Dog Cushing's Disease Treatment: Welfare Through Hormonal Management

Managing Cushing's disease in dogs requires careful medication balance and regular monitoring. Welfare-centred treatment improves quality of life while avoiding complications from over or under-treatment.

Key Facts

Trilostane blocks cortisol synthesis and is the most widely used treatment for pituitary-dependent Cushing's in dogs
Mitotane selectively destroys adrenal cortical tissue and remains an option in some countries
ACTH stimulation testing monitors treatment adequacy, aiming for post-stimulation cortisol in the target range
Under-treatment leaves dogs symptomatic while over-treatment can cause life-threatening adrenal insufficiency
Monthly ACTH stimulation testing is typically recommended initially, reducing once stable control is achieved
Dogs with adrenal-dependent Cushing's may be candidates for adrenalectomy as curative surgical treatment
Concurrent conditions including diabetes, hypertension, and urinary tract infections require co-management

Welfare Considerations

Cushing's disease management requires sustained attention to achieving the narrow therapeutic window between under-treatment that leaves dogs symptomatic and over-treatment that risks adrenal crisis. The welfare of well-managed Cushingoid dogs is substantially improved: coat grows back, activity increases, drinking and urination normalise, and muscle strength improves. Regular monitoring, while requiring frequent veterinary visits, is essential for maintaining safe and effective control. Owner education about early signs of both under-treatment (return of Cushingoid signs) and over-treatment (lethargy, inappetence, vomiting) enables faster response to changing medication requirements. Concurrent condition management, particularly urinary tract infections which occur frequently due to immune suppression, is an important component of comprehensive welfare-centred care.

What You Can Do

Adhere strictly to monitoring schedules for ACTH stimulation testing when managing Cushing's disease
Learn to recognise signs of both under-treatment and adrenal insufficiency from over-treatment
Manage concurrent conditions including hypertension and urinary infections proactively
Report any significant changes in your dog's condition between monitoring appointments
Consider specialist endocrinology referral for dogs with complex or treatment-resistant Cushing's disease