Dog Cushing's Disease: Managing Hyperadrenocorticism for Better Quality of Life

Cushing's disease (hyperadrenocorticism) is a common endocrine disorder in older dogs that causes widespread systemic effects and requires careful management to preserve welfare.

Key Facts

Cushing's disease results from excess cortisol production, most often from a pituitary tumor (85–90% of cases)
Adrenal tumors account for 10–15% of cases and may be benign or malignant
Classic signs include pot-bellied appearance, increased thirst and urination, hair loss, muscle wasting, and lethargy
Middle-aged to older small-breed dogs are most commonly affected; Poodles, Dachshunds, and Boxers are predisposed
Diagnosis requires multiple tests including ACTH stimulation test and low-dose dexamethasone suppression test
Medical treatment with trilostane or mitotane suppresses cortisol production and significantly improves symptoms
Untreated Cushing's leads to hypertension, diabetes, blood clots, and recurrent infections
With appropriate treatment, many dogs achieve good quality of life for 2–4 years post-diagnosis

Welfare Considerations

The systemic effects of excess cortisol cause wide-ranging suffering: muscle weakness makes movement painful, skin thinning leads to fragility and wounds, and immune suppression causes recurrent infections. Dogs with untreated Cushing's are chronically thirsty and urinate excessively, which disrupts sleep and causes housetraining accidents that may be misinterpreted as behavioral problems. The pot-bellied appearance from abdominal organ enlargement causes discomfort and pressure. Hypertension can cause sudden blindness. Many dogs suffer for months before owners recognize the subtle signs as a medical problem rather than normal aging. Early diagnosis and treatment dramatically reduces this cumulative suffering and restores a more normal life.

What You Can Do

Recognize early signs in older dogs: increased thirst, pot belly, hair thinning, and reduced activity
Request ACTH stimulation testing if your veterinarian suspects Cushing's disease
Once diagnosed, commit to regular monitoring visits — trilostane dosing requires careful adjustment
Keep treated dogs away from extreme heat as their thermoregulation remains impaired
Support endocrine research through veterinary school donations
Join Cushing's dog owner communities to share management strategies and welfare tips