Cushing’s disease in dogs
A high ALP alone isn’t Cushing’s — and steroid drops can invalidate the test. What to track, and when to test.
Many owners arrive here because a routine panel showed a high ALP and someone mentioned Cushing’s. A raised ALP can be a reason to ask a question, but it is not the answer on its own.
Cushing’s testing is ordered deliberately and interpreted beside the dog’s history, medications, other conditions, and observations.
BarkLens doesn’t diagnose. Your vet does.
Why the routine panel is not the answer
ALP can be raised in dogs with Cushing’s, but it can also move with steroid exposure, growth, and other conditions. A routine panel does not confirm Cushing’s.
Keep the ALP result with the original range, urine results, glucose, medications, and the owner’s observations.
What actually tests for it
An ACTH stimulation test measures the adrenal response to a stimulating hormone. A low-dose dexamethasone suppression test measures whether cortisol suppresses as expected.
AAHA describes the urine cortisol-to-creatinine ratio as sensitive but nonspecific. A negative result may help rule the condition out, while a positive result does not confirm it.
Source · 2023 AAHA endocrinopathies guidelinesWhy timing and context matter
AAHA recommends trying to stabilize or resolve known related conditions before pursuing Cushing’s testing when possible. Recent steroid exposure and other illnesses can change the testing conversation.
“Not yet” can be a clinical plan rather than a delay. Keep the reason, timing, and next step in the chart.
A practical plan
Prepare the testing context
Bring the routine results and the reasons the veterinarian is considering a dedicated test.
- ALP, glucose, and urine results with dates and ranges
- Current and recent steroid medications
- Water intake, urination, appetite, panting, skin, and coat notes
- Other diagnosed conditions and the testing plan
Questions worth asking
Bring the next question, not just the latest number.
- What makes Cushing’s worth testing for in my dog?
- Could medication or another condition affect the result?
- Which dedicated test are you considering and why?
- Does anything need to happen before the test?
Published veterinary sources