Dear Joan, I’m so glad you went ahead and started this thread although I surely understand why it might not have been easy. OMG, to have Cushing’s rear its ugly head for you AGAIN????? This is so unfair, and nope, I don’t think you’re in denial. I just think you’re struggling with the best path forward, given the fact that Cushing’s does seem like a real possibility for Cooper. Yep, I went ahead and said it. Given his labwork and his symptoms, he does look like a Cushpup to me. I see that Leslie is expressing special concern about Cooper’s liver. But my own thought is that the moderate elevation in ALT and the more significant elevation in ALKP is pretty commonplace for Cushing’s. As is the elevated cholesterol and even the mild elevation in the PSL. So my own guess is that Cushing’s is indeed the root cause, and the question will end up being what to do about it, if anything.

In terms of Cushing’s, I’m so glad Lori suggested doing a UCCR. I totally agree with that as a reasonable first step if you’re able to collect urine from him. I suspect his result *will* be elevated, and then we’ll need to discuss next steps. But who knows, maybe it won’t be and what a help it would be to find that out. If the result *did* rule out Cushing’s, though, then I’d join with Leslie in wondering what else may be going on to cause those liver/pancreas elevations.

I also agree 100% with Leslie that trying to get some weight off would be a huge benefit, no matter what. I don’t know if you can talk some tough love into Victor, but somehow we’ve got to convince him that loving Cooper means NO SCRAPS!! Good luck with that, my friend!

And I know I’m putting the cart way ahead of the horse, but if Cushing’s turns out to be a reality, perhaps a very low dose of trilostane and the simple pre-pill cortisol monitoring would be something that would seem manageable to at least try. Or maybe not. For sure, this isn’t your first rodeo and I understand why treatment may not be in the cards this time around. I promise, we won’t be judging you either way.

But again, I’m so glad you started this thread so that you don’t have to worry about this all by yourself! And as I say, I think my first step would be a UCCR if that could be arranged. We can certainly tell you more about the specific protocol involved — basically you collect a morning urine sample at home on three successive mornings, you refrigerate and pool the urine, and then take it to the vet for analysis. But we can talk more about that, and anything else, as much as you want.