Senior lab with high liver enzymes. Is it Cushing's disease? Tests?

Question

My 12 year old male lab recently had blood tests which showed an increase in liver enzymes: Alk Phos went from 235 in 6/17 to 533 in 3/18, ALT from 118 in 6/17 to 184 in 3/13. The vet put him on Denamarin and Flagyl with recheck in 2 weeks. He seems to be slowing down on walks and seems more lethargic. No vomiting or diarrhea The vet said XY & U/S is the next step. Could this be early signs of Cushings ? Which tests should I ask for? He did have pancreatitis in 2015, but recovered. Any advice? Pet's info: Dog | Labrador Retriever | Male | neutered | 75 lbs

Dr. Heidi DVM, CVA, CCRT, CVTP, CVSMT, CVCH · Accepted Answer

I'm sorry that Miller is not feeling well. We certainly see an increase in ALKP as an early sign of Cushing's disease, but ALT is not as commonly elevated. I am attaching a handout with more information about Cushing's disease below. https://www.veterinarypartner.com/Content.plx?P=A&S=0&C=0&A=1551 The most common test that we will use to diagnose Cushing's disease is called a Low Dose Dexamethasone Suppression Test. I am attaching a handout below that discusses the specific tests we use for Cushing's disease. https://www.veterinarypartner.com/Content.plx?P=A&S=0&C=0&A=636 However, an abdominal ultrasound is also an excellent test to evaluate the adrenal glands to look for evidence of Cushing's disease. So, I would discuss with your veterinarian if they would recommend doing further blood testing first or an abdominal ultrasound. That answer will likely depend on what Miler's lab work looks like when it is rechecked in 2 weeks. Good luck! I hope that was helpful and you can figure out what is going on with Miller. Thanks for using PetCoach.

Senior lab with high liver enzymes. Is it Cushing's disease? Tests?

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