Is your middle-aged or senior dog drinking and urinating more than usual? Does your dog have a pot-bellied appearance? These are just a few signs of Cushing’s disease in dogs (also known as hyperadrenocorticism). Integrative veterinarian Dr. Julie Buzby shares symptoms, diagnosis, medications, prognosis, and life-expectancy for Cushing’s disease in dogs.
“Have you ever heard of Cushing’s disease in dogs?” I asked my new veterinary client, the loving parent of a 15-year-old Labrador Retriever, Jake. I knew it was important that we discuss Cushing’s disease at that appointment because Jake’s symptoms were textbook for the condition.
My client had mentioned noticing Jake’s thirst, urination, and panting were increased. These are three cardinal symptoms of Cushing’s disease in dogs. Also, while we were talking, I sat rubbing the thin skin of Jake’s pot belly. (Yes, thin skin and a pot belly are two more cardinal symptoms.)
By the end of our conversation, my client had a good idea of what Cushing’s disease was, tests for Cushing’s, and what the diagnosis could mean for his dog. And I hope you come away from this article on Cushing’s disease with a better understanding of the condition, too.
What is Cushing’s disease in dogs?
Cushing’s disease in dogs (i.e. hyperadrenocorticism) occurs when an older dog’s adrenal glands produce too much cortisol, a stress hormone. Cortisol is the body’s natural steroid and is absolutely essential for day-to-day life. Normally, the body regulates cortisol levels very carefully. But if the amount of cortisol gets out of whack, as occurs in Cushing’s syndrome in dogs, bad things can happen!
What causes Cushing’s disease?
This increase in cortisol levels can occur for three main reasons—a pituitary tumor, an adrenal tumor, or the administration of steroids. Let’s take a look at each of these three types of Cushing’s disease in dogs.
Pituitary-dependent Cushing’s disease in dogs
Approximately 80% of dogs with Cushing’s disease will have pituitary-dependent Cushing’s disease. This type occurs when the dog develops a tumor in the pituitary gland. The pituitary gland is a tiny structure located at the base of the brain that controls the secretion of various hormones.
One of the many hormones that comes from the pituitary gland is adrenocorticotropic hormone (ACTH). This particular hormone, ACTH, is what tells the adrenal glands (paired bean-shaped glands located near the kidneys) to produce cortisol. When a pituitary tumor releases more ACTH than normal, the adrenal glands obediently make more cortisol. And the end result is pituitary-dependent Cushing’s disease.
Do not fear, though! While the phrase “brain tumor” is frightening when used in the same sentence with our beloved dogs, these tumors are usually small and do not spread. Only occasionally does a dog have a larger tumor.
Overall, smaller breed dogs (e.g. Bichon Frises, Miniature Schnauzers, Yorkshire Terriers, Lhasa Apsos, or Jack Russell Terriers) are more likely to have pituitary-dependent Cushing’s disease. And they tend to be middle-aged or older (at least 7 years of age).
Adrenal-dependent Cushing’s disease
In the other 20% of dogs, a cortisol-secreting tumor grows on the adrenal gland instead. This tumor can be benign or malignant (i.e. cancerous). Since the adrenal glands make cortisol, functional adrenal tumors also lead to elevated levels of cortisol in the body. The official name for this form of Cushing’s disease is adrenal-dependent Cushing’s disease.
Unlike pituitary-dependent Cushing’s, adrenal-dependent Cushing’s is more common in medium or large breed dogs. And the average age at the time of diagnosis is 11 years.
Iatrogenic Cushing’s disease
While the pituitary-dependent and adrenal-dependent forms of Cushing’s disease are the two naturally-occurring varieties, there is also a third reason dogs can have Cushing’s disease—iatrogenic Cushing’s disease. The term “iatrogenic” indicates that a medical treatment or procedure accidentally caused the condition.
In the case of iatrogenic Cushing’s disease, the administration of prednisone for dogs or other corticosteroids causes the Cushing’s disease. These drugs mimic the action of cortisol in the body, so they can cause identical symptoms to adrenal or pituitary tumors. However, this is not to say that every dog who takes steroids will develop iatrogenic Cushing’s disease.
What are the symptoms of Cushing’s disease in dogs?
If you have ever taken a steroid (for example, prednisone) for a medical condition, or your dog has been on steroids in the past, you may have some idea of the symptoms of Cushing’s disease in dogs. They tend to be very similar to the side effects that humans and dogs may experience while on steroids.
Changes in thirst, urination, appetite, and behavior
Dogs with Cushing’s disease may change their normal habits or behavior. Some common signs include:
- Increased thirst in dogs (i.e. polydipsia)—occurs in 80-90% of dogs
- Increased urination (i.e. polyuria)—occurs in 80-90% of dogs
- Leaking urine
- Increased appetite (i.e. polyphagia)
- Restlessness, which may include senior dog anxiety at night
- Panting
- Circling, seizures in dogs or other neurologic signs (mostly seen if the dog has a larger pituitary tumor)
- Being a lethargic dog
Affects of Cushing’s syndrome on a dog’s back legs
Since Cushing’s disease can cause muscle wasting or lack of muscle mass, you may notice that your dog’s back legs are collapsing or your dog looks weak. Additionally, due to loss of muscle mass, dogs with osteoarthritis in dogs who develop Cushing’s disease may suddenly have an worsening of the signs of arthritis in dogs.
