Can Cushing's disease in dogs be cured?

In most cases it is not cured but very well controlled with treatment tailored to the individual dog. The form caused by a tumour of one adrenal gland can, in selected cases, be tackled surgically. With the right treatment the thirst, hunger and coat improve, and quality of life returns to good for years. The key point is regular monitoring, because the dose must be kept in the safe zone, avoiding both too much and too little.

At what age does it usually appear?

It is a disease of the middle aged and older dog: most diagnoses are in dogs over six or seven years. Some small breeds are more prone, but it can affect any dog. Precisely because it arrives late in life, the first signs are often mistaken for normal ageing, which delays the diagnosis. An older dog that suddenly starts drinking much more still deserves a visit.

My dog is drinking a lot more: does that mean Cushing's?

No. A rise in thirst and urination is an important but non specific sign: it also belongs to diabetes, to several kidney diseases, to liver problems and to other hormonal conditions. That is why the first step is not a Cushing's test but a visit with baseline blood and urine tests to see which direction to look in. Measuring how much water the dog drinks in a day and reporting it to the vet is very useful.

The diagnosis is costly and involved: can some tests be skipped?

The diagnosis needs several steps because no single test is enough, and skipping one risks treating the wrong disease. That said, the path is built gradually: it starts from baseline tests, which sometimes on their own redirect towards another diagnosis, and continues with hormone tests and ultrasound only when suspicion stays solid. Discussing the steps and costs with the vet in advance helps you plan without surprises.

Health and prevention8 min readUpdated on August 19, 2026

Cushing's disease in dogs: the first signs and how the diagnosis is made

Increased thirst, hunger and urination, a pot belly and a thinning coat: how to spot the early signs of Cushing's disease in dogs and how it is diagnosed.

Audience: Pet owners
Species: Dog
Scope: Valid everywhere, European Union, Italy

Cushing's disease, more properly called hyperadrenocorticism, is one of the most common hormonal disorders in the adult and older dog, and also one of the hardest to spot. The excess cortisol acts on the whole body, and the earliest changes are so gradual that they blend into normal ageing: the dog drinks more, eats more insistently, the belly hangs lower, the coat thins. No single one of these signs points to a specific illness, which is exactly why the diagnosis often arrives months after the first clues appear. This page explains what changes inside the body, which signs deserve a visit, and why the diagnostic path needs more than a single blood test.

What Cushing's disease actually is

The adrenal glands, two small structures near the kidneys, produce cortisol, a hormone that regulates metabolism, the stress response, blood pressure and the immune system. In Cushing's this hormone circulates in chronic excess. The body behaves as if it were permanently under pressure: it holds on to water, pulls in sugars, redistributes fat towards the abdomen, and weakens muscle, skin and defences against infection.

The result is a slow, many sided picture that touches different organs without one dramatic sign. It is a disease of middle aged and older dogs, more common in some small breeds, and it needs to be told apart carefully from plain ageing, because a correct diagnosis changes the quality of the years that remain.

The signs owners notice first

The most consistent sign is a rise in thirst and urination. A dog that used to ignore the water bowl overnight starts emptying it, asks to go out more often, or has the odd accident indoors. It is the change owners catch first, and on its own it justifies a visit.

Drinks far more and passes larger volumes of urine, often needing to go out at night.
Has a relentless appetite: scavenges, steals from the table, seems hungry even right after a meal.
The belly drops and takes on a barrel shape, from fat redistribution and weakening of the abdominal muscles.
The coat thins symmetrically over the flanks and trunk while the head and legs stay covered; the skin becomes thin and bruises more easily.
Panting at rest becomes frequent, exercise tolerance falls, and the overall look is tired.
Skin and urinary infections tend to recur, because immune defences are suppressed.

Taken one at a time these signs are generic, but their combination, above all increased thirst and hunger together with the change in body shape, is very suggestive. Noting when they started and how they changed helps the vet frame the case faster.

The two forms and why the distinction matters

In the large majority of cases the problem starts from a small benign tumour of the pituitary, the gland at the base of the brain that commands the adrenals. In a minority it is one of the two adrenal glands producing excess cortisol. The distinction is not academic: it changes treatment, monitoring and outlook.

The two forms of hyperadrenocorticism compared
Aspect	Pituitary form	Adrenal form
Frequency	About four cases in five	About one case in five
Origin	Small pituitary adenoma stimulating both adrenals	Tumour of a single adrenal, benign or malignant
Main approach	Long term medical therapy	Surgical assessment where possible, otherwise medical therapy
Confirming tests	Hormone tests and sometimes brain imaging	Abdominal ultrasound and advanced imaging to stage

Working out which form is at play almost always needs an abdominal ultrasound, which lets the vet look at the adrenals and judge their size and symmetry. In selected cases more detailed imaging is needed to choose the best strategy.

