Quote:
Urinary Cortisol:Creatinine Ratio
Creatinine is excreted in the urine at a constant rate; cortisol is not. The UCCR is a sensitive test to detect cortisol hypersecretion. It is imperative the dog is not stressed for the urine sample collection. To minimize stress, the owner should collect free-catch samples for 1-3 days at home and bring to the practice; first morning samples are ideal. Samples can be pooled to increase chances of observing an elevated cortisol due to daily variation. Stress and non-adrenal illness can cause increases in urine cortisol levels. False positives are common (specificity is as low as 20-25%), but a normal ratio is considered truly negative, and HAC can be ruled out.
So if it was me, I’d go ahead and perform a UC:CR first, since it shouldn’t be stressful for Suni. If that result is elevated, then you can shift to making a decision about the ultrasound or any other testing.