By Courtney Prue | February 6, 2025

Cushing’s Disease In Dogs

What is Cushing’s disease in dogs?         

Cushing’s disease (Also known as hyperadrenocorticism) is a hormonal imbalance and chronic condition that occurs when a dog’s body produces too much cortisol. Cortisol is a hormone produced by the adrenal gland (these sit above the kidneys in the abdomen) that plays a crucial role in the body’s core functions. It helps regulate blood sugar levels, blood pressure, and the immune system and also affects the metabolism of protein, carbohydrates, and fats. Cortisol is involved in the body’s “fight or flight” response to stress, and when it is released it increases heart rate, blood pressure, and respiration, and can also cause the liver to release glucose into the bloodstream for energy.

The condition is almost always lifelong and will require daily medications, regular monitoring and blood tests. At the end of their lives, these dogs benefit from close monitoring and palliative care. 

What causes Cushing’s disease in dogs? 

Approximately 80-85% of Cushing’s cases are due to harmless growths in the pituitary gland, which sits at the base of the brain. Less commonly the disease is caused by tumours in the adrenal gland, which sits above the kidney. Approximately 50% of these adrenal tumours are harmful and cancerous. Cushing’s disease can also be caused by the long-term use of corticosteroid medications such as prednisolone. 

How do I know if my dog has Cushing’s?

Symptoms can vary between dogs and can sometimes be mistaken for other medical conditions. Common symptoms include:

• Increased thirst and urination: Cortisol, which is overproduced in Cushing’s disease, affects the dog’s kidneys and makes them produce more urine. As a result, your dog may need to go outside more often or may start having accidents in the house.
• Increased appetite: Cortisol stimulates the appetite and can make your dog feel hungry all the time. Your dog may beg for food or may even start raiding the trash or stealing food from the counter.
• Weight gain: Cushing’s disease can cause weight gain, particularly in the abdomen. This occurs because cortisol causes the body to store fat, particularly around the midsection. It also relaxes the muscles in this area. You may notice that your dog’s belly becomes distended or that they have a sagging belly.
• Hair loss and thinning: Cortisol affects hair follicles and can cause them to shrink. Your dog may develop thinning or bald patches on their flanks, tail, thigh, back and face.
• Skin problems: Including dryness, itching, and thinning. Your dog may also develop skin infections or hot spots, which can be painful and uncomfortable.
• Panting: Cortisol affects the dog’s respiratory system and can cause them to breathe more heavily. You may notice that your dog is panting even when they are not exercising or that they have trouble catching their breath.
• Muscle weakness: Cushing’s disease can cause muscle weakness, particularly in the hind legs. Your dog may have trouble standing up or walking, and may even fall down or stumble.

An emergency situation:

While Cushing’s disease in dogs is a chronic condition, there are some emergency situations that require immediate veterinary attention. It is important for pet owners to recognise these emergency signs so that they can seek prompt medical attention for their furry friend. Some emergency signs that indicate an animal needs to go to the vet ASAP include:

• Collapse
• Seizures
• Difficulty breathing
• Loss of appetite or vomiting

If you notice any of these signs, get in touch with your regular veterinarian or our team. 

How is Cushing’s disease diagnosed in dogs?

Diagnosing Cushing’s disease in dogs can be challenging due to the vague nature of the symptoms and the presence of other diseases that have similar clinical presentations. There are several diagnostic tests that a veterinarian may perform to confirm or rule out the presence of Cushing’s disease in a dog. Here are some of the most common diagnostic tests used for this purpose:

