Cushing’s disease in dogs, also called canine hyperadrenocorticism, is one of the most common endocrine disorders in middle-aged and senior dogs. This condition develops when the body produces too much cortisol, a stress hormone that affects nearly every organ system. Pet owners often ask: “What is Cushing’s disease in dogs?” or “Can dogs get Cushing’s disease?” - the answer is yes, and while it is manageable, it requires lifelong care.
This article reviews the causes, symptoms, treatment options, diet considerations, and life expectancy of dogs with Cushing’s disease. It also addresses common owner concerns, including whether the disease is painful, whether it can cause neurological dysfunction or blindness, and how to care for a dog in the later stages of the condition.
What Causes Cushing’s Disease in Dogs?
Cushing’s disease has three main forms:
- Pituitary-Dependent Hyperadrenocorticism (PDH): Caused by a benign pituitary tumor; accounts for 80–85% of cases.
- Adrenal-Dependent Hyperadrenocorticism (ADH): Caused by an adrenal gland tumor, which may be benign or malignant (owners often ask: “Is Cushing’s disease cancer in dogs?” - sometimes yes).
- Iatrogenic Cushing’s Disease: Caused by long-term corticosteroid use (e.g., prednisone can cause Cushing’s disease in dogs).
Dog breeds prone to Cushing’s disease include Poodles, Dachshunds, Terriers, Beagles, and Boxers. While not strictly hereditary, certain genetic factors may increase risk. Importantly, Cushing’s disease is not contagious and is not linked to vaccines.
Symptoms of Cushing’s Disease in Dogs
Recognizing early cushing’s disease dog symptoms can improve outcomes.
Classic Signs
- Increased drinking and urination (PU/PD)
- Excessive appetite (polyphagia)
- Pot-bellied appearance
- Hair loss & thin skin (owners ask: “Will hair grow back on dogs with Cushing’s disease?” - sometimes, if managed)
- Panting, lethargy, muscle weakness
Behavioral Changes
Some dogs experience restlessness, anxiety, or changes in temperament - often described by owners as “cushing’s disease dog behavior.”
Complications
- Neurological dysfunction: Pituitary tumors can press on the brain, causing circling, seizures, or vision loss (“Can Cushing’s disease in dogs cause neurological dysfunction or blindness?” - yes, in advanced cases).
- Cardiovascular issues: Hypertension and blood clots may increase stroke risk.
- Metabolic disease: Elevated liver/pancreas enzymes, pancreatitis, and even diabetes.
- Orthopedic issues: Weak ligaments, lameness (treatment can help but not always fully correct).
Is Cushing’s disease painful in dogs?
The disease itself is not usually painful, but complications like pancreatitis or skin lesions can cause discomfort.
Diagnosis and Misdiagnosis
When to suspect HAC
Compatible signalment and hallmark signs, plus exam and routine lab changes: stress leukogram, elevated ALP, hypercholesterolemia, low urine specific gravity/proteinuria, recurrent UTI.
Screening and confirmatory testing
- ACTH stimulation test or low-dose dexamethasone suppression test (LDDS) are the most used confirmatory tests; each has strengths/limitations depending on clinical context.
- Urine cortisol:creatinine ratio is highly sensitive but nonspecific - use to screen low-risk dogs or rule out HAC; positives need confirmation.
Differentiation (PDH vs ADH)
- Abdominal ultrasound (adrenal size/architecture, vascular invasion, metastasis).
- Endogenous ACTH (eACTH) concentration.
- Selectively, high-dose dexamethasone suppression (HDDS).
Common diagnostic pitfalls
Non-adrenal illness, recent steroid exposure, and lab artifacts can muddy results; interpret tests in light of clinical signs and repeat if discordant.
Treatment Options for Dogs with Cushing’s Disease
Conventional medical therapy (gold standard)
Trilostane (Vetoryl®) inhibits 3-β-HSD, reducing cortisol synthesis.
- Dosing & monitoring: start with label-guided dosing; ACTH stimulation tests and clinical assessment at 10–14 days, 30 days, 90 days, then every 3 months (or as clinically indicated). Monitor electrolytes for hypo-/hyperkalemia, watch for GI upset, lethargy, or rare adrenal necrosis/Addisonian crises.
