Cushing's disease in dogs: what to track
This guide is general information and not a substitute for your veterinarian. For your own dog, your vet is always the right person to ask.
You have the diagnosis, your dog is on a tablet every day now, and the next recheck is a few weeks off. In between, you're the one who sees how he's actually doing. The short version: write down water intake, appetite, panting, energy, and whether the tablet was given, plus weight once a week. Those are the things that shift first, and they're exactly what your vet will ask you about.
Cushing's is a condition where a lot happens between appointments and very little of it gets measured. Below is what's worth recording, the warning signs that can't wait, how the rechecks work, and how you'll know the treatment is doing its job. There's a log you can print, too.
What Cushing's disease actually is
With Cushing's disease, the body makes too much cortisol, its own stress hormone. Usually the cause is a small benign growth on the pituitary gland that keeps driving the adrenal glands; less often it's a tumour on an adrenal gland itself. The medical name is hyperadrenocorticism.
Too much cortisol over a long stretch explains nearly every sign you noticed: the huge thirst, the constant hunger, the panting, the belly that got rounder, the coat that got thinner, the infections that keep coming back. In plenty of dogs the first hint isn't a symptom at all, it's a raised liver value on bloodwork run for something else entirely. It mostly affects older dogs, which is why the changes get written off as him just getting on a bit.
Warning signs that need a vet the same day
First, because this is the part that can't wait. Call your vet today if your dog shows any of these while on treatment:
- He's vomiting or has diarrhoea.
- He's refusing food, or eating markedly less than usual.
- He's noticeably weak, flat, or unresponsive.
- He's wobbly on his legs, staggering, or collapses.
Here's why. The treatment works by bringing cortisol down, and if it comes down too far, the problem flips to the opposite one. Too little cortisol looks exactly like the list above and can become serious. That's why the owner leaflet for trilostane, the usual medication for Cushing's, tells owners to stop giving it and seek veterinary advice immediately if these signs appear. That instruction comes with the medication, not from us. Read the leaflet your vet gave you and follow it.
Everything else about dosing is a conversation with your vet, even when a change seems obvious from where you're standing. Staying calm never means downplaying the danger.
What to write down each day
It doesn't need to be long. One line in the evening is enough, as long as it's there every day. These are the things worth having:
- Water intake in millilitres. This is the single most telling number in Cushing's, because increased thirst usually arrives first and usually settles first once treatment is working. How to measure it properly is in our guide to how much water a dog should drink.
- Appetite. Eating normally, ravenously, or leaving food? The desperate hunger often eases as things improve. Suddenly refusing food, on the other hand, belongs in the list above.
- Panting. Just note whether he panted noticeably without being hot or having exercised. It's one of those signs nobody remembers accurately in hindsight.
- Energy. How far he came on the walk, whether he wanted more, whether he stopped. One sentence does it.
- Accidents indoors and night-time trips out. Puddles in the hall or getting up at 3am are urine volume seen from the other side, and they're easy to count.
- Whether the tablet was given, with the time and whether it went with food. Not out of diligence, but because a missed or doubled dose skews the monitoring results, and your vet needs to know in order to read them properly.
- Weight once a week, on the same scales where you can.
- Coat, skin, and infections when something changes. Bald patches, flaking, thin skin, another urinary infection.
If that's too much, take the first three. Water, appetite, tablet given or not. A short list you keep for six months is worth far more than a complete one that stops after a fortnight.
How the rechecks work
Cushing's doesn't get set up once and then left alone. The treatment gets adjusted through monitoring tests, and those cluster closely together at the start, after treatment begins or a dose changes. Once things are steady they spread out. Which rhythm applies to your dog is your vet's call.
At those appointments blood is usually taken to see where cortisol sits under treatment. Often that's an ACTH stimulation test, measuring before and after an injection, or a level taken shortly before the next tablet is due. Your dog may need to stay at the practice for a few hours, and you'll likely be asked exactly when the last tablet was given. Ask beforehand whether he should be fed that day and when the tablet should go in, because both affect the result.
The key thing: the lab number doesn't decide on its own. Your vet reads it alongside how your dog is doing at home. A result in the target range for a dog still drinking three litres means something different from the same result for a dog whose intake has halved. Your records are the other half of that judgement, and without them it's simply missing.
How you'll know the treatment is working
The order is similar in most dogs, and knowing it helps you place what you're seeing. Drinking and urinating drop back first, often within the first weeks, and the ravenous hunger eases. Panting settles. Energy comes back slowly, and the belly firms up over months. Coat and skin take the longest, often several months, which makes them the worst yardstick for whether things are going well right now.
This is where the logging pays for itself. If your dog was on 2.8 litres before treatment started and sits steadily at 1.3 eight weeks later, that's an answer. "Seems better" isn't. And it works in both directions: if water intake climbs again after months, that's often the earliest sign the dose no longer fits, well before your dog looks any different. So keep the uneventful weeks too. A run of quiet numbers is the answer to whether the control is holding.
Notebook, spreadsheet, or app?
The honest answer: the best method is the one you'll actually keep up. Cushing's is a long haul, and that argues for the simplest thing that works.
- A sheet on the fridge hangs where the tablets live and needs no battery. Our printable monitoring log has rows for water intake, appetite, panting, energy, weight, and medication, plus room for questions to raise at the next recheck.
- A spreadsheet shows water intake across months as a line, and that line is exactly what you want to see with Cushing's.
- An app can remind you about the daily tablet and keep the numbers together for the recheck.
That's what we're building Felova for, an app that reminds you about medications and keeps the numbers in one place for your vet. It's not out yet. You can join the waitlist, and until then a sheet on the fridge does the same honest work. What matters is that there are numbers at the next appointment rather than an impression.
Common questions
My dog is still drinking a lot after weeks. Is the treatment not working?
Not necessarily. Some dogs take longer, some doses aren't right yet, and sometimes something else is going on alongside it. That's exactly why you keep measuring instead of guessing: your numbers are what your vet uses at the next appointment to decide whether anything changes. Don't adjust the dose yourself.
Do I really have to write something down every day?
The trend matters more than the gaps. If you forget three days, just carry on rather than stopping. Water intake is worth measuring properly for a few days in a row before each recheck though, so you arrive with a solid current number.
Can Cushing's be cured?
With the common pituitary form it's about control rather than cure: the medication keeps cortisol down for as long as it's given. With an adrenal tumour, surgery may be an option. Which applies to your dog depends on which form he has, and that's a conversation for your vet.
Do cats get Cushing's disease?
They can, but it's rare. When it happens it's often tied to diabetes that's proving hard to control. This guide is written for dogs because Cushing's is far more common in them.
Felova is being built for exactly this kind of tracking, a calm place for the daily tablet, the water intake, and the weight so the trend is there when your vet needs it at the recheck. It's not out yet.
Join the waitlist →