Cushing's Disease in Dogs Symptoms and Treatment

If your veterinarian has mentioned Cushing's disease as a possibility for your senior dog, you probably have a lot of questions. The name itself sounds intimidating, and the medical terminology surrounding it can feel overwhelming. But Cushing's disease, while a serious condition, is one that many dogs live with for years when it is properly managed.

This guide is designed to give you a clear, accessible understanding of what Cushing's disease is, what the signs look like, and what management generally involves. It is educational information to help you have more informed conversations with your veterinarian, not a substitute for professional diagnosis or treatment guidance.

What Is Cushing's Disease?

Cushing's disease, known medically as hyperadrenocorticism, occurs when a dog's body produces too much cortisol. Cortisol is a hormone produced by the adrenal glands, two small glands located near the kidneys. In normal amounts, cortisol plays important roles in stress response, metabolism, immune function, and inflammation control. When too much cortisol is produced over an extended period, it affects virtually every system in the body.

The Three Types of Cushing's Disease

Pituitary-dependent Cushing's is the most common form, accounting for the majority of cases. It occurs when a small tumor on the pituitary gland at the base of the brain sends excessive signals to the adrenal glands, telling them to produce more cortisol than the body needs. These tumors are usually benign but overactive.

Adrenal-dependent Cushing's is less common and occurs when a tumor on one of the adrenal glands itself produces excess cortisol, independent of signals from the pituitary gland. These tumors may be benign or malignant.

Iatrogenic Cushing's is caused by long-term use of steroid medications (such as prednisone). The external steroids mimic cortisol and, over time, produce the same effects as if the body were overproducing the hormone. This form typically resolves when the medication is gradually discontinued under veterinary supervision.

Recognizing the Signs

Cushing's disease is often called "the great imitator" because its signs can mimic many other conditions and develop so gradually that they are easy to attribute to normal aging. Knowing what to look for is the first step toward earlier recognition.

Increased Thirst and Urination

This is often the most noticeable early sign. Dogs with Cushing's disease may drink dramatically more water than usual and need to urinate much more frequently. You might notice your dog emptying the water bowl faster than usual, asking to go outside more often, or having accidents in the house despite previously being well house-trained. Some owners first notice wet spots on bedding from overnight urination.

Increased Appetite

Excess cortisol stimulates appetite, sometimes dramatically. Your dog may seem ravenous, beg for food more insistently, get into the trash, or seem unsatisfied even after eating. This sign is sometimes viewed positively by owners, as a good appetite is generally associated with health. In the context of other signs, however, it can be significant.

The Pot-Bellied Appearance

As Cushing's disease progresses, many dogs develop a noticeably distended abdomen. This is caused by a combination of fat redistribution to the abdominal area, liver enlargement, and weakening of the abdominal muscles. The overall silhouette can change significantly, with a sagging belly that contrasts with muscle loss elsewhere.

Skin and Coat Changes

The skin is one of the organs most visibly affected by excess cortisol. Dogs may experience hair loss, particularly on the trunk, flanks, and tail, while the head and legs are often spared. The skin may become thin, fragile, and slow to heal. Some dogs develop blackheads, darkened patches of skin, or hard, calcified plaques. Recurrent skin infections are also common.

Muscle Weakness and Lethargy

Cortisol breaks down muscle tissue over time, leading to weakness, particularly in the hind legs. Dogs may have difficulty climbing stairs, jumping, or getting up from a lying position. General lethargy and decreased interest in activities they once enjoyed are common as the disease progresses.

Panting

Excessive panting, even at rest or in cool environments, is a frequently reported sign. This occurs because excess cortisol affects the respiratory muscles and fat distribution around the chest and abdomen.

How Cushing's Disease Is Typically Managed

Management of Cushing's disease depends on the type, the dog's overall health, and the owner's goals. This is a conversation between you and your veterinarian, tailored to your individual dog.

