Monitoring Cushing's Disease in Dogs: A Welfare Guide

Canine Cushing's disease requires ongoing monitoring to balance treatment efficacy against risks of over-suppression, with careful attention to quality of life throughout a dog's long-term management.

Key Facts

Cushing's disease (hyperadrenocorticism) results from chronic cortisol excess, most commonly from a pituitary tumour
Dogs typically present with increased thirst, urination, appetite, pot-bellied appearance, and hair loss
Treatment with trilostane or mitotane suppresses cortisol production and requires regular monitoring
ACTH stimulation tests are used to monitor treatment efficacy and avoid dangerous over-suppression
Over-suppression causing hypoadrenocorticism (Addisonian crisis) is life-threatening if not recognised promptly
Most dogs show significant quality of life improvement within weeks of starting effective treatment
Pituitary-dependent Cushing's is far more common than adrenal-dependent, comprising about 85% of cases

Welfare Considerations

Managing Cushing's disease in dogs is a long-term commitment requiring regular veterinary monitoring to navigate the narrow therapeutic window between under-treatment and dangerous over-suppression. Dogs with untreated Cushing's suffer from the chronic effects of cortisol excess — muscle weakness, susceptibility to infection, hypertension, and the indignity of uncontrolled thirst and urination. Successful treatment dramatically improves quality of life, and owners frequently report their dog seeming 'like a puppy again.' However, monitoring cannot be skipped: ACTH stimulation tests every 4-6 weeks initially, then every 3 months in stable patients, are essential to confirm cortisol levels remain in the safe therapeutic range. Signs of over-suppression including lethargy, vomiting, and weakness require immediate veterinary attention. The financial commitment of regular testing can be substantial; pet insurance coverage for chronic conditions varies widely and owners should discuss realistic monitoring costs with their veterinarian at diagnosis.

What You Can Do

Learn to recognise signs of over-suppression including lethargy, vomiting, and weakness in dogs receiving Cushing's treatment
Commit to regular ACTH stimulation test monitoring as the cornerstone of safe long-term management
Use daily quality of life scoring to track your dog's wellbeing and detect changes between appointments
Discuss realistic long-term costs and insurance options with your veterinarian at diagnosis