Cushing's disease, also known as hyperadrenocorticism, is a hormonal disorder that affects dogs. It is caused by the overproduction of cortisol, a steroid hormone that plays a crucial role in many of your dog’s bodily functions. Cortisol is in charge of regulating weight, stress, infections, and blood sugar levels. An imbalance in cortisol, whether too little or too much, can wreak havoc on your dog's body.

Cushing's disease can develop due to several underlying causes, resulting in a range of clinical signs and health issues. There are three primary forms of Cushing's disease in dogs.

Pituitary-Dependent Cushing's Disease (PDH): This is the most common form of Cushing's disease in dogs, accounting for about 80-85% of cases. It occurs when there's an overproduction of adrenocorticotropic hormone (ACTH) by the pituitary gland. ACTH stimulates the adrenal glands to produce excess cortisol.

Adrenal-Dependent Cushing's Disease: This form occurs when there is a tumor in one or both adrenal glands, causing them to produce excessive cortisol. About 15-20% of Cushing's cases are due to adrenal tumors.

Iatrogenic Cushing's Disease: This form develops due to long-term administration of corticosteroid medications, such as prednisone or dexamethasone. These medications are used to treat various inflammatory conditions but can lead to elevated cortisol levels when used excessively.

Clinical Signs of Cushing’s Disease in Dogs

Cushing's disease, or hyperadrenocorticism, can manifest in various clinical signs in dogs. The severity and combination of signs can vary, but common clinical signs associated with Cushing's disease include:

Increased Thirst and Urination (Polydipsia and Polyuria): Dogs with Cushing's disease often drink more water and urinate more frequently.

Increased Appetite: Dogs may exhibit an insatiable appetite, leading to weight gain and a pot-bellied appearance.

Hair Loss (Alopecia): Hair loss is common, typically starting on the trunk and progressing to other areas. The skin may appear thin and fragile.

Thin Skin: The skin may become thinner and more easily bruised, predisposing to skin injuries. Wounds might take longer to heal.

Panting and Increased Respiratory Rate: Dogs might pant excessively and show an increased respiratory rate, even at rest.

Muscle Weakness: Weakness or muscle wasting can occur, leading to reduced activity levels and difficulty performing usual activities.

Susceptibility to Infections: Immune system suppression caused by excess cortisol can make dogs more prone to infections. Skin infections can occur due to immune system suppression. 

Behavioral Changes: Dogs may exhibit behavioral changes such as restlessness, irritability, or changes in interactions with family members.

Diagnosis of Cushing's disease involves a combination of clinical signs, blood tests (such as cortisol level measurements and an ACTH stimulation test), and sometimes imaging studies (like ultrasound or MRI) to locate adrenal tumors.

Treatment depends on the underlying cause and severity of the disease. Options might include medication to control cortisol production, surgical removal of adrenal tumors, or managing the condition if it's iatrogenic.

Cushing's disease is a chronic condition that requires careful management and monitoring. If you suspect your dog has Cushing's disease, it's essential to consult a veterinarian. Early diagnosis and appropriate treatment can improve your dog's quality of life and manage the clinical signs effectively.

Factors Contributing to Dogs Developing Cushing’s Disease

The prevalence of Cushing's disease varies depending on factors such as breed, age, and geographic location. It's more commonly seen in middle-aged to older dogs, typically around 6 to 10 years of age. The prevalence of Cushing's disease in dogs is estimated to range from 1% to 2% of the general dog population.

Certain breeds, such as Poodles, Dachshunds, Boston Terriers, Beagles, German Shepherds, Golden Retrievers, Labrador Retrievers, and Boxers, are more prone to developing Pituitary-Dependent Cushing's Disease (PDH). 

The risk of developing Cushing's disease increases with age. Older dogs are more likely to be diagnosed with the condition. Dogs with obesity and other underlying health conditions have a higher risk of developing Cushing's disease.

Although Cushing's disease is relatively uncommon compared to other health conditions in dogs, it can significantly impact your dog's quality of life if left untreated. If you suspect your dog might have Cushing's disease or if you notice any clinical signs, consult your veterinarian for proper diagnosis. Early intervention can help manage the condition and improve your dog's well-being.

Veterinary Treatment of Cushing’s Disease in Dogs

Cushing's disease is caused by excessive cortisol production, which can lead to health issues and complications if left untreated. Chronic complications may include compromised immune function, muscle weakness and atrophy, skin and coat changes, metabolic diseases such as diabetes, cardiovascular system disruptions, osteoporosis, and organ dysfunction. 

While you may consider alternative treatments, such as dietary changes, supplements, and herbal remedies, these approaches are unlikely to address the condition's root cause or provide comprehensive management. Your dog’s quality of life can be negatively impacted without proper medical intervention. 

Conventional medical treatment, which may involve medications like trilostane or mitotane, aims to regulate cortisol production and manage the symptoms of Cushing's disease. Veterinarians prescribe these medications after correctly diagnosing and evaluating the dog's health status.


Treatments for each of the types of Cushing’s disease include:

Pituitary-Dependent Cushing's Disease (PDH):

Trilostane: Trilostane is a medication that inhibits cortisol production by blocking the enzymes involved in cortisol synthesis. It's a common choice for managing PDH. Dogs need regular monitoring to adjust the dose and ensure cortisol levels are within the target range.

Mitotane (Lysodren): Mitotane can destroy part of the adrenal cortex, reducing cortisol production. It's often used in cases where trilostane is not effective or well-tolerated.

