Alivia was recently diagnosed with Cushing's - Alivia has passed

[MBK]

I am so very sad that I need this site, but since I do, I'm thankful that I found it. My 13 year old, 18 pound, Jack Russell Terrier, Alivia, was recently diagnosed with an Adrenal tumor causing Cushing's. She had dental surgery for 2 abscessed teeth and at a follow up appointment I told her dentist she did not seem to be herself, so she did blood work. Many of the values were outside of normal ranges so I took her to her internist for further testing.

Alivia had an ultrasound which showed an adrenal mass and that side was approx. 4x the size of the other one. She also had a Dexamethasone Sup. Test that day. A week later she had the full Adrenal Function testing (sent to U. of Tenn.). Post ACTH reslts were Cortisol-249.0, Androstenedione-7.84, Estradiol-65.4 (one in the normal range!), Progesterone-2.55, 17 OH Progesterone-3.25 and Aldosterone-414.5. I cried for two days and also started researching options. Her internist said she could attempt surgery or treat her with Lysodren. Because of Alivia's prior health issues and age, I am terrified to attempt the surgery. When Ali was 7 years old, she had IMHA and almost died. At the time there were no specialists in Pittsburgh, so I drove her back and forth to Ohio State University, where she was in intensive care several times. Long story short, she made a miraculous recovery but has some residual health issues, which she is still monitored for. She takes amlodopine for elevated blood pressure and a low dose compounded aspirin daily to help prevent any clotting issues. Lysodren therapy also seems impossible because Ali's tumor is apparently causing her levels to fluctuate - sometimes her appetite and thirst are increased, sometimes they are normal for days and every so often she has no appetite for several hours to a full day. There is no way I could accurately judge the loading dosage. Plus, I have read that dogs on Lysodren have an average survival time of only 16 months?

Ali still seems to have a good quality of life, but tires easily. My goal is to keep her as comfortable as possible for as long as possible. I adore this little dog! My regular vet suggested Trilostane, but my understanding is that although it does tend to lower the cortisol, it increases all the other hormone levels and may even cause the tumor to grow more rapidly. I have started her on melatonin (3mg 2x a day) and Flax Hull (SDG) lignans (about 20 mg per day) and am considering asking her vet to prescribe Ketoconazole. She took this before for a skin problem with no bad effects - in fact, in hindsight, she had no Cushing's symptoms while on Ketoconazole. For added measure, I started giving her The Missing Link Canine Food supplement. I'm desperate.

Sorry this post is so long, but I was trying to give some background info. My question is: Does anyone here have any experience using the combination of Melatonin, Flax Hulls (SDG) Lignans and Ketoconazole for symptom tratment in a dog with an adrenal tumor? Any insight into ANY of this would be greatly appreciated.

Moderator's Note: I have moved your thread to the main discussion forum where other members who are dealing with both forms of Cushing's will see your post, & drop by to respond to your questions.