Dog Cushing's Disease: Managing a Complex Hormonal Condition

Hyperadrenocorticism (Cushing's disease) is a common hormonal condition in older dogs causing significant welfare impacts. Diagnosis and management are complex but achievable.

Key Facts

Cushing's disease affects approximately 1-2 dogs per 1,000 annually — predominantly middle-aged to older animals
It is caused by excess cortisol production, usually from a pituitary or adrenal tumour
Signs include increased thirst and urination, pot-bellied appearance, muscle wasting, skin changes, and recurrent infections
Pituitary-dependent disease (85% of cases) is managed with trilostane or mitotane
Adrenal tumours may require surgery alongside medical management
The condition is manageable but not curable — lifelong monitoring is required

Welfare Considerations

Cushing's disease causes significant welfare impacts through chronic cortisol excess: muscle weakness, skin fragility, susceptibility to infection, and the discomfort of dramatically increased water intake and urination. Untreated dogs deteriorate progressively. Treatment with trilostane effectively controls cortisol levels and dramatically improves welfare in most dogs — owners typically describe their dog as "younger" or "revitalised" after achieving good disease control. However, treatment requires regular monitoring and carries risks of over-suppression — adequately managed Cushing's has good welfare outcomes; poorly monitored treatment carries its own welfare risks.

What You Can Do

Seek veterinary assessment if your older dog shows increased thirst, pot belly, or skin changes
Commit to the regular monitoring required with Cushing's treatment — monitoring is not optional
Understand the signs of Addisonian crisis from over-suppression and have an emergency plan
Work with a veterinary internist for complex or difficult-to-control cases
Maintain quality of life assessment throughout treatment — the goal is a comfortable, engaged dog