Cushing’s Disease in Dogs: Symptoms, Treatment and When to Seek Emergency Care
You know your dog better than anyone. You know the exact spot behind the ears that makes their leg twitch, the specific bark that means "mail carrier," and the routine that signals it’s time for a walk. So, when patterns start to change, such as when the water bowl is empty faster than usual, or they seem to be losing hair—it’s natural to worry.
Is it just old age? Is it a dietary change? Or is it something more serious?
One potential cause for these changes is Cushing’s disease. While a diagnosis of any chronic condition can be scary, understanding the "what," "why," and "how" is the first step in ensuring your pet continues to live a happy, comfortable life.
This guide will walk you through the symptoms, treatment options, and crucial emergency signs you need to watch for.
Understanding the Condition: What is Cushing’s Disease?
To understand Cushing’s disease, we first need to look at the adrenal glands. These small glands, located near the kidneys, are responsible for producing cortisol. You might know cortisol as the "stress hormone." In the right amount, cortisol is vital. It helps your dog respond to stress, control their weight, fight infections, and keeps blood sugar levels in check.
However, too much of a good thing becomes a problem. Cushing’s happens when your dog’s body produces an excessive amount of cortisol.
Cushing’s Disease vs. Cushing’s Syndrome
You may hear veterinarians use these terms interchangeably, but there is a slight technical difference that dictates treatment.
- Cushing’s disease is typically caused by a benign tumor on the pituitary gland (a pea-sized gland at the base of the brain). This tumor signals the adrenal glands to work overtime, pumping out too much cortisol. This is the most common form, accounting for about 80% to 85% of cases in dogs.
- Cushing’s syndrome is the broader term for the condition of having excess cortisol. This can be caused by the pituitary tumor mentioned above, but it can also be caused by a tumor on the adrenal gland itself. Furthermore, it can be "iatrogenic," meaning it is caused by long-term use of steroid medications prescribed for other conditions like allergies or arthritis. Cushing syndrome can also be caused by tumors elsewhere in the body, producing an excess amount of Adrenocorticotropic hormone (ACTH).
Recognizing the Symptoms
Because it typically affects middle-aged to older dogs, the signs of Cushing's disease in dogs are often mistaken for normal aging. However, if you see a combination of the following signs, it is time to schedule a visit with your veterinarian.
1. Increased Thirst and Urination
You might be wondering, "why is my dog really thirsty?" Increased thirst is often the first red flag for Cushing’s that owners notice.
You might find yourself filling the water bowl three or four times a day because your dog is drinking so much water. Because of this, increases in urination* are also common.
*Increased thirst and urination can also be caused by other serious diseases, such as diabetes or kidney disease. Your pet should be seen as soon as possible if they are showing this sign
2. The "Pot-Belly" in Dogs
Does your dog look like they have gained weight around the middle, even if they haven't been overeating? Excess cortisol causes muscle weakness and the redistribution of fat to the abdominal area. This, combined with an enlarged liver (another side effect), creates a distended, pot-bellied appearance.
3. Skin and Coat Changes
You might notice hair loss (alopecia), usually on the body rather than the head or legs. The skin may also become thin, fragile, and prone to infections or bruising. In some cases, hard calcium deposits can form under the skin.
4. Increased Appetite
Cortisol stimulates appetite. Your once picky eater might suddenly become ravenous, begging for food constantly or even raiding the trash.
5. Panting and Lethargy
Excessive panting, even when the dog is at rest or in a cool room, is common with Cushing's. You may also notice they tire easily on walks or are less interested in playing.
How is it Diagnosed?
Diagnosing Cushing’s is not as simple as a single blood test. Because cortisol levels fluctuate naturally throughout the day, a snapshot isn't enough. Your veterinarian will likely start with standard blood work and a urinalysis to check for elevated liver enzymes and diluted urine.
They may also run an additional test on the urine called a urine cortisol-to-creatinine ratio. This can help rule out Cushing's syndrome. However, if the ratio is above a certain number, then additional testing is needed.
If those indicators are present, they will move on to specific hormone testing. The most common tests include:
- ACTH Stimulation Test: Measures how the adrenal glands respond to a hormone that prompts cortisol production.
- Low-Dose Dexamethasone Suppression Test: Involves giving a small amount of man-made cortisol to see if the body suppresses its own production (a healthy dog will; a dog with Cushing’s won't).
- Abdominal Ultrasound: This allows the veterinarian to evaluate the adrenal glands for changes in size or appearance, which can help differentiate between pituitary-dependent and adrenal-dependent disease, even though tumors themselves are not always directly visible.
Treatment and Management
While Cushing’s generally cannot be "cured" (unless it is caused by an adrenal tumor that is surgically removed), it can be successfully managed. For the most common form (pituitary-dependent), medication is the standard route. Drugs like trilostane (Vetoryl) or mitotane work to inhibit the production of cortisol.
It’s important to remember that managing Cushing’s is a marathon, not a sprint. It requires regular monitoring and follow-up blood tests to ensure the dosage is correct. Too little medication won't control the symptoms; too much can lead to dangerous side effects.
With consistent care and regular vet visits, many dogs go on to live normal lifespans with a good quality of life!
Addison’s Disease: The Opposite End of the Spectrum
Inversely, the adrenal glands can also fail to produce enough cortisol and electrolytes. This condition is called Addison’s disease (Hypoadrenocorticism).
While less common than Cushing’s, Addison’s is a serious condition that can be life-threatening if not treated. Interestingly, treating Cushing’s disease too aggressively with medication can sometimes tip the scales too far and induce a temporary Addisonian state.
If you are interested in learning about the signs of low cortisol, you can read our guide on Addison’s disease here.
When to Seek Emergency Care
While Cushing’s is a chronic condition managed by your primary veterinarian, complications can arise that require immediate attention from an emergency veterinarian. Because Cushing’s affects the immune system and blood clotting ability, your dog is at higher risk for certain emergencies.
Do not wait for a scheduled appointment if you notice:
- Sudden Collapse or Weakness: This could indicate a rupture of an adrenal tumor or a sudden drop in electrolytes.
- Difficulty Breathing: Dogs with Cushing’s are at a higher risk for pulmonary thromboembolism (blood clots in the lungs). Rapid, shallow breathing or gasping for air is a critical emergency.
- Seizures or Neurological Signs: If the condition is caused by a pituitary tumor, the tumor can sometimes grow large enough to press on the brain, causing seizures or behavioral changes.
- Severe Vomiting or Diarrhea: Especially if there is blood present; this requires immediate IV fluids and medical support and can be a sign of an Addisonian crisis.
Managing Your Dog’s Health Journey
Receiving a diagnosis of Cushing’s disease changes things, but it doesn't mean the end of your adventures together. It simply means a new routine of medication and observation.
The most important tool in managing your dog's health is your attention. You are the one who sees them every day. You are the one who knows when they aren't feeling right. Trust that instinct.
If you are currently managing a dog with Cushing’s and notice a sudden decline in their health, or if you are unsure if a symptom warrants emergency care, please feel free to call your closest EVCC. We are here 24/7 to provide compassionate, dedicated treatment when your pet needs it most.
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