Adrenal-dependent Cushing's disease (caused by adrenal tumours rather than pituitary disease) presents distinct welfare challenges and may require surgical adrenalectomy for optimal management.
Adrenal-dependent Cushing's causes the same chronic welfare impairment as pituitary-dependent disease — polydipsia, polyphagia, pot-belly, muscle weakness, and thin skin — with the additional welfare concern of a potentially malignant tumour. Dogs with adrenal carcinomas face the welfare burden of both the hormonal effects and tumour progression including possible metastasis. Surgical adrenalectomy, when successful, is curative for benign tumours and provides long-term welfare improvement dramatically superior to lifelong medical management. The post-operative period requires careful corticosteroid replacement management but the outcome for most dogs with benign adrenal adenoma is excellent. Referral to a specialist internal medicine or surgical centre is appropriate for these cases.