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Gray cat with blue eyes

The essentials

  • Cushing’s disease is more common in dogs — There is no cure, but medication can help manage symptoms.
  • It can produce dermatologic effects in cats — One of the most common symptoms is extremely fragile skin.
  • There are two causes — A tumor near the pituitary gland or the adrenal cortex or overuse of steroids.

Cushing’s disease in cats is a rare but significant condition primarily affecting middle-aged female cats. While cat owners might be familiar with the symptoms of Cushing’s disease in dogs, the symptoms in cats are similar. Here’s what owners need to know about Cushing’s disease in cats.

What is Cushing’s disease?

Cushing’s disease, also called hyperadrenocorticism, is caused by too much cortisol. Cortisol is a hormone found in all mammals, and it helps the body deal with stress, control blood pressure, and metabolize sugar.

When a cat, human, or dog has Cushing’s disease, the excess cortisol in their body causes the amount of glucose in their bloodstream to increase. Overproduction of this hormone leads to several problems in cats requiring veterinary treatment.

The most common reason for these high cortisol levels is the presence of small tumors on the pituitary gland. Some cats may also develop Cushing’s disease because they have small tumors on their adrenal cortex, the gland that’s directly responsible for producing cortisol.

Older cats are more likely to get Cushing’s disease, and most cases first present when a cat is middle-aged or older. Cushing’s is also more common in female cats, with approximately 70% of cases occurring in females. Despite this, Cushing’s disease in cats is rare. Our vet, Dr. Armstrong, has only seen one confirmed case in 42 years of practicing veterinary medicine.

Certain breeds, like Siamese, Persians, Abyssinians, and domestic long hairs, have a slightly higher risk of developing Cushing’s disease. However, most cases are seen in domestic short hair.

Genetic factors are rarely associated with Cushing’s disease in cats. The most common cause is a naturally occurring tumor on the pituitary gland in the brain or the adrenal gland in front of the kidneys. The tumor causes an overproduction of a hormone called adrenocorticotropic that produces excessive cortisol.

Although rare, another cause of Cushing’s disease, called iatrogenic, is the long-term overuse of high-dosage steroid medication. Prolonged use of cortisol or progesterone medications can cause it.

Signs and symptoms of Cushing’s disease

If you’re concerned your cat might have Cushing’s or a related pituitary disorder,  here are some clinical signs and symptoms to look out for:

  • Feline skin fragility syndrome. One of the most debilitating and recognizable symptoms of Cushing’s disease in cats is extremely fragile and thin skin, which can lead to painful wounds.
  • Patchy skin. If your cat suddenly develops patchy fur or skin, visit your vet. Cushing’s disease isn’t the only cause of this issue, so it’s important to get a proper diagnosis.
  • Uncontrollable appetite. Insatiable hunger is often a sign of a hormone imbalance, such as that caused by Cushing’s disease.
  • Pot-bellied appearance. Cushing’s disease causes weight gain, particularly around the stomach.
  • Enlarged liver. While an enlarged liver may not be easy to see on the outside, it’s a sure sign that something’s wrong. Your vet can detect this in an X-ray.
  • Muscle atrophy. Cushing’s disease causes a reduction in muscle mass and vitality.
  • Hair loss. Hair loss in cats has many different causes, including alopecia, so it may not be a definitive sign of Cushing’s disease.
  • UTIs. Recurrent urinary tract infections (UTIs) can also be common in cats with Cushing’s disease.
  • Weight loss. Hormone imbalances can cause cats to suddenly gain or lose weight.
  • Excessive thirst or urination. High levels of cortisol can cause excessive thirst, which can lead to an increase in urination.
  • Lethargy and weakness. Too much cortisol can cause lethargy and weakness. However, it can also be symptomatic of other hormonal issues.
  • Curling ear tips. The thinning and weakening of the skin can cause a cat’s ear tips to curl in.

A note on diabetes

80% of cats with hyperadrenocorticism also present with diabetes mellitus and insulin resistance. Diabetes, just like Cushing’s, is closely related to hormone imbalances and glucose in the bloodstream. Drugs to manage diabetes, as well as dietary changes, may be necessary. The comorbidity of these conditions can make insulin dosage regulation challenging.

