My senior dog has Cushing's symptoms, but tests are negative. What now?

Question

Spayed Golden Retriever age 13 on Levothyroxine .5mg 2x daily. Symptoms of Cushing.Asymmetrical hair loss, excessive panting, lethargy, Cushing blood test negative, cbc negative. Vet wants to do ultrasound because he feels she has Cushing. What would you suggest?? Pet's info: Dog | Golden Retriever | Female | spayed | 13 years old | 58 lbs

Jennifer Summerfield, DVM CPDT-KA · Accepted Answer

Hi there. Cushing's disease can be difficult to diagnose in some cases, unfortunately. I would agree that Kelly's symptoms sound very suspicious for this problem, so it would be a good idea to pursue additional testing to try and get a diagnosis, if you can. If the initial blood test (probably a low-dose dexamethasone test?) was normal or inconclusive, then you could consider an ACTH stim test (a different type of blood test), a urine cortisol/creatinine ratio, or an abdominal ultrasound as the next logical step. I usually use the ACTH stim test as my second test if the low-dose dex test is negative and we're still suspicious, but an ultrasound would also be reasonable as the second test if your vet is skilled at doing this.

My senior dog has Cushing's symptoms, but tests are negative. What now?

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