Senior dogs with Cushing’s disease may have trouble getting up from lying down, be more prone to slipping on the floor, or generally look more wobbly than normal. Additionally, these changes in the muscle mass, especially of the back legs, can make dogs reluctant or unable to continue their normal activity levels.
Changes in skin or abdominal contour
Additionally, you may notice Cushing’s symptoms related to your dog’s appearance, including:
- Weight gain
- Pot-bellied dog appearance
- Thinning skin
- Hair loss
- Dark pigmentation of the skin
- Comedones (i.e. blackheads)
- Poor hair regrowth (may be more noticeable if your dog was shaved for some reason)
- Firm areas of the skin (i.e. calcinosis cutis in dogs)
Increase in conditions related to poor immune system function
Since steroids suppress the immune system, dogs with Cushing’s disease may be more prone to various infections. Skin infections (i.e. pyoderma in dogs) and urinary tract infections (UTI in dogs) seem to be the most common. In fact, about 50% of dogs with Cushing’s syndrome have a UTI at the time of diagnosis, although they may not be symptomatic.
What are the stages of Cushing’s disease in dogs?
While there aren’t well-defined stages of Cushing’s disease in dogs, more and more symptoms may appear the longer a dog has Cushing’s disease. In the early stages of Cushing’s disease, you may notice that your dog is drinking more, urinating more, and eating more but otherwise looks fairly normal.
However, over time the excessive cortisol from Cushing’s disease may weaken the abdominal muscles, cause more fat to accumulate in the abdomen, and increase the size of the liver. Together, those changes can lead to the pot-bellied appearance.
Additionally, as Cushing’s disease progresses, you may notice changes to your dog’s skin and haircoat, increased panting, or more obvious muscle weakness. And your dog may be more prone to infections or show some changes in behavior.
In the final stages of Cushing’s disease, the dog’s symptoms may be severe and greatly impacting his or her quality of life. Your dog may be extremely thirst and hungry all the time or having accidents in the house from producing so much urine. Other symptoms of advanced Cushing’s disease in dogs include struggling to get around due to muscle weakness, painful, inflamed skin, or frequent infections.
How is Cushing’s disease diagnosed?
Sometimes you may see symptoms of Cushing’s disease and schedule a vet appointment. Other times, your vet may suspect Cushing’s disease after talking with you at an appointment. In either situation, the vet will select the diagnostic testing that he or she feels is right for your dog.
Testing to rule OUT Cushing’s disease
Sometimes, I recommend that my client starts with a simple and relatively inexpensive test called a urine cortisol creatinine ratio (UCCR). The UCCR test measures the ratio of cortisol (the hormone overproduced in Cushing’s syndrome) to creatinine (a normal component of urine).
Since cortisol is normally secreted in times of stress, for best results, the client should collect the dog’s urine sample at home, at least two days after a vet visit. This way, the dog doesn’t get anxious from a visit to the veterinary clinic, secrete a bunch of cortisol, and skew the results. Additionally, the first urine sample of the morning seems to provide the best results.
Before I run the test, I always want my clients to understand that the UCCR test rules OUT the diagnosis. But does not definitively rule it IN. In other words, an elevated UCCR doesn’t prove that a dog has Cushing’s syndrome. But a dog with a normal UCCR has a very low chance of having Cushing’s disease. Thus, the UCCR does a very good job of ruling OUT the diagnosis.
This may seem counterintuitive, but it’s actually quite valuable. If the UCCR is normal, we can cross Cushing’s off the list as a possible diagnosis. Then we can move on to figuring out what else could be causing your dog’s symptoms.
And if the dog has an elevated UCCR, this is an indication that we should perform more specific tests to confirm the diagnosis.
Testing to confirm Cushing’s disease
Tests to rule IN Cushing’s (i.e. confirm the diagnosis) are blood tests for dogs. There are three main tests—the ACTH stimulation test, a low dose dexamethasone suppression test, or a high dose dexamethasone suppression test.
ACTH stimulation test
The ACTH stimulation test involves drawing a blood sample to determine a baseline cortisol level. Then the vet will administer synthetic ACTH, which should stimulate the adrenal glands to release cortisol. In dogs with Cushing’s disease, post ACTH blood cortisol levels are usually elevated above what would be expected for a “normal” response to ACTH.
This test is positive in around 80-85% of dogs with pituitary-dependent Cushing’s disease and 60% of dogs with adrenal-dependent Cushing’s. It cannot distinguish between the two types. The ACTH stimulation test is, however, the test of choice for diagnosing iatrogenic Cushing’s disease.
