Hello,
My dog has been exhibiting PU/PD and some other symptoms for a while now. We've been running tests and almost everything comes back negative. I'm looking for any ideas on how to proceed, and what to focus on.
## Background
(Generally) healthy 12 years-old female mini-schnauzer, spayed. Weight fluctuates between 9.5-10.5 kg. In 2017, had a relatively severe case of bladder stones which required surgery and a switch to a different type of food. a few years since, we switched back to regular food.
In late 2023, she was diagnosed with SARDS. Despite being supposedly blind, she functions significantly better during the day than at night.
## Current Symptoms
**DISCLAIMER**: I've been researching this topic all over. I won't be surprised if I'm biased in this section.
**NOTE**: All of these symptoms have been happening in the past 6-8 months.
1. PU/PD:
- Drinks 0.5-1 liter per day (Before it was about half)
- Pees at night in the house once-twice a week
- Drinks from any available water source (e.g. puddles), regardless of whether her water bowl is only 20 meters away.
2. Fur:
- Significantly less "vital" than before
- Significantly more shedding (She's a mini-schnauzer, she barely sheds in general). The shedding is not at a singular point and there are no patches.
3. Hunger:
- Hard to measure, since she eats only as much as we give her, but she begs more for food, and she eats quite hysterically when she's given a meal.
4. Pot-belly:
- Her stomach is enlarged. It feels bloated, as in it's quite "taut" when you apply pressure.
5. Panting:
- Hard to measure, but it feels she's panting more. It's winter here, so I can't infer whether this has anything to do directly with heat.
## Test Results
### CBC
RBC: 8.01; HCT: 56.4; HGB: 18.9; MCV: 70.4; MCH: 23.6; MCHC: 33.5; RDW: 18.7;
RETIC%:
0.7; RETIC: 52.9; RETIC-HGB: 29.0; WBC: 6.47; NEU%: 62.5; LYM%: 26.1; MONO%: 6.5;
EOS%: 4.9; BASO%: 0.0; NEU: 4.04; LYM: 1.69; MONO: 0.42; EOS: 0.32; BASO: 0.00; PLT:
;280; MPV: 15.1; PDW: 18.8; PCT: 0.42
### Chemistry
GLU: 89; CREA: 0.9; BUN: 15; BUN/CREA: 17; PHOS: 4.0; CA: 10.9; TP: 7.3; ALB: 4.0;
GLOB: 3.3; ALB/GLOB: 1.2; ALT: 71; ALKP: 934; GGT: 1; TBIL: 0.3; CHOL: 209; AMYL: 582;
; : ;LIPA: 2133
NOTE: ALKP raised from 562 to 934
### Urinalysis
USG levels:
1. 1.012
2. 1.014
3. 1.019
### [Urine Culture](https://imgur.com/a/9nuGVDl)
### [Cortisol-Creatinine](https://imgur.com/a/ayjYqEl)
### [Low-dose Dexamethsone Suppression Test (LDDST)](https://imgur.com/a/2uxkN9V)
## Current treatment
The urine culture came back with an infection, so the vet decided to treat with antibiotics (Synolux, 500mg).
## My Actual Questions
The thing is, I'm fairly certain her symptoms won't end with antibiotics, and the UTI is just another symptom of Cushing's, so I'm looking for advice on how to proceed:
1. Should we perform an ACTH test, despite LDDST coming back negative?
2. If ACTH is negative, should we just monitor her symptoms and try to perform the LDDST again in two months?
3. I'm aware that giving Cushing's treatment to a dog without Cushing's is dangerous. However, is there an option to give her Cushing's treatment in a safe environment (e.g. dog hospital), and monitor her reaction, rather than continuously do tests with low sensitivity?
Thank you, I'm here for any questions!
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