When to euthanize a dog with Cushing's disease

It is time to consider euthanasia for a dog with Cushing's disease when its complications have taken away your dog's comfort and adjusting treatment no longer brings it back. In practice that means a dog too weak to get up, infections and accidents that keep returning, nights spent panting and pacing, or neurological signs such as circling and seizures.

A diagnosis on its own is not a reason. Cushing's is usually managed with medication for years, and many dogs who have it eventually die of something unrelated.

How long can a dog live with Cushing's?

Cushing's disease means the body makes too much of the stress hormone cortisol. In most dogs the cause is a small tumor in the pituitary gland at the base of the brain. Less often it is a tumor on an adrenal gland. It is mostly a disease of middle-aged and older dogs.

With treatment, the figure most often quoted is an average of around two years after diagnosis, and some dogs live a good deal longer. That number is partly a reflection of age. Most dogs are already seniors when Cushing's is found, and many die of other old-age illnesses with their Cushing's still under control.

Without treatment, the signs tend to get worse and the risk of complications rises. Some dogs with mild signs are monitored for a time before starting medication, and that is a judgment for the vet. The outlook for an adrenal tumor depends on its type and whether surgery is possible. Your own vet is the only person who can give a prognosis for your dog. Our guide to Cushing's disease in senior dogs explains diagnosis and treatment.

What progression and complications look like

High cortisol affects nearly every part of the body over time. These are the problems that tend to appear as the disease advances or becomes harder to control.

Not every dog develops these, and several of them can be treated or eased if they are caught early. Diabetes can develop alongside Cushing's, and each makes the other harder to manage. See diabetes in senior dogs for what that involves.

End-stage Cushing's disease in dogs

Cushing's has no formal stages. "End-stage" is the term owners use for the point where several complications have piled up and medication no longer keeps the signs in check. A typical picture is a thin-skinned, weak dog who cannot manage steps, pants most of the time, has one infection after another and wets the bed most nights.

Loss of appetite deserves special attention. Dogs with Cushing's are usually ravenous, so one who stops eating has had a real change. It can point to a complication, to another illness, or to cortisol having been pushed too low by the medication. All three need a vet promptly.

Before you conclude that this is the end, ask for a recheck. Signs that have crept back can mean the dose needs adjusting, which your vet judges from monitoring blood tests. A new problem such as a urinary infection may be treatable in its own right. Never change the dose yourself, in either direction. For a large pituitary tumor, radiation therapy at a specialist center is sometimes an option. It is costly and not available everywhere, and declining it is a reasonable choice.

Signs quality of life is failing

• Your dog cannot get up, climb a step or squat to toilet without help
• Most nights are spent panting and pacing, and neither of you sleeps
• Accidents happen daily despite treatment, and the skin is sore from urine
• Infections come back as soon as each course of treatment ends
• Your dog has stopped eating or has to be coaxed at every meal
• There are neurological signs: circling, head pressing, seizures, or no longer knowing you
• Diabetes or another complication cannot be stabilized despite your vet's efforts
• Tablets, blood tests and clinic trips have become a daily source of fear
• Bad days outnumber good ones

One or two of these is a reason to see the vet. Several together, after treatment has been reviewed, is a reason to talk about euthanasia. If accidents are the main problem and your dog is otherwise content, senior dog incontinence solutions has practical ways to make them easier to live with.

How to decide

Score your dog once a week on a quality-of-life scale for senior dogs and keep the scores. A falling trend over several weeks tells you more than any single day.

Then take three questions to your vet:

1. Is the Cushing's itself controlled on the latest tests?
2. Is anything treatable causing what I am seeing?
3. What is likely to come next for this dog, and how soon?

Cost and capacity are part of an honest decision. Cushing's treatment means lifelong medication and repeat blood tests, and a second condition such as diabetes adds daily care on top. If you cannot keep that up, tell your vet. They can talk through what is realistic. Choosing euthanasia over a slow decline that cannot be treated is a humane decision.

Plan before a crisis. Blood clots and seizures can arrive without warning. Decide in advance what you would want done, and know where your nearest emergency clinic is. When to say goodbye covers how to think it through as a household.

Euthanasia is carried out only by a veterinarian. Never attempt it yourself. The vet normally gives a sedative first, so your dog is asleep before the final injection. What happens during pet euthanasia explains the steps, how much it costs to put a dog down covers typical fees, and coping with the loss of a pet is there for afterwards.

When to call the vet today

Call your vet or an emergency clinic now if your dog has any of these. If your dog is on Cushing's medication, say which one.

• Vomiting, diarrhea, weakness, shaking, collapse or refusing food while on Cushing's medication
• Sudden fast or labored breathing
• A seizure, circling, head pressing or sudden blindness
• No food for a full day
• Straining to urinate, or blood in the urine
• A sharp rise in thirst together with weight loss or vomiting
• Collapse or pale gums

This article is general educational information and is not veterinary advice. Cushing's disease varies widely between dogs, the survival figures here are commonly quoted averages and not a prediction for your dog, and many of the signs described can come from other conditions. Decisions about testing, medication doses and euthanasia should be made with your veterinarian. Never start, stop or change a prescribed medicine without their direction.