As our senior dogs age, they may face a variety of health challenges. In fact, there are so many conditions we are encouraged to watch out for that it can be overwhelming.
One common condition as they age is Cushing’s disease in dogs.
But what is Cushing’s disease? What does it mean for your senior dog? What can you do to help?
In this article, we’re going to look at the important facts about this condition, including what it is, the signs to look for, how it’s diagnosed and how to help your dog if they are given this diagnosis.
Updated: Sept 4, 2023
What Is Cushing’s Disease in Dogs?
Let’s start at the very beginning… What is Cushing’s disease in dogs, and what does that mean for your dog’s quality of life?
Cushing’s disease is a medical condition that results from an overproduction of the hormone cortisol.
While this hormone is essential for many bodily functions, in an excessive amount, it can lead to a range of health problems.
The development of Cushing’s disease can be broken down into the following steps:
- The pituitary gland (at the base of the brain) produces a hormone called ACTH
- ACTH stimulates the adrenal gland (on top of the kidneys) to produce glucocorticoid hormones/corticosteroids (Cortisol)
- Something goes wrong in the pituitary or adrenal glands
- Too much cortisol is produced by the adrenals
- Cushing’s disease develops
The Two Types of Cushing’s Disease in Dogs
Pituitary-Dependent
This means the pituitary gland (a pea-sized gland at the base of the brain) is overproducing cortisol due to a tumor or enlargement of the gland.
It is the most common form, affecting around 80%-85% of dogs.
Adrenal-Dependent
A tumor in one or both of the adrenal glands (on top of the kidneys) is responsible for about 15%-20% of cases.
Approximately half of these will metastasize (spread)
A Third Type…
I did say there were two types, but “iatrogenic” Cushing’s disease occurs due to high doses of steroids over a long period of time.
Once the steroids are discontinued, symptoms should go away.
If your dog takes steroids, they must be gradually weaned off them over several weeks because it is too dangerous to stop them abruptly.
What Role Does Cortisol Play
If cortisol has the potential to cause so many problems, why is it even present?
The truth is that cortisol plays many vital roles in your dog’s day-to-day life. Some examples of the functions that it plays include:
- Helps your dog cope with physical and emotional stress
- Suppresses inflammation
- Helps with wound healing
- Supports muscle and ligament health
- Controls weight
- Necessary for proper brain function
- Maintains bone health
- Fights infection
- Maintains regular blood sugar (glucose) levels
Signs of Cushing’s Disease in Dogs
Cushing’s disease comes on very slowly, and the first signs you tend to see are your dog having to drink and pee more frequently.
I cannot stress enough the importance of making an appointment with your vet when you notice any physical or behavioral changes.
Unfortunately, these changes are usually just attributed to the natural aging process, but in most cases, they signal a problem.
Other Cushing’s disease symptoms in dogs to watch our for include:
- Increased hunger
- Weight gain
- Hair loss
- Potbelly/abdominal swelling
- Thinning skin
- Tired, lethargic, and inactive
- Skin infections
- Muscle loss
- Fat accumulation on the neck and shoulders
- Hypertension
- Housebroken dogs may start to have “accidents”
- May bruise easily
- Bladder or kidney infections
- Panting
- Susceptible to blood clots
How is Cushing’s Disease Diagnosed?
It can be challenging to diagnose because the symptoms are pretty mild in many cases, especially in the case of senior dogs.
Often in older dogs, the symptoms are attributed to natural aging and overlooked.
In addition, many of the signs are similar to other conditions, and there is no one definitive test for Cushing’s disease in dogs.
During your appointment, your vet will want to hear your concerns and what new behaviors you’ve noticed.
If you’re going to a new vet, they will need a detailed medical history. You may want to have your dog’s notes emailed over ahead of your appointment.
Once you have had a chat, your vet will examine your dog. They will then take blood and urine for testing.
Thank about bringing a urine sample with you to make things easier.
Urine should be collected less than 2 hours before your appointment. Use a clean container.
If your vet suspects a Cushing’s disease diagnosis is a possibility based on the above, there are further tests they can run for confirmation. They include the following:
Urine Cortisol: Creatinine Ratio
This test measures the cortisol:creatinine ratio in your dog’s urine.
If it is high, further testing will be needed because there are other explanations for this result, not just Cushing’s disease.
Low-Dose Dexamethasone Suppression Test (LDDST)
The next test would be the low-dose suppression test, which is the most common. It involves taking a blood sample to measure a dog’s baseline cortisol level.
A man-made version of cortisol called Dexamethasone is injected into your dog, and then blood cortisol levels are measured after 4 hours and 8 hours.
The pituitary gland should mistake it for cortisol and tell the adrenal gland to stop producing it.
In a “healthy” dog, there would be a significant decrease in blood cortisol levels.
