Your senior dog is finishing his water bowl three times a day now. He's hungrier than ever, but somehow he's carrying a saggy, round belly, and his coat looks thinner than it did last year. You've chalked it up to "just getting old" - but this exact pattern has a name, and it's one of the most common hormonal diseases vets see in aging dogs.

Cushing's disease, medically called hyperadrenocorticism, happens when a dog's body is exposed to too much of the stress hormone cortisol for too long. It is most common in middle-aged and senior dogs and is usually caused by a small tumour on the pituitary gland or, less often, on one of the adrenal glands. It cannot usually be cured, but with the right testing and daily medication, most dogs go on to live comfortably for years.

Key Takeaways

• Cushing's disease develops when a dog's body makes too much cortisol over a long period, most often because of a tumour on the pituitary gland or an adrenal gland.
• The classic pattern is a senior dog that drinks more, urinates more, eats more, pants more, and slowly develops a pot-bellied shape with thinning fur.
• Diagnosis is never based on one single test - it usually needs bloodwork, urinalysis, an endocrine screening test, and often an abdominal ultrasound.
• Trilostane is the standard daily medication used to manage Cushing's disease in most dogs, and it needs lifelong monitoring rather than a one-time fix.
• Small and medium breeds like Poodles, Dachshunds, Beagles, and Lhasa Apsos - all common in Indian homes - are seen with this condition more often than large breeds.
• Naturally occurring Cushing's disease cannot be prevented, but catching it early through routine senior check-ups makes a real difference to your dog's quality of life.

What Is Cushing's Disease in Dogs?

Cushing's disease - the everyday name for hyperadrenocorticism - happens when a dog's body is exposed to excess cortisol for a long period. Cortisol is a normal hormone made by the adrenal glands, two small organs that sit near the kidneys, and it plays a role in metabolism, immune response, blood pressure, and how the body reacts to stress. When cortisol output stays high for months or years, it slowly affects almost every organ system, which is why the symptoms can look like a dozen different things before a vet connects the dots. According to the Merck Veterinary Manual, it is one of the most common endocrine diseases seen in adult and aged dogs.

There are three recognised forms of Cushing's disease in dogs. Pituitary-dependent Cushing's is by far the most common, making up roughly 80–85% of naturally occurring cases. Adrenal-dependent Cushing's, caused by a tumour directly on one adrenal gland, accounts for most of the rest. A third form, iatrogenic Cushing's, isn't caused by a tumour at all - it develops after long-term use of steroid medication such as prednisolone, and it is the one form pet parents have some control over.

What Causes Cushing's Disease in Dogs?

Pituitary-Dependent Hyperadrenocorticism (Most Common)

In this form, a small, usually benign tumour grows on the pituitary gland, a pea-sized gland at the base of the brain. The tumour keeps producing ACTH (adrenocorticotropic hormone) even when the body doesn't need it, and ACTH's job is to tell the adrenal glands to release cortisol. The result: both adrenal glands are pushed into overdrive and enlarge in response, flooding the body with cortisol. The Cornell University College of Veterinary Medicine notes that this pituitary-driven form is seen most often in smaller breeds.

Adrenal-Dependent Hyperadrenocorticism

Here, a tumour grows directly on one of the adrenal glands and produces cortisol on its own, independent of any signal from the pituitary. Because only one gland is affected, the opposite adrenal gland typically shrinks from disuse - a detail vets look for on ultrasound to help tell the two forms apart. Some of these tumours are benign; others are malignant and can spread, which is one reason imaging matters so much once Cushing's is suspected.

Iatrogenic Cushing's Disease

This form develops after weeks or months of steroid treatment for another condition - commonly allergies, arthritis, or an immune disorder. The steroid dose itself mimics excess natural cortisol, producing the same signs as the other two forms. If your dog needs long-term steroids for a separate illness, your vet will usually aim for the lowest effective dose and will taper the medication down slowly rather than stopping it suddenly, since abrupt withdrawal after long-term use can itself cause a dangerous drop in natural cortisol.

Which Dogs Are Most at Risk?

Cushing's disease is seen almost exclusively in middle-aged and senior dogs, and it rarely shows up before six years of age. Certain breeds appear to carry a higher risk, including Poodles, Dachshunds, Boston Terriers, Boxers, Beagles, Miniature Schnauzers, Yorkshire Terriers, and Lhasa Apsos. Cornell's clinical data also lists Jack Russell Terriers and Bichon Frises among the breeds more prone to the pituitary-dependent form. Interestingly, Golden Retrievers, Labrador Retrievers, Border Collies, and Cocker Spaniels are reported as being among the least likely breeds to develop it.

Is My Indian Pet's Breed at Risk?

A number of these higher-risk breeds - Dachshunds, Beagles, Lhasa Apsos, and Miniature Schnauzers - are genuinely popular companion breeds across Indian cities, alongside Pomeranians and Shih Tzus, which are close cousins in size and metabolic profile. Breed alone never confirms or rules out Cushing's disease, but if your ageing Dachshund or Lhasa Apso from Pune or Bangalore has started drinking more water than usual, it's a reasonable thing to flag with your vet a little sooner rather than later.

