Cushing’s Disease in Dogs: Symptoms, Causes, Diagnosis, Stages, and Treatment
Cushing’s disease is one of the most commonly diagnosed hormonal disorders in older dogs. It affects the adrenal glands and causes the body to produce too much cortisol, a hormone that helps regulate stress, metabolism, and the immune system. While cortisol is essential for normal body function, too much of it can cause a range of serious health problems over time.
On this page, we’ll take a detailed look at what causes Cushing’s disease in dogs, what signs to look for, how it’s diagnosed, what stages the disease can go through, and what treatment options are available.
What is Cushing’s disease in dogs?
Cushing’s disease, also known as hyperadrenocorticism, occurs when a dog’s adrenal glands produce too much cortisol. There are three main types of Cushing’s disease in dogs:
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Pituitary-dependent Cushing’s: This is the most common form, making up about 80–90% of cases. It’s caused by a small, usually benign tumor on the pituitary gland, located at the base of the brain. This tumor signals the adrenal glands to release too much cortisol.
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Adrenal-dependent Cushing’s: This form is caused by a tumor on one of the adrenal glands themselves. It accounts for roughly 10–15% of cases.
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Iatrogenic Cushing’s: This form is caused by the long-term use of corticosteroid medications, such as prednisone, given to treat other health conditions.
Each type of Cushing’s requires a different treatment approach, which is why accurate diagnosis is important.
What are the symptoms of Cushing’s disease in dogs?
Cushing’s disease tends to develop slowly, and the symptoms may be easy to miss at first. Over time, they become more noticeable and can affect the dog’s daily life.
Some of the most common signs include:
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Increased thirst and urination
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Increased appetite
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Panting more than usual
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A pot-bellied appearance
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Thinning of the skin
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Hair loss, often symmetrical
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Lethargy or decreased activity
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Muscle weakness
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Recurring skin infections
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Dark spots or skin pigmentation changes
Not all dogs will show every symptom, and some signs may be mistaken for aging. If your dog is showing several of these signs, it’s important to speak with your veterinarian.
What causes Cushing’s disease in dogs?
The cause of Cushing’s disease depends on the type.
Pituitary-dependent causes
This form is usually triggered by a small, non-cancerous tumor on the pituitary gland. The tumor causes the gland to release too much ACTH (adrenocorticotropic hormone), which stimulates the adrenal glands to produce excess cortisol. These tumors grow slowly and may not spread, but they can still lead to major health issues.
Adrenal-dependent causes
This form is the result of a tumor on one of the adrenal glands. The tumor could be benign or malignant. Adrenal tumors are less common than pituitary tumors but may require surgery if they are operable.
Iatrogenic causes
Iatrogenic Cushing’s is caused by long-term steroid therapy. When steroids are used for too long or in high doses, they can mimic the effects of naturally occurring cortisol, which suppresses the body’s natural production and leads to hormonal imbalances.
How is Cushing’s disease in dogs diagnosed?
Diagnosing Cushing’s disease can be complex. Your veterinarian will start with a physical exam and a thorough medical history, especially if symptoms like excessive drinking, urination, or hair loss are reported.
Blood and urine tests
Initial tests often include:
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Complete blood count (CBC)
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Serum chemistry panel
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Urinalysis
These tests help rule out other conditions and check for common signs of Cushing’s, like elevated liver enzymes or dilute urine.
Specific diagnostic tests
If your vet suspects Cushing’s, they may perform one or more of these specialized tests:
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ACTH stimulation test: Measures how the adrenal glands respond to ACTH.
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Low-dose dexamethasone suppression (LDDS) test: Monitors how cortisol levels react to a synthetic steroid.
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High-dose dexamethasone suppression test: Used to differentiate between pituitary and adrenal causes.
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Ultrasound or MRI/CT scan: Helps identify adrenal tumors or evaluate the pituitary gland.
Each test provides different information, so your vet may use a combination of them to make a clear diagnosis.
What are the stages of Cushing’s disease in dogs?
Cushing’s disease doesn’t have clearly defined medical stages, but it can be thought of in terms of progression:
Early stage
Dogs may show subtle symptoms, such as increased thirst or appetite. These are often dismissed as normal aging.