But if the levels are high, it could mean a pituitary tumor that continues to produce ACTH or an adrenal tumor that continues to produce cortisol.
Just a reminder of what ACTH is – Adrenocorticotropic hormone produced in the pituitary gland in the brain that regulates cortisol levels.
High-Dose Dexamethasone Suppression Test
Same as the low-dose test except more Dexamethasone is given.
ACTH Stimulation Test
Blood is drawn before and after a shot of ACTH to see how the hormone affects your dog.
Abdominal Ultrasound
An abdominal ultrasound will allow your vet to see the adrenal glands and whether a tumor is present.
Who Is at Risk of Developing Cushing’s Disease?
I have read reports that say it doesn’t discriminate based on sex or breed.
Other reports say breeds like Beagles, Boston Terriers, Dachshunds, Yorkies, Poodles, and Boxers are more prone, and females slightly more than males.
I’ve also read it tends to happen around 6 or 8 years of age, making Cushing’s disease in older dogs more common.
Please don’t start panicking if you have one of the breeds mentioned because it does not mean your dog will develop Cushing’s disease.
Carry on caring for him as you do, and as I mentioned above, see your vet if you notice any changes.
Treatment for Cushing’s Disease in Dogs
If your dog has iatrogenic Cushing’s disease, we know it is caused by steroid use. So, stopping their use is the obvious way to reverse the condition.
Your vet will help you do that with a withdrawal schedule.
Since there is a strong possibility that the original condition being treated will return, be sure to speak to your vet about alternative treatments.
If your dog has Adrenal Dependent Cushing’s disease, the tumor could technically be removed by surgery.
However, they are often impossible to see, may have already spread, the operation is tricky, and post-op complications are a big enough concern that it is not commonly done.
The following information about treatment options was taken from the FDA website:
“Vetoryl (trilostane) is the only drug approved by FDA to treat both pituitary- and adrenal-dependent Cushing’s in dogs. This prescription drug works by stopping the production of cortisol in the adrenal glands. Vetoryl should not be given to a dog that
- has kidney or liver disease
- takes certain medications used to treat heart disease
- is pregnant
The drug’s most common side effects are poor or reduced appetite, vomiting, lack of energy, diarrhea, and weakness. Occasionally, more serious side effects, including bloody diarrhea, collapse, severe sodium/potassium imbalance, and destruction of the adrenal gland may occur, and may result in death.
Only one other drug, Anipryl (selegiline), is FDA-approved to treat Cushing’s disease in dogs, but only to treat certain cases caused by a pituitary tumor.
In the past, veterinarians often used a chemotherapy drug approved for people called Lysodren (mitotane) “off-label” to treat Cushing’s in dogs. Lysodren destroys the layers of the adrenal gland that produce cortisol. It requires careful monitoring and can have severe side effects.”
“Extra-label” or “off-label” refers to drug use in a way not outlined on the drug’s label.
These uses aren’t studied as closely as the intended use (which is why they are off-label), which may result in an unpredictable reaction.
Understanding the potential side effects is critical to making an educated decision on whether you are willing to take the risk with your pet.
If you’re interested in alternative treatments, there are options for you to explore.
Having said that, please do not stop the treatment your veterinarian recommended without discussing your options.
There may be a way to integrate the two, or if your vet is completely opposed, find a holistic vet and schedule a consultation to discuss alternatives.
What is Your Dog’s Prognosis?
So, your dog has been diagnosed with Cushing’s disease. Now what? Is Cushing’s disease fatal in dogs?
The prognosis will vary from dog to dog depending on several important factors. Therefore, this is a conversation you are going to want to have with your vet.
Some factors that they will consider include:
- Your dog’s overall health
- The type of Cushing’s disease they have
- Their response to the treatment
- If the tumor spread and if it is causing other issues
Final Thoughts: Life with Cushing’s Disease
Contact your veterinarian if you suspect your dog may be showing signs of Cushing’s disease. They will run the necessary testing to reach a diagnosis and recommend a treatment plan.
Follow your dog’s treatment plan to the letter, discussing any potential alternative treatments with your vet before making changes. Keep up with regular vet checks and testing to stay on top of any new developments.
At home, focus on providing your dog a low-stress, quiet life.
Feed your dog a high-quality, nutritious diet, paying careful attention to their daily meals and any treats you are giving them.
Watch out for new symptoms or signs of change, and maintain open communication with your vet. This will allow them to adjust your dog’s treatment plan as needed.
With treatment and management, many dogs with Cushing’s disease will go on to live a long, happy life.
Does your dog have Cushing’s? What symptoms did you start to see that had you concerned? What tests did your vet carry out to arrive at this diagnosis? What treatment is your dog on, and how is he doing? Sharing helps others, so please leave your comments below.