Mitotane (Lysodren®) causes adrenocortical necrosis; effective but with a narrower therapeutic window and structured induction/maintenance plus ACTH-stim-based monitoring.
Both drugs require owner education about signs of over-control (anorexia, vomiting, lethargy, collapse) and the need for timely rechecks/dose adjustments.
Surgical and radiation options
- Unilateral adrenalectomy is treatment of choice for resectable ADH; outcomes vary with tumor type/size and invasion.
- Pituitary radiation therapy improves neurologic signs and can extend survival in dogs with macrotumors; hypophysectomy is available at specialty centers and offers disease control in experienced hands.
Nutrition & integrative care (critical appraisal)
Dietary principles (supportive, not curative):
- Maintain lean body condition and adequate high-quality protein; use moderate fiber and restricted fat if there is a history or concern for pancreatitis (fat targets vary by patient and product - often ≤8–15% fat on a dry-matter basis under veterinary guidance). Use WSAVA nutrition guidelines for individualized plans; avoid unbalanced home-prepared or high-fat/raw diets in at-risk dogs.
Herbals/nutraceuticals (evidence check):
- Lignans/melatonin: sometimes used (especially in so-called “atypical” HAC with sex-steroid excess), but controlled clinical evidence remains limited; they may be considered as adjuncts with clear goals and monitoring - not replacements for proven therapy when cortisol excess is clinically significant.
- Hepatoprotectants (e.g., SAMe, silymarin) are commonly used empirically for steroid hepatopathy; evidence for outcome improvement is limited but safety is favorable.
- Mushroom supplements (e.g., turkey tail/PSK/PSP): no peer-reviewed evidence supports efficacy in HAC; avoid therapeutic claims and discuss product quality/Drug-Supplement interactions. (Inference from absence of HAC trials; oncology data do not generalize.)
Managing comorbidities
- Hypertension: monitor BP; treat per small-animal guidelines.
- Diabetes mellitus: insulin therapy and diet; HAC control may improve insulin resistance.
- Proteinuria/thromboembolism risk: manage with antithrombotic strategies when indicated.
Pancreatitis: low-fat, highly digestible diets and standard pancreatitis care reduce recurrence risk.
Diet & Nutritional Support
Many owners ask about the best dog food for Cushing’s disease or the role of diet in management.
- Best dry dog food for Cushing’s disease: Look for formulas with high-quality protein, moderate fiber, and controlled fat.
- Alkaline diet for dogs with Cushing’s disease: Some holistic practitioners suggest alkaline-leaning diets, though research is limited.
- Specific foods: Lean meats (including beef in moderation), sweet potatoes, and high-fiber vegetables may be beneficial.
Always consult a veterinarian before making diet changes, especially if your dog also has kidney disease or diabetes.
Prognosis & Life Expectancy
- With treatment: Many dogs live 2–4 years, sometimes longer, depending on tumor type and comorbidities.
- Without treatment: Cushing’s disease progresses, shortening lifespan and lowering quality of life.
- End stages of Cushing’s disease in dogs: Severe neurological signs, uncontrolled diabetes, repeated infections, or organ failure.
Can a dog die from Cushing’s disease? Yes. Dogs may pass from complications such as stroke, blood clots, pancreatitis, or cancer. While not typically curable, Cushing’s disease is manageable with proper veterinary care.
Owner Considerations
- Cost to treat Cushing’s disease in dogs: Initial diagnostics can cost several hundred dollars; long-term medication and monitoring often exceed $1,000–2,500 annually.
- At-home care: Keep water accessible, feed a tailored diet, and schedule regular vet visits.
- When to euthanize a dog with Cushing’s disease: When symptoms can no longer be controlled, and quality of life is poor, humane euthanasia may be the kindest choice.
Conclusion
Cushing’s disease in dogs is a complex but treatable condition. With early diagnosis, the right combination of medication, dietary support, and close veterinary monitoring, many dogs enjoy a good quality of life for years after diagnosis.
For more information or to schedule an evaluation, contact Oklahoma Veterinary Specialists - we’re here to help guide your pet’s care every step of the way.
.jpg)