• Health screening blood test: This routine test can help rule out other diseases that may present similarly, and there are some markers that are commonly increased on these tests that can indicate Cushing’s is more or less likely. 
• ACTH stimulation test: This test involves measuring cortisol levels before and after the administration of ACTH, a hormone that stimulates the adrenal glands to produce cortisol. Dogs with Cushing’s disease will have abnormally elevated cortisol levels after the administration of ACTH.
• Abdominal ultrasound: An ultrasound can detect changes in the size and shape of the adrenal glands, which can help determine if the disease is pituitary-dependent or adrenal-dependent.
• Endogenous ACTH concentration: This test measures the level of ACTH in the blood. Pituitary-dependent (when there is a growth in the pituitary gland) Cushing’s disease is associated with increased levels of ACTH, while adrenal-dependent (when there is a growth in the adrenal gland) Cushing’s disease is associated with decreased levels.
• Urine cortisol-to-creatinine ratio (UCCR): This test is non-invasive and involves collecting a urine sample from the dog to measure the ratio of cortisol to creatinine (a waste product). Elevated levels of cortisol in the urine may suggest Cushing’s disease.
• Low-dose dexamethasone suppression test (LDDS): This test involves administering a low dose of dexamethasone, a synthetic steroid, to the dog and measuring the cortisol levels before and after the administration. Dogs with Cushing’s disease will have higher than normal cortisol levels after the administration of dexamethasone.
• High-dose dexamethasone suppression test (HDDS): Similar to LDDS, but a higher dose of dexamethasone is administered. This test can help distinguish between pituitary-dependent and adrenal-dependent Cushing’s disease.

It is important to note that no single test can definitively diagnose Cushing’s disease, and a combination of tests may be needed to make a diagnosis. Your veterinarian will determine which tests are appropriate based on your dog’s individual case

Your veterinarian may also recommend additional tests to rule out other conditions that may have similar symptoms.

Regular diagnostic testing will also be required throughout the life of your pet to ensure the treatment is working, adjust dosages and monitor the function of other organs. The medical management of this condition can be confusing and overwhelming. Get in touch with our team today for a personalised discussion. 

What are possible complications for my dog with Cushing’s disease?

In addition to the symptoms caused by the disease itself, Cushing’s disease can also lead to a number of secondary complications. These complications can arise as a result of excess cortisol production and can significantly impact a dog’s quality of life. Some of the common secondary complications associated with Cushing’s disease include:

• Urinary tract infections (UTIs): This is due to a weakened immune system. Symptoms include frequent urination, straining to urinate, and bloody or cloudy urine.
• Skin infections: This is due to a weakened immune system and hair thinning. Symptoms may include itching, redness, and discharge.
• Mucocele formation: This occurs when the gallbladder becomes filled with thick, gelatinous material, which can obstruct the flow of bile and cause inflammation of the gallbladder. Symptoms may include abdominal pain, vomiting, loss of appetite, and lethargy. In severe cases, the gallbladder can rupture, leading to a potentially life-threatening situation.
• Diabetes: A chronic condition in which the body cannot properly regulate blood glucose levels. Symptoms can include increased thirst, frequent urination, and weight loss.
• Pancreatitis: An inflammation of the pancreas that can cause digestive problems and potentially life-threatening complications. Symptoms include abdominal pain, vomiting, and diarrhoea.
• Hypertension: Dogs with Cushing’s disease are at an increased risk of developing high blood pressure (hypertension). This can lead to a range of complications, including damage to the kidneys and eyes.
• Tracheal collapse: This condition occurs when the cartilage rings that support the trachea weaken and collapse, leading to the narrowing of the airway. Tracheal collapse can cause coughing, difficulty breathing, and even respiratory distress in severe cases. 

It’s important to note that not all dogs with Cushing’s disease will develop these secondary complications. However, if your dog has been diagnosed with the disease, it’s important to monitor them closely for any changes in their health and to address any new symptoms or concerns with your veterinarian. These additional issues can impact your dogs quality of life so it is important to work closely with a veterinarian. 

Your veterinarian may also recommend further testing to make sure your dog does not have these common secondary issues. With proper management and treatment, many dogs with Cushing’s disease can go on to live happy, healthy lives. Work with your regular veterinarian or our team to achieve this. 

What is the treatment of Cushing’s disease in dogs?

The treatment for Cushing’s disease usually involves daily and lifelong administration of medications, along with regular blood tests. 

If the condition is caused by a tumour on the adrenal or pituitary gland, surgical removal of the tumour may be recommended. However, this procedure carries a high risk of complications and is generally only recommended in certain cases.

