Best Dog Food for Cushing's Disease

The honest starting point is that there is no established therapeutic diet for canine Cushing's disease. The major veterinary references describe the diagnosis and the drug and surgical treatments in detail and do not specify a nutritional protocol. Pages that confidently prescribe a "Cushing's diet" are going beyond the evidence. What diet can genuinely do is manage the metabolic problems that come with the disease — and those are worth taking seriously.

The Real Dietary Target: The Lipid Panel

Elevated lipids are among the typical laboratory findings in Cushing's, alongside a raised alkaline phosphatase — the most common abnormality of all — a mild ALT rise and mild hyperglycaemia. The mechanism is direct: raised cortisol increases hormone-sensitive lipase activity while decreasing lipoprotein lipase activity, so more fat enters circulation and less is cleared from it.

Where hyperlipidaemia is present, most nutrition resources recommend a diet providing no more than 24 grams of fat per 1,000 kcal, equivalently about 20% of calories from fat. That is a real number you can check a label against, which is more than the generic advice offers.

But Treat the Disease First

Before changing the food, it is worth knowing that hyperlipidaemia may resolve from treating the underlying disease without any need for diet changes. In other words, controlling the Cushing's with trilostane or mitotane may normalise the cholesterol on its own. Putting a dog on a restrictive diet in the same week you start medication means you will never know which one worked, and may be restricting fat permanently for no reason. Treat, recheck the lipids, then decide about the food.

The Appetite Is a Symptom, Not a Requirement

Polyphagia — relentless hunger — is a classic sign of Cushing's, along with a pendulous abdomen, muscle wasting and panting. It is easy to read constant hunger as a need for more food, and feeding to appetite reliably produces weight gain in a dog that is already carrying fat in the wrong places. Feed to calculated calorie requirement and body condition instead. The hunger easing is itself a useful early sign that treatment is taking effect.

Muscle Wasting and Protein

Cortisol is catabolic, which is why these dogs lose topline and develop the characteristic pot-bellied outline — weak abdominal muscles rather than fat alone. Adequate good-quality protein is sensible and there is no reason to restrict it unless kidney disease dictates otherwise. But no specific protein target has been established for Cushing's, and it would be misleading to give you one. What reverses the muscle loss is bringing the cortisol down, not the food bowl.

The Conditions That Do Change the Diet

Cushing's rarely arrives alone, and the companions are where actual dietary decisions get made.

• • Diabetes mellitus — cortisol causes insulin resistance, and a proportion of these dogs become diabetic. If that happens, the diabetic diet takes over: consistent meals timed to insulin, with fibre doing the work.
• • Pancreatitis — high triglycerides raise the risk, and in dogs, unlike cats, fat restriction is a genuine cornerstone of management. See feeding a dog with pancreatitis.
• • Systemic hypertension — many dogs with Cushing's have it. Blood pressure is worth measuring, not assuming.

This is why "what should I feed my dog with Cushing's" has no single answer. The right diet is determined by which of these the workup actually found, and that makes the bloodwork the thing to look at rather than the diagnosis label.

Practical Feeding

• • Measure meals rather than filling the bowl. A polyphagic dog will eat whatever is in front of it.
• • Use low-calorie bulk — green beans, plain cooked vegetables — if the hunger is distressing, rather than increasing the main meal.
• • Account for treats in the daily total. Trilostane is often given with food, and treats used for pilling add up.
• • Keep feeding consistent around medication timing, especially if diabetes is also in play.
• • Weigh monthly. Weight and body condition are the honest measures; both muscle loss and fat gain can happen at once here.

What to Ask Your Vet

• • Are my dog's cholesterol and triglycerides actually elevated, and by how much?
• • Should we recheck the lipids after the trilostane is working before changing food?
• • Has blood pressure been measured?
• • Is there any sign of diabetes or pancreatitis developing?
• • What daily calorie target should I be feeding to?

Frequently Asked Questions