Dogs with Cushing’s disease develop a distinctive look: a round, sagging belly, thinning hair, and fragile skin, often combined with constant thirst and panting. These changes happen gradually, which is why many owners initially chalk them up to normal aging. But the combination of signs is recognizable once you know what to look for.
The Pot-Bellied Silhouette
The most recognizable physical change is a swollen, drooping abdomen that gives dogs a “pot-bellied” appearance. This happens for two reasons working at the same time. Excess cortisol, the stress hormone driving the disease, causes fat to redistribute toward the midsection. Simultaneously, the muscles in the abdominal wall and limbs weaken and waste away. Muscle fibers are gradually replaced by fatty tissue in a process called endocrine myopathy, and the abdominal muscles can no longer hold the organs in place. The result is a belly that hangs low, sometimes almost touching the ground in smaller breeds, while the legs and back look thinner than they used to.
This combination of abdominal swelling and limb thinning creates a distinctive body shape that’s hard to miss once it’s advanced. In earlier stages, though, you might just notice your dog looking a little rounder or heavier without being able to pinpoint why.
Skin and Coat Changes
Cushing’s takes a visible toll on skin and fur. Hair loss is one of the hallmark signs, and it tends to follow a symmetrical pattern, falling out evenly on both sides of the body. It often starts on the flanks, belly, and tail, while the head and legs are usually the last areas affected. The hair loss typically isn’t itchy, which helps distinguish it from allergies or parasites.
The skin itself changes too. It becomes noticeably thin and fragile, tearing or bruising more easily than normal. Some dogs develop darkened patches of skin (hyperpigmentation), blackheads, or small hard calcium deposits under the skin called calcinosis cutis. Because excess cortisol suppresses the immune system, recurrent skin infections are common. You might notice sores that heal slowly, or bacterial or fungal infections that keep coming back despite treatment.
Drinking, Urinating, and Eating More
This trio of behavioral changes is often the first thing owners notice, and it’s the most consistent finding. Increased thirst and increased urination occur in 80 to 90 percent of dogs with Cushing’s. Your dog may drain the water bowl repeatedly, need to go outside far more often, or start having accidents in the house after years of being housetrained. The increase can be dramatic, not just a slight uptick.
Appetite also ramps up significantly. Dogs with Cushing’s can become ravenous, begging for food constantly, getting into the trash, or acting hungry immediately after eating. This happens because cortisol directly stimulates appetite and alters how the body processes nutrients. If your otherwise well-behaved dog suddenly seems obsessed with food, it’s worth paying attention to what else might be going on.
Panting and Low Energy
Excessive panting, even at rest and in cool environments, is another hallmark sign. The fat redistribution into the abdomen puts pressure on the diaphragm, making it harder for dogs to breathe deeply. Cortisol also affects respiratory drive. You may notice your dog panting heavily while lying on the couch or waking you up at night with noisy breathing.
Reduced activity and general lethargy round out the picture. Dogs with Cushing’s often slow down considerably. They may be reluctant to jump, climb stairs, or go on walks they previously enjoyed. Muscle weakness plays a role here, as does the overall metabolic strain the disease puts on the body. Owners frequently describe their dog as “acting old,” which is part of why Cushing’s is so often mistaken for aging.
Early Signs vs. Advanced Disease
Cushing’s develops slowly, and early signs are subtle. The first changes are usually behavioral rather than visual: drinking more water, needing more bathroom breaks, wanting more food, or seeming a bit less energetic. At this stage, a dog’s appearance may look completely normal.
As the disease progresses over weeks to months, the physical signs start to emerge. The belly begins to enlarge, the coat starts thinning, and the skin becomes more fragile. In advanced cases, the full picture comes together: a pronounced pot belly, widespread hair loss, paper-thin skin with recurring infections, visible muscle wasting in the legs, and constant panting. By this point, the appearance is distinctive enough that an experienced veterinarian may suspect Cushing’s on sight.
Which Dogs Are Most at Risk
Cushing’s is primarily a disease of middle-aged and older dogs, with an average age at diagnosis of about 10 years. Certain breeds carry a significantly higher risk. Standard Schnauzers have by far the greatest predisposition, with roughly 58 times the risk of mixed-breed dogs in one large epidemiological study. Fox Terriers (about 20 times the risk), Cavalier King Charles Spaniels, Boxers, Shih Tzus, Pit Bulls, Jack Russell Terriers, Maltese, Miniature Dachshunds, Miniature Poodles, and Yorkshire Terriers are also overrepresented.
If you have an older dog from one of these breeds and you’re noticing increased thirst, a bigger belly, or thinning fur, Cushing’s should be on your radar. That said, any breed can develop it.
What Causes the Disease
About 80 to 85 percent of Cushing’s cases in dogs are pituitary-dependent, meaning a small, usually benign tumor in the pituitary gland (at the base of the brain) is overproducing a hormone that tells the adrenal glands to churn out cortisol. The remaining 15 to 20 percent are caused by a tumor on one of the adrenal glands themselves. Both forms produce the same set of visible symptoms.
There’s also a third form called iatrogenic Cushing’s, which develops when a dog has been on steroid medications (like prednisone) for an extended period. The external steroids flood the body with cortisol just as the disease would, producing the same pot belly, hair loss, increased thirst, and skin changes. This form resolves when the steroids are gradually tapered off.
How It’s Diagnosed
Because the signs of Cushing’s overlap with many other conditions, diagnosis requires blood testing. Veterinarians use specialized hormone tests that measure how the adrenal glands respond to stimulation or suppression. These tests check whether cortisol levels rise too high or fail to drop when they should. Routine bloodwork often shows clues as well, including elevated liver enzymes, high cholesterol, and dilute urine. Imaging like ultrasound can reveal enlarged adrenal glands or an abdominal liver that’s grown larger than normal.
No single test is definitive on its own, so vets typically combine test results with the physical picture. If your dog has several of the classic signs, particularly the combination of increased thirst, a pot belly, and skin or coat changes, that clinical presentation carries real diagnostic weight.
What Treatment Looks Like
For pituitary-dependent Cushing’s, treatment is almost always medication that reduces cortisol production. Your dog will take a daily or twice-daily pill for the rest of their life, with periodic blood tests to make sure cortisol levels stay in the right range. Most dogs show improvement within the first few weeks: water intake drops, urination normalizes, energy picks up, and appetite becomes more reasonable. The pot belly gradually shrinks as fat redistribution reverses, and fur often regrows over several months, though it may come back with a different texture.
For adrenal tumors, surgery to remove the affected gland is sometimes an option, depending on whether the tumor has spread. When surgery isn’t feasible, the same medications used for pituitary-dependent cases can manage symptoms effectively. Dogs with iatrogenic Cushing’s are gradually weaned off the steroid medication causing the problem, and their symptoms typically resolve as cortisol levels normalize.