Medications used to control the level of cortisol in the body:

• Trilostane: This medication is most commonly used. It is given orally once or twice a day. It works by inhibiting the enzyme responsible for cortisol production. 
• Mitotane: This medication is used in severe cases of Cushing’s disease or when other treatment options have failed. It works by destroying the cells in the adrenal gland that produce cortisol. However, this medication can have serious side effects and can be toxic to humans.

Other medications may also be prescribed by your veterinarian to manage any secondary complications relating to this chronic disease. 

Cortisol levels must be closely monitored when first starting medications, and then regularly throughout their life. This is because lowering cortisol levels too far can be life-threatening.

Symptoms include vomiting, diarrhoea, lethargy, weakness, collapse, low blood pressure, and a rapid heart rate. If these signs are noted, consult with your veterinarian or our team ASAP.

How do I manage my dog’s Cushing’s disease at home?

If your dog has been diagnosed with Cushing’s disease, there are several things you can do at home to help manage the condition:

• Feed a healthy, balanced diet to maintain a healthy weight. A weight loss program is regularly recommended as Cushing’s disease commonly causes excess weight gain. 
• Provide plenty of fresh water to help manage increased thirst and urination.
• Exercise your dog regularly to help maintain muscle tone and prevent weight gain.
• Keep up with veterinary appointments and follow-up tests to monitor the condition.
• Be aware of potential side effects of medications and report any concerns to your veterinarian.
• Consider palliative care to maximise comfort for as long as possible.

An in-home veterinary assessment can also be helpful to identify any other areas of improvement that can help your beloved pet stay comfortable for as long as possible. 

How long can my dog live with Cushing’s disease?

The prognosis for dogs with Cushing’s disease varies depending on the underlying cause and severity of the condition. With appropriate treatment and management, many dogs with Cushing’s disease can live a relatively normal life. However, some dogs may experience complications such as diabetes, infections, or other health problems. If they seem increasingly uncomfortable or their quality of life is impacted, palliative care may be the kindest option. 

End-of-life care tips 

If your dog’s seizures or underlying condition has progressed to a point where treatment is no longer effective or its symptoms are too severe, it’s important to consider end-of-life care options, including possibly putting your dog to sleep (euthanasia). This can be an overwhelming and distressing thing to even think about. Rest Your Paws is here to support you and provide compassionate care for your beloved pet throughout their journey. Here are some end-of-life care tips for dogs with Cushing’s disease:

• Keep them comfortable and well-nourished with food that they enjoy
• Spend quality time with them, making the most of every moment, such as with a bucket list.
• Offer a peaceful and stress-free environment, free from triggers that can exacerbate symptoms
• Administer medications as prescribed for pain management and symptom relief
• Provide a warm and comfortable space for your dog to rest and sleep, with easy access to food, water, and a place to relieve themselves
• Monitor your dog’s breathing, heart rate, and overall condition, and seek veterinary attention if necessary
• Evaluate their quality of life regularly, or reach out to a palliative care vet to help you with this. 
• Consult our End of Life Care Pack to get prepared to put your dog to sleep.
• Track good days and bad days on our Quality of Life Assessment Calendar.

Please know that we are here to support you every step of the way. We understand that this is a challenging time for you and your family, and we are committed to providing you with the guidance and care that you and your furry friend deserve. If you want to learn more about putting your pet to sleep, dog euthanasia at home, options to put your pet down at home, costs of euthanasia at home or what it looks like to put your pet to sleep at home, call us on 0422 157 675 or visit our website.

Conclusion

Cushing’s disease in dogs can be a challenging condition to manage, but with proper diagnosis, treatment, and ongoing care, many dogs can live comfortable lives. It’s important for pet owners to be aware of the potential complications and to work closely with their veterinarian to ensure their dog’s needs are being met. Rest Your Paws is here to offer support and resources for pet owners navigating the complexities of Cushing’s disease in dogs. We hope this information has been helpful and that pet owners feel empowered to make informed decisions and provide the best possible care for their furry friends. Please do not hesitate to reach out to us if you have any questions or concerns – we are here to help.

Rest Your Paws

We offer in-home pet euthanasia for dogs and cats. Say goodbye with peace and dignity to your beloved pet. Professional and experienced end-of-life support.