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Hi Hindy,
Great information about taking care of older dogs. Dogs is a man best friend and a lojal companion. It’s really incredible that you have this website and so much information about caring for senior dogs.
Well written about cushing and how to take care of it. I have friends that have dogs and I will recommend this site to them.
Have a nice day and keep up the good work 🙂
Nam
Hello Nam, thank you very much for your comment, and I’m so glad you like the information on my site. My goal is to provide as many resources as I can, to help people caring for older dogs. I’m very happy if you want to recommend this site to people you know who have dogs. I can help with dogs of any age, so please be sure to let them know if they have any questions, to contact me.
Great explanation of this disease. I think one of the main problems with pet owners is they don’t want to spend the money on their pets so don’t go to the vet regularly. My vet said in this current economy he’s seen a dramatic drop off in annual visits. It’s one of the first things people cut back on when money’s tight. So, the pet suffers, shame really!
Great post, thoroughly enjoyed it!
Hi Peter, thanks very much for taking the time to comment, and so glad you enjoyed the post. I agree, pets definitely suffer when we don’t take them to the vet as often as we should. Sadly it feels like you have to be rich to afford to share your life with a pet these days. My senior dog Red is costing us thousands and thousands, with no break, ever, from the vet. I recently started researching some of her medications in order to buy online, and the difference in price really is staggering. When a vet would rather put down an animal that could be treated, than allow the client to spread out payments, there’s something very wrong.
I’m interested in knowing the side effects of the medications for Cushings.
Thank you.
Hello Kim and thanks for your comment. I’m afraid I can’t answer that question. There are various medications and treatments available, and I have no idea what your vet will recommend. One he/she decides on the best treatment plan for your dog, he will discuss any possible side effects.
My 13 yo staffy just died of Cushings! Such a ugly disease. When will research discover a cure?? I understand Cushings is becoming more prevalent. This is unacceptable!! My sweet girl suffered very much!
I’m very sorry to hear that Linda, I know how tough it is to say goodbye.
Thank you for this information. I have heard of Cushings in dogs before but never quite understood what it was, the causes or symptom to look out for – and apparently there are many.
I think it’s a bit misunderstood and can go undiagnosed, particularly because it shares symptoms with other conditions. Hopefully by highlighting this disease senior dog parents won’t allow themselves to be dismissed when general tests come back negative, and they will think to ask about Cushing’s.
Hindy thanks so much for this great information as with Layla aging I am keeping a closer eye on her although at this moment TG she is a healthy 11 year old and want to keep it that way.
Layla is so lucky to have such a fantastic dog mom Ruth. She’s doing so well and it’s thanks to your wonderful love and care.
Great post. I know what you mean about people associating a lot of issues with a dog being old when really it could be a symptom of something being wrong. I’m the opposite – now that my first dog is a bit older I feel like I’m running to the vet for every little thing, lol. I don’t even want to think about how much money I’ve spent just for the vet to tell me that something I’m worried about is normal for a dog his age. He’s my first senior dog so he’s teaching me a lot. On the plus side, at least if it ever was anything more I’d hopefully get it treated asap.
Thank you Michelle, and I can relate to the expense!! I was such a regular the staff recognised my phone number and would answer the phone “hello Mrs. Pearson.” Now that’s often! It’s better to go when you have a concern than wait until it’s too complicated or late to treat. It is absolutely a learning curve having an older dog, but you’re obviously doing great.
So interesting and a bit scary (Kilo is 6 now and so many things can go wrong). I always thought of Cortisol as the stress hormone in humans and associated it with inflammation- lots of benefits as well I see but not when too much. I guess it is all about balance which is why it is so important to know what is normal for your dog and go to the vet if anything changes. We just signed Kilo up with a new vet I just love – he is a difficult patient so it is a big relief. Sorry we did not get to see you in person in Toronto. Next time.
I always encourage every senior dog parent (although of course this applies to animals of any age) to contact their vet if they see any changes in behaviour, no matter how slight. Things can go downhill quickly in an old dog, so the sooner they’re looked at the greater the chances of successful treatment or at least maintenance. Glad you found such a great vet, I’m afraid there aren’t enough of them around. I’ll be back in Toronto sooner rather than later hopefully.
Having older pets is a challenge isn’t it? It seems like a lot of the same issues that affect people are affecting pets. Or at least research is bringing it to light as our pets live longer.
It can definitely be challenging, although I must admit I have a soft spot for the old animals…I just love them!! It’s true, just like humans tend to develop issues as they age so do our pets.
Wow I’ve head of Cushings disease in humans but had no idea this impacts dogs too! This is a great wealth of information and advice for pet parents. I love Dr. Karen Becker’s videos. She’s really knowledgeable and practical too. Sharing!