Low-dose dexamethasone suppression test
For the low-dose dexamethasone suppression test (LDDST), the vet will draw a blood sample to obtain a baseline cortisol level. Then he or she will give the dog a low dose of the steroid dexamethasone. In a normal dog, the dexamethasone should tell the body to make less cortisol. However, in dogs with Cushing’s disease, a low dose of dexamethasone will not suppress cortisol production.
The test is positive in about 90% of dogs with Cushing’s disease. And about 50% of the time, it can distinguish between pituitary-dependent and adrenal-dependent Cushing’s disease.
High-dose dexamethasone suppression test
The high-dose dexamethasone suppression test is performed in the same basic way as the LDDST, except it uses a higher amount of dexamethasone. The goal of this test is not to determine if the dog has Cushing’s disease but to attempt to distinguish between the adrenal-dependent and pituitary-dependent forms. Sometimes it is able to do so, but not always.
Each of these three tests has some pros and cons. Your vet will select the one that he or she thinks is right for your dog. In some situations, your vet may recommend more than one of these tests. This is especially likely to be the case if he or she is trying to differentiate between the three types of Cushing’s disease.
Some dogs require further diagnostic testing
Occasionally, the results are still not conclusive. In order to nail the diagnosis, the vet may recommend an abdominal ultrasound to assess the adrenal glands. Or she or she may suggest an MRI or CT, further bloodwork, or other tests.
In addition to tests to rule out or confirm Cushing’s disease, your veterinarian may also recommend a urinalysis and/or urine culture. These tests look for evidence of urinary tract infections, which can be “silent” and accompany Cushing’s disease, especially in female dogs.
How is Cushing’s disease in dogs treated?
In most cases, Cushing’s is a lifelong disease that often requires daily treatment and careful monitoring by your veterinarian. It is a commitment and it can be daunting. However, the good news is that there are several treatment options to help your dog feel better.
Medical treatment for dogs with Cushing’s disease
Often, medications to control cortisol levels are the treatment of choice for managing a dogs with adrenal or pituitary-dependent Cushing’s syndrome long-term. (Treatment for iatrogenic Cushing’s disease just involves carefully weaning the dog off of steroids.)
Common medications used to treat pituitary or adrenal dependent Cushing’s disease in dogs include:
Vetoryl
Vetoryl® (trilostane for dogs) is currently the only veterinary-approved product on the market that treats both the pituitary and adrenal-dependent forms of the disease. It blocks the production of cortisol to bring cortisol levels back to normal.
While side effects of Vetoryl are fairly common, they are thankfully usually mild and only last for a few days. Some of the potential side effects include nausea (which can be decreased by giving Vetoryl with food), vomiting, decreased appetite, lethargy, diarrhea, or weakness.
Lysodren
Another treatment option is a drug called Lysodren® (mitotane). It targets the adrenal glands, which are over-producing cortisol. This medication keeps the glands from producing as much cortisol by selectively killing some of the cortisol-producing cells.
Typically, but not always, the vet will use a two-phased approach to treatment. The first phase, induction, uses higher doses of Lysodren. It is important to watch your dog carefully, especially during this phase. If your dog isn’t eating as much, has vomiting or diarrhea, becomes lethargic, or isn’t drinking enough water, promptly contact your vet. Those symptoms indicate it may be time to switch to the maintenance phase, which uses lower doses of mitotane long-term.
Overall, dogs in either phase may experience side effects such as decreased appetite, lethargy, weakness, vomiting, or ataxia (i.e. unsteady gait). If you see these side effects, it is best to check in with your vet.
Selegiline, ketoconazole or melatonin
Selegiline for dogs, a drug used to manage canine cognitive dysfunction, is also approved to treat the pituitary-dependent form of Cushing’s disease. Also, there are some off-label medication options for Cushing’s disease such as ketoconazole and melatonin for dogs.
However, melatonin and ketoconazole are not approved to treat Cushing’s disease. So they must be used with care and with the understanding that they may not be effective. Plus, if you choose to try melatonin for your dog with Cushing’s disease, please be aware that some products, especially melatonin gummies, may contain xylitol, which is toxic for dogs. Always check the label for xylitol (i.e. birch sugar) before giving melatonin to your dog.
Surgical treatment for adrenal-dependent Cushing’s disease
Additionally, if an adrenal tumor is the cause of the Cushing’s, the affected gland can be surgically removed. This is not a simple surgery and is ideally performed by a board-certified surgeon. Risk of hemorrhage from surgical removal of the gland is significant, as is the risk of other post-operative complications.
Depending on the study you look at, between 10% and 25% of patients may not survive surgery and post-op period. Thus, many pet parents opt to treat their dogs with medical management to avoid the cost and risk of surgery.
What sort of monitoring do dogs with Cushing’s disease require?
It is important to know from the outset that dogs taking medications such as Vetoryl or Lysodren require close monitoring with frequent lab work.
