Conditions/Internal Medicine/Cushing's Disease in Dogs (HAC)
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Cushing's Disease in Dogs (HAC)

Hyperadrenocorticism (HAC), or Cushing's disease, is a common endocrine disorder in middle-aged to older dogs caused by excess cortisol. It causes increased thirst, urination, appetite, pot-bellied appearance, and skin changes. Diagnosis is complex, requiring multiple tests that are frequently misinterpreted, and treatment selection depends on whether the disease originates in the pituitary gland or adrenal gland.

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At a glance

ConditionCushing's Disease in Dogs (HAC)
Speciesdogs
Typical treatment cost$2,000–$6,000 ongoing management
The complexity

What makes cushing's disease in dogs (hac) hard to diagnose correctly

Multiple overlapping test options (LDDS, HDDS, ACTH stim, urine cortisol:creatinine ratio) are frequently misinterpreted; PDH vs adrenal-dependent HAC requires different treatment. No single test is 100% diagnostic, and each test has different sensitivities and specificities — the right test sequence depends on clinical presentation, and misinterpretation leads to either unnecessary treatment or missed disease.

Specialist advantage

What a specialist catches that your GP might miss

Correct test sequence interpretation, PDH vs adrenal tumor differentiation, and trilostane vs mitotane selection and monitoring. A specialist can determine whether your dog has pituitary-dependent HAC (treated medically) or adrenal-dependent HAC (may require surgery), and design a monitoring protocol that minimizes the risk of adrenal crisis.

Diagnostics

Common diagnostic tests

  • Urine cortisol:creatinine ratio (screening)
  • Low-dose dexamethasone suppression test (LDDS)
  • ACTH stimulation test
  • High-dose dexamethasone suppression test (HDDS)
  • Abdominal ultrasound (adrenal gland size)
  • Abdominal CT scan (for adrenal tumor evaluation)
Treatment

Treatment options

  • Trilostane (Vetoryl) — first-line for PDH
  • Mitotane (Lysodren) — alternative for PDH
  • Adrenalectomy — for adrenal-dependent HAC
  • Radiation therapy (for large pituitary tumors)
  • Supportive care and monitoring
Typical cost range: $2,000–$6,000 ongoing management
Why it matters

Why get a second opinion for cushing's disease in dogs (hac)?

Diagnosis confirmation

Cushing's Disease in Dogs (HAC) can be difficult to diagnose correctly. A specialist second opinion confirms, or revises, your pet's diagnosis before treatment begins.

Treatment optimization

Treatment choices for cushing's disease in dogs (hac) have significant cost and outcome differences. A specialist review ensures your pet gets the most appropriate protocol.

Peace of mind

Knowing a board-certified specialist has reviewed your pet's case gives you the confidence to make treatment decisions without second-guessing.

Every opinion is written by a board-certified internal medicine specialist, not a general vet. You get a detailed written report to share with your own vet, and if it does not address your case you can request a refund within 48 hours.

Board-certified specialists. Written report in 24-48 hours. 48-hour refund window.

Get a specialist review for cushing's disease in dogs (hac)

A board-certified internal medicine specialist reviews your pet's complete case and delivers a written second opinion in 24-48 hours.

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Request a refund within 48 hours if the opinion doesn't address your case