Cushings disease

An integrative treatment plan – including alternative therapies such as diet, herbs and acupuncture – can effectively treat Cushing’s disease in many dogs.

 If your dog has been diagnosed with Cushing’s disease, he’s not alone. This increasingly common condition is caused by an overactive adrenal gland that’s producing too much adrenal hormone. Cushing’s is occasionally caused by a tumor in the adrenal gland – but a more common cause is a benign pituitary tumor, which signals the adrenals to produce more hormone than needed.

The main symptoms of Cushing’s disease in dogs are a potbellied appearance, excess hunger, increased water consumption and symmetrical hair loss. Cushing’s can also cause weakness and panting. These dogs have weakened immune systems and are prone to infections and cancers. They may also experience increased agitation and some may have issues with sleeping through the night.

In the case of an adrenal tumor, removal is usually recommended. With pituitary tumors, however, removal is too difficult. Conventional treatment involves a drug such as Trilostane, which stops the production of adrenal hormone by blocking its release. This can be risky, however, because if too much hormone is blocked, the dog can become seriously ill, or develop the more serious Addison’s disease.

Over years of practicing holistic medicine, I have gone from thinking I could help control the side effects of Cushing’s disease in dogs on drugs, to having dogs in my care that are completely controlled with diet, herbs and acupuncture. My preference is always to begin treating dogs early in the disease, before they are put on any drugs. I sometimes even have success with dogs who have been chronically ill.

1. Diet is a big factor

No one knows for sure why there has been such an increase of Cushing’s disease in dogs, but dietary issues are definitely a big factor. Inflammation seems to play a large role as well, whether it arises from poor diet, or other factors such as over-vaccination, overuse of pesticides, or the general increase of chemicals in our environment.

My first goal with a Cushing’s dog is to change his diet. I pull out all grains and most carbohydrates, and feed the dog the least processed diet he can tolerate. Raw, high protein diets are best. If raw is not possible, then a grain-free, potato-free, high protein, high quality homemade or purchased cooked food is second best. High quality canned foods with these characteristics can also be an acceptable option. I have found that changing the diet alone can make a huge difference in these dogs.

2. Herbal treatment

After addressing the dog’s diet, I also treat the inflammation with herbal formulas. This is the best way to get the endocrine system back to normal regulation. (Note: be sure to work directly with a holistic or integrative veterinarian before giving your dog these or other herbs.)

  • In most dogs, the best Chinese herbal formula for Cushing’s is Si Miao San. It helps decrease inflammation in the body, regulates insulin, and improves digestion. I sometimes add corn silk to this formula to help with insulin resistance. Not surprisingly, this is also one of the main formulas I use for diabetes (see below). Si Miao San works best for the hot, panting, overweight Cushing’s dog.
  • For thin, weak, deficient dogs, especially if there is emaciation, I often start with a formula called Eight Treasures, which treats Qi and blood deficiency and helps with digestion and absorption.
  • I also will sometimes work with the kidney-tonifying formula Liu Wei Di Huang Wan if the emaciation is not so severe and there are issues with empty heat and panting.
  • I put almost all my patients with Cushing’s disease on ginkgo biloba. Ginkgo slows the release of adrenal hormone and can help control some of the symptoms of this disease. I almost always use it in a formula with hawthorn (leaf, flower and berry). This combination of herbs helps quite a bit with nighttime anxiety. Sometimes this formula makes the difference between good and mediocre control of the disease.

Acupuncture also assists

Most of my practice centers around acupuncture. I love to needle dogs with Cushing’s because they have such a great response. Acupuncture helps regulate the endocrine system and reduce inflammation in the body. I have found that many dogs will only need acupuncture about every two months once we get them stabilized, unless we are treating other health issues as well.

I practice Traditional Veterinary Acupuncture and some of the points I have found to be helpful for Cushing’s are: Fei shu (BL13), Gan shu (BL17 or BL18), Pi shu (BL20), Ming men (GV4) and Hou san li (ST36). I also always needle Tien men (GV17) and Bai hui to open up the body to receiving.

Drug dosages may need to be reduced

Be aware that natural treatments can change the amount of Trilosten and other drugs needed to control Cushing’s. If a dog stops eating, becomes lethargic, or has sleep disturbances or vomiting and diarrhea, this could be a sign of overdose.

While I have not been able to get all my Cushing’s patients controlled without Western drugs, I am usually able to significantly reduce clinical signs and/or the dose of drugs needed to regulate the illness. In a disease without many good, safe options for treatment, I love having effective natural options to offer my patients.

The link between Cushing’s disease and diabetes

Cushing’s disease appears to be closely related to Type II diabetes. Some believe that both diseases are the same syndrome, but are just manifesting differently. Both seem to be induced by an overload of carbohydrates.

Animals with Cushing’s disease and diabetes develop what is called metabolic syndrome. Their bodies cannot handle the quantities of carbohydrates and high glycemic index ingredients found in many processed pet foods.

These diets cause high levels of inflammation in the body, which lead to problems in the endocrine system. This in turn can lead to insulin resistance, development of pituitary tumors, and other inflammatory diseases.

Case studies


A few years back, I treated a cute, spunky little Cairn terrier named Clancy. We were able to catch his Cushing’s disease very early. His main symptoms were an increase in weight, panting, excessive jumpiness when touched, and easy startling. He also drank a lot of water and was always hungry.

With acupuncture, herbs and diet, we were able to keep Clancy happy and symptom-free. Occasionally, he would have a little flare-up of symptoms, but we were able to treat them with acupuncture and some herbal and dietary changes. Clancy received acupuncture every eight weeks or so. He was on Si Miao San with corn silk, and after a year I also started him on ginkgo.


Patty was a lovely 11-year-old golden retriever diagnosed with pituitary Cushing’s. She presented with excessive drinking, urinating, a ravenous appetite and panting.  She had bilateral hair loss with complete baldness on both sides. She also had arthritic hips and a lot of hind end weakness.

She originally came to me for just a couple of acupuncture treatments while her regular holistic vet was away, and was already on ginkgo and Mai Men Dong Tang. I switched her over to Eight Treasures with added corydalis for hip pain, and Cang Zhu, Yi Yi Ren and Huai Niu Xi to treat her Dampness. I also started acupuncture treatments.

Within a month, Patty’s hair started growing back and her hips improved. She had a small stroke a couple months after I started treating her and her Western vet started her on Trilostane.  At that point, Si Miao San and Bai Ji Li were added to the acupuncture, ginkgo and her original formula.  Over the next year, she had three Trilostane toxicity events (vomiting and diarrhea) as we regulated her Cushing’s with acupuncture and herbs, and each time we reduced her dosage until she was completely off the drug and controlled just with acupuncture and herbs.


Veterinarian Dr. Lena McCullough graduated from Washington State University in 1999 and received her CVA from the American Institute of Traditional Chinese Veterinary Medicine in 2005. She owns an integrative holistic medicine clinic for both people and animals in Seattle. She also operates a small online (etsy) custom herb shop for animals, Kingdom of Basil, and writes a blog on holistic animal health at Dr. McCullough loves practicing acupuncture and herbal medicine, especially working with hospice cancer animals. Her book on treating cancer in animals with holistic and integrative medicine will be out soon -- an early digital version is available at