Regular Monitoring: Dogs on medication need regular follow-up appointments and blood tests to monitor cortisol levels, adjust medication dosages, and assess overall health.

Adrenal-Dependent Cushing's Disease:

Surgery: Adrenal gland tumors can sometimes be removed surgically. This is often the preferred treatment for adrenal-dependent Cushing's if the tumor is localized and can be safely removed.

Medication: If surgery is not possible or practical, medication options like trilostane or mitotane might be used to manage adrenal-dependent Cushing's.

Iatrogenic Cushing's Disease:

Gradual Corticosteroid Reduction: If Cushing's disease is caused by long-term corticosteroid use, the first step is to reduce and discontinue the corticosteroid medication under veterinary supervision gradually.

Regular veterinary check-ups, blood tests, and monitoring of clinical signs are essential to ensure the treatment plan is effective and adjusted as needed. While treatment can help manage the symptoms of Cushing's disease, you must realize that the condition is usually managed rather than cured, and lifelong management may be necessary.


Prolonged exposure to high cortisol levels can alter the absorption of vitamins and minerals in dogs. Cortisol regulates various physiological processes, including those related to digestion, metabolism, and nutrient absorption. An appropriate nutrition plan can alleviate the excess cortisol produced when a dog has Cushing's. It can also increase your dog's lifespan and improve clinical signs.

Elevated cortisol levels can affect digestion and gastrointestinal motility, potentially influencing nutrient absorption, including vitamins and minerals. Cortisol can impact the gut microbiome, which affects nutrient absorption and overall health. Changes in the microbiome composition can affect nutrient availability. 

Provide a moderate amount of high-quality protein to support muscle health. Lean meats like chicken, turkey, lean beef, and fish are good options. Feeding organically, pasture-raised meats will provide a better nutrient profile for your dog while minimizing potential toxins in grain-fed factory-farmed meats. 

Raw, meaty bones should be included to maintain calcium and phosphorus ratios. Prolonged exposure to elevated cortisol can reduce bone density, making bones more prone to fractures.

Your dog’s diet should contain minimal carbohydrates. Excessive carbohydrate intake can exacerbate some clinical signs of Cushing's disease. Only low-glycemic, non-starchy fruits and vegetables should be fed, including broccoli, spinach, kale, green beans, and berries. Small amounts of fruits and vegetables will provide essential nutrients and antioxidants.

Include small oily fish to provide Omega-3 fatty acids to support skin and coat health. Cushing’s dogs tend to have poor skin and hair coats. Because Omega-3s are anti-inflammatory, they will offset some of the inflammatory effects from the high cortisol levels in your dog’s body.

Liver and other secreting organs are beneficial as they supply essential vitamins and minerals to your dog. Studies have shown that prolonged exposure to cortisol can impact the absorption of calcium, vitamin D, B vitamin, zinc, magnesium, and iron. 

Because weight gain is a concern, add fiber-rich foods like vegetables or fur to your dog’s bowl to support digestion and help manage weight. Fiber can also help regulate blood sugar levels and provide a feeling of fullness. Monitor your dog's weight and adjust portion sizes accordingly. Weight management is essential, as obesity can worsen the clinical manifestations of Cushing's disease.

Adaptogenic herbs like ashwagandha and astragalus help your dog’s body handle the stress of dealing with unnaturally high cortisol levels. Ashwagandha is an adaptogenic herb that helps the body adapt to stress and supports adrenal health. It's available in various forms, including capsules, powders, and tinctures.

Ashwagandha can be mixed into your dog's food. Capsules can be opened and the powder sprinkled on the food, or you can use a liquid extract (tincture) and follow the dosing instructions provided by the manufacturer.

Astragalus is an herb that is often used to support the immune system. It is available in various forms, including capsules, powders, and tinctures. Astragalus can be given similarly to ashwagandha. You can mix the powdered herb into your dog's food or follow the dosing instructions on the tincture.

Although Cushing’s cannot be cured, it can be managed. 

A diet of ultra-processed foods that are high in carbohydrates must be avoided. 

The key to longevity and well-being for your dog with Cushing’s disease is good nutrition and working closely with your veterinary team to manage the clinical signs. 

The role of nutritional therapy in the treatment of equine Cushing's syndrome and laminitis 

ACTH-independent hyperadrenocorticism due to food-dependent hypercortisolemia in a dog: a case report 

Adrenocortical overexpression of gastric inhibitory polypeptide receptor underlies food-dependent Cushing's syndrome 

Cushing Disease (Pituitary-dependent Hyperadrenocorticism) in Animals - Endocrine System - Merck Veterinary Manual 

Diagnosis of hyperadrenocorticism in dogs 

Diagnosis of Spontaneous Canine Hyperadrenocorticism: 2012 ACVIM Consensus Statement (Small Animal) - Behrend - 2013 - Journal of Veterinary Internal Medicine - Wiley Online Library 

Cushing's disease, also known as hyperadrenocorticism, is a hormonal disorder that affects dogs. It is caused by the overproduction of <a href="https://feedreal.com/glossary/cortisol">cortisol</a>, a steroid hormone that plays a crucial role in many of your dog’s bodily functions. Cortisol is in charge of regulating weight, stress, infections, and blood sugar levels. An imbalance in cortisol, whether too little or too much, can wreak havoc on your dog's body.

What to Feed a Dog with Cushing's Disease

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