Understanding Cushing's: A Picture of a Dog With Cushing's Disease

By :Becki Baumgartner, PhD 0 comments

A Picture of a Dog With Cushing's Disease

Dogs suffering from Cushing’s disease often develop a very recognizable appearance and set of symptoms. In many cases, the physical changes happen gradually, so pet owners may not notice them right away.

In this article, we’ll explain the common signs of Cushing’s disease, what causes those symptoms, and how the condition may affect your dog’s daily comfort and quality of life.

Cushing’s disease, also called hyperadrenocorticism, is a hormonal disorder that occurs when the body produces excessive amounts of cortisol. Cortisol is a steroid hormone produced by the adrenal glands, located near the kidneys.

Under normal conditions, cortisol plays an important role in many body functions, including:

metabolism and weight regulation
immune system function
blood sugar balance
stress response
inflammation control

However, when cortisol levels remain elevated for long periods, the hormone can begin to place significant stress on the body. Excess cortisol may weaken muscles, suppress immune function, affect the skin and coat, increase thirst and urination, and contribute to long-term health problems.

There are two main forms of Cushing’s disease in dogs:

Pituitary-dependent Cushing’s disease (PDH)
Adrenal-dependent Cushing’s disease

Pituitary-dependent Cushing’s disease is by far the most common form, accounting for approximately 80% to 85% of cases. This type usually develops when a small tumor in the pituitary gland overstimulates the adrenal glands, causing them to produce too much cortisol.

Adrenal-dependent Cushing’s disease is less common and occurs when a tumor develops directly within one of the adrenal glands.

From a TCVM perspective, dogs with Cushing’s disease often show patterns associated with Yin deficiency, internal Heat, and Kidney imbalance. Excess cortisol may create chronic internal stress, gradually weakening vitality and disrupting normal balance over time.

Understanding the signs of Cushing’s disease early may help pet owners seek treatment sooner and improve their dog’s comfort, energy, and long-term quality of life.

As you can see in the above picture of a dog with Cushing's disease, there are several obvious signs.

Drinking More and Peeing More

One of the earliest and most noticeable signs of Cushing’s disease in dogs is excessive drinking and urination. Many pet parents first realize something is wrong when they suddenly find themselves refilling the water bowl more often or needing to let their dog outside more often.

The medical terms for increased thirst and increased urination are polydipsia and polyuria, respectively. Both are extremely common symptoms in dogs with Cushing’s disease.

Elevated Cortisol Levels

Cushing’s disease causes the body to produce excessive amounts of cortisol, a hormone that affects many important body functions. High cortisol levels can disrupt the body’s normal water balance and place extra stress on the kidneys.

When cortisol remains elevated for extended periods, dogs often drink much more water than usual to stay hydrated.

How Cortisol Affects Urination

Excess cortisol also interferes with the normal function of antidiuretic hormone (ADH), the hormone responsible for helping the kidneys conserve water and concentrate urine.

When ADH function becomes disrupted, the kidneys lose their ability to properly concentrate urine. As a result:

Dogs produce larger amounts of dilute urine
More fluids are lost from the body
Increased thirst develops to replace lost water

This cycle often causes dogs with Cushing’s disease to drink and urinate excessively throughout the day and night.

Panting and Dehydration

Many dogs with Cushing’s disease also pant excessively. Elevated cortisol increases internal stress and may raise body temperature, both of which contribute to heavier panting.

Panting causes additional fluid loss, which can further increase dehydration and thirst. In response, dogs naturally drink more water to replace lost fluids and maintain body balance.

Cortisol's Effect on the Kidneys

High cortisol levels may also directly affect kidney function over time. Cortisol can impair the kidneys’ ability to reabsorb water efficiently, leading to further fluid loss through urination.

As the body loses water faster than normal, dogs instinctively increase their water intake to compensate.

From a TCVM perspective, excessive thirst and urination are often associated with Yin deficiency and internal Heat. Dogs with Cushing’s disease may experience internal dryness and depletion caused by long-term hormonal imbalance and chronic stress within the body.