Sometimes these medications can work TOO well and cause the opposite condition—hypoadrenocorticism (i.e. Addison’s disease in dogs). If you notice signs of Addison’s disease such as vomiting, diarrhea, lethargy, tremors, or loss of appetite, contact your veterinarian immediately. Addison’s disease can be life threatening, so it is critical your dog gets veterinary attention right away.
On the other hand, if it seems like your dog’s Cushing’s symptoms aren’t resolving, or if they go away and then come back, you should also give your vet a call. This may be an indication that the Vetoryl or Lysodren dose isn’t sufficiently controlling your dog’s Cushing’s disease. Or it could mean that your dog has developed a concurrent condition with similar symptoms, such as diabetes in dogs.
In addition to monitoring your dog’s symptoms, you will need to bring your dog back to the vet periodically for an examination and follow-up bloodwork. This is important so the vet can determine how well the medications are working.
In the interest of full disclosure, these vet visits can represent a significant financial and time commitment. When initially starting therapy and when making dose adjustments, your vet may need to examine your dog and run bloodwork as often as every few weeks or months.
How can I help comfort a dog with Cushing’s disease?
In addition to treating your dog’s Cushing’s disease and keeping up with the necessary monitoring, here are five more things you can do to be vigilant in managing your dog’s condition.
1. Keep your dog’s water bowl full of fresh clean water
Always have fresh water available. As I mentioned, Cushing’s causes increased thirst and urination, so your dog will want to drink more and need to go out frequently for potty breaks. Make sure you refill the water bowl often and give your dog plenty of opportunities to go potty.
2. Be on the lookout for signs of skin problems
Keep a sharp eye on your dog’s skin. If you notice signs of skin infection such as bumps, crusts, hair loss, or red irritated skin, speak with your vet. It is important that skin infections are addressed promptly. In some cases, your vet may also prescribe antifungal and antibacterial shampoos and wipes to proactively help combat skin infections.
3. Know how to recognize the signs of a UTI
Watch for signs of urinary issues such as increased frequency of urination, foul odor to the urine, straining to urinate, and/or blood in the urine. If you observe any of these signs, take your dog to your veterinarian. For dogs with Cushing’s, urinary tract infections are nearly impossible to prevent. However, you can help your dog by seeking treatment promptly.
4. Partner with your veterinarian
Keep in close contact with your veterinarian about any changes in your dog’s symptoms. You see your dog every day and know your dog better than anyone else. So you are in the perfect position to spot signs that may signal you dog has flipped over to having Addison’s disease or indicate the medications aren’t working. Trust your instincts and reach out to your vet if you have any concerns.
5. Address mobility issues due to Cushing’s disease
If your dog is having mobility issues due to muscle wasting, look for options to minimize discomfort and falling. I recommend the following to many of my clients:
- Keep your dog on carpet
- Avoid slick floors
- Learn how to relieve arthritis pain in dogs
- Choose a soft bed for your dog’s comfort (Consider a memory foam dog bed)
- If possible, avoid stairs
- Consider laser therapy for dogs and physical therapy
- Teach your dog to use ramps
- Additionally, I’ve had many patients with muscle wasting due to Cushing’s syndrome thrive using ToeGrips® dog nail grips. The non-slip grips fit on dogs’ toenails to improve traction on hardwood floors, preventing sliding and falling.
Is my dog in pain with Cushing’s syndrome?
While you are thinking about how to keep your dog with Cushing’s disease comfortable, it is understandable to wonder if Cushing’s syndrome is painful. Thankfully, Cushing’s disease doesn’t cause pain in dogs in the traditional sense of the word. It isn’t like a torn ACL in dogs or intervertebral disc disease (IVDD) in dogs. However, I would argue that it can negatively impact quality of life. Hear me out.
Dogs with uncontrolled Cushing’s disease are thirsty all the time and need to urinate frequently. Sometimes they may have accidents in the house if they can’t make it outside in time. That can be hard on a dog’s dignity. It may also be more difficult for them to rest peacefully since they are prone to panting and pacing.
We can’t know for sure the emotional impact those changes have on a dog. And I’ve seen hundreds of “untreated” Cushing’s patients over the years who seemed fine. However, living with symptoms of Cushing’s is not ideal for the dog nor their family. The good news, though, is that treating your dog’s Cushing’s disease will help get those symptoms under control. This can greatly improve your dog’s quality of life.
What is the prognosis for dogs diagnosed with Cushing’s disease?
The prognosis and life expectancy for dogs with Cushing’s disease can vary depending on which form of Cushing’s disease they have and how well they respond to therapy.
Life expectancy for pituitary-dependent Cushing’s disease in dogs
With pituitary-dependent Cushing’s disease, the moderate-term prognosis is good with treatment. Median survival time (i.e. the point at which 50% of dogs with the condition are still alive) is 2 – 2.5 years. Most of the time, the majority of the clinical signs will go away quickly after starting medication. But it may take about three months for the skin-related signs to resolve. And sometimes symptoms like calcinosis cutis don’t fully disappear.
