Tuesday, November 28, 2023


Ask the Pet Vet: Cushing’s syndrome in dogs. Should this reader be worried?

Dear Dr. Karel,
I’m worried about my dog, Puddin, who drinks a lot of water and is gaining weight. I have reduced her food but her belly is huge. She is a 10-year-old Cockapoo. She’s spayed, her vaccinations are up to date, and she hasn’t had many health problems. Her skin has become very greasy and she has lost a lot of hair. What could cause this? —Marci K.

Hi, Marci, 
First, I love the name Puddin!

What you are describing sounds as if Puddin has developed a condition called Hyperadrenolcorticism, also known as Cushing’s syndrome (or Cushing’s disease). Unfortunately, it is quite common in middle-aged dogs.

The telltale signs of Cushing’s syndrome in dogs are:

  • Drinking a great deal of water—much more than usual. This is accompanied by urinating more and more frequently. It is called polyuria-polydipsia or PUPD in the vet world. It is a symptom of many diseases such as diabetes and renal/kidney disease, too, but it is a hallmark of Cushing’s
  • Greasy, smelly coat and skin. The hormonal imbalance wreaks havoc on the skin, and dogs frequently develop skin infections (pyoderma) and clogged glands. They will lose fur, usually on their flanks and belly. This is known as pattern alopecia. They can also develop hardened paw pads.
  • Voracious appetites. Excess cortisol (adrenaline) supercharges a dog’s metabolism and makes them very, very hungry. The big belly is not a sign of obesity in this case. Does Puddin pant a lot, even when resting? Her overcharged metabolism needs more oxygen, so she pants.
  • Distended abdomen. Puddin’s big belly is distended because her abdominal muscles are weak and lose tone. This causes the bulge. The hormonal imbalance impacts all the muscles but it is particularly noticeable in the abdomen.

Here is a dog with Cushing’s syndrome showing all the tell-tale symptoms.

A small dog with Cushing's Syndrome
Courtesy Dr. Stephen White.

What to do

Puddin needs to go to the vet and have tests and imaging done. There are two causes of Cushing’s syndrome: an adrenal tumor or a pituitary tumor. It’s important to determine which type Puddin has. Most commonly, both types can be treated with medication. Knowing the type may determine the choice of drug. Sometimes there is a very distinct tumor that may be a good candidate for surgical removal.

Note that these medications have side effects that must be managed, as well.

Speak with your vet and get the tests done. There is another disease, Hypoadrenocorticism, also known as Addison’s disease, that sometimes mimics other diseases and often has symptoms that overlap with Cushing’s. It’s important to have a thorough exam and all pertinent tests done so Puddin can feel better.

I hope this information helps. You can find more on the FDA’s website.

If you have any more questions or would like to share Puddin’s progress, please visit my forum here.



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