Because increased thirst and urination are often among the first warning signs of Cushing’s disease, recognizing these symptoms early may help pet owners seek veterinary care sooner and improve long-term management of the condition.

Potbelly Appearance

Many dogs with Cushing’s disease develop a classic pot-bellied appearance. In fact, a swollen or rounded abdomen is one of the most recognizable physical signs of the condition.

This change in body shape usually develops gradually over time as elevated cortisol levels begin affecting fat distribution, muscle strength, and internal organs.

Abdominal Fat Redistribution

Excess cortisol alters how the body stores and uses fat. Dogs with Cushing’s disease often begin accumulating more fat around the abdomen while losing muscle in other parts of the body.

This abnormal fat redistribution causes the stomach area to appear larger, rounder, and more protruded. Even dogs that are not significantly overweight may develop a noticeable potbelly because of the hormonal effects of cortisol.

Muscle Wasting and Weakness

High cortisol levels also contribute to muscle wasting, also called muscle atrophy. Over time, the body begins breaking down muscle tissue faster than it can rebuild it.

As abdominal muscles weaken, they lose their ability to properly support the organs and abdominal wall. This loss of muscle tone can make the abdomen sag outward and appear even more enlarged.

Many dogs with Cushing’s disease also experience weakness in their legs and reduced stamina because muscle loss affects the entire body, not just the abdomen.

Enlarged Organs

In some cases, Cushing’s disease may also cause enlargement of internal organs, especially the liver. Chronic exposure to elevated cortisol can lead to fat accumulation in the liver, causing it to enlarge.

An enlarged liver may press outward against the abdominal wall, further contributing to the abdomen's swollen appearance.

Changes in Body Shape

The combination of:

Fat redistribution
Muscle wasting
Weak abdominal muscles
Enlarged organs

creates the classic pot-bellied appearance commonly seen in dogs with Cushing’s disease.

From a TCVM perspective, this pattern may reflect underlying Qi deficiency, Kidney imbalance, and Damp accumulation within the body. Chronic hormonal stress can gradually weaken muscle tone, disrupt fluid metabolism, and reduce overall vitality.

Recognizing early changes in body shape may help pet owners identify Cushing’s disease sooner and begin supportive treatment before symptoms become more advanced.

Hair Loss

Yorkshire terrier with bald patches being pet by a woman

Hair loss, also called alopecia, is one of the most common symptoms seen in dogs with Cushing’s disease. Many dogs gradually develop thinning hair, patchy bald spots, or poor coat quality as the condition progresses.

In most cases, hair loss develops slowly and often appears along the sides of the body, on the belly, tail, or neck. Some dogs may also develop dry, darkened skin or a dull, brittle coat.

There are several reasons why Cushing’s disease can lead to hair loss.

Hormonal Imbalance

As mentioned earlier, Cushing’s disease causes the body to produce excessive amounts of cortisol. High cortisol levels disrupt the normal hair growth cycle and can compromise hair follicle health.

Over time, the hair follicles become less responsive to normal growth signals. As a result:

Hair grows back more slowly
Existing hair becomes thinner and weaker
Hair loss gradually develops

In many dogs with Cushing’s disease, hair may not regrow normally after grooming or shaving because the follicles remain suppressed by elevated cortisol levels.

Skin Changes

Dogs with Cushing’s disease often develop significant skin changes in addition to hair loss. Excess cortisol can cause the skin to become thin, fragile, and more easily damaged.

Some dogs may bruise more easily or develop skin tears because the skin loses strength and elasticity over time.

Elevated cortisol can also weaken the immune system, making the skin more vulnerable to bacterial or yeast infections. Chronic skin irritation and inflammation may further contribute to coat problems and hair loss.

Excessive Grooming and Licking

Some dogs with Cushing’s disease become restless, uncomfortable, or itchy, and may begin to lick, chew, or groom themselves excessively.

Constant licking and chewing can damage hair shafts and irritate hair follicles, leading to further hair loss over time.

