Seeking advice - 12 year old German shorthaired pointer

[Harley PoMMom]

I want to make you aware that a regular urinalysis may not pick up any bacteria in a dog's urine, this is especially true when the urine is dilute like in dog's with Cushing's. In cushdogs when an UTI is suspected a urine culture and sensitivity test is preferred, this test can pick up bacteria and show exactly what bacteria is present and then the correct antibiotic can be prescribed, so if the regular urinalysis doesn't show an UTI I would recommend having the urine culture and sensitivity test done.

[Brusso89]

I just looked at my invoice from yesterday and it was a standard urinalysis that they preformed. Honestly I didn't know the difference until I read and researched your reply, thank you so much for the info. I can't change the test now but is it safe to say that a urinalysis should have just been skipped all together and started with a culture and sensitivity test to begin with?

[Harley PoMMom]

I believe when a dog has diluted urine, an urine culture and sensitivity test should be performed.

[EspressoAddict]

Lori, you may be on to something. Now that you mention it, there are a few signs that would lead me to believe that he could have a UTI. Yesterday I had a urine test done and hopefully I'll have the results today.

Marianne, thank you for the info!
As far as me wanting to increase his Trilostane dosage, it's a relief to know I'm not crazy haha. I fully understand the risks of increasing it too much and him not being able to produce enough cortisol on his own. But on the other hand, I haven't come this far to just stop when I could be close to making him more comfortable. From my research, I get the picture that every dog reacts to the medication individually and there can be no rhyme or reason to predicting increases or decreases in relation to cortisol levels per mg or Trilostane. For example, if I added a 5mg or 10mg to Trigger in the morning, it could have zero effect on his cortisol levels or it could make a huge difference, correct? I have read a little about giving uneven doses. I'm not sure if I should start at 5mg, 10mg or greater. The ACTH test was stressful for Trigger. I didn't want to preform another one unless it was absolutely necessary. If I increase his dosage, I take it we would have to do another ACTH test within a week or two to see how his levels are correct? Again my vet has been very helpful and his willingness to communicate with me during his busy days is priceless to me. I have not flat out asked him if I was to increase Trigger's dosage against his opinion, how would that effect our relationship going forward. I have had bad experiences with vets in the past for a wide range or reasons. This vet is by far my favorite and he has gone above what I would think an average vet should do during my time with him and treating Trigger. I'm not gonna make a decision until I get the urine test back and at this point, I kind of hope Trigger has a UTI because that would give me hope to treat that in hopes of giving him more comfort vs the challenge of mixing and matching Trilostane and doing it against my vets opinion. Any words of wisdom if I do have to have that conversation with my vet?

I think it's always best to be above board with your vet. We don't know for sure how they'll react as some might wash their hands off the case given that you're not listening up to the dot, but I believe most would remain helpful if things do start to go awry.