Symptoms of Cushing's Disease in Dogs

Because Cushing's disease develops slowly, over months rather than days, many pet parents first assume their dog is simply "slowing down with age." Watch for this cluster of changes, especially if several show up together:

• Increased thirst (polydipsia) - often the earliest and most noticeable sign; your dog may empty the water bowl far more often than before
• Increased urination (polyuria) - larger volumes, more trips outside, or new accidents from a dog who was previously reliably house-trained
• Increased appetite (polyphagia) - persistent hunger, begging, or scavenging behaviour that feels out of character
• Pot-bellied abdomen - caused by fat redistribution, an enlarged liver, and weakening of the abdominal muscle wall
• Hair loss (alopecia) - usually symmetrical along the trunk and flanks, typically sparing the head and lower legs
• Thin, fragile skin - skin that bruises easily, heals slowly, or tears with minor trauma
• Excessive panting - sometimes even at rest or in mild weather
• Recurrent skin, ear, or urinary infections - high cortisol suppresses normal immune defences
• Muscle weakness or wasting - trouble jumping onto furniture, climbing stairs, or keeping pace on daily walks
• Lethargy - reduced enthusiasm for play or walks; if you're noticing this alongside other signs on this list, our guide on preventing lethargy in dogs explains the wider range of possible causes
• Darkened or thickened skin patches - a result of long-term hormonal change
• Calcinosis cutis - firm, gritty calcium deposits under the skin; uncommon, but strongly linked to Cushing's when present

My Senior Dog Is Drinking Water Constantly and Has a Pot Belly - Could This Be Cushing's Disease?

Constant thirst combined with a pot-bellied shape in a middle-aged or senior dog is one of the most recognisable Cushing's patterns, but it isn't proof on its own. The same combination can point to diabetes, kidney disease, or liver disease, all of which need very different treatment. The only way to know for certain is bloodwork and a specific endocrine test, so this combination is worth a vet visit rather than a guess.

Call your vet promptly if these signs are worsening, if your dog has repeated infections, or if you notice vomiting, diarrhoea, sudden weakness, or collapse - those can point to a complication, or, in a dog already on treatment, to a dosing problem that needs same-day attention.

How Is Cushing's Disease Diagnosed?

Diagnosing Cushing's disease is almost never a single-test process, which is part of why it can take time to confirm.

Step 1 - History, exam, bloodwork, and urinalysis. Your vet starts by reviewing your dog's symptoms and running baseline bloodwork and a urine test. Dogs with Cushing's often show patterns such as a raised alkaline phosphatase (ALP) enzyme, high cholesterol, dilute urine, or signs of a low-grade infection - useful clues, but not proof on their own, since several other diseases share these same patterns.

Step 2 - Endocrine screening test. This is where the diagnosis is actually confirmed. The three most common options are:

Step 3 - Abdominal ultrasound. Once Cushing's is confirmed or strongly suspected, an ultrasound helps your vet see whether both adrenal glands are enlarged (pointing to the pituitary-dependent form) or whether just one is affected (pointing to an adrenal tumour). It can also pick up other changes, such as an enlarged liver or bladder stones.

Step 4 - Advanced imaging (in select cases). A CT or MRI scan may be recommended if surgery or radiation therapy is being planned, particularly for a suspected pituitary tumour.

Because thirst, urination, and hair changes can overlap with diabetes, kidney disease, liver disease, and hypothyroidism, don't be surprised if your vet rules a few of these out along the way - it's part of getting to an accurate answer rather than a guess.

Treatment Options for Cushing's Disease in Dogs

There is no single "right" treatment for every dog - the best plan depends on which form of Cushing's your dog has, their overall health, and what your vet recommends after reviewing the full picture.

Trilostane (the Standard Daily Medication)

For most dogs - both pituitary-dependent and many adrenal-dependent cases that aren't good surgical candidates - the mainstay of treatment is a daily oral medication called trilostane, best known under the brand name Vetoryl. It works by partially blocking the enzyme responsible for cortisol production, given with food once or twice a day depending on your vet's protocol.

Most dogs show noticeable improvement in thirst, urination, appetite, and panting within a few weeks of starting treatment; visible coat regrowth and body-shape changes usually take longer. This is lifelong management, not a cure, and it needs consistent monitoring - over-suppressing cortisol can cause a dangerous low-cortisol state. According to the U.S. FDA, regular veterinary rechecks and bloodwork are essential for as long as a dog stays on the medication. In India, trilostane and its generic equivalents are typically sourced through your treating vet or a veterinary specialty pharmacy rather than a general chemist, since dosing has to be tailored precisely to your dog's weight and follow-up test results.