Unfortunately though, there is a small number of dogs with pituitary-dependent Cushing’s who don’t respond as expected to treatment. Thus, their prognosis may be worse. Additionally, if the dog has a large pituitary tumor rather than the more common tiny tumor, the prognosis is also worse. This is especially the case if the dog is showing any neurological abnormalities.
Life-expectancy for adrenal-dependent Cushing’s disease in dogs
For adrenal-dependent Cushing’s, the method of treatment and whether the tumor was benign or malignant (i.e. cancerous) both impact prognosis and life expectancy. Benign tumors and those that are small and less invasive usually carry a better prognosis. Overall, the median survival time is 1.5 – 4 years (depending on the study) with surgical removal of the tumor. But average life expectancy is closer to one year with Lysodren or Vetoryl therapy.
Concurrent conditions may impact quality of life
Additionally, your dog’s prognosis for either form of Cushing’s disease will also depend on any other conditions your dog may have. If your dog has concurrent medical problems such as diabetes or arthritis, the symptoms from those problems can compound with the symptoms of Cushing’s or make Cushing’s harder to manage. This can contribute to a decline in quality of life.
Knowing when it is time to say goodbye
Despite the fact that dogs with Cushing’s disease have a reasonably high chance of having a good year or several good years, the time may eventually come when you need to consider when to euthanize your dog with Cushing’s disease.
Some dog parents may start preparing for their dog’s euthanasia when they begin to see symptoms of advanced Cushing’s disease that are not controlled by medication. Others may decide to say goodbye because their dog is no longer taking pills well or tolerating the frequent vet visits. Or dog parents may know it is time when the financial toll or pet caregiver fatigue become too much to bear.
Sometimes it may also be a different medical problem, not the final stages of Cushing’s disease, that ultimately mean setting your dog free is the kindest course of action.
There isn’t one universally right time or right reason to make that decision. But your trusted veterinarian and your close friends or family members can help you determine what is right for your dog and your family. And they can help support you as you grieve the loss of your dog.
Don’t lose hope
I know that these statistics and the discussion of the final stages of Cushing’s disease and when to say goodbye may seem grim. But I want you to know that Cushing’s disease in dogs is not a hopeless diagnosis. Yes, your dog may need a risky surgery or daily medication and frequent rechecks with the vet. But once Cushing’s disease is under control, your dog can often have an excellent quality of life for years. And that is huge.
Let me remind you too that you can play an important role in your dog’s health. Watching him or her carefully for symptoms, keeping up with all medication monitoring appointments, and working closely with your vet can all help your dog feel his or her best despite having Cushing’s disease.
This is exactly the pep talk I gave to Jake’s mom when I diagnosed my sweet senior Lab patient with Cushing’s disease. I’m optimistic that he has several happy years ahead. And I look forward to partnering with his mom to provide him the longest, healthiest life possible. The same may be true of your dog too. So don’t lose hope!
What questions do you have about Cushing’s disease in dogs?
Please comment below.
Hello Dr,
Need some help please. Our 6-year-old Dobie, Ren, suddenly started drinking massive amounts of water a little over 3 weeks ago. One night we were sleeping normally in bed, the next night we were sleeping on the couch to let him out every two hours to urinate.
He had an x-ray and ultra sound. His Vet said his spleen looked enlarged but his liver looked about 1/2 to 3/4 the normal size (rough estimate). His ALT was 506, AST 125 and ALP 332. We don’t have any reference x-rays for his liver. No tumors or anything observed. His glucose was normal. Kidneys were healthy. Urine was normal. No pot belly or other symptoms. Other than the constant drinking and urination, he’s as normal as can be, which is usually very high-strung. He comes back in and runs straight to his bowl. He was very lethargic for 2 days after the anesthesia. He didn’t take it well. His Vet thinks it was because of his small liver.
Another set of urine was sent for a culture a week ago for some rare disease normally found with farm dogs (Ren doesn’t live on a farm). The Vet said that if this comes back negative, which he’s guessing it will, he’ll start him on some hormone eye drops to see if this help. I’m guessing this is ostensibly for Cushing’s. After reading your article, I’m not sure why he wasn’t tested for Cushing’s.
Kind of at a loss. Our life and Ren’s life have been severely disrupted. Our Vet has been practicing for 30 years and is a great guy, but we’re a little lost. Should we wait to try the eye drops or seek a second opinion?
Thanks!
Shashi
Hi Shashi,
I understand your concern for Ren and think it is good you are searching for answers. It sounds like your vet is being very thorough and ruling out the diseases that best fit with Ren’s lab work and symptoms. Cushing’s is definitely a possibility, and your vet may decide to do testing after results from these other tests are obtained. I am assuming the rare disease of farm dogs you mentioned is leptospirosis. I always like to test for this if I think there is any possibility of infection. While cows can shed this parasite, it is more commonly spread by rodents. Lepto is actually not that rare and is found in every state in the US, present in urban environments, and is contagious to people! It sounds like the eye drops your vet wants to try next would be desmopressin. This is a way to test for diabetes insipidus (which is what came to my mind first after reading your post). I will attach links to other articles with more information. Hoping a diagnosis can be made and you can partner together with your vet to make a plan for treatment. Wishing you and Ren all the best and praying for a positive outcome.
