All canine diagnoses

Your dog was diagnosed with Pituitary Macroadenoma / Macrocarcinoma. Pituitary tumours are the most common cause of pituitary-dependent hyperadrenocorticism (Cushing's disease) in dogs. Macroadenomas (>10mm) can cause neurological signs by compression of surrounding brain tissue. Most are functional (ACTH-secreting). Compare 3 treatment options for dogs including Radiation Therapy, Transsphenoidal Hypophysectomy, Medical Management (Trilostane) + Monitoring — with survival times, costs, and what to expect during treatment.

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Pituitary Macroadenoma / Macrocarcinoma

BreedsPoodleDachshundBoxerBoston TerrierBeagle
canine

Neuroendocrine

About This Cancer

The pituitary gland, located at the base of the brain, is a small but critically important 'master gland' that controls hormonal systems throughout the body. Pituitary tumours in dogs are usually functional adenomas that secrete excess ACTH, leading to Cushing's disease (hyperadrenocorticism) — a condition characterised by increased drinking and urination, pot-bellied appearance, hair loss, and skin changes. When the tumour grows large enough (macroadenoma, typically >10 mm), it can press on surrounding brain structures, causing neurological signs such as lethargy, circling, or blindness. While the hormonal effects of Cushing's disease can be managed medically, the growing tumour mass itself requires different treatment — typically radiation therapy to shrink the tumour, or in specialised centres, surgical removal via the transsphenoidal approach.

Pituitary tumour size classification

Based on MRI measurements relative to brain area. Microadenoma vs macroadenoma threshold varies by source (~10mm or pituitary height/brain area ratio >0.31).

Stage MicroadenomaSmall tumour confined to sella turcica, <10mm
Stage MacroadenomaLarger tumour with suprasellar extension, ≥10mm or P/B ratio >0.31
Stage MacrocarcinomaInvasive pituitary tumour with local invasion or rare metastasis
Prognostic Factors(2)
Tumour sizeLarger tumours have higher perioperative mortality with hypophysectomy (20-30% for large tumours vs 8-10% for small-moderate)
Neurological signsPresence and severity of neurological signs correlate with survival and response to radiation(Rapastella et al., 2023)
Minimum Workup(6 steps)
1MRI of the brain (gold standard — assess pituitary size and dorsal extension)
2Endocrine testing (ACTH stimulation, LDDS, HDDS, urinary cortisol:creatinine ratio)
3Complete blood count, biochemistry, urinalysis
4Abdominal ultrasound (adrenal gland assessment)
5Thoracic imaging
6Neurological examination

Median Survival Time Comparison

How long the average patient survives with each treatment

Bar opacity reflects evidence strength
Radiation Therapy
~18 mo (12–24)
Transsphenoidal Hypophysectomy
See notes
Medical Management (Trilostane) + Monitoring
See notes
Reading this page: MST (Median Survival Time) is how long the average patient survives with a given treatment. ORR (Overall Response Rate) is the percentage of patients whose tumour shrank or disappeared. CR = Complete Response (tumour gone); PR = Partial Response (tumour shrank). Hover over any abbreviation for a quick explanation.
Strength of Evidence

Each treatment is rated by how much published research supports its use. Solid bars indicate stronger evidence; dashed bars mean less certainty.

StrongLarge published studies with strong agreement among veterinary oncologists.
ModerateWidely used in clinical practice, but supported by smaller or retrospective studies.
IndirectEvidence comes from a different tumour type or species and has been applied here.
LimitedVery little published data is available for this specific treatment.

Please note: All treatment data is sourced from published peer-reviewed literature. Survival times and cost figures are approximate guides. Your pet's individual factors — including tumour grade, stage, and overall health — will influence outcomes and should guide all treatment decisions. The strength-of-evidence rating reflects how much research exists, not how strongly a treatment is recommended. This tool is designed to help you have informed conversations with your veterinary oncologist, not to replace them. Costs shown are US referral centre estimates and may vary significantly by region.