Dog Cushing's Disease — Welfare and Management

Hyperadrenocorticism (Cushing's disease) is a common endocrine disorder in older dogs — chronic cortisol excess causes significant suffering that is dramatically improved with appropriate treatment.

Key Facts

Cushing's disease affects approximately 1–2 per 1,000 dogs annually, primarily middle-aged to older dogs and certain breeds including Poodles, Dachshunds, and Terriers
Most cases (85%) are pituitary-dependent — a benign pituitary tumour drives excess cortisol production
Clinical signs include increased thirst and urination, pot-bellied appearance, muscle weakness, hair loss, thin skin, and increased susceptibility to infection
Cortisol excess impairs immune function, wound healing, liver health, and neurological function — long-term uncontrolled disease causes significant systemic harm
Medical treatment with trilostane (Vetoryl) or mitotane effectively controls cortisol levels and significantly improves quality of life
Response to treatment is often dramatic — owners frequently report their dog "coming back to life" within weeks of starting treatment
Regular monitoring (ACTH stimulation tests every 3–6 months) is essential to maintain appropriate cortisol control and avoid adrenal insufficiency

Welfare Considerations

Cushing's disease causes chronic, multisystem welfare impairment. The pot-bellied dog with thin, bruised skin, muscle weakness, and insatiable thirst is not just aesthetically changed — they are uncomfortable, immunosuppressed, weak, and unable to engage normally in the activities that constitute canine well-being. The profound response to treatment — restoration of normal energy, muscle tone, and engagement — demonstrates retrospectively how significantly the untreated condition impairs quality of life. Early diagnosis through awareness of clinical signs, followed by appropriate treatment and monitoring, is the key welfare intervention for this highly treatable condition.

What You Can Do

If your dog shows a combination of increased thirst, pot-belly, skin changes, and hair loss, request an ACTH stimulation test from your vet
Begin trilostane treatment promptly after diagnosis — the quality-of-life improvement is rapid and significant
Schedule ACTH stimulation tests every 3 months initially to establish the correct dose — under-treatment allows disease progression; over-treatment risks Addisonian crisis
Monitor for signs of over-treatment: lethargy, vomiting, weakness — these may indicate adrenal insufficiency requiring emergency treatment
Consider that atypical signs (skin issues, recurring infections without PU/PD) may still represent Cushing's in breed-predisposed dogs
Support pet insurance that covers endocrine conditions — Cushing's management requires ongoing monitoring and medication costs
Donate to endocrinology research at veterinary schools — improved diagnostic tests and treatment protocols benefit all affected dogs