Canine Cushing Disease Monitoring: Supporting Long-Term Wellbeing

Hyperadrenocorticism in dogs requires ongoing monitoring to balance treatment effectiveness against side effects and maintain quality of life over years of management.

Key Facts

Cushing disease is caused by excess cortisol production, usually from a pituitary or adrenal gland tumor
Signs include increased thirst, urination, hunger, a pot-bellied appearance, muscle weakness, and thin skin
Poodles, Dachshunds, Boxers, and Boston Terriers are among the most frequently affected breeds
Treatment with trilostane or mitotane reduces cortisol production but requires careful dose titration to avoid adrenal crisis
Regular ACTH stimulation tests are needed to verify cortisol suppression remains in the therapeutic range
Untreated Cushing disease leads to progressive muscle wasting, skin infections, diabetes, and systemic hypertension
Dogs with pituitary-dependent Cushing disease may also develop neurological signs if the pituitary tumor grows large
Many dogs live comfortably for several years with well-monitored treatment protocols

Welfare Considerations

Cushing disease significantly diminishes quality of life before treatment through constant hunger, thirst, discomfort from a distended abdomen, weakness that prevents normal activity, and skin fragility that causes infections and poor healing. Affected dogs often cannot engage in exercise or play they previously enjoyed. Treatment dramatically improves wellbeing but carries risks: inadequate suppression leaves dogs suffering from cortisol excess, while over-suppression can cause life-threatening Addisonian crisis. The monitoring burden falls heavily on owners, requiring multiple veterinary visits and lab tests. Ensuring owners understand the importance of follow-up testing is essential for sustained welfare. Dogs with well-managed Cushing disease can have comfortable lives despite the chronic nature of the condition.

What You Can Do

Never miss scheduled ACTH stimulation tests as these protect against both under- and over-treatment
Learn the signs of adrenal crisis: lethargy, vomiting, weakness, and loss of appetite after medication changes
Maintain a daily log of water intake and urination frequency to track treatment response at home
Report any significant behavioral changes or appetite shifts to your vet promptly
Keep a medication administration record to ensure no doses are missed or accidentally doubled