Moderate stage
At this point, more obvious symptoms appear. Hair loss, pot belly, and skin changes may start to show. Dogs may be more prone to infections, especially on the skin and ears.
Advanced stage
In severe cases, the disease can lead to muscle wasting, extreme fatigue, persistent infections, high blood pressure, or even diabetes. If left untreated, complications can become life-threatening.
Monitoring progression closely and starting treatment early can greatly improve a dog’s quality of life.
What treatment options are available for Cushing’s disease in dogs?
Treatment will depend on the type and cause of Cushing’s disease, as well as the overall health of the dog.
Medical management
Most dogs with pituitary-dependent Cushing’s are treated with oral medications:
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Trilostane: The most commonly prescribed drug. It blocks cortisol production at the adrenal gland level.
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Mitotane: A chemotherapy agent that destroys part of the adrenal cortex to reduce cortisol levels. It requires careful dosing and monitoring.
Dogs on these medications need regular blood tests to make sure cortisol levels stay in a safe range.
Surgical options
For dogs with adrenal tumors, surgery to remove the affected adrenal gland may be an option. This can be curative if the tumor is benign and fully removed. However, the procedure is complex and carries risks, so it’s typically done at a specialty veterinary hospital.
Treating iatrogenic Cushing’s
If steroids have caused Cushing’s, the treatment involves slowly reducing the dose under veterinary supervision. This helps the body restart its natural hormone production.
Supportive care and mobility aids
Cushing’s can lead to muscle weakness, joint stiffness, and general fatigue, especially in older dogs. Maintaining mobility is key to preserving quality of life.
This is where mobility aids, such as dog wheelchairs, can play a helpful role. At Walkin’ Pets, we provide wheelchairs designed for dogs experiencing hind leg weakness, muscle loss, or coordination issues caused by chronic conditions like Cushing’s. By reducing pressure on their back legs and improving stability, a wheelchair can help dogs stay active, go on walks, and enjoy more time with their family.
Can dogs live a good life with Cushing’s disease?
Yes, many dogs with Cushing’s disease live for years with a good quality of life, especially when the condition is diagnosed early and managed properly. Regular veterinary check-ups, proper medication, and a consistent care routine make a big difference.
Monitoring your dog at home is just as important. Look out for signs of new or worsening symptoms, and follow up with your veterinarian if anything seems off.
Supporting their mobility, especially as muscle tone decreases, is also important. If walking becomes a challenge, using a supportive device like a rear dog wheelchair can help them stay mobile and reduce discomfort.
Helping your dog stay comfortable long-term
Managing Cushing’s disease is a long-term commitment. It means keeping up with medications, monitoring symptoms, making regular vet visits, and adapting to your dog’s changing needs. While it can feel overwhelming at first, many pet parents find a new rhythm that helps their dog feel good and stay happy.
If mobility becomes an issue, don’t wait too long to explore options. At Walkin’ Pets, we’ve seen how giving dogs extra support when they need it can help them regain confidence and keep doing the things they love. Whether it’s a short walk in the yard or playing with a favorite toy, mobility aids can help make those moments easier and more comfortable.
Cushing’s may be a serious condition, but with the right care, treatment, and support, your dog can still enjoy a full and happy life.
Frequently asked questions
What is the life expectancy of a dog with Cushing’s disease?
The average life expectancy of a dog with Cushing’s disease is around 2 to 4 years after diagnosis, but many dogs live longer with proper treatment. The outcome depends on the type of Cushing’s, the age of the dog, and how early the disease is diagnosed.
Dogs with pituitary-dependent Cushing’s often respond well to medication and maintain a good quality of life. In contrast, dogs with adrenal tumors may have a shorter prognosis, especially if the tumor is malignant or surgery is not an option.
How can I tell if my dog’s Cushing’s disease is getting worse?
Worsening Cushing’s symptoms may include increased thirst, more frequent urination, worsening hair loss, new skin infections, or signs of muscle weakness. You may also notice your dog slowing down, gaining abdominal weight, or panting more than usual.
