Hi, I am Dr. Jeff. I will try to help you. Please feel free to follow up if any more information is needed. I tend to agree with your leanings that chasing a diagnosis of Cushings may not be the best option. If cushings were present, I would expect some of the classic symptoms especially the drinking/ peeing, appetite, and pendulous belly. Frankly, the fact this Bella is an aging Golden with elevated liver tests, I am more concerned about bigger issues. There is a form of cancer common in Goldens called Hemangiosarcoma. This can occur in the liver, spleen, heart, lungs, skin (not likely in this case), etc. When present in the liver or spleen it can cause elevations in the liver values. Some of these dogs will have a slightly pendulous belly like with cushings syndome, because a mass can grow large enough to cause this effect. I would consider a recheck/ second opinion and discuss testing that includes xrays of the chest and abdomen as well as CBC (complete blood count which looks are red and white blood cells and their relationship to each other). I would also make sure your vet sends the CBC to a lab for review versus an inhouse blood machine. This allows human eyes to note any strange red cell formation. A pathologist will review these cells. Hemangiosarcoma, as well as other forms of cancer and liver disease, have red cell findings that can guide your vet. You may also see a slight anemia (you may see pale gums) among other changes. So, I hate to scare you with a potential grave prognosis, but this is always a concern when a lethargic older golden walks in my door. It is very common, and is missed frequently by some vets. These dogs pant due to slight blood loss and discomfort and are weak. So, cushings is far down my list of concerns, but I would certainly look at the xrays and CBC as your next step. I hope this helps and gives you direction.
Thanks
Dr. Jeff