Reduced Blood Flow to Hair Follicles

Cortisol may also affect circulation within the skin. High cortisol levels can constrict blood vessels and reduce blood flow to the hair follicles.

When hair follicles receive less oxygen and fewer nutrients, their ability to produce healthy hair becomes impaired. Poor circulation may contribute to thinning hair, delayed regrowth, and worsening coat quality.

Melatonin Support

Our founding veterinarians often recommend melatonin as part of a supportive approach for dogs experiencing hair loss associated with Cushing’s disease. Melatonin may help support the normal hair growth cycle in some dogs and is commonly used to encourage coat regrowth and improve skin health.

From a TCVM perspective, hair and skin health are closely connected to Blood, Yin, and overall organ balance. Chronic hormonal imbalance and long-term internal stress may weaken nourishment to the skin and coat, contributing to dryness, thinning hair, and poor coat quality.

Supporting the body through proper nutrition, stress reduction, hydration, and individualized care may help improve both skin health and overall comfort in dogs with Cushing’s disease.

Thin, Scaly Skin

Thin, fragile, and scaly skin is another very common sign of Cushing’s disease in dogs. Many pet owners notice that their dog’s skin becomes dry, flaky, delicate, or easily irritated as the disease progresses.

In some cases, the skin may appear almost paper-thin and may tear or bruise more easily than normal.

Several factors contribute to these skin changes in dogs with Cushing’s disease.

Cortisol's Effect on the Skin

Excess cortisol has a major impact on skin health. One of cortisol’s effects is to reduce collagen production, an important protein that gives the skin strength, structure, and elasticity.

When collagen production decreases:

The skin becomes thinner and weaker
Healing slows down
The skin becomes more fragile and easily damaged

As a result, dogs with Cushing’s disease often develop delicate skin that may crack, flake, or become irritated more easily.

Reduced Skin Cell Turnover

Healthy skin constantly renews itself by shedding old skin cells and replacing them with new ones. Elevated cortisol levels can slow this natural process.

When skin cell turnover slows, dead skin cells begin to build up on the skin's surface. This buildup contributes to:

Dryness
Flaking
Scaly patches
Dull skin appearance

These changes often make the skin look rough, unhealthy, or chronically irritated.

Impaired Sebum Production

The skin also relies on sebaceous glands to produce sebum, a natural oily substance that keeps the skin moisturized and protected.

In dogs with Cushing’s disease, excess cortisol may interfere with normal sebaceous gland function and reduce sebum production.

Without enough natural oil, the skin becomes:

Dry
Flaky
Less protected
More prone to irritation

Reduced skin moisture contributes to the thin, scaly appearance commonly seen in dogs with Cushing’s disease.

Secondary Skin Infections

Elevated cortisol also suppresses the immune system, making dogs with Cushing’s disease more vulnerable to skin infections caused by bacteria or yeast.

These infections may lead to:

Redness
Inflammation
Odor
Itching
Additional scaling and skin damage

Recurring skin infections are very common in dogs with Cushing’s disease and may significantly affect comfort and quality of life.

From a TCVM perspective, chronic skin problems are often associated with Yin deficiency, Blood deficiency, and internal Heat. Long-term hormonal imbalance may weaken nourishment to the skin and disrupt the body’s natural balance, contributing to dryness, irritation, and poor skin health.

Supporting skin health through proper nutrition, hydration, stress reduction, and individualized TCVM care may help improve comfort and overall vitality in dogs with Cushing’s disease.

Dark Patches of Skin

Many dogs with Cushing’s disease develop dark patches of skin, especially in areas where the skin has become thin, irritated, or inflamed. These darker areas are often most noticeable on the belly, underarms, neck, or groin.

The medical term for this darkening of the skin is hyperpigmentation. In dogs with Cushing’s disease, hyperpigmentation usually develops gradually as long-term hormonal imbalance affects the skin and coat.

Several factors contribute to these dark patches.