Watch for these warning signs and call your vet the same day if you see them: poor appetite, vomiting, diarrhoea, sudden weakness, or unusual lethargy. These can signal that the dose needs adjusting.

Surgery or Radiation (Select Cases)

For dogs with an adrenal tumour that is localised and hasn't invaded nearby blood vessels, surgical removal of the affected adrenal gland (adrenalectomy) can occasionally be curative. It is a higher-risk procedure because these tumours sit close to major vessels, so it's usually reserved for dogs who are otherwise stable enough for anaesthesia and surgery. Dogs with a large pituitary tumour causing neurological signs - unsteadiness, changes in behaviour, or vision problems - may be considered for radiation therapy at a specialist referral centre, according to the VCA Animal Hospitals overview of treatment approaches.

Monitoring-Only Approach

For dogs with very mild signs, multiple other illnesses, or advanced age, some families choose to start with close monitoring rather than medication - tracking water intake, appetite, and energy at home, treating any secondary infections, and rechecking bloodwork every few months. This doesn't lower cortisol and the disease usually progresses, but it can be a reasonable starting point while a family gathers more information, as long as it's paired with honest, regular check-ins with the vet.

Living with a Dog on Cushing's Treatment: What Should I Track at Home?

Once treatment starts, your day-to-day observations matter almost as much as lab results. Keep a simple daily note of your dog's water intake, appetite, urination pattern, panting, and general energy - these often tell your vet as much about how well the plan is working as the blood tests do. Most vets recheck bloodwork within 10–14 days of starting trilostane, then again over the following one to three months, before settling into a longer-term monitoring schedule. A dog with thinning fur or fragile skin during this period can also benefit from added coat and skin support alongside their prescribed treatment - something worth raising with your vet.

Can Cushing's Disease Be Prevented?

Naturally occurring Cushing's disease usually cannot be prevented. Pituitary and adrenal tumours tend to develop on their own, and there is currently no proven diet, supplement, or screening programme that stops them from forming in the first place.

What you can influence is early detection. If your dog is middle-aged or older, keep an eye on changes in thirst, urination, appetite, panting, coat quality, and body shape - these signs tend to creep in slowly. Our guide on 10 signs your pet is sick can help you spot the broader warning signals worth mentioning at your next vet visit.

Iatrogenic Cushing's disease is the one form you have real control over. If your dog needs steroids for allergies, an immune condition, or inflammation, ask your vet about using the lowest effective dose for the shortest reasonable time, and never stop a long-term steroid abruptly - always follow your vet's tapering schedule.

Routine senior wellness exams and annual bloodwork don't prevent Cushing's disease, but they often catch the early lab patterns - like a rising ALP or cholesterol - that justify testing sooner rather than later, well before the pot belly and hair loss become obvious.

FAQ

What is the life expectancy of a dog with Cushing's disease?
Many dogs with well-managed Cushing's disease live comfortably for two to four years or more after diagnosis, and some live even longer, since the disease itself is usually more of a quality-of-life issue than an immediately life-threatening one. Untreated or poorly controlled cases carry a higher risk of complications like infections, blood clots, and diabetes, so consistent treatment and monitoring genuinely extend both lifespan and comfort.

Is Cushing's disease painful for dogs?
Cushing's disease itself is not typically described as painful, but the secondary effects - muscle weakness, skin infections, joint discomfort from muscle loss, and reduced mobility - can affect a dog's comfort and quality of life. This is why many vets pair cortisol-lowering treatment with supportive care for skin, joints, and muscle condition.

Can Cushing's disease in dogs turn into diabetes?
Yes, chronically high cortisol interferes with how the body uses insulin, and some dogs with poorly controlled Cushing's disease go on to develop diabetes mellitus as a complication. This is one of the reasons vets recommend regular blood glucose checks alongside cortisol monitoring in dogs on long-term treatment.

What foods should I avoid feeding a dog with Cushing's disease?
There's no single food that causes or cures Cushing's disease, but many vets recommend a moderate-fat, controlled-calorie diet, since affected dogs are prone to weight gain, pancreatitis, and elevated blood fats. Ask your vet whether a therapeutic or weight-management diet fits your dog's specific case.

How much does treating Cushing's disease cost in India?
Costs vary widely depending on your city, the tests your vet recommends, and whether specialist imaging or surgery is needed, so there's no single reliable number to quote. As a general pattern, the biggest ongoing cost is usually the monthly medication plus periodic recheck bloodwork rather than the initial diagnosis - ask your vet for a written estimate specific to your dog's weight and treatment plan.

References

1. SpectrumCare - Cushing's Disease in Dogs: Symptoms, Diagnosis & Treatment
2. Merck Veterinary Manual - Disorders of the Adrenal Glands in Dogs
3. Cornell University College of Veterinary Medicine - Cushing's Syndrome
4. VCA Animal Hospitals - Cushing's Disease in Dogs
5. U.S. Food and Drug Administration - Treating Cushing's Disease in Dogs