I re read your entire thread to refresh my memory... couple things.. did you ever give the milk thistle? I ask because when I used it my dog's alkphos levels went down. I know it was recommended but not sure if you tried it. I throw it out there as if you are using it, maybe that is why the numbers are down and not the anipryl. I tend to agree with the others and your vet that maybe you should try not giving it to see what happens.

I see where you did the ldds test but never saw an acth test. I would be curious how high her cortisol levels are. That would tell you how 'advanced' the cushing's is. That would assist in deciding whether to treat or not.

I can see why you'd be asking questions about lysodren/trilostane but I still don't see enough symptoms that I'd go there yet. Of course this is the internet and I might be missing a whole lot of the picture so... you make the call there.

Regarding which is best - theyare equally effective but work differently. I think most go with what their vets are most comfortable with. I used lysodren and my gal did just fine.

Since you mentioned the itching - have you tried melatonin? It could be that the hormones are elevated (common in cush dogs) and as a result some dogs get skin issues which can include itching and licking. Melatonin is available at health food stores and I used it with my dog. She was a licker.

It seems like your biggest concern is the issue with jumping and stairs. Have you done xrays etc to eliminate those issues? If so it probably is cushings related.

I'm not sure I helped you a whole lot but those are my thoughts for now... Kim