1. Liver Disease in Dogs: Signs, Symptoms, Causes, Treatment
2. High Liver Enzymes in Dogs: A Vet Explains What It Means
3. Diabetes Insipidus in Dogs: Signs, Diagnosis and Treatment
Hi. My 14 year old rat terrier has liver disease & enlarged adrenal glands. He has an enlarged liver & has has high liver enzymes for years. He’s on Denosyl & Denomarin. His enzymes were in the 100s on January 19 but his most recent bloodwork revealed them to be in the 500s! He’s also on anti seizure medication. He’s had X-rays of his abdomen & chest & throat. And a liver aspiration. Only thing that was found was enlarged liver & adrenal glands. We’re almost positive he has Cushing’s but haven’t tested him. Should we put him through testing? Is it worth it? If he does have it, is it worth getting treatment at this point? He’s already drinking more water than usual & has a DECREASE in appetite which our last Cushing’s dog had at the end stage of her life. He’s also been sleeping a lot. Thanks.
Hi Mrs. Christine,
I am so sorry your senior boy is dealing with so many issues at once. I am not sure there is truly a right or wrong way to proceed, it all depends on what you are most comfortable with. It would not be wrong to pursue testing and treatment, but I am a strong advocate for palliative and hospice care as well. Trust your intuition. You know your pup better than anyone. If you want to make him comfortable and let him live out his days, then that could be the most loving option. Here is a link to another article with good advice and great comments from other readers: When To Euthanize A Dog With Cushing’s Disease: A Vet’s Advice
Wishing you both peace and strength to face each new day. Bless you and your sweet boy.
Thank you. So now he’s no longer eating kibble & hasn’t for a while. He was eating eggs, chicken, ground beef & steak depending on his mood for a while. Recently he stopped eating those. He will, however, eat freeze dried beef dog food. He’ll also eat liver treats. Still drinking lots of water & sleeping a lot. Has good energy when he’s awake. I just need to make sure I don’t let him go too soon. I keep waiting for some kind of sign. All our other dogs that have passed, I knew it was time & I don’t think we waited too long or let them go too soon. I don’t think he’s suffering yet. Any advice?
Dear Christine,
I understand how difficult it can be to determine when is best to say goodbye to a beloved dog. I am glad your boy is still eating, but the presence of an appetite does not necessarily equal a good quality of life. Is your pup still happy to receive affection from you and other family members? Does he still do things that bring him joy (playing, going for walks, watching birds out the window, etc.)? Would you say he is truly living or just merely existing? I always think it is better to say goodbye one day to early rather than one day too late and allow unnecessary suffering. I will attach links to other articles with more information on making this hard choice and great advice from other readers as well. Hoping you will know when it is time to give your boy the freedom and rest he deserves. Bless you and take care. ♥
1. Using a Quality of Life Scale for Dogs
2. Dog Euthanasia: Knowing When to Say Goodbye
3. Preparing for Your Dog’s Euthanasia: 10 Thoughts for Peace
Our Doxen, Precious, has Cushins and is 14 years old. She is on the Vetoryl 60 mg and 30 mg 60 in am, 30 nite time. Our vet has been real good treating her. She has suddenly not wanting to eat as usual. We have tried a lot of foods people and regular dog food. She ate Fresh Pet but not now snifs and walks away. I need suggestions of what to try that she might eat. She can’t keep going and not eating. I would appreciate help. Also, She has the test stim every 3 months. Our vet tests her as you stated.
Hi Pat,
I am sorry Precious is not eating well. I understand why you are concerned and agree this sounds worrisome. Without examining her myself, I can’t make specific conclusions or recommendations. Is your vet aware of this recent change in your dog’s appetite? They may need to do some testing to narrow down the cause. An appetite stimulant might be helpful, and I encourage you to discuss this with your vet. Hoping there will be a way to restore your sweet girl’s quality of life. Bless you and your Dachshund, Precious.
My 14 year old Mexican rescue pup for at least a year isn’t the keen walker he was; also struggles to get his rear end up on his rear legs, especially on lino or wood floors in house. When out walking or short distance to pee, his rear end trembles. He pants frequently, drinks a lot, and all day, if not sleeping, needs out to pee; since last October has begun peeing inside unless I’ve let him out soon enough…but at least always on the newspapers covering the plastic protection over the hardwood floor, along the same wall of his room. In the evening, after being fed, the agitated pacing has increased! 4 weeks ago, my vet analyzed urine and blood samples, which showed nothing of concern, although he mentioned Cushings disease, could be an issue. He sent us home with Fluoxetine, which finished 3 days ago, perhaps it helps the agitation and more frequent urinating! Beginning tomorrow, vet clinic opens, so I can call to pick up more. I accept that he’s got CCD, and don’t want to wait too long before deciding to euthanize him, since he’s been a strong survivor of a rotten start in life, but don’t want to put him through un-needed vet visits, since he gets so anxious there, nor can my patience with dealing with the soaked newspapers, or the incessant pacing in the evening.
