Cushings/CHF

I have a 10 year old female poodle who was diagnosed with cushing's sindrome (syndrome) em june/2009; we started treatment with vetoryl and she responded very well. A few months after that she was diagnosed with CHF, and also responded extremelly well on medication. She was then taking trilostane, enalapril, lasix, amlodipine and pimobendan. All the blood work was fine too. However, a couple months ago she started panting and eating excessively again. The problem is that between all the cardiologists and regular vet visits, exams, medications, e bad economy, money started being an issue. First we increased the pimobendan, but that didn't help at all. Then we did an ACTH test and it showed that her cortisol level was, although within limits, was high, so we increased her trilostane dosage. Her apettite is better, but the panting is still not that much better. Also, she developed partial facial paralysis on the left side of her face, she did not have an ear infection or a thyroid problem, so all I could do was make sure her eye was lubricated. That got better with time, but as soon as her face was normal again, it started on the right side of her face, and this time it seems to have affected her month more strongly that the first time, as she is dropping a lot of food and water. She is uncomfortable, but not to the point where I could endure euthanizing her. But unfortunetly, I can't afford to investigate her problems as I should. So, I guess, my question is, how long would the trilostane take to start making a difference, it's been 2 and 1/2 week since the drug increase. Or could it be her heart, even though we doubled the dose and it didn't help? What about the facial paralysis, does she feel any discomfort?
I am very lost, if anyone has any suggestions, I would appreciate it.

[Aleda M Cheng, D.V.M., C.V.A]

I would give the Trilostane another week and if still not effective the dose should be increased slightly, if possible or, you may have to switch to another medication such as Lysodren.

If you are interested in holistic treatment for Cushing's,  the holistic chemotherapy agent: Neoplasene seems to shrink adrenal and pituitary tumors.  This treatment must only be used under direct supervision of your vet, and additionally may not be suitable for your dog due to concurrent heart disease.

[Lucy_08092000]

Thank you Dr Cheng, I will give it some more time.