Cushing's disease (hyperadrenocorticism) is a common endocrine disorder in middle-aged and older dogs. Long-term management is complex and requires balancing treatment efficacy against the welfare burden of both the disease and its treatment.
Long-term Cushing's management creates a complex welfare balance. The disease itself causes sustained discomfort: increased urinary frequency disturbs sleep, muscle weakness impairs normal activity, skin fragility causes wounds, and the systemic effects of excess cortisol affect every body system. Well-controlled Cushing's dogs — with cortisol levels normalised through appropriate trilostane dosing — show significant improvement in activity, comfort, and quality of life. The treatment welfare burden is significant but manageable: regular injections (if medication is injectable), frequent blood sampling for monitoring, and the risk of acute hypocortisol crisis from over-treatment require owner commitment and veterinary partnership. Treatment side effects — particularly risks of Addisonian crisis — require owners to recognise emergency signs and act rapidly. Over time, the monitoring frequency often reduces in stable cases, decreasing the treatment burden. The welfare goal is achieving sustained cortisol control that normalises the dog's experience without creating excessive monitoring-related stress.