Boston Terrier.
Boston Terrier by Shutterstock. Photography by Nailia Schwarz / Shutterstock.

Cushing’s Disease in Dogs — Signs, Diagnosis and Treatment

What is Cushing’s disease in dogs? What symptoms should you look for, how is Cushing’s in dogs diagnosed and what is the treatment for it?
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When a dog starts drinking more water than usual and peeing more often, it may be a sign that something abnormal is going on. Excessive drinking and urination are symptoms of many different issues, from diabetes to kidney disease, but another concern is Cushing’s disease in dogs, which is also called hyperadrenocorticism.

First, what is Cushing’s disease in dogs?

A beagle or hound dog looking sick and under the weather.
Senior dogs, and certain breeds, like Beagles, have a higher risk for Cushing’s disease. Photography by Igor Normann/Shutterstock.

Cushing’s disease is named for Harvey Cushing, the human neurosurgeon who first described the endocrine disorder in 1912. Dogs with Cushing’s disease have a problem with their adrenal glands, two small glands nestled in front of each kidney. These glands produce important hormones that regulate crucial body functions. With Cushing’s, the glands produce too much of a hormone called cortisol. When the hormones in the body are out of balance, bad things start happening.

“The most striking symptom in Cushing’s disease is excessive urination and concurrently drinking tremendous amounts of water,” says Jeff Grognet, DVM, co-owner of Mid-Isle Veterinary Hospital in Qualicum Beach, BC, Canada. “As the disease progresses, dogs lose muscle, become weak, the skin thins, and you see hair loss on the flanks, neck and perineum [the area around the genitals and rectum].” You might also notice panting, increased hunger and a pot-bellied appearance.

What dogs are at risk for Cushing’s disease?

Cushing’s disease in dogs is more common in senior dogs, usually 8 years and older. It’s also seen more frequently in certain breeds, including Beagles, Boston Terriers, Boxers, Dachshunds, Dandie Dinmont Terriers, German Shepherd Dogs, Poodles, Yorkshire Terriers and small terriers.

Cushing’s disease in dogs is caused by one of three things:

  1. A tumor on the pituitary gland at the base of the brain (this gland is responsible for telling the adrenal glands to secrete cortisol). This type of Cushing’s disease is pituitary-dependent hyperadrenocorticism (PDH). This is the most common cause of Cushing’s disease in dogs. Sometimes, this form of Cushing’s occurs in younger dogs.
  2. A tumor on the adrenal gland. This type of Cushing’s disease is adrenal-dependent hyperadrenocorticism. Large-breed dogs often have this form of Cushing’s.
  3. Overuse of steroid medications. This type of Cushing’s disease is iatrogenic Cushing’s syndrome.

Diagnosing Cushing’s disease in dogs

Unfortunately, Cushing’s disease in dogs can be difficult to diagnose, requiring complex tests. If your vet suspects Cushing’s disease in your dog, the first step will be blood and urine tests. If your vet sees anything abnormal on those tests, the next step is usually a special test called an ACTH-stimulation test.

For this test, your vet will draw your dog’s blood to check his cortisol levels, then give him an injection of adrenocorticotrophic hormone. A few hours later, your vet will draw your dog’s blood again to test the cortisol another time. If your dog is diagnosed with Cushing’s disease, other tests, including ultrasound, can help your vet discover the cause of the Cushing’s disease, which will determine the treatment.

Read more about diagnosing Cushing’s disease in dogs >>

Treatment of Cushing’s disease in dogs

“More than 90 percent of dogs with Cushing’s disease have a benign pituitary gland tumor,” explains Dr. Grognet, who also operates the ACE Academy for Canine Educators. “Being extremely small and not tending to spread, they don’t cause a physical problem. Most dogs with pituitary-dependent Cushing’s are therefore treated with medication.”

If an adrenal tumor is the cause of Cushing’s disease in dogs, your vet will want to run further tests to confirm if the tumor is cancerous or benign (non-cancerous). Surgery to remove an adrenal tumor might be an option. If the tumor is cancerous, the prognosis is poor.

“Once treatment has been initiated, the symptoms of Cushing’s disease slowly dissipate,” Dr. Grognet says. “The first thing is that the drinking falls dramatically. It takes longer for the skin lesions to resolve. The average survival time for a dog with Cushing’s disease is about two years, but this statistic does not mean that Cushing’s causes death. In fact, most dogs die of unrelated disease processes brought on by aging — they are already geriatric when Cushing’s is first diagnosed.”

Thumbnail: Photography by Nailia Schwarz / Shutterstock.

This piece was originally published in 2018. 

About the author

Pet expert Jackie Brown has spent 20 years following her passion for animals as a writer and editor in the pet publishing industry. She is contributing writer for National Geographic’s Complete Guide to Pet Health, Behavior, and Happiness: The Veterinarian’s Approach to At-Home Animal Care (April 2019) and author of the book It’s Raining Cats and Dogs: Making Sense of Animal Phrases (Lumina Press, 2006). Jackie is a regular contributor to pet and veterinary industry media and is the former editor of numerous pet magazines, including Dog World, Natural Dog, Puppies 101, Kittens 101 and the Popular Cats Series. Prior to starting her career in publishing, Jackie spent eight years working in veterinary hospitals where she assisted veterinarians as they treated dogs, cats, rabbits, pocket pets, reptiles, birds and one memorable lion cub. She lives in Southern California with her husband, two sons and miniature poodle Jäger. Reach her at jackiebrownwriter.wordpress.com.

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51 thoughts on “Cushing’s Disease in Dogs — Signs, Diagnosis and Treatment”

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  2. The problem with loving a dog so much but thinking that the vet can do more is a valid one. I have had two dogs with Cushings. The first one had a veterinarian who pulled out all the stops to treat his Cushings. He was on Lysedren( sp?) – what was used 14 years ago- and other organ supports. She gave him Miralax for occasional constipation. And she was very instructional on various ways that we could help him be his best with this disease.
    But I moved away from the City that the best veterinarian was, and now I am in NM with a very laid back vet whom I had to ask her to check him for Cushings, although she just thought it was age ( he is 12. ). I so wish that I had my other vet to treat this baby too. This is a very small city, and one vet clinic. I’m going to look for a new vet in the next city. I feel as though this vet is not very motivated to improve my dogs symptoms. Doctors are human, and some humans do not belong in the professions that they have chosen.

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  4. My Frenchie was just diagnosed with cushings and in a matter of days he’s painting peeing and now he won’t walk on his back leg. I’m wondering if anyone has had this issue he will barely put any pressure on. My heart is breaking !

  5. Hi, responding to a couple of posts at once…

    My toy poodles don’t do well with chicken (they get diarrhea) but they do great with beef products. To fortify their gut, I give them organic apple cider vinegar (mixed with water) and also doggie bone broth (Otto’s organic bone broth). I get the Otto’s at Pet Food Express. Both turned 14 in Oct. One has suspected Cushings (loss of coat, history of ravenous appetite and drinking but both are now normal, has cataracts (related?) and former pot belly but that is now normal). Currently giving Cushex-S (Amazon). Tried Adrenal Harmony (also from Amazon) but he got diarrhea. I understand that the Adrenal Harmony can be a digestive irritant so I am giving him the Cushex-S only at this time, no side effects. Later again I will adjust his dosage of the Adrenal Harmony and try it again. For example, instead of giving a whole drop or several drops but I will give him one drop in 2 oz water. For anything that they won’t eat by adding to their food, I mix it in water and then use a syringe/eye dropper to squeeze in their mouths. This is how I give them the ACV and bone broth and for the one poodle, the Cushex-S. I think the bone broth and ACV will help his gut and I will use the Adrenal Harmony again later. See OnlyNaturalPet.com and NaturesPetHerbs.com. Hope this helps and thank you all for your posts, extremely helpful.

  6. My girl is 14 and was diagnosed with Cushings at age 13. She is on 30mg of Veteroyl every 3 days (reason for this was every other day was causing low cortisol reading for 40) . She’s been on a raw diet since she was 9 years old. To help with the hunger I feed her a well rounded tablespoon of canned pumpkin (not pumpkin pie filling) but natural pumpkin with each meal (she is fed twice a day) . This helps with her stools and it also keeps her full with all the fibre provides. I hope Holly is still doing well

  7. Denise stephenson

    My beautiful little boy Remy has cushings diagnosed a year ago and now 13. He’s a cross poodle schitzu maltese we think as rescued by me at 20 months. I’m crying every day watching him go downhill. Loss of hair plus terrible diaherrea last few days. Trying everything to fix his gut. I’m dreading the next 2 days as this will determine if he can keep going as diaherrea making him so weak. I have wooden floors thank god. But its still terrible. I love him soo much.

    1. So sorry to hear this! Please continue working on treatments with your vet. We hope your little boy feels better. Thinking of you!

  8. My Jack Russell Cody who’s 12 has Cushing n diabetes he’s coping fine jut now with meds he’s lost his sight and his coat n skin is going darker , got him on Chappue dog food n biscuits and he’s doin ok on them ,still hard watching him cope banging into things ,we but his meds on the net ,good saving x

  9. My Boston Terrier BABY was diagnosed with Cushions and is also on Vetoryl.
    The big problem is she has all the time diarrhea. she is about 10 years old and was
    rescued from a breeder. I cook rice with chicken and try the best food I can get
    and she loves to eat, but she looses weight and she feels not good, I can tell.
    Can somebody tell me what to do about the diarrhea.
    Thank you

    1. Hi there,
      Thanks for reaching out! We suggest discussing this issue with a vet. These articles might provide some insight, too:
      https://www.dogster.com/dog-health-care/what-to-feed-a-dog-with-diarrhea-or-other-stomach-issues
      https://www.dogster.com/dog-health-care/dog-diarrhea-at-home-treatment-and-when-to-see-a-vet
      https://www.dogster.com/lifestyle/does-your-dog-have-diarrhea-heres-what-you-need-to-know
      https://www.dogster.com/dog-health-care/all-about-dog-gastrointestinal-issues-diarrhea-vomiting-constipation-and-more

    2. I give my 2 dogs ( not mine is my daughter dogs but I keep them now because she couldn’t take care of her full time job & 3 boys age 5,3 & 17 months old), 2 schnauzer 11 (blind ,diabetic) & 12 cushing ,diabetic too ,morning meals I put abit Phsylium to prevent from getting diarhrea, it helps.For the diabetic they get human insulin twice a day & for cushing 12.5mg trilostane

  10. My Yorkie is 11 years and was diagnosed by the Vet with cushing disease. He took Vetoryl for two months then started to buy him from Amazon drops for cushing but no improvement.
    My Bingo eats so little and doesn’t drink or urninate much although having like two big pockets above his kidneys and started to walk slowly with coughing and high breath.
    I am giving him liver supports, glucasamine syrup, plus seven seas vitamin plus detox for liver and kidney in addition to aldactone 25mg and the drops for the cushing disease

  11. Hi my dog Holly has been diagnosed with cushings…im devastated, she is 14 end of september….she is on 30mg vetrolyn in morning and 10mg at tea time ….. im just wondering if their is anything else i should be doing as she is starving at 1am to 2am …. barking to get food…..and again at 5pm to 6pm then after for nearly 2 hours begging and barking thanks one tired mum ????

    1. Hi Carol,

      Sorry to hear about your dog’s diagnosis and your struggles with this! We suggest bringing these issues up to your vet.

    2. Hi, my dachshund Francis has recently been diagnosed with Cushing and is starving all the time. If I move he moves and goes to frig. I love him so. I’m starting to look to see if I can find anything. He can’t even have his treats. If he eats to much he gets diarrhea. Nice to have someone to share with. Hope you and Holly have good day. Going to get Fran his lunch. Truly,Carol.

    3. My bichon is excessively hungry and I started giving her raw baby carrots for her treats and other raw veggies because I am afraid of the weight as her belly looks like it should blow up. It is hard to know what to do would appreciate any feedbacks.

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  13. Hi Linda:
    Only people that have owned a furbaby that has become ill will understand, that you have to do what is right for your furbaby. I had to put my little girl down, as she was suffering from liver failure caused by the medication to control her epilepsy. It was like losing a part of my heart. That was 3 years ago and I still have days where I have break downs. I loved her do much. So you did the best you could, and you did her a favour as it was time. As the days go by it does get easier.

  14. So, my vet is a bit stumped.

    Initially started with urination frequency and water consumption. My girl is 10 so we figured it was the development of kidney issues. Vet confirmed crystals in urine but no infection. Put her on the Royal Canin Urinary SO food and asked us to come back in a few months.

    Few months later, same issues. We return to the vet who does another urine test plus a blood screen. Finds nothing (crystals are gone) but suggests maybe it is a low-grade infection that isn’t really showing up very well so we try antibiotics. No improvement.

    Third test was another, more complete blood screen. Signs point to Cushings so we schedule the ACTH test. The only strange thing – her glucose is low. Like, really low (60).

    ACTH test confirms Cushings but the glucose numbers don’t match. Vet suggests possible bile-duct tumor that could be the culprit of her symptoms. We schedule an ultrasound.

    Ultrasound comes back fine. Swelling in the places you would expect with Cushings but the glucose number is completely throwing everyone off and they are hesitant to start her on Cushings treatment protocol without figuring it out.

    At this point, no noted hair loss, skin seems fine, belly is a little bloated (but whose isn’t?). She is a little more tired these days (but who isn’t?). The vet suggested a spoonful of honey if she seems ‘off’ and we’ve given it to her 3 or 4 times. When I come home there is usually still at least a little water in her bowl and she typically seems completely fine except for the evidence on the piddle pad.

    Are we just catching this super early? ACHT test confirmed Cushings but could it be something else that has the same symptoms? (also tested for Addisons – and there are zero indicators). We absolutely cannot figure out why her glucose would be so low. Additionally, she isn’t getting any treatment while we solve this riddle.

    My vet is extremely cognizant of finances and really tries the “one step at a time” approach to mitigate expense. But at this point, even with consulting with other vets who specialize in Internal Medicine, she is at a loss.

    Any ideas about what could be causing the glucose issue? And although my vet said she didn’t know of any “natural” supplements that were effective; but in the absence of any other treatment, I feel like I should do *something*. (melatonin/etc)

    Whatever advise you could offer would be most welcome. Thanks in advance!

    1. Hi RT—
      We think you’re doing the right thing by continuing treatment and communication with your vet. If you want to look into natural, alternative supplements, you may want to reach out to a holistic vet.

  15. Dear Linda,

    I wanted to reach out to you and state, that I absolutely believe that you did the right thing. Just today my vet informed me that he believes my little baby girl of 14 has this disease. I’ve been crying for a week since her senior screen turned up abnormalities. BTW, she also has a murmur and just found out she has high blood pressure, so going under isn’t an option to do a biopsy. I got this dog for my girls, but of course she became mine. I have watched my sister’s put all kind of money and energy to keep her dog alive, however, every time I visited her dog was in pain. Keeping a dog alive for us isn’t being a best friend, show love, or kindness (in my opinion.) I’m sure if Buddy could talk he would have told you he was ready and that you were making a harder decision for yourself, which is ❤️.

  16. I have a rescue Chow Chow, almost 12, she has suspected Cushings, is going blind and deaf. Due to incontinence, I can’t have her in the new house so she is relegated to the garage, laundry room or yard. She was an indoor dog for over 9 years, but now outside for the last year. I can’t afford to have the tests done or pay $50-100 per month for Cushing meds on top of her other expenses. I have been advised by the rescue who was responsible for her not to re-home her due to her age and her attachment to me and that the best thing if I can’t manage her anymore would be to put her down. It’s not fair to her to be stuck out of the house, but in addition to everything else, I started working full time last year and with our schedules, she’s alone for 8-10 hours per day. Another reason she can’t be in the house. Thoughts? And no attacks please. This is a very hard decision.

    1. Wow Laura….God bless you….8 dogs and half are elderly and one has Cushing’s…..I can’t imagine how you do it! I hope you have help!

    2. I just wrote you a long reply and I lost it when I went back to my mail to see what address I needed to use. So bummed. I can not repeat myself nation this time. I will give you a tiny version…I was nice and understanding. An elderly dog with an untreated serious illness as well as other maladies who is living outside or in a garage virtually alone while feeling lousy has no quality of life. If you can not treat a dog, the next best thing is not usually no treatment. The best thing is often euthanasia. You do not want your dog feeling abandoned when she needs you the most. She probably pees all over herself and urine burns the skin. I had an incontinent dog and even though I cleaned her after each pee, she still developed skin breakdown on her tail and that is very painful. Based on everything you said, the kindest thing you can do for your beloved dog is to put her to sleep. She has no quality being sick and lonely. I understand your circumstances. I will keep her and you in my prayers and hope you find the strength to do riget by her. It is never easy to do, but it is not about you. Good luck.

    3. Get wee wee pads and bring that poor animal back indoors. Going blind and deaf and you are leaving her outdoors?
      Check around, as others have commented there are other establishments where you can get the drugs cheaper. In my opinion, leaving this poor animal in a garage or small laundry is cruel. You‘ve answered your own question.

  17. I just had to put my Buddy down he was 18 had cushings started getting seizures losing his balance groaning when he was laying down I am devastated praying to God that he was ready to go home I just hope someone can tell me that I did what was best, he was my best friend and I am having a really hard time missing him.

    1. God bless you for putting your pet first such a hard decision
      Looks like my terrier has this too just hope i have your courage

    2. My deepest sympathies. You did right by Buddy by giving him care and love and then keeping him from further suffering. I have no doubt that he has gone on to a wonderful place where he is very happy. You will see him again one day. God bless.

    3. Jacqueline Alvez

      I just put down my Charlie and am devastated. He had cushings as well. I did not want to see him suffer. I pray as well that I made the right decision. It’s so heartbreaking to lose someone you love. He was my friend my companion my buddy my everything. I know how you feel!

    4. To love them is knowing when to let them go , helping him cross the Rainbow Bridge was an act of love .. he was starting to suffer and now he is no longer in pain ! hugs to you

  18. My Chiweenie has Cushings. Must have had it when I rescued her about 6 years ago. Potbelly, hair loss. Vet estimated her age then at 10 or 11. We immediately started treatment with Vetoryl. Have that test done (can’t remember name) to make sure meds are still working well. Do that every 6 months. At first did it every 3 mos.
    17 now. Arthritis is bad – partially her dachshund heritage I think. Deaf. Cataracts developing. Typical for her age.
    But recently she began having seizures. Vet thinks it may be due to growth of the adrenal (?) tumor. She takes Zonisimide daily. Hasn’t had any seizures recently. Hope it lasts for awhile.
    Put her on super low fat diet and she seems to be feeling ‘more perky’.
    Does anyone have any dietary ideas that might help?
    She is the pickiest eater I’’ve ever owned and being a failed rescuer (I can’t let them go) I’ve currently got 8 dogs in my house including a 16 yr old Coonhound and 2 beagles (ages 21 and 18).
    Only diseases worse than Cushings I’ve had to live through have been osteosarcoma and vaccinosis.

    1. Michaela Conlon

      Hi there,

      Thanks for reaching out Laura! We suggest contacting your vet for diet advice that is specific for your dog’s needs. We hope your dog feels better!

  19. Go to Lambvert pet supply, they sell Veteroyl (30MG) for $59.99 monthly. Your vet will have to call a script to them. Been using them for 2 years.

    Lenore

    1. My Francis takes 15mg. of Vetoryl a day. A months supply cost $160. a month . I’m searching for something I can afford. Truly Carol

      1. Hi Carol,
        Thanks for reaching out. We suggest asking your vet for more cost-effective options. Here are some articles on affording vet bills:
        https://www.dogster.com/dog-health-care/affordable-vet-care-for-your-dog
        https://www.dogster.com/dog-health-care/affordable-pet-care-for-dog-parents
        https://www.dogster.com/dog-health-care/need-help-with-vet-bills-ideas-that-anyone-can-do

  20. Hello,
    Our Pit is just about 16 at the present. W e have been using Vetoryl (Trilosane) Capsules for several years. He does have all the Simtions ( Sorry for the spelling ), Heavy Peeing, Drinking a ton of water, Pot belly, slow walking, ect. BUT he is still with us at almost 16 !! Is taking Vetorl (Trilostatine ) Capsules which are costing us $ 90.00 Per Month. Any other suggestion that can lower the cost ? Both of us are on a strick ! Money problem.

    Thank you for anyhelp you might think of.
    Jay and Bobbie Leishman and our boy “CHAMP”

    1. Hi Jay —

      Thanks for reaching out! Sorry to hear your dog isn’t feeling well. We suggest contacting your vet for alternatives. Additionally, here are some ways to keep vet costs down:
      https://www.dogster.com/dog-health-care/affordable-vet-care-for-your-dog
      https://www.dogster.com/dog-health-care/need-help-with-vet-bills-ideas-that-anyone-can-do

    2. Hey Jay,
      My Pekingese has cushings and is treated with Vetoryl as well. Like you, I was amazed at the price I had to pay per month on his medication. It was costing us $92.00 a month through our vet. Luckily, I found PetMedRX.com, and they supply his same dosage for a month supply, and only charges around $60.00 per month. All you need to do is check with your vet and make sure that they will “OK” the prescription through PetMedRX (maybe explain to them that $90 per month is just a little steep, and hopefully they’ll allow PetMedRX.com to process the prescription order. I live in Ohio and it usually tends to take around 3-4 business days to get the prescription in. Hope this helps!

      1. How did your dogs symptoms resolve after you started treatment? Any of the scary side effects listed in the brochure?

    3. My dog has cushings also I give him cushex M from pet alive it is not as strong . also give him cushex S from them also don’t know if you need both you can talk to them they are very nice. Shirley

    4. Chewy has Vetoryl cheaper. I got Eddie’s meds through them. You can order it on line and they will send it to you. Good Luck I lost Eddie 07/14/2020, he was 9.

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