Increased Melanin Production

Melanin is the natural pigment responsible for skin color. Elevated cortisol levels associated with Cushing’s disease can stimulate increased melanin production within the skin.

As melanin levels rise, certain areas of the skin may become darker than normal and develop brown, gray, or black discoloration.

Chronic Skin Inflammation

Dogs with Cushing’s disease often experience chronic skin irritation and inflammation. Excess cortisol weakens the skin barrier, making the skin more fragile and sensitive over time.

Inflammation can trigger the body to produce additional melanin as part of the skin’s response to irritation. As a result, areas of chronically inflamed skin often become progressively darker.

Darkened skin may develop alongside other symptoms such as:

Hair loss
Thin skin
Flaking or scaling
Recurrent skin infections
Itching or discomfort

Scratching, Chewing, and Friction

Many dogs with Cushing’s disease frequently scratch, lick, chew, or rub irritated areas of skin. Constant friction and trauma can worsen inflammation and contribute to additional skin darkening.

Over time, repeated irritation may cause thickened, roughened, or hyperpigmented areas to develop in places where the dog experiences the most discomfort.

Secondary Infections

Because elevated cortisol suppresses the immune system, dogs with Cushing’s disease are more prone to bacterial and yeast skin infections. These infections can increase inflammation and further contribute to darkened skin changes.

From a TCVM perspective, skin discoloration and chronic irritation may reflect underlying Heat, Yin deficiency, Blood imbalance, and stagnation within the body. Long-term internal imbalance can affect circulation and skin nourishment, contributing to chronic inflammation and visible skin changes.

Addressing the underlying hormonal imbalance while supporting skin health through nutrition, hydration, and individualized TCVM care may help improve comfort and overall skin condition in dogs with Cushing’s disease.

Poor Wound Healing

Poor wound healing is another common problem in dogs with Cushing’s disease. Many pet owners notice that cuts, scrapes, hot spots, surgical incisions, or skin irritations take much longer to heal than normal.

In some cases, even minor skin injuries may become infected or fail to heal properly for weeks.

Several factors associated with Cushing’s disease contribute to delayed wound healing

Elevated Cortisol Levels

As discussed earlier, dogs with Cushing’s disease produce excessive amounts of cortisol. While cortisol is important for regulating stress and inflammation, chronically elevated levels can interfere with the body’s normal healing process.

High cortisol levels can delay the inflammatory phase of wound healing, which is one of the first and most important stages of tissue repair. Without a healthy inflammatory response, the body struggles to begin rebuilding damaged tissue efficiently.

Suppressed Immune Function

Excess cortisol also suppresses the immune system. A weakened immune response makes it more difficult for the body to fight bacteria, yeast, and other pathogens that may enter the body through damaged skin.

As a result, dogs with Cushing’s disease are more prone to:

Skin infections
Slow-healing wounds
Recurring hot spots
Delayed recovery after surgery or injury

Even small wounds may become irritated or infected more easily because the immune system cannot respond as effectively.

Reduced Collagen Production

Collagen is a structural protein that plays a critical role in skin strength and tissue repair. Healthy collagen production is essential for rebuilding damaged skin and properly closing wounds.

Elevated cortisol can interfere with normal collagen synthesis, reducing the body’s ability to produce strong, healthy new tissue.

When collagen production decreases:

Skin becomes thinner and weaker
Wounds heal more slowly
Scar tissue may form poorly
The skin tears more easily

This lack of collagen is one reason dogs with Cushing’s disease often have fragile skin and delayed healing.

Reduced Blood Flow

High cortisol levels may also constrict blood vessels and reduce circulation to the skin and wound sites.

Adequate blood flow is necessary to deliver:

Oxygen
Nutrients
Immune cells
Growth factors

to damaged tissue during healing.

When circulation becomes impaired, the healing process slows down significantly because the tissues are not receiving the support they need to repair themselves efficiently.

Metabolic Changes

Cushing’s disease can also cause metabolic disturbances, including elevated blood sugar levels. High blood sugar may further impair immune function and create an environment that allows bacteria to grow more easily within wounds.

