Helping Dogs With Cushing's Disease

From Animal Doctor syndicated newspaper column April 2023


By Dr. Michael W. Fox

DEAR DR. FOX, I am in search of your “Endocrine Disruption Syndrome” article addressing Cushing’s. I have a 13–14-year-old Lhasa Apso that has been diagnosed with Cushing’s recently. Initially my dog Jody was diagnosed with Hyperthyroidism and we believed we treated with surgery years ago. Although his calcium levels are still high but stable. We were just told by our internal medicine doctors that we cannot treat his Cushing’s because Trilostane would make things worse. So I am in the hunt to better the quality of life of my poor dog.

S.M., West Palm Beach FL

DEAR S.M, There is evidence that dogs are more at risk from developing this disease if they have been neutered, a consequence I have long suspected due to endocrine imbalance. ( Carotenuto, G, et al. Cushing’s syndrome-an epidemiological study based on a canine population of 21,281 dogs. Open Vet J. 2019 Apr;9(1):27-32).

I have also recommended melatonin to help dogs with this endocrine disease. See Treatment Option Considerations for Hyperadrenocorticism in Dogs Clinical Endocrinology Service/College of Veterinary Medicine/University of Tennessee.(

“Where positive results of increased adrenal activity are present, consider the need for: Ultrasound and/or Endogenous ACTH. Procedures to rule out primary adrenal tumor presence. Melatonin is often used as a first treatment, especially if alopecia is present, since it is cheap, has few side effects and is available in health food stores or via nutrient suppliers on the internet. Typically, a dose of 3 mg is given every12 hrs for dogs 30 lbs. Regular melatonin is usually used rather than rapid release or extended release products.

Melatonin has anti-gonadotropic activity, and it inhibits aromatase enzyme in tissues (decreases androstenedione and testosterone conversion into estradiol) and 21-hydroxylase enzyme (lowers cortisol level). Allow at least 4 months for treatment to be effective. Response time is variable among dogs. Monitor treatment effectiveness by improvement in clinical signs, biochemistries or by repeat of steroid profile.”