Hello again...

I am looking for some other opinions about how to proceed with Hannah. (12 y/o Shih Tzu with recent Cushing's diagnosis). You can read my initial post to see Hannah's test results. The plan as of now with my regular vet is to treat with Anipryl (we started yesterday) for two months and to see if the symptoms have improved. I also asked about something to support her liver and he has ordered Denamarin. We would re-check liver values in two months as well. If the Anipryl is not working, he said he would then pursue other tests (first doing an ultrasound and x-ray) to see how her organs look,and if it still looked like Cushing's, he would then try Trilostane.

I feel good about that for a couple of reasons-the low risk of problems with Anipryl IF it works, and the fact that I am a teacher and this would then be about the time for our summer break and although I teach summer school, I will have more time to watch her closely, and I will also have more income for tests/treatment. However, I am a worrier and I have been wondering if this is a good decision or if I should do something now. I am so worried about not helping her enough, or doing the wrong thing, or her getting dramatically worse during this two month period. I am also still confused about if it for sure IS Cushing's. She did have high ALKP levels (my vet said this is often a marker), which led to the LDDS test, which my vet said showed she was positive for PDH Cushing's. A few of you also agreed; however, I do know that often more than one test is needed to confirm this disease.

I am wondering if you would question if does indeed have Cushing's, or if it could be something totally different....or if it is more that it is Cushing's and there could be SOMETHING ELSE too. She does not have diabetes, as her glucose is normal and her urine sample was as well. I know I have read about false positives, but she does have some symptoms (increased thirst/urination, but not out of control, and definite increase in appetite). She has lost weight in the past 9 months (1.5 lbs.) though, not gained, and has been eating more. She doesn't have the potbelly or skin issues. She has no gastrointestinal issues (I know this is another symptom of liver disease) or any other problems, except she does a lot of itching/biting (which she has always done, although it is a bit worse this winter and is usually only a summer allergy problem).

I did find out there is an IM specialist close to me and for $105 she will meet with us, examine Hannah, and review her other records and make a recommendation. I have spent about $500 this past week and have both dogs due for their exams/heartworm test/vaccines in early April(usually a few hundred for that trip), and still have to figure out when Hannah can/should get her yearly dental (usually about $400). Plus, I know the ultrasound/x-ray is likely in the future (about $650), as well as Izzy's (my other dog's) dental in August.

I can't decide if it is worth seeing the specialist now, or if I should wait out the two months and see what happens as long as we have already started something. My husband will support whatever I decide, but is concerned about how much money we may be spending. I am as well, and don't want to totally drive myself crazy doing everything and anything, but also don't want to NOT do something I should. I also realize the specialist could recommend additional tests, which it sounds like my regular vet might do this summer anyway.

Like I said, I am a worrier (and I analyze everything!) so I would love some other opinions. I am so worried about doing the "right" thing, but of course, I have no idea what that is. If you were in my position, what would you do?


Thanks!
Julie