Cushing's Disease in Dogs

This page is educational reference material for preparing questions. A licensed veterinarian examines the animal, makes the diagnosis, and sets the treatment.

Practical guide to Cushing's disease (hyperadrenocorticism) in dogs. Covers symptoms, diagnosis, treatment options, and managing quality of life.

Causes and Risk Factors

Multiple factors can contribute to the development of this condition.

• Genetic predisposition: Certain breeds are at higher risk due to inherited traits
• Age: Some conditions are more common in puppies/kittens or senior pets
• Environmental factors: Diet, toxin exposure, stress, and living conditions play a role
• Underlying health issues: Other conditions may increase susceptibility
• Immune system status: Compromised immune function can predispose to disease

Symptoms to Watch For

Early detection significantly improves treatment outcomes. Watch for these signs.

• Changes in appetite, water consumption, or weight
• Behavioral changes including lethargy, restlessness, or hiding
• Physical symptoms specific to the affected body system
• Changes in bathroom habits (frequency, appearance, straining)
• Visible discomfort, pain response to touch, or changes in posture
• Respiratory changes, coughing, or labored breathing

Diagnosis

Cushing's disease, hyperadrenocorticism, is confirmed with endocrine tests, then imaging. A high alkaline phosphatase alone does not confirm it. A urine cortisol-to-creatinine ratio is a screen: a normal result makes Cushing's unlikely, and a high result still needs a confirming test. The low-dose dexamethasone suppression test and the ACTH stimulation test are the tests that confirm it. Ultrasound looks at the adrenal glands after those results, to separate a pituitary drive from an adrenal tumor.

Treatment Options

Pituitary-dependent Cushing's is usually managed with a drug that lowers cortisol production. Trilostane is the drug used to lower cortisol. The veterinarian sets the dose from follow-up ACTH stimulation tests. An adrenal tumor can be removed by adrenalectomy when imaging shows it has not spread. Medical control is the alternative when surgery is not chosen.

Prevention and Management

• Regular veterinary checkups (as recommended by the AVMA for all companion animals) for early detection (annually, or semi-annually for seniors)
• Maintain a healthy weight through proper nutrition and exercise
• Keep vaccinations and preventive medications current
• Breed-specific health screenings recommended by your veterinarian
• Provide a low-stress, enriched environment
• Follow your vet's recommendations for diet and lifestyle modifications

Cost of Treatment

Treatment costs vary based on severity and duration.

Is this condition curable?

Pituitary-dependent Cushing's disease, the common form, is controlled rather than cured. Trilostane lowers cortisol and has to be checked with ACTH stimulation tests. It does not remove the pituitary tumor. An adrenal tumor is the uncommon form, and adrenalectomy can be curative in a dog whose imaging shows one adrenal mass and no spread.

How can I afford treatment?

The repeating Cushing's cost is the ACTH stimulation test after each trilostane change, for the rest of the dog's life. An abdominal ultrasound that distinguishes a pituitary driver from an adrenal tumor is an earlier, separate line item. Ask for both figures before the first dose. Adrenalectomy is a specialty surgical quote on top of the medical plan.