10 year old FS mid-sized dog started showing signs of Cushings over summer-- voracious appetite, pendulous belly, alopecia. Took to primary vet in September, found ALP scary high, so recommended an abdominal U/S. Imaging center started with chest rad, and said there were multiple lung tumors, gave poor prognosis, and did not do U/S. Owners went to celebrity vet Sue Ettinger for second opinion, she thought lungs looked "busy" on CT, plus found liver mass. Then Cornell oncology did equivocal FNA of liver mass, but could not reach lung-- but say two discrete masses. Their dx is primary lung (probably adenocarcinoma with a metastasis) and primary liver (probably biliary in origin, but can't be sure). They want to start her on Palladia metronomyc, 3x week at home orally.
Owners want integrative approach, and have not started chemo because dog recovered rough from day at Cornell and still has diarrhea. They are fine with chemo, but want best options. Dog has still not been tested for Cushings.
Between history and PE, seems like Damp Heat is primary problem, and since SMS nicely anti-neoplastic, plus addresses the probably hyperadrenoacorticism, seemed to cover all bases. I suggested TID for 2 weeks then BID. Added Hoxsey because she is hot. MY QUESTION-- how well does this herbal strategy play with the chemo strategy? The crazy thing is that all these tumors were incidental findings! AND the dog has a big history of severe rabies vaccinosis that has not been adequately addressed, and is probably KI deficient. Did not treat with AP today-- too aggressive and too much else going on. I could not even perceive her pulse on either side (with her muzzled)-- tried for a long time, so I'm guessing not toned or wiry. Tongue dark pink, but not red. Thoughts?