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When in a situation where I have to make that difficult decision my vet always gives me her opinion. She will say things like, She is no longer enjoying life, it if were my dog this is what I would do.
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I only met him for the first time today but the doc was a good listener and responded to all my questions with real answers. He was glad I took a video of Toto walking around the house in circles and scratching himself against things. Doc also said if Toto were his dog he'd do the Cushings test and treat the skin condition so that is the plan for now.
If he gets his energy back I will take him for some really nice walks (even though I detest this humidity so much I moved 1000+ miles away from it).