How to Spot Cushing’s Disease in Dogs Before It’s Too Late

Your dog is drinking more water than usual, waking you up for late-night potty breaks, and looking just a little… rounder. You might chalk it up to age or a change in routine—but what if it’s something more?

Cushing’s disease, also known as hyperadrenocorticism, is a condition that often creeps up quietly and gradually. It occurs when your dog’s body produces too much cortisol—a stress hormone that, in excess, can wreak havoc on internal systems.

While it’s more common in middle-aged to older dogs, it’s often missed or mistaken for normal aging until symptoms become impossible to ignore.

The tricky part? Many of the early warning signs—like increased thirst, hair thinning, or a pot-bellied appearance—don’t seem alarming at first glance.

But these subtle red flags are often the earliest whispers of a body struggling to maintain balance.

And because cortisol affects nearly every part of a dog’s physiology, Cushing’s disease can show up in surprising ways: skin issues that don’t heal, sudden muscle weakness, or even behavioral shifts like anxiety or confusion.

Without timely diagnosis and treatment, these symptoms can snowball into serious health complications.

This article breaks down the most common—and often overlooked—signs of Cushing’s disease in dogs.

Whether you’re noticing subtle shifts in your dog’s behavior or managing a pup who seems “off” lately, knowing what to look for can help you act early and get the right treatment plan in place.

1. Excessive Thirst and Urination

One of the most noticeable early signs of Cushing’s disease is a dramatic increase in how much your dog drinks and urinates.

You might find yourself refilling their water bowl more often or waking up at night to take them outside. Some dogs even start having accidents in the house—something that can be frustrating if they’ve been housetrained for years.

This behavior is caused by cortisol’s effect on the kidneys. The hormone tells the body to hold onto sodium and release more water, which leads to excessive thirst and a constant need to urinate.

If your dog suddenly seems obsessed with water or can’t make it through the night without a potty break, it’s time to look a little closer. While other conditions like diabetes can mimic this, Cushing’s is a strong contender.

2. Increased Appetite

You may notice your dog becomes unusually food-driven, even if they were never that way before. Dogs with Cushing’s disease often seem insatiable—raiding trash cans, stealing from counters, or begging in ways that feel out of character.

This hunger spike is due to elevated cortisol levels, which can increase appetite and override the body’s natural “full” signals.

Unlike normal food motivation, this type of appetite may be persistent and obsessive, with your dog acting anxious or unsettled when they’re not eating.

Though a big appetite might seem harmless or even funny at first, it’s actually a warning sign.

If your dog’s food habits change drastically and suddenly, and especially if paired with other symptoms, it’s worth a vet visit to rule out endocrine issues like Cushing’s disease.

3. Pot-Bellied Appearance

A bloated, saggy-looking belly is a hallmark of Cushing’s disease—and one that’s often mistaken for weight gain or laziness. But this pot-bellied appearance isn’t due to overeating.

It’s a result of internal muscle wasting, organ enlargement, and fat redistribution in the abdomen.

As cortisol breaks down muscle, the core becomes weaker. Combine that with excess fat around the organs and a swollen liver, and the result is a rounded belly that looks out of proportion with the rest of the body.

Even if the dog’s limbs remain slim and their weight stays stable, the belly can protrude noticeably.

If your pup suddenly looks like they swallowed a balloon, it’s not just middle-age spread—it could be a sign of something more serious happening inside.

4. Thinning Skin

Dogs with Cushing’s disease often develop skin that feels paper-thin to the touch. You may notice it tears more easily or bruises from even minor bumps.

What once felt like tough, healthy hide can become fragile and overly delicate seemingly overnight.

This happens because cortisol interferes with collagen production, which is vital for skin elasticity and strength. Without it, the skin loses its resilience, leading to a higher risk of wounds, irritation, and discomfort.

Even everyday activities like scratching, grooming, or rough play can result in small injuries. If your dog’s skin seems more sensitive or you’re noticing cuts or bruises that didn’t used to happen, it’s worth investigating.

Thinning skin isn’t just a cosmetic change—it’s a physiological signal of a deeper imbalance.

5. Hair Loss (Alopecia)

Hair loss in Cushing’s disease is usually gradual but distinct. You might spot thinning fur along the back, sides, or tail, often in a symmetrical pattern. Unlike seasonal shedding or hot spots, this hair loss doesn’t come with itching or redness.

The cause? Excess cortisol disrupts the hair growth cycle. It puts hair follicles into a prolonged resting phase, so shed hairs aren’t replaced. Over time, this leads to widespread bald patches that creep across the body.