Medical Management

For pituitary-dependent Cushing's, medication is the most common approach. The most widely used medications work by either destroying a portion of the adrenal gland tissue or inhibiting cortisol production. These medications require careful dosing and regular monitoring through blood tests to ensure cortisol levels are appropriately controlled without dropping too low.

Regular follow-up appointments are essential. Your veterinarian will typically schedule recheck visits and blood tests at specific intervals after starting medication, then periodically throughout treatment. These visits help ensure the medication is working effectively and that your dog is tolerating it well.

Surgical Options

For adrenal-dependent Cushing's, surgical removal of the affected adrenal gland may be an option if the tumor is operable and the dog is a good surgical candidate. This surgery is complex and is usually performed by a veterinary surgeon with specialized training. When successful, it can be curative for benign adrenal tumors.

Monitoring and Adjustments

Managing Cushing's disease is an ongoing process. Medication doses may need adjustment over time, and regular blood work helps your veterinarian fine-tune the treatment. Watch for signs that the medication may be working too well, which can cause the opposite problem: too little cortisol. Signs of this include lethargy, vomiting, diarrhea, and loss of appetite. If you notice these signs, contact your veterinarian promptly.

Supportive Care at Home

Beyond medical management, there are things you can do at home to support your dog's comfort and quality of life.

Water and Bathroom Access

Ensure fresh water is always available, as increased thirst is a persistent feature of the disease even with treatment. Provide frequent opportunities for bathroom breaks. If your dog is having accidents, consider waterproof bed covers and washable pads rather than restricting water, which can be dangerous for dogs with Cushing's.

Skin Care

Dogs with Cushing's disease often have fragile, infection-prone skin. Gentle bathing with soothing shampoos can help. Avoid rough handling that could tear thin skin. Monitor for signs of skin infection, including redness, warmth, discharge, or an unusual smell, and report these to your veterinarian promptly.

Nutritional Support

Discuss dietary considerations with your veterinarian. Some vets recommend a diet that is moderate in fat, high in quality protein, and rich in antioxidants. Because dogs with Cushing's tend to gain weight, especially around the abdomen, calorie management may be important. Avoid high-fat treats and table scraps.

Gentle Exercise

While muscle weakness is a feature of Cushing's disease, gentle, regular exercise helps maintain whatever muscle mass remains and supports overall well-being. Short, easy walks on flat terrain are usually appropriate. Avoid overexertion and watch for signs of fatigue. Swimming, if your dog enjoys it and has access, can be a gentle way to maintain muscle tone without stressing joints.

Living with Cushing's Disease: Quality of Life Considerations

One of the most common questions owners have is whether treatment is worth it. This is a deeply personal decision that depends on your dog's age, overall health, the severity of their symptoms, and your family's circumstances. Some things to consider include how much the symptoms are affecting your dog's daily life, your ability to commit to regular monitoring and medication, and your dog's overall health beyond the Cushing's disease.

Many dogs with well-managed Cushing's disease enjoy a good quality of life. The excessive drinking and urination often improve with treatment, energy levels may increase, and skin condition may improve over time. The condition requires ongoing attention, but many owners find that once a management routine is established, it becomes part of the normal rhythm of life with their senior dog.

Monitoring Your Dog at Home

Between veterinary visits, tracking certain things at home can help you and your vet assess how well the management plan is working. Keep a simple log of how much water your dog drinks daily, how often they need to urinate, their appetite level, their energy and activity level, and any skin or coat changes you observe.

This information gives your veterinarian a more complete picture than a brief office visit can provide. It also helps you notice trends, either improvement or changes that need attention, that might otherwise be easy to miss day to day.

Cushing's disease is a complex condition, but it is not a hopeless one. With accurate diagnosis, appropriate management, and attentive home care, many senior dogs with Cushing's continue to live comfortable, connected lives. Your partnership with your veterinarian, combined with your daily observations and care, is the foundation of effective management.