How the diagnosis is reached

There is no single test that says yes or no. The diagnosis is built from clinical suspicion and then confirmed with targeted tests, because the hormone tests give misleading results if used on a dog that does not truly have the disease. That is why you observe first and test later.

Examination and history
The vet pulls together the reported signs, their duration, the breed and the age. Your notes on how much the dog drinks and eats, with photos of the body shape over time, make this step far more solid.
Baseline blood and urine tests
These picture the liver, kidney, sugar and urine concentration, and above all rule out other diseases that mimic Cushing's. Some changes are typical, but none alone is proof.
Abdominal ultrasound
This looks directly at the adrenals and searches for a mass. It is often the step that points towards the pituitary or the adrenal form.
Confirming hormone test
One of the available dynamic tests measures how the adrenals respond to a stimulus or a brake, usually with several blood samples over a few hours. It is the piece that confirms the cortisol excess.
Test to distinguish the form
If the origin needs clarifying, further tests show whether the command comes from the pituitary or an adrenal, information that decides the treatment route.

Management and monitoring over time

Cushing's is rarely cured, but in most cases it is well controlled, and a dog on the right treatment goes back to drinking and eating normally, regrows coat and muscle and regains energy. Treatment must be tailored to the individual and adjusted over time, never improvised: too high a dose can push cortisol too low, with serious risks.

That is why monitoring is part of the treatment. In the first months checks are closer together, then they space out once things stabilise. The owner has a central role, because they see the dog every day and are first to notice the signs of a dose that needs revising.

Keep a log of how much the dog drinks and urinates: thirst climbing back up or crashing down is the first sign that something needs recalibrating.
Weigh the dog regularly and note appetite, energy and coat, so you bring hard data to the visit.
Report vomiting, diarrhoea, dullness or refusal to eat at once: in a treated dog these can mean cortisol has gone too low and call for quick contact with the vet.
Keep the follow up appointments with hormone tests even when the dog seems fine, because they keep the dose in the safe zone.
Never change the dose on your own initiative and never stop treatment without guidance.

What can look like Cushing's

Many of the things that suggest Cushing's belong to other diseases, and that is why you do not start from hormone tests. Increased thirst and hunger, for instance, are also the calling card of diabetes and of some kidney diseases.

Conditions that share signs with Cushing's
Condition	Shared signs	What usually tells it apart
Diabetes mellitus	Increased thirst, hunger and urination	High sugar in blood and urine
Chronic kidney disease	Increased thirst and urination, weight loss	Typical kidney changes and dilute urine
Hypothyroidism	Coat changes, lethargy	Weight gain and low thyroid values, not increased thirst
Corticosteroid treatment	The whole Cushing's picture	An ongoing treatment to review

This overlap explains why rushing is counterproductive. An orderly path, one that starts from the signs and reaches the tests only when suspicion is well founded, avoids wrong diagnoses and pointless treatments, and gets to the right care faster.

Frequently asked questions

Can Cushing's disease in dogs be cured?: In most cases it is not cured but very well controlled with treatment tailored to the individual dog. The form caused by a tumour of one adrenal gland can, in selected cases, be tackled surgically. With the right treatment the thirst, hunger and coat improve, and quality of life returns to good for years. The key point is regular monitoring, because the dose must be kept in the safe zone, avoiding both too much and too little.
At what age does it usually appear?: It is a disease of the middle aged and older dog: most diagnoses are in dogs over six or seven years. Some small breeds are more prone, but it can affect any dog. Precisely because it arrives late in life, the first signs are often mistaken for normal ageing, which delays the diagnosis. An older dog that suddenly starts drinking much more still deserves a visit.
My dog is drinking a lot more: does that mean Cushing's?: No. A rise in thirst and urination is an important but non specific sign: it also belongs to diabetes, to several kidney diseases, to liver problems and to other hormonal conditions. That is why the first step is not a Cushing's test but a visit with baseline blood and urine tests to see which direction to look in. Measuring how much water the dog drinks in a day and reporting it to the vet is very useful.
The diagnosis is costly and involved: can some tests be skipped?: The diagnosis needs several steps because no single test is enough, and skipping one risks treating the wrong disease. That said, the path is built gradually: it starts from baseline tests, which sometimes on their own redirect towards another diagnosis, and continues with hormone tests and ultrasound only when suspicion stays solid. Discussing the steps and costs with the vet in advance helps you plan without surprises.

What to do next

If your adult or older dog has begun drinking and eating much more, has a lower belly and a thinning coat, do not write it off as old age: note how long it has been going on, measure how much water it drinks and book a visit. A Cushing's diagnosis is built step by step, from the signs to baseline tests to hormone testing, and once treatment is set, regular monitoring is what keeps the dog well for years.