Thank you. It's the rare dog indeed who is cushingoid but not polydipsic (increased thirst), polyuric (increased volume of urine), and polyphagic (increased hunger). I've never pursued the diagnosis of Cushing's if my patient didn't demonstrate those symptoms.
Cholesterol can elevate in cushingoid dogs but an elevated cholesterol is also consistent with hyperlipidemia (elevated fat level in the blood), hypothyroidism
, hepatic insufficiency, and protein losing enteropathy. An elevated AP is consistent with Cushing's but it's a nonspecific enzyme often elevated in older dogs. It usually indicates biliary stasis (sludging of bile) and isn't pathognomonic (specifically indicative) of Cushing's.
Consider having the urine protein:cortisol ratio performed. It's a good screening test for normalcy. In other words, if the ratio is normal it's very unlikely that Sophia is cushingoid. If the ratio is elevated, it doesn't diagnose Cushing's because non-adrenal disease can elevate the ratio too but it does indicate further testing with a low dose dexamethasone suppression (LDDS) blood test.
For alternative approaches to Cushing's, please relist your question but amend it to say, "I'm looking for a naturopathic vet..."
I'll opt out which will allow such a vet to enter our conversation. Please don't leave a rating or respond to me - either of which will dissuade other vets from responding to you.