(Pet Talk) Conquering Cushings: Life after diagnosis
Published 3:55 pm Monday, February 17, 2025
- For decades, medication has been the cornerstone of treatment for Cushing’s syndrome, with trilostane — a drug that blocks cortisol production in the adrenal glands — remaining the most common option today. Stock art via Pet Talk
Discovering that your dog or cat has Cushing’s syndrome can be both discouraging and overwhelming, but it also marks the beginning of their journey toward better health and an improved quality of life.
This condition, resulting from excessive production of cortisol, also known as the stress hormone, can stem from either a pituitary gland tumor (pituitary-dependent hypercortisolism) or an adrenal gland tumor (adrenal-dependent hypercortisolism).
Dr. Andrew Bugbee, a clinical associate professor of internal medicine, and Dr. Daisuke Ito, an associate professor of neurology — both from Texas A&M’s College of Veterinary Medicine & Biomedical Sciences — share their expert insights to guide pet owners through treatment options and life after diagnosis.
Managing Cushing’s with medication
For decades, medication has been the cornerstone of treatment for Cushing’s syndrome, with trilostane — a drug that blocks cortisol production in the adrenal glands — remaining the most common option today.
“This medication is safe and effective when monitored properly,” Bugbee said. “It can provide significant symptomatic relief within four to six weeks, but it requires lifelong administration and regular check-ups to ensure it’s working as intended.”
Routine blood tests are necessary to monitor cortisol levels and determine if dosage adjustments are needed. Maintaining the right balance is essential to avoid under-treating the condition or causing complications from excessive suppression of cortisol production, including gastrointestinal upset, weakness, or collapse.
When surgery is needed
For cases of adrenal-dependent Cushing’s or large pituitary tumors, surgical options are also considered.
“Adrenal tumors can often be treated by surgically removing the affected adrenal gland,” Bugbee said. “In many cases, this procedure can resolve the disease entirely, eliminating the need for lifelong medication.”
While surgically removing the adrenal gland has long been a reliable treatment for adrenal-dependent Cushing’s, addressing pituitary-dependent Cushing’s has historically been more challenging, as treatment was limited to medication administration because of the complexity of the pituitary gland removal surgery. However, advancements in veterinary medicine have made hypophysectomy — a procedure to remove the pituitary gland — a viable option for pets.
“Hypophysectomy is a standard approach in human medicine and has now proven to be highly feasible in dogs and cats,” said Ito, who has extensive experience performing this surgery. “This approach can provide immediate symptomatic relief and long-term, disease-free periods for pets with pituitary-dependent Cushing’s who don’t respond well to medication, even if the tumor is small and not causing neurologic signs.
“While it’s a complex procedure that requires specialized expertise, it offers hope for many cases previously deemed untreatable,” Ito said. “This procedure is not offered at most veterinary hospitals and there are only a handful of places in the world performing this surgery, with Texas A&M being one.”
Life after treatment
Successfully managing Cushing’s syndrome doesn’t end with treatment — it’s a continuous partnership between pet owners and their veterinary care team. Whether a pet is on medication, recovering from surgery, or navigating long-term management, this collaboration is essential for ensuring the best outcome.
Pets who undergo hypophysectomy require diligent post-operative care immediately after surgery, followed by intermittent monitoring and check-ups. While pets often need a lifelong oral hormone replacement therapy after surgery to compensate for the loss of pituitary function, this supplementation is much easier to manage long-term than standard Cushing’s treatments.
“After this surgery, pets may need thyroid, adrenal, and antidiuretic hormone replacements,” Ito said. “But the benefits often far outweigh the challenges. Many pets experience dramatic improvement in their quality of life, free from the symptoms that once burdened them.”
With the right care, pets diagnosed with Cushing’s can thrive. A diagnosis marks the beginning of a journey toward better days — one filled with renewed health and the joy they bring to their families.
Pet Talk is a service of the College of Veterinary Medicine & Biomedical Sciences, Texas A&M University. Stories can be viewed on the web at vetmed.tamu.edu/news/pet-talk. Suggestions for future topics may be directed to vmbs-editor@tamu.edu.
