Hyperadrenocorticism (Cushing's Disease)

What is Cushing’s disease?

Cushing’s disease is an excess of the hormone cortisol, because of a pituitary gland or adrenal gland tumor, or long-term use of steroid medication (i.e., iatrogenic). The pituitary gland stimulates cortisol production by the adrenal glands, and pituitary tumors represent 85% of Cushing’s disease cases in dogs. Up to 6% of pituitary tumors can be cancerous, and up to 20% can become large enough to affect the brain. Approximately 50% of adrenal tumors can be cancerous. Cushing’s disease complications can include chronic urinary tract infections, skin disorders, hypertension, and liver disease. 

What are common Cushing’s disease signs in dogs?

Early signs include:

• Excessive drinking and urination
• House accidents or incontinence
• Increased appetite
• Excessive panting

Intermediate to advanced signs include: 

• Hair loss
• Skin disorders
• Weight gain
• Muscle wasting
• Pot-bellied appearance
• Disorientation or seizures

How is Cushing’s disease managed in dogs?  

Cushing’s disease management is designed to control cortisol production. Pituitary or adrenal forms of the disease can be treated with medications, or specialized surgery for tumor removal. Radiation may also be an option. Iatrogenic Cushing’s disease can be resolved by slowly withdrawing steroid medication. Dogs with Cushing’s disease need regular veterinary visits and diagnostic tests to monitor their status and prognosis. Discussing a personalized management plan with your veterinarian is important for the best outcome for your dog.

What is the prognosis for dogs with Cushing’s disease?

Medical treatment of Cushing’s disease usually has a good prognosis, but excess suppression of adrenal hormones can result in Addison's disease. Surgery can provide a complete cure for an adrenal tumor and resolve more than 85% of pituitary tumor signs, but the procedure is complicated, and higher risk. A pituitary tumor that affects the brain has a poorer prognosis. Cancerous adrenal or pituitary tumors also have a poor prognosis.

Management tips for dogs with Cushing’s disease   

At-home needs include:

• Easy access to food and water, and a comfortable location
• Strict consistency with prescribed medications
• A weight-loss diet, if recommended by your veterinarian
• Monitoring appetite, drinking, urination, weight, and energy level

For end-of-life care:

• Try to keep your dog safe and comfortable
• Ensure adequate nutrition and hydration
• Monitor for pain or discomfort
• Evaluate your dog’s quality of life with our scoring tool
• Track progression of their health with our calendar

In a crisis situation:

Contact your veterinarian immediately if your dog stops eating, has diarrhea, collapses, or is lethargic, vomiting, or vocalizing in pain.

Before your dog‘s condition becomes unmanageable, or they begin losing their quality of life, beginning end-of-life care discussions is vital. Learn more about pet hospice, in-home euthanasia, and our teleadvice service, or contact a Lap of Love veterinarian in your area, so you can feel fully prepared for this difficult time.