How vets diagnose Cushing’s disease

Diagnosing Cushing’s disease in cats is more difficult than in dogs. Initial bloodwork can reveal hyperglycemia or elevated blood sugar, high cholesterol, and a high blood urea nitrogen (BUN) content.

A urine sample test for a few days allows your vet to track your cat’s cortisol levels over time. It can also show excess proteins or glucose. Additionally, a positive result from a low-dose dexamethasone suppression test (LDDST) is a strong sign your cat has it.

While no one test is foolproof, a combination of tests gives a better overall picture to confirm Cushing’s diagnosis. Your vet may recommend additional tests, ultrasounds, and X-rays to identify other health issues affecting treatment or prognosis.

How Cushing’s disease is treated in cats

The treatment for hyperadrenocorticism seeks to stop the overproduction of cortisone and keep hormones at normal levels. Many cats need medication to control their adrenal glands’ overproduction of cortisol. Treating Cushing’s disease in cats depends on the type and any comorbid conditions.

Pituitary tumor

Treatment for pituitary tumors includes surgical removal of the pituitary gland or medical therapy. However, lifelong hormonal replacement therapy is necessary after gland removal to restore hormonal functions. Drugs like trilostane can also help with medical management. In some cases, your vet may recommend radiation therapy to ease neurological symptoms.

Adrenal tumor

Addressing an adrenal tumor may require a CT scan to monitor the tumor and its potential spread. Some vets may also recommend surgery to remove the abnormal adrenal gland. If the tumor is non-cancerous and completely removed, your cat may return to normal health. If surgery is not doable, your vet may prescribe adrenal support medication. Your vet can help you determine the best treatment for your pet based on the severity of their case.


Gradual discontinuation of the steroid can treat this type of Cushing’s disease. However, it can lead to a recurrence of the condition it was treating. Hormonal treatment therapy may be necessary to replace adrenal hormones.

Prognosis of Cushing’s disease

Cushing’s disease worsens over time if not addressed. Cats untreated may develop severe infections or uncontrolled diabetes. Proper treatment can improve the outlook. However, complications after removing adrenal glands are high, and not all cats do well with the medication. Removal of both adrenal glands tends to have the best prognosis and longest survival rates.

How to care for a cat with Cushing’s disease

You may be unable to cure your cat’s Cushing’s disease or relieve its side effects at home, but that doesn’t mean you can’t help. Here are our vet-approved recommendations for keeping your cat comfortable as they recover:

  • Always have fresh water available. Having fresh water nearby makes it easier for them to stay hydrated and manage their hormone levels.
  • Keep an eye on your cat’s skin. If they’re getting better, their skin health should improve. If not, it will get worse.
  • Make sure they have a soft bed. Fragile skin, open wounds, and patchy fur can make it hard to feel comfortable, but a soft bed can provide a safe refuge from pain and discomfort.
  • Try a onesie or shirt to help protect their fragile skin. Fragile skin needs protection, and a cat shirt or onesie can help protect it.
  • Keep up with regular vet visits. Regular vet visits can help you manage and treat your cat’s Cushing’s disease.

Although rare, Cushing’s disease in cats is a serious condition that requires timely and accurate diagnosis by a medical professional. While managing Cushing’s can be challenging, early intervention and treatment can significantly improve your cat’s quality of life. Regular vet visits and care can help identify and manage this condition, ensuring the best outcome and quality of life for your cat.

Frequently asked questions

Is Cushing’s disease in cats preventable?

No. The best way to help your cat is to know the signs of Cushing’s disease and get them help ASAP.

How long do cats live with Cushing’s disease?

Cushing’s disease doesn’t seem to affect a cat’s life expectancy, so long as it’s caught early and the cat responds well to treatment. A severe case of Cushing’s disease, which often appears alongside diabetes, may reduce a cat’s life expectancy.

What are the symptoms of Cushing’s disease in cats?

The most common symptoms of Cushing’s disease are fragile skin, weight gain, and patchy hair. If you notice any of these signs, you should make an appointment with your vet as soon as possible.

Can a cat recover from Cushing’s disease?

Yes. With proper treatment and care, the effects of Cushing’s disease can be significantly reduced. Hormonal replacement therapy can balance hormonal imbalances caused by Cushing’s.

How is Cushing’s disease treated in cats?

The two most common treatments for Cushing’s disease are medication and surgery to remove the adrenal glands. Your vet can determine the correct method of treatment for your cat.