If your dog was previously stable on medication and symptoms return or intensify, this may indicate that the treatment is no longer effective or the disease is progressing. Regular veterinary check-ups and lab testing are essential to track these changes and adjust treatment as needed.
Can diet help manage Cushing’s disease in dogs?
Yes, diet can support overall health in dogs with Cushing’s disease but cannot replace medical treatment. A veterinarian may recommend a balanced diet that is low in fat, moderate in protein, and rich in antioxidants to support liver function, immune health, and weight management.
Some dogs benefit from low-sodium foods if they develop high blood pressure. Avoiding excessive treats and managing portion sizes can also help with obesity, which is a common issue in dogs with Cushing’s. Always check with your vet before making dietary changes.
Is Cushing’s disease in dogs painful or uncomfortable?
Cushing’s disease itself is not usually painful, but the symptoms it causes can lead to discomfort over time. Excess cortisol can weaken muscles, reduce energy, and make dogs more prone to skin infections, which may cause itching or irritation.
Joint pain and stiffness can also occur due to muscle loss. If left untreated, complications such as high blood pressure or diabetes can reduce your dog’s comfort and health. Managing symptoms early and keeping your dog active with support tools can help reduce discomfort.
What are the risks of not treating Cushing’s disease in dogs?
Untreated Cushing’s disease can lead to several serious complications over time. These include diabetes, high blood pressure, kidney infections, bladder stones, blood clots, and persistent skin or urinary tract infections. Overproduction of cortisol also suppresses the immune system, making dogs more vulnerable to illness.
In advanced cases, muscle wasting and mobility loss may reduce quality of life significantly. Early diagnosis and proper treatment can prevent many of these outcomes and help your dog stay healthier for longer.
Can Cushing’s disease in dogs be cured?
Cushing’s disease can sometimes be cured, but it depends on the underlying cause. If the disease is caused by a benign adrenal tumor that can be surgically removed, the condition may be cured entirely.
However, most cases are pituitary-dependent and cannot be cured, but they can be managed long-term with medication. Dogs with iatrogenic Cushing’s caused by steroid use may recover if the steroids are gradually reduced or stopped under veterinary guidance. Even when not curable, many dogs live well with proper care.
How often should a dog with Cushing’s disease be monitored?
Dogs with Cushing’s disease typically need to be monitored every 1 to 3 months, especially during the first few months after starting treatment. Follow-up appointments usually include blood tests like an ACTH stimulation test or cortisol level checks to ensure the medication dosage is correct.
Over time, if the dog is stable, the vet may reduce the frequency of visits to every 3 to 6 months. Regular monitoring helps avoid complications from over- or under-treatment and ensures the dog stays comfortable and safe.
Are there natural remedies or supplements that help with Cushing’s disease in dogs?
Some natural remedies and supplements may help support general wellness in dogs with Cushing’s, but they should never replace veterinary treatment. Herbal products like melatonin and lignans are sometimes used to help manage hormone levels, especially in early or mild cases.
Omega-3 fatty acids, probiotics, and milk thistle may also support skin, gut, and liver health. However, not all supplements are safe or effective. Always speak with your veterinarian before starting any new supplement or natural remedy.
Can a dog wheelchair help a dog with Cushing’s disease?
Yes, a dog wheelchair can help dogs with Cushing’s disease if they experience muscle weakness, difficulty walking, or loss of coordination. As the disease progresses, some dogs struggle to support their weight, especially in their hind legs.
A rear-support wheelchair provides stability, reduces strain on joints, and allows the dog to stay mobile and active. At Walkin’ Pets, wheelchairs are designed to be adjustable and lightweight, making it easier for dogs to continue enjoying walks and daily movement even with muscle loss.
Is Cushing’s disease in dogs more common in certain breeds or ages?
Cushing’s disease is most common in middle-aged to senior dogs, typically those over the age of 7. Certain breeds are more likely to develop the condition, especially small to medium-sized dogs.
These breeds include Poodles, Dachshunds, Beagles, Boston Terriers, Boxers, and Yorkshire Terriers. Larger breeds can also develop Cushing’s, but it is seen less frequently. Being aware of your dog’s breed risk and watching for early signs can help with early diagnosis and better treatment outcomes.