dramatic improvement in activity, coat quality, and owner-assessed quality of life within weeks. Welfare-centred management requires regular monitoring of cortisol levels after ACTH stimulation to ensure adequate but not excessive suppression — both under- and over-treatment carry welfare risks.

What You Can Do

Seek veterinary assessment if your dog shows the classic signs of polyuria, polydipsia, and pot-bellied appearance with muscle weakness
Follow the prescribed trilostane monitoring schedule precisely — ACTH stimulation tests at 10 days, 4 weeks, and 12 weeks after initiation
Monitor for signs of over-suppression — lethargy, reduced appetite, shaking — and seek urgent veterinary attention if they occur
Maintain regular follow-up appointments even once the condition is well controlled as dose requirements change over time
Discuss quality-of-life assessment tools with your vet to track the benefit of treatment objectively at each visit