It’s funny because I had only heard of it in relation to dogs, never people and I just heard one of my neighbours has it!! I think she’s amazing, I really enjoy learning from her, she presents such a different perspective.
Excellent information on Cushing’s Hindy. I shared on my Pinterest board. Having a senior gal, I always keep an eye out for this as she does have some, but not all of the symptoms. As you said, it can be so many things especially with aging dogs, but so important to keep an eye out and bring it to vet’s attention just to be safe.
Thanks, and thanks for pinning Dorothy. There are quite a few illnesses that share symptoms, and sometimes it can be challenging identifying which one our pets are suffering from. I agree, used to watch Red like a hawk and the slightest thing that seemed “off” I was on the phone. I called so often they would recognise my number and answer the phone “hello Mrs. Pearson!!”
Mr. N is one of the breeds prone to it apparently. Not that I don’t watch him like a hawk but I’ll definitely keep a watch out for any beginning symptoms!
I must admit I don’t pay too much attention to which breeds are susceptible to what. I just see them as a dog and contact my vet if I see something that doesn’t seem right.
I’ve heard of Cushings Disease but never knew what it was. All of my dogs are over 8 years old, and technically seniors, so I am trying to observe them more carefully now.
You’re right to do that Beth. Unfortunately too many senior dog parents, and vets, attribute changes to the natural process of aging when in fact it is often a sign something is going on.
Thanks for sharing this information Hindy. Not having a firm test for Cushings makes it harder to diagnose for sure but I’m glad there are other tests that can help narrow it down and that there is treatment.
Love & Biscuits,
Dogs Luv Us and We Luv Them
Just like there is no test for dementia whose symptoms are similar to others, it can make it harder to narrow down. Another reason to keep after your vet when searching for answers, and to not accept “your dog is old” as a diagnosis.
I’d always heard of Cushing’s Disease, but didn’t quite know what it was. Thank you for the informative post!
Glad you found it so helpful!
Nice overview. It seems this disease still often goes undiagnosed.
Thanks and yes it does seem to be often overlooked.
I just lost a dog with Cushing disease, June 3 will mark 2 years. She drank like she couldn’t get enough, you could not feed her enough, she was constantly hungry, she wasn’t just tired, she was flat…we took her to two separate facilities… told them what we saw at home, they never once checked her for this disease. My dog suffered, which is what I tried to prevent…im still so sad, my girl is gone…she was a papillion..she is missed beyond measure.
I’m so terribly sorry to hear that Wanda, I’m sure she really is terribly missed. It’s shocking you went to two different practices and no one thought to test for Cushing’s. Surely they would have wanted a diagnosis. I had two different vet practices responsible for the deaths of two of my dogs, it was absolutely shocking. I’ve learned to stay on top of everything and demand explanations and if I can’t get them in one place I have no problem finding another.
Yep, we are looking for a new doctor..what really made us sad is that our girl had to have specialists..that is why we were going 2 places..they worked with my dr…she had other health issues but the Cushing’s just threw her into the worst case scenario. I still miss her and had a dream about her last week…i woke up thinking she was here…only to remember that she was gone. Miss my girl terribly. We thought we were on top…we did question everything…but they are the doctors…its so sad to lose a best friend.
I’m very sorry for your loss, I know how tough it is. We can only do the best we can do, and I think it’s important to question and stay on top of our pets’ care, but at the end of the day the vets are the experts and we have to rely on them for treatment. Sometimes we don’t know they weren’t much use until after the fact, and sadly I have had that experience more than once.
Yes, what you say is true…i just wish they would have listened to my husband and i…because she would not have suffered as she did…thats the one thing we both tried to eliminate…and it didn’t work.Have a great day…
It’s tough because we rely on our vets to help us take the best possible care of our animals, sadly not every vet is a good one. I have had too much experience in that arena. I learned painful lessons but now there is no such thing as a vet not listening to my concerns. If that would ever be the case I would be out of there like a shot and researching the next vet. One day I actually had them unhook my dog from an IV because I was petrified of what they might do. I immediately took her to another vet I trusted.
We all try to be the best doggie parents we can be….and yes we get let down by the ones we depend on the most…we are currently looking for new doctors for our new girls..i won’t go back. It just makes you nervous when your dog gets sick and you’re not sure who to trust. We had a very good vet…my girls loved her, she left the practice to move out of state to marry!!! How could she!!! Lol…she was a great doctor. Happy holidays to you and your family..
I hope you manage to find a new vet you like and trust. I also know from experience how scary it is when your dog is sick and you don’t have anyone to turn to for help. I used to panic every time my vet would go on vacation or be out of the office for a day or two. I agree, how selfish to move just to get married!! I want a great vet available for me 24 hours a day!! Happy holidays to you and yours as well.