My dog a 43/44 lb beagle was just diagnosed with Cushing diesease jointly by vet and vet university about 4-5 weeks after completing a CHOP protocol for stage 4 lymphoma of which enlarged lymph was detected by his dad and we ask our vet to test. We had dog at an emergency center 2 days prior and 1 month before for prostatic cyst and skin condition. Emergency center agreed lymph node felt large but did not suggest anything further. Fast forward to the present and dog is in remission but now Cushings can be added to the list of items this baby has to deal with. He also is taking medicine for seizures and a thyroid condition. Heart slightly enlarged since birth. As mentioned he also has a prostatic cyst which vet and us both agreed the risk to surgically treat is greater right now than the benefit. For cushings, vet prescribed 60mg of Vetoryl but agreed to start with a 40mg dosage after I express concernsbeginning with a dosage exceeding the 1mg recommended on insert. Also vet recommended we continue with enalapril, while university had told us to stop. Only gave dog 2 doses of that medicine before stopping. Vet explained the 60mg is a low dose for a dog his size; not consulted with resident at university. A concern is that dog was not fasted for the low dex testing; I had asked prior and told not necessary.
Dog is losing protein in urine (range 3+) and university ruled out infection or blood in urine as possible cause. ACTH level was at 200 when blood work first completed and 500 7 days later (results are from CBC panel/specific results from low dex testing not shared). Results of low dose dex testing is what made vets diagnose Cushing. The ACTH simulation test results were inclusive...in a gray area. Dog is drinking and urinating excessively. Energy level is lower in evenings and tires easily when playing with our other dog, a 11 yr old. I would like feedback on whether we should start with 40mg instead of the 60mg and increase if blood work in 10 days support or could we be causing more harm by doing so