Adrenal Mass

[bel]

My old boy, Pugsly, a 13.5 year old silky cross bred has just been diagnosed with a mass on his adrenal gland.

He went to the vet for weight loss (over 1kg in 6 months), bloods showed elevated liver enzymes so she booked him in for a specialist ultrasound, which was done yesterday.

We are waiting for his results of his ATCH stim test to come back.

Please keep my boy in your thoughts.

My vet was talking about surgery to remove the mass but I dont know if i want to put my boy through this. Has anyone done this with an older dog?

[Erny]

Hi Bel. Sorry to hear this news.

My avatar girl "Kal" was found to have had a tumour on her adrenal gland. She was 12yo at the time. Surgery was indicated and I was going to go through with it as apart from the tumour and its affects on her, she was in good health and was very young for her age.

I am unable to give you any advice on it or on how it went because unfortunately, 4 days prior to the scheduled surgery, she showed symptoms that her brain was affected. There was nothing I could do and so, after a period of palliative care, I gave her the freedom of her wings before the tumour could cause her adrenal gland to rupture. If it weren't for that (or any other unexpected and devastating health issue) I think my girl would have had another 2 years in her at least - going by how she was in herself and also going by her immediate ancestors in terms of longevity of life span.

I can tell you that whilst the mortality rate of these surgeries is fairly high, in my girl's case the tumour appeared to be well encapsulated. It was to have been a very pricey surgery (anticipated $6-7000.00) but I was going to proceed. There is a post-surgery period that is fairly critical as well, if I remember rightly. But in our case it was a matter of either the surgery being successful in which case she would be 100% cured OR I would lose her on the operating table. Without the surgery it was predicted that she would have about 6 months. So, I opted for the surgery, but as you've read, life had other plans that prevented this occurring.

I think the choice must be yours and yours alone. You, and only you, know your dog. I would like to think that your Vet would not suggest it unless he/she felt it was a good option for your dog, but perhaps have a further chat with him/her if you remain uncertain.

The surgeon who was lined up to operate on my girl was absolutely wonderful. I was scared witless of my decision to go ahead and had many moments of hesitation along the way. I was using Dr. Guy Yates who back then was at Werribee (Melbourne University Vet Hospital) and he talked me through the surgery, what to expect, the possibilities etc. etc. on more than one occasion. Bless him, because when it was found to be futile to continue with our plans for surgery and I put Kal on palliative care, Guy stuck with me and took my many calls of query and concern in the following months, even though his field of speciality was as a surgeon.

I'm sorry that you are facing making this decision. In my experience I think these are the things that you need to consider objectively :

• Assuming surgery is successful, is your dog likely to live a good many years of quality life after to have made the experience of surgery worth it for your dog?
  
• Are you prepared for the fact that you could be up for a huge financial expense, whether your dog makes it through or not?
  
• How long is your dog likely to survive without the surgery and will the period be one of quality?
  

Any choice you make is one that you do not deserve to be judged by others on, whichever way you go. As I mentioned, it has to be your own choice and I am sure that whatever choice you make you'll make it believing in your heart that it is the best for your dog. I wish you luck with it all and know that there are people out her who feel your pain and the absolutely rotten feeling of having to make a decision without the assistance of a crystal ball.

ETA: I can only speak of my situation with my girl. Your dog's case could be different - the expense and the mortality rate could be different than those which were likely in my situation.

ETA: In my girl's case, she was negative for Cushings.

Edited April 28, 2010 by Erny

[chiquito]

We went through the same scenario last year with our little dog Chiquito: adrenal tumour, elevated liver enzymes and ACTH positive for cushings. We scheduled the adrenalectomy five weeks after the diagnose. During that period I saw that he was in good health so one week before the operation I asked for another ultrasound, another ACTH test - this time the one that is done with three samples taken over a period of 8 hours, X rays, urine and blood tests. Cushings came back negative this time and the tumour did not grow so we cancelled the operation. He was 13.5 yo at that time and we didn't want to operate as it was very risky.

Please ask for the ACTH test that is done with three samples of blood taken over a period of 8 hours as it is more reliable than the ACTH test done with one sample of blood. And also seek the advise of a specialist.