What’s especially telling is that the hair on the head and legs often remains unaffected.

If your dog’s coat is thinning mostly on the trunk or tail, that pattern is a key clue. Pair it with other signs like increased thirst or appetite, and it strongly points toward Cushing’s.

6. Slow Hair Regrowth

If your dog was recently shaved for grooming, surgery, or a medical procedure, and their fur just isn’t growing back like it used to, it may be more than bad luck. Slow or absent hair regrowth is a classic sign of Cushing’s disease.

Cortisol disrupts the skin’s normal healing and hair regeneration process. That means after fur is clipped, the hair follicles may remain dormant for months—or longer. In some dogs, the hair never comes back at all.

This symptom can be easy to overlook, especially if your dog gets regular trims. But when regrowth stalls or stops entirely, it’s worth noting. Combined with thinning skin and patchy fur loss, it points to a hormonal imbalance rather than a grooming issue.

7. Muscle Weakness

Have you noticed your dog struggling to climb stairs, jump onto the couch, or even rise from a lying position?

Muscle weakness, particularly in the back legs, is a common symptom of Cushing’s disease and often one of the earliest functional changes owners spot.

Excess cortisol breaks down muscle tissue over time. This leads to noticeable wasting, especially around the hips and thighs, causing dogs to look thinner in the limbs but still bloated in the belly.

They may seem clumsy, slip more often on smooth floors, or tire quickly during walks. If your dog appears wobbly or avoids formerly easy movements, don’t just assume it’s old age.

Muscle loss with no obvious injury can be a red flag for an underlying endocrine issue.

8. Lethargy or Decreased Activity

Not every dog with Cushing’s turns into a sleepy lump—but many slow down in ways that feel off. If your once energetic pup now spends most of the day dozing or seems disinterested in toys, walks, or play, it might be more than a lazy streak.

Cortisol imbalances sap energy. They mess with metabolism, disrupt sleep cycles, and reduce muscle stamina. Over time, dogs may not have the physical or mental drive to stay active like they used to.

This drop in energy is often subtle at first, especially in older dogs. But if your pet seems more withdrawn, slow to move, or just not themselves, it’s worth noting.

Lethargy paired with other symptoms—like appetite changes or a pot belly—deserves a closer look.

9. Panting

Excessive panting—especially when it’s not hot, your dog hasn’t exercised, or there’s no clear stressor—is another telltale sign of Cushing’s disease. This panting often seems random or persistent and may even continue during rest or sleep.

The cause? Elevated cortisol affects the respiratory system and overall metabolism, which can result in a faster breathing rate.

Fat buildup around the organs, particularly in the abdomen, also puts pressure on the diaphragm, making breathing feel more labored.

You might hear heavier breathing at night or notice your dog constantly seeking cool surfaces. While occasional panting is normal, a pattern of unexplained, frequent panting should raise a flag.

Combined with other Cushing’s indicators, it’s a symptom worth reporting to your vet.

10. Restlessness or Pacing

Dogs with Cushing’s disease can become noticeably restless, especially during times they used to be relaxed—like late at night. They may pace the house, circle repeatedly, or seem unable to settle in one place for long.

This behavior is linked to cortisol’s impact on the nervous system. Elevated levels of the stress hormone can make dogs feel agitated or anxious, even in familiar, safe environments. It’s not just physical energy—it’s internal discomfort.

You might see them get up and down frequently, move from bed to floor to couch, or even whine as they walk.

If your dog is pacing more than usual, especially at odd hours, it could be more than boredom—it might be a hormonal imbalance affecting their sense of calm.

11. Confusion or Disorientation

While Cushing’s is primarily a hormonal disorder, it can also have neurological effects—particularly when caused by a large pituitary tumor pressing on brain tissue. This can result in confusion, circling, staring into space, or even head pressing.

Dogs who once navigated your home easily might start bumping into furniture or forget familiar routines. You may notice hesitation at doorways, difficulty recognizing commands, or periods of seeming “zoned out.”

These symptoms are especially concerning because they’re often mistaken for cognitive decline or dementia in senior dogs.

But when paired with other physical changes—like thirst, appetite, or skin issues—they could point to Cushing’s disease. Any sudden mental or behavioral shift deserves prompt medical attention.

12. Recurring Skin Infections

If your dog keeps getting skin infections—especially in the same spots—it may be more than bad luck. Cushing’s disease weakens the immune system, making dogs more susceptible to bacterial and fungal skin problems.