Dear Karen,
I am sorry your senior guy is struggling a bit, and his health is beginning to decline. I agree, it would be a kindness to offer your boy peace instead of more stress and hardship. I know that deciding on the “right time” is difficult. But I encourage you to trust your intuition as you know your boy better than anyone. Wishing you both strength and comfort as you navigate this emotional path. Bless you.
I’m starting to suspect that my 8 year old cattle dog mix might have Cushings. It was first mentioned 1.5 years ago when I took her in for frequent urination thinking it was a uti which came back negative. 3 months she developed grand mal seizures and has had 2 so far in which she is now on Potassium Bromide. Her thirst and urination is still so excessive, her appetite has increased, back legs are showing weakness, and she is panting so badly when at rest mainly at night. I am waiting to get in to the vet to talk about testing but I guess my question is with her now developing seizures and if she has cushings, I am really worried about her quality of life but don’t want to think about euthanasia too soon.
Hi Michele,
I am sorry your girl is dealing with seizures and possibly Cushing’s as well. I understand your concern about her quality of life and think it is good you are reaching out for advice. While there is no way to know how things will progress, I do think it would be worth pursuing testing for the Cushing’s disease. Most dogs show vast improvement once Cushing’s treatment is started. Many owners talk about how their senior dog almost seems like a puppy again. Hoping you can make the best choice for everyone involved. Praying your sweet girl still has many happy years ahead.
Hi Julie,
Thanks for this article. Thanks for sharing this information! My dog is 7 years old and has been diagnosed with Cushing’s disease.
Is it possible for the potted stomach to disappear with treatment? Additionally, she used to love walking, but now she doesn’t. Can she go for walks again?
Thank you.
Hi Rebecca,
I am glad to hear the article was helpful and informative. I hate that your senior girl has received this difficult diagnosis but am hopeful you can get things stabilized quickly. It is possible for the “potbellied” appearance to decrease a bit with treatment, but it will probably still be noticeable for the majority of Cushing’s dogs. You should see an increase in her energy level and also a decrease in water consumption and frequency of urination (if your girl is experiencing these symptoms). Praying your pup will start to feel better soon and wishing you both many happy years ahead!
Do you not recommend lignans and melatonin for Cushings? It has been recommended by an internal medicine specialist for our sheltie with Cushings disease.
Thank you
Hi Kathy,
There are many supplements that can be very beneficial to Cushing’s patients. You are correct that melatonin is gaining more attention and showing positive results when used as part of the treatment plan for this disease. This article was published back in May of 2021 and intended to cover the basics. We routinely go through older articles and try to update them to the most recent information available. I am sure when this article comes up for review that supplements will probably be added and discussed. Thank you for calling this to my attention. I will pass this along to the team!
Hello, I have a Service Dog my Chocolate Lab. She is almost 12 yrs old. I never had tested for Cushings but the signs are there.
I’ve took 2 approaches.
1. Equine Vet very smart but busy so he’s no nonsense, he prescribed Ketoconozole didn’t work. Made her symptoms worse.
2. The Holistic approach, seems to have everything in check with all cortisol issues However skin gets better to worse to ok to bad it’s never ending.
Needless to say I have my baby on Prana Pets Holistic regimen.
A. Adrenal suppressant 10-12 drops
B. Immune Support
C. Melatonin and Lignins pills ( will knock your dog out be careful) I do not use CBD and Melatonin together.
D. Liver support liquid drops.
E. Joint support liquid.
I’m on it daily with her. I give cooked organic egg white in her food, coconut oil I melt in her food mix up to help with skin.
She’s also had TPLO surgery less than a year ago. So we really watch that close. Her legs do get weak I do walk her to prevent atrophy. (very short walks) this seems to help and believe me I’ve treated her with everything. Now working on her skin issues. Good luck but I’d really try prana pets (combo) their customer service is awesome as well.
I’d get the complete kit includes melatonin & lignan. pills, adrenal support, immune support and CBD around $200 give or take a little less last way over a month. I give 2/ things 4-5 times a day. (10 drops ea. of adrenal and immune support. Melatonin at night (1) pill always. Any more eyelids droop…. DONT DO IT!
CBD when legs hurt but not with Melatonin….
Every once in a while it’s carprofen for inflammation because surgery and arthritis. But watch liver. Feel free to reach out anyone if questions
Rick 716-803-5479 cell
Hi Rick,
It sounds like your senior girl is doing well and it is clear she is dearly loved. Thank you for sharing your experience with us! Wishing you and your pup all the best. Take care!