Our boy lived without problems after that for a few months without any treatment whatsoever. Sadly he died three weeks ago due to heart failure totally unrelated, as I understand, to the adrenal tumour.

There is a group in yahoo about cushings where you can find some information about adrenal based cushings.

I wish you and your boy all the best.

[bel]

Thanks heaps for the reply Erny.

I will be speaking to my vet when She rings with Pugsly's lastest blood results.

In himself, you wouldnt even know he was sick. He still runs around with the other dogs, and loves to play with the 7 week old babies.

Money is no problem, but I want him to have a quality life.

We are in Sydney, so I dont know whch specialist my vet will refer him to. I would prefer to take him to SASH or ARH (North Ryde) as I have dealt with the eye and neuro specialists there in the past with other dogs and was extremely happy.

Again Thank you for the reply and I know we have a hugh disission to make.

This is My Beautiful Boy taken about 8 weeks ago.

[bel]

Thanks for the reply, chiquito.

So sorry to hear about you boy.

Pugsly has also been diagnosed with a grade 2 heart mumor, which the vet put down to the sudden weight loss. This has me worried as well his father died of heart failure about 6 years ago.

I will be speaking to my vet either tomorrow or when i take the babies in for their first needles on friday.I will ask her about the ATCH taken over 8 hours.

Thanks again for you reply.

Bel

[Kelly_Louise]

My old girl has Cushings (pituitary dependant though) and is treated by the ARH at Strathfield… I can’t recommend them highly enough as specialists.

I think it’s a very hard decision to make at 14 years old – and of course it depends on his overall health and ability to pull through surgeries.

The decision can be affected by many things… what his prognosis/lifespan would be without treatment/surgery, whether the progression of the mass and any related symptoms can be slowed down with medication (and therefore giving you both time to enjoy life for a while longer), and if surgery was performed and he survived the surgery – whether the aftercare and the trauma of going through it all in the later stage of his life will be worth the time it will give him.

I hope you hear some positive news from the vet. It’s such a hard thing, knowing what the right thing to do is… but I agree with Erny, only we who know our dogs best and what they are capable of can make the tough calls.

Best of luck.

[Dog_Horse_Girl]

I don't envy you in this terrible decision at all. Our staffy cross Ruby, aged 9, was scheduled to have cruciate ligament surgery the week of Christmas last year, when the surgeon discovered a large abdominal mass as he put her under for the second time (long story short, she had started seizuring under GA the previous day so they used a different drug the second time and while she still reacted somewhat to the second drug, the surgery went ahead). The phone call went along the lines of:

Surgeon: "We've discovered a mass...in the abdomen."

Me: "Okay, what does that mean?"

Surgeon: "We're not sure, but we need to know if you are willing to have us investigate further."

Me: "Sure, what do you need?"

Surgeon: "Well, we need at least an X-ray, ultrasound, perhaps exploratory surgery, and if we find a tumour and it's attached to something, we'll need to make some more decisions."

Me: "Okay, sure, whatever you need to do to find the problem, please do. When will you know what we're dealing with?"

Surgeon: "Let's take a look. I'll give you another call shortly."

It turned out to be a tumour on her spleen - in a split second, our whole world turned upside down. We had to decide whether to proceed with a splenectomy then and there, or whether to let her go on the table. A horrible decision to make when it's the last thing you expect. Of course the cruciate surgery was put on the back-burner and we opted to have the splenectomy and hope like anything it was benign. But we also decided that if the pathology came back bad, we wouldn't do more than keep her comfortable and happy for whatever time she had left. So it was a very tense week-long wait for the results. And thankfully the tumour was benign.

Ruby has now also had the cruciate surgery and is almost back to her normal self. Of course now she's got a problem with an anal gland which we hope is just an infection...although our vet mentioned it might be a tumour causing the symptoms. This poor dog has been through so much, and we think she deserves to have good health for the rest of her life, however long that may be. Everything she's been through, she's managed to overcome and despite it keeping us broke, she's worth every cent.

I wish you and your boy the best - only you know how your dog is within himself and only you can decide (with the best information and advice possible) how to proceed. We're here to support you, whatever decision you make.