You might notice redness, scabbing, greasy patches, or a strong odor. These infections often return quickly after treatment or take longer than expected to heal. The skin may also ooze or have areas of discoloration.

Since cortisol suppresses the body’s natural defenses, even minor skin irritations can spiral into persistent issues.

If you’re stuck in a cycle of antibiotics and medicated shampoos with no long-term improvement, it’s time to ask your vet about possible hormonal causes—especially if other Cushing’s symptoms are also present.

13. Calcinosis Cutis

One of the more dramatic skin-related symptoms of Cushing’s disease is calcinosis cutis—a condition where calcium deposits form under the skin. These hard, chalky plaques feel gritty to the touch and may look like scabs or lesions.

They’re typically found along the back, neck, or groin and can cause significant discomfort.

In severe cases, the skin around them can become inflamed, crack open, or get infected. It’s not just unsightly—it’s painful and signals a serious systemic imbalance.

Calcinosis cutis is rare in other conditions but relatively common in dogs with untreated or advanced Cushing’s.

If your dog suddenly develops strange, raised skin patches or hard lumps, especially in combination with other symptoms, it’s time to press for testing. This one’s a red flag you definitely don’t want to ignore.

14. Darkened Skin Pigmentation

If your dog’s skin is turning darker—especially on the belly, elbows, or armpits—it could be a clue. Hyperpigmentation is a common symptom of Cushing’s and tends to develop gradually over time.

While it’s not painful or itchy, it’s a visual marker of chronic hormonal stress. The change is caused by cortisol’s effect on melanin production, which can lead to patches of darkened skin, particularly in thin-furred areas.

This symptom is often overlooked because it doesn’t seem harmful on its own. But when paired with hair loss, thinning skin, or a pot belly, it paints a more complete picture.

So if your pup’s belly is starting to look more like leather than skin, don’t brush it off as “just aging.”

15. High Blood Pressure

Just like in humans, chronic high blood pressure in dogs can quietly wreak havoc—especially when linked to Cushing’s disease. Elevated cortisol levels increase vascular tension, which raises blood pressure and puts extra strain on the heart and kidneys.

You likely won’t notice this one without a vet check. But if your dog has symptoms like sudden vision changes, blood in the eyes, or seems more lethargic or anxious, hypertension could be part of the puzzle.

Routine exams or pre-surgical workups often uncover high blood pressure in dogs with undiagnosed Cushing’s.

If your vet flags it, don’t assume it’s isolated—push for further testing. It’s one of those “silent” symptoms that can do major damage if left unchecked.

16. Elevated Liver Enzymes

If your dog’s bloodwork shows high liver enzymes, especially alkaline phosphatase (ALP), it might be a quiet warning. Elevated enzymes don’t always mean liver disease—they can also be a side effect of hormonal disorders like Cushing’s.

Cortisol causes the liver to work overtime, breaking down excess fats and proteins. Over time, this can lead to liver enlargement, fat accumulation, and sluggish processing of toxins—reflected in routine lab tests as elevated markers.

Often, this clue is discovered before outward symptoms become obvious. If your vet mentions high liver values and your dog is also thirstier, hungrier, or losing hair, Cushing’s should be on the radar.

It’s not just about liver health—it’s about what’s throwing the liver off balance in the first place.

17. Protein in Urine

Another silent but telling sign of Cushing’s is proteinuria—meaning your dog’s urine contains too much protein.

Normally, the kidneys filter waste while keeping important proteins in the bloodstream. But in Cushing’s, cortisol damages this filter system.

The result? Vital proteins leak into the urine, which can lead to long-term kidney issues if untreated. You likely won’t notice anything visually different, but urine tests during annual checkups can detect this change early.

It’s one of those subtle clues that points toward systemic stress. If your vet finds protein in your dog’s urine—especially if paired with other hormonal red flags—ask about Cushing’s testing.

Catching it here can help prevent future kidney damage and improve quality of life.

18. Poor Wound Healing

Small cuts that should heal in a few days dragging on for weeks? That’s a classic sign of poor tissue repair, and it often shows up in dogs with Cushing’s disease. Elevated cortisol slows down the body’s natural healing process.

You might notice scabs that keep reopening, surgical sites that don’t close properly, or even minor skin irritations that escalate into infections. It’s frustrating—and it puts your dog at risk of ongoing pain or secondary issues.

Even if wounds don’t seem serious at first, slow recovery is a red flag. When your dog’s immune system and tissue repair mechanisms are compromised, everything takes longer to bounce back.

In combination with other symptoms, poor healing deserves a deeper medical investigation.