A 13-year-old FS Shih Tzu dog was presented for a growth on the right flank and increased appetite. Previous echocardiography had shown mild mitral regurgitation, and mild but compensated tricuspid valve regurgitation. Abnormalities on physical examination were a growth on the right flank, a growth on the right eye, and generalized alopecia. No abnormalities were seen on urinalysis, and urine culture yielded no growth. Urine Cortisol/ Creatinine ratio and LDDS test results were elevated, CTSH results were high, and T-4 and free T-4 were within normal range. 

A 13-year-old FS Shih Tzu dog was presented for a growth on the right flank and increased appetite. Previous echocardiography had shown mild mitral regurgitation, and mild but compensated tricuspid valve regurgitation. Abnormalities on physical examination were a growth on the right flank, a growth on the right eye, and generalized alopecia. No abnormalities were seen on urinalysis, and urine culture yielded no growth. Urine Cortisol/ Creatinine ratio and LDDS test results were elevated, CTSH results were high, and T-4 and free T-4 were within normal range.