Hello. My 9 year old Maltese/Yorkie mix was diagnosed with Cushing’s disease, She has been successfully taking Vetoryl (20 mgs daily) for the past 14 months. We do have her dosage monitored regularly with blood work and ACTH testing. However, I have noticed at night she seems to be too warm and sleeps on the cooler tile floor off/on during the night. Is this a normal condition of Cushing’s? Also, will the appetite she developed with Cushing’s ever subside? she used to only eat until she her hunger was satisfied, now she seems to be hungry all the time. Is this normal for treated Cushing’s? Thank you.
Hi Shirley,
I am glad your pup seems to be doing well with treatment and your vet is monitoring things closely. Yes, the behavior of seeking cool surfaces is common and should not be cause for worry. A ravenous appetite is a symptom of Cushing’s disease and is also common with steroid administration. Some dogs will have their appetite return to normal with treatment while others just see a slight improvement. Resolution of symptoms can be a way to evaluate how well the treatment is working. Please make sure your vet is aware this is persisting. They may decide to adjust your dog’s dosage of Vetoryl or may think it is not worth the risk of your girl becoming unregulated. Wishing you both the best. Keep up the good work!
HELLO, Please I need help on what I should do, I need an advice on what I should do. my dog has been diagnosed with Cushing disease just recently she’s 14 years old and this more small shih-tzu. she’s the only family I have. I currently don’t have the money to take her to vets and get treatment right away but she’s been having it for almost a year and a half now and I didn’t know I thought she was just getting a bit bigger and older so I really just put her on a diet to limit her food portion, and even had her exercise more. I started noticing the patches and her skin her tail losing for her eyes building too much eye boogers and becoming white and cloudy almost a bit blind, she survived two strokes, she can’t even walk anymore, her back legs has gotten too weak and she doesn’t have any desire to eat or drink water, it’s been about 2 days and a half now, she is heavy breathing and just laying down and sleeping majority of the time. I just want to know how much time she has left is what I can do it treat her in the meantime until I get money take her to the vet, please email me back very soon, I need answers please.
Dear Esmeralda,
I am so sorry your girl’s health is declining and you are in this difficult situation. From what you describe, it sounds like she may be nearing the end of her life. I know you mentioned there are financial issues and a vet visit is not an option. Without immediate treatment I am afraid you may have to make some tough choices about saying goodbye. Hoping you were able to get the help you needed for your sweet girl.
Our 11-tr ld Yorkie, Bella, has been diagnosed with Cushing. She does not pant so much anymore, nor does she have a pot belly or skin problems, but she refuses to eat her food endlessly barking all day for treats. Is this normal, and how can we get her to quit her endless barking at us?
Thanks, Paul & Jill Belcher
Hi Paul,
I understand your concern for Bella and these worrisome behaviors she is displaying. Without examining your dog, myself, it is hard to make specific conclusions or recommendations. It would be a good idea to discuss these problems with your vet. They can let you know if Bella’s medication needs to be adjusted or if diet changes might help. Bella may be starting to show some early signs of dementia/canine cognitive dysfunction and your vet can explain this in greater detail if they suspect it could be an issue. I am hopeful you can find a way to make Bella more comfortable and content. Wishing you both the best.
My vet is pretty certain My dog has Cushing’s disease. He is a 14 year old Bichon…they did do a blood test & Although he is my only child. I don’t have the money to see for certain. Harley does have all the symptoms.
And I don’t know if he is suffering. He’s the only dog I have had as an adult and I don’t.
know how to tell if he’s suffering. I would appreciate any advice you may have..
Hi Felecia,
I am sorry you are in this difficult situation with Harley. I understand that it can be hard when you want to do what is best for your boy but there are financial constraints that limit the options. Please make sure your vet is aware of the circumstances. They may have some ideas about how to proceed with the care Harley needs with also being mindful of your concerns. Also, it is ok to focus on quality of life and discuss palliative care if that is something you would be comfortable with. I am hopeful you will find a way to do what is best for everyone involved. Wishing you and your sweet boy many happy days ahead.
My dog developed a rare condition called Autoimmune Neutropenia. Without Prednisone his neutrophil count will drop to unsustainable levels and he develops a high fever. However, after a year on the Prednisone he is developing signs of Cushing’s disease. ‘
I feel we are caught between a rock and a hard spot- continue with the prednisone to control the autoimmune disease and at the same time create iatrogenic Cushing’s syndrome.
Looking any advice or suggestions you may have.
Thank you for your time and consideration.
Kris
Hi Kris,
I am sorry you dog is struggling with this rare autoimmune disease. It is difficult to balance the good with the bad when it comes to needing immunosuppressive medications to remain stable. My best advice is to schedule a consult with an internal medicine specialist. They can let you know if there are other treatment options that could give the same benefits without the harsh side effects. It may be possible to slowly switch your dog over to a different medication like cyclosporine, but this would be best discussed with your vet. I hope you can find a good solution that allows your pup to feel good and continue to thrive. Best wishes to you both.