Health
Drinking like he has run a marathon, accidents indoors, panting at rest, a dropped belly. It may be more than old age: that combination has a name and can be treated.
Caution. A dog who stops drinking or vomits everything, sudden weakness, breathing that turns laboured out of nowhere, a belly swelling within hours, or a dog already on Cushing's treatment who goes flat, vomits and will not eat: ring your vet today.
Do not look for the answer in a Facebook group, on TikTok or on a forum. Look for someone trained for this: your dog's own veterinarian, the only person who can examine, investigate and treat them.
Use this page to know what to observe, what to note and what to ask at the appointment, not to treat at home. If you still have doubts after a consultation, ask another vet or a specialist (dermatologist, internist) for a second opinion, not a group. And if you do not have a regular vet yet, find one now, while your dog is healthy: how to choose a veterinary clinic.
Your dog is ten, spends all day on the sofa and drinks as if he has just run a marathon. He empties the bowl twice before evening. He wakes you at night to go out, and in the last month he has had a few accidents indoors, something that has not happened since he was a puppy. His belly has dropped, his coat has thinned on his flanks, he pants in a cool room and he eats as though you never feed him. Someone told you it is old age. It might be. But that combination has a name vets look for quickly: Cushing's disease. Here is what you can watch for, which tests come next and what not to do at home. The treatment itself is for your vet to decide.
Cushing's disease (vets also call it hyperadrenocorticism) means the body makes too much cortisol, the stress hormone, for months and years on end. It comes on slowly, so it is rarely an emergency in itself. A few situations will not wait for next week's appointment, though:
Whatever the situation, ring, say what you are seeing and, if he is on treatment, what he gets and since when.
The vet makes the diagnosis with tests. With Cushing's, though, tests run on a dog without the right signs can mislead. So what you notice matters more than usual: it tells the vet whether testing is worth doing.
This is the most useful thing you can do. For three days, use a measuring jug to note how much water goes into the bowl in the morning and how much is left in the evening, plus everything you top up during the day. A healthy dog drinks around 50 ml per kilo per day. That shifts with the weather, exercise and diet (a dog on tinned food drinks less). Over 100 ml per kilo per day is clearly too much and worth discussing, whatever the cause.
How often he goes, whether he wakes you at night, whether accidents have started indoors. The urine is very pale, almost like water.
He begs at the table and steals whatever he can. Many owners take it as a sign of good health: "at least he's eating well".
A dropped, pear-shaped belly with wasted muscle along the back and thighs. Hair thinning evenly on both flanks and not growing back after clipping. Thin skin through which you can see blood vessels, bruises that appear easily, small hard white crusts in the skin. Skin or urinary infections that keep coming back.
At rest, in a cool room, for no reason. Note when it happens and how long it lasts.
He tires quickly on walks, no longer jumps into the car or onto the bed. Easily mistaken for arthritis.
If he has had steroid anti-inflammatories for a long time, like the ones given for allergies and itching (tablets, injections, even some creams or drops), tell the vet. There is a form of Cushing's caused by the treatment itself.
| What you see | Cushing's | Other common causes |
|---|---|---|
| Drinking and weeing a lot | Yes, almost always | Diabetes, kidney disease, urinary infection, womb infection in unspayed bitches, high blood calcium |
| Eating a lot | Yes | Diabetes, some medications |
| Pot belly | Yes | Extra weight, fluid in the abdomen, enlarged liver |
| Symmetrical hair loss | Yes | Underactive thyroid, breed-specific hair loss |
| Panting at rest | Yes | Pain, heart or lung disease, heat |
Diabetes or a womb infection are often more urgent than Cushing's. That is exactly why a dog who is drinking a lot does not get put off until next week.
Take a morning urine sample to the appointment, the first of the day, in a clean container. And your water diary.
Diagnosing Cushing's happens in stages, and it often takes a few visits.
Before you leave, ask which signs mean the dose is too high (stick them on the fridge), when the first check-up test is and what to do if he vomits.
A dog with Cushing's who is treated and monitored can live comfortably for years. Walks carry on, matched to his muscles. Nose games suit him precisely because they need no strength: food hidden around the house or in the grass keeps him busy without wearing him out. Keep the diary going, with water drunk, trips outside and appetite. When the numbers come down, the treatment is working, and you will see it before the blood tests do.
What dog owners search for most often on the internet about this problem, with the short answer. The answers are a guide only: the decision belongs to your dog's own vet, after an examination.
Usually thirst: the dog drinks far more water and wees more often, sometimes at night or indoors. Then come a big appetite, a pot belly, thinning hair on the flanks, thin skin and panting at rest. The signs creep in over months and are easy to put down to age. A diary of how much he drinks is the best place to start.
In stages. First blood and urine tests, which show suggestive changes and rule out diabetes or kidney disease. Then hormone tests that measure cortisol before and after an injection, and an abdominal ultrasound to look at the adrenal glands. The tests are only done on dogs with the right signs, because stress and other illnesses can give false positives.
The pituitary form, the most common one, is usually kept under control for life with medication and check-up tests. The form caused by a tumour in one adrenal gland can sometimes be operated on. The form caused by long-term steroid treatment resolves when that treatment is tapered off gradually, to the vet's plan. Many treated dogs live comfortably for years.
No. He drinks a lot because he is losing a lot of water through his urine, and without water he dehydrates within hours. Keep the bowl full, take him out more often, add a late-evening and an early-morning trip and put puppy pads by the door. The accidents ease once treatment starts working, usually within a few weeks.
Any dog can get it, but it is reported more often in poodles, dachshunds, terriers (especially Yorkshire and Boston), boxers and beagles, usually over the age of 6. The adrenal form is more common in large dogs. Breed does not make the diagnosis; it just makes the vet look more closely.
The information on this page is educational and does not replace an examination. For full details and a diagnosis, consult your dog's own veterinarian.
They often come together: the same causes, plans that complement each other.
The bowl filled three times a day, requests to go out at two in the morning, a puddle in the hall. Sometimes it is just summer. Sometimes it is the first sign of illness.
The water bowl is empty by lunchtime, she wakes you at night to go out and loses weight though she eats everything. Diabetes is for life, but very manageable.
Sleeping more, gaining weight without eating more, glued to the radiator, thinning flanks. It may be the thyroid, or something else that looks very like it.
Tufts on the sofa are one thing. Round patches, bald flanks or a dog scratching himself raw are something else. Here is how to tell them apart.
We work with your dog's behaviour, not its health. For any sign described here, book an appointment with your own vet; the related services page explains how to choose a clinic.