Hi,

My Shih Tzu, Hannah, who will be 12 tomorrow, was just diagnosed with Cushing's Disease this week. She went into the vet for her yearly dental cleaning, but her bloodwork was concerning and led my vet to suspect Cushing's, so we postponed the dental procedure and he instead did the low dose dexamethasone suppression test. On her regular blood test, everything was in the normal range except for PLT (which I figured out is platelets, and the vet never mentioned this, so he must not be concerned-should I be?) and ALKP. The normal range for PLT is 175-500 and her reading was 618. The normal range for ALKP is 23-212 and hers was 1770. (Last year it was a bit high at 263, but we let it go).

He told me he suspected Cushing's and asked if I have seen any symptoms. She has maybe had a slight increase in drinking (although I never thought she drank enough compared to other dogs previously) and occasionally seems to urinate more. This seems to come and go. Over the last couple of months I have noticed that she seems to eat more quickly and is more often trying to sneak into my other dog's bowl. I increased her feeding amount a little bit since it is winter here, but also noticed that she has lost some weight. She was 10.8 pounds at the vet this week and was 12 pounds 9 months ago.

These are the results he gave me over the phone on the second test: The level he measured at the start of the test (I didn't write down what level this is as I was writing quickly at work, so hopefully you know) was 3.7. After four hours it was 1.9. After 8 hours it was 5.4. He said this can basically confirm the pituitary form of Cushing's. He told me he thinks she is in the beginning stages, as she is showing no major signs, and that it may be a good idea to just watch and see how she does/progresses for now. The medication he recommends we try first (when/if we decide to) is Anipryl because of the low side effects. If that doesn't work he recommends Trilostane. He said the point is really only to treat symptoms and that nothing will add length to her life, which seems to match up with what I read.

I am wondering if you all agree with this diagnosis, and if you think it is smart for me to wait before trying Anipryl since symptoms seem very slight, or if you would start it now. The only other thing that she has started in the last year or so, but has become more frequent is occasional barking at us like she is trying to tell us something (her tail is wagging and she will paw at us), but we can't figure out what she wants-we try letting her out, playing, petting her,etc. Sometimes I wonder if it is old age, and now if it is connected to this. But it also only happens sometimes. She is also a poop eater-she was rescued from a puppy mill and had many litters, and sometimes I think she just wants to go outside because she will dig around in the snow trying to find poop (even though we pick it up). Sometimes this behavior happens more after she or the other dog have recently pooped.

I do like the idea that if there is any cognitive stuff going on the Anipryl could help that too. She doesn't have any hair loss or the pot belly stomach, and no skin infections. She has had allergies for years, but seems to still lick/itch in the winter, and we thought it might also be nerves/mental, as she is a somewhat nervous dog. I now wonder if this could have anything to do with Cushing's...but again, there are no visible signs of problems in terms of coat/skin.

Any advice/opinions you can share will be greatly appreciated. I love my Hannah very much and she is the sweetest most loyal dog I have even known. I want to make the right decisions, but don't want to jump into anything too quickly. I trust my vet, but would like to hear from others too. Sorry this is so long, but I wanted to share everything.

Thank you for reading!

Hannah's Mom