These metabolic changes can make healing even more difficult and increase the risk of chronic skin infections.

From a TCVM perspective, poor wound healing may reflect underlying Qi deficiency, Blood deficiency, Yin depletion, and chronic internal imbalance. When the body’s vital energy weakens over time, tissue repair and circulation may be compromised.

Supporting healing through proper nutrition, hydration, stress reduction, and individualized TCVM care may help improve skin health, immune function, and overall resilience in dogs with Cushing’s disease.

Fat Pads

Dogs with Cushing’s disease often develop abnormal fat deposits called fat pads. These soft areas of fat are commonly seen around the shoulders, neck, back, flanks, or near the base of the tail.

Many pet owners notice these changes as their dog’s body shape gradually becomes less muscular and more rounded or bulky in certain areas.

Several factors related to Cushing’s disease contribute to the formation of fat pads.

Elevated Cortisol Levels

As mentioned earlier, Cushing’s disease causes excessive cortisol production. High cortisol levels affect how the body stores fat and uses energy.

Cortisol promotes fat accumulation in specific areas of the body while also contributing to muscle breakdown. As a result, dogs may lose muscle tone while simultaneously developing abnormal fat deposits.

Fat pads often develop in areas such as the:

shoulders
neck
abdomen
flanks
jowls or face

This abnormal fat redistribution is one of the classic physical signs of Cushing’s disease.

Insulin Resistance

Excess cortisol can also contribute to insulin resistance. Insulin is the hormone that helps cells absorb and use glucose properly.

When the body becomes resistant to insulin:

Blood sugar regulation becomes disrupted
The body produces more insulin
Fat storage increases more easily

Elevated insulin levels may encourage the body to store additional fat, contributing to the formation of fat pads and overall weight gain.

Increased Appetite

Many dogs with Cushing’s disease experience an increased appetite, also called polyphagia. Elevated cortisol affects the brain’s appetite-regulating centers and may make dogs feel constantly hungry.

As a result, dogs may:

Beg for food more frequently
Eat excessively
Gain weight more easily

Overeating combined with hormonal imbalance often contributes to additional fat accumulation throughout the body.

Metabolic Changes

Cortisol also changes the body’s metabolism. High cortisol levels encourage the breakdown of muscle protein while shifting the body toward fat storage.

This metabolic imbalance can lead to:

muscle wasting
reduced muscle tone
increased body fat
abnormal fat deposits in specific areas

Over time, these changes create the characteristic body shape commonly seen in dogs with Cushing’s disease.

From a TCVM perspective, fat accumulation and altered body composition may reflect underlying Damp accumulation, Spleen Qi deficiency, and hormonal imbalance. Chronic internal stress and weakened metabolism may contribute to improper fluid and energy transformation, leading to weight gain and abnormal tissue buildup.

Supporting metabolic health through proper nutrition, weight management, exercise, and individualized TCVM care may help improve overall comfort and body balance in dogs with Cushing’s disease.

Need Extra Help with Cushing's Disease?

If you’d like to learn more about Cushing’s disease and natural ways to support your dog, be sure to read our article, Inside Scoop: TCVM Veterinarians Share Holistic Cushing's Disease Protocol.

Managing Cushing’s disease can feel overwhelming at times, especially because symptoms often affect many different body systems. Every dog responds differently, which is why individualized support can make a significant difference.

If you ever feel like you need extra help managing your dog’s Cushing’s disease naturally or with TCVM herbal formulas, we’re here to help.

Dr. Marc Smith and Dr. Casey Damron, co-founding veterinarians of TCVM Pet Supply, offer TCVM telemedicine consultations for pet owners seeking a more integrative and personalized approach to care.

During a TCVM telemedicine consultation, your veterinarian will evaluate your dog’s symptoms, health history, diet, energy balance, and overall constitution from both a conventional and TCVM perspective. The goal is to create a customized plan that supports your dog’s specific needs and quality of life.

With a TCVM consultation, you may receive personalized recommendations such as: