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Thread: Hari 5 days post adrenalectomy

  1. #11
    Join Date
    Jan 2018
    Posts
    7

    Default Re: Hari 5 days post adrenalectomy

    Hi, Hari is a Portuguese Water Dog. Sorry I have not been online for a bit due to nursing duties. That is very bad luck about two dogs having Cushing's despite very good conditions.
    Now almost 3 weeks from surgery and he is doing very well as far as healing. His staples are out (there was a very big incision), he has had one reduction in Prednisone but still acting like a dog who is on very high steroid (currently 7.5mg/d and he is about 28 kg). He is completely food obsessed and spends all his time standing in the kitchen looking at the counter as if food will jump off. He is not interested in playing. But he is interested in being petted, eating and drinking, peeing mostly in appropriate places and sleeping reasonably well. He has a benign tumour on his foot that he has bothered and made bleed so he has been with cone (tried everything else) for 3 weeks.
    We hoped to postpone surgery on the tumour until he was on a lower dose of prednisone but it is a very fragile vascular tumour (cavernous hemangioma, but not a sarcoma). There is very scant information on these tumours online. The treatment is removal, with low rate of recurrence but given that he is on steroids and it is in a place where closure will be an issue it seems like a no win situation. Poor chance of healing whether he has removal or not.
    I asked my vet, who is very good to prescribe Timolol drops to use topically as there are reports that infantile hemangiomas can stop growing and subside with this fairly risk free treatment. It does help it stop bleeding and with the eye of faith might be increasing the tissue growth around the margins.
    My vet says there is no way to know if the other adrenal is kicking in.

  2. #12
    Join Date
    Jan 2018
    Posts
    7

    Default Re: Hari 5 days post adrenalectomy

    Hi Sharlene,
    Thank you for your welcome and your wishes and yes, Hari is so far a surgical success but not sure his QoL is any better or different than before. Indeed it is a fair bit worse due to the tumour on his foot and the cone that ate New York. It has to be enormous so he can't reach his foot, and that means he can't eat or drink without help, and I think it is depressing him. I am with him except for short trips to gather provisions.
    Though the tumour is benign it is vascular and bleeds a lot. A topical beta blocker timolol has been shown in human babies to cause reduction in hemangioma growth and occasionally to produce remission after a few weeks, though those tumours generally grow for a while and then spontaneously regress and disappear at age 3-4years or so. The literature I can find on canine hemangiomas that are not sarcomas is extremely meagre. What I can find it that they are typically locally invasive of tissue which I think makes it likely to heal very poorly with a local excision.
    Have you ever heard of this sort of vascular tumour appearing in Cushing's pups? Interesting that those places have lower rates of desexing too I think.
    The connection to Cushings is that his post op Prednisone is interfering with healing, and will interfere if and when we try to resect. I thought that he was a little more like his pre Cushing's self, but have to say that no, he is still completely food driven and cognitively dull as before.
    I moved to Comox about 13 years ago but am from BC originally and don't regret moving to a more rural location. Lovely place to live. I have a good vet, though he is quite clear when he would rather refer to a bigger centre. We don't have a full time open vet emergency but my vet has a call schedule and they will come in for emergencies. There is some availability of CT and there is a very good Ultrasonographer who can be booked, but that is not an emergency service.
    Where in the world are you situated? Where on the Island (note the capital letter it was done without thought) have you been?
    Thanks for being there. Lauren

  3. #13
    Join Date
    Jun 2012
    Location
    Canada
    Posts
    16,098

    Default Re: Hari 5 days post adrenalectomy

    Hi Lauren, I'm in Mississauga, Ontario (next door to Toronto) My mother in law lived in Victoria until recently when she moved here to be closer to us as she gets older. My Brother in Law still lives in Victoria though and I have friends there and work colleagues.

    No I haven't heard of any speicific vascular tumor like what Hari has. It might be unrelated to the cushings in fact.

    Are you reducing the prednisone? I think that the predinsone needs to be reduced on a schedule, as was discussed earlier with Kellie. And then testing to see if his adrenal gland can produce on it's own. The prednisone has to be decreased so that the other gland actually does start to kick in. A follow up ACTH once pred is removed will determine if the gland is working.

    If it never kicks in then a move to Dex would be an option.

    You want him off the pred so that the surgery can be done, with him off prednisone.

    Poor guy to go through so much. I had a golden retreiver that had such horrible allergies (since age 2) she was on prednisone all her life, and no one told me anything about introgenic cushings, which she had, but I was just told, side effect of the prednisone. Anyway, she had hematomas in her ears, so bad, and so often, that she lived in a cone it felt like. Off and on for years. Many surgeries, it was horrible that girl, she would definitely figure out a way to get around and do whatever she wanted with that cone on or not. Would any of the soft cones work?
    Sharlene and the late great diva - Molly muffin (always missed and never forgotten)

  4. #14
    Join Date
    Jan 2018
    Posts
    7

    Default Re: Hari 5 days post adrenalectomy

    Re: Update on Hari the PWD. Hari turned 13 on May 22. He has done very very well. The tumour on his toe, we named Timmy and he was very difficult to heal as it was vascular but benign. I put Timolol on it as that is supposed to shrink hemangiomas on babies and it worked I think. Anyway the tumour shrank to a nubble that was barely palpable and did not need surgery. His prednisone was tapered and gone by end of February and his remaining adrenal making sufficient cortisol. He may have had a bit of a stroke during surgery or recovery because he is a bit wobblier than before, so much so that vet thought he might have Degenerative Myelopathy. However, with physio he has regained some muscle rather than deteriorating further and has even played with another dog, something not seen in almost 2 years.
    He has not regained his lovely coat it is dry and scant, and he has very dry flakey skin, more so than ever before. His appetite remains very good, too good in fact and his loss of manners persists. I have to remove the knobs from the gas stove as he jumps up and turns on the gas!
    His personality is more like his former self and I feel like one lucky dog mom.
    Thanks so much for this forum and the love of dogs, Lauren

  5. #15
    Join Date
    Mar 2009
    Location
    rural central ARK
    Posts
    13,607

    Default Re: Hari 5 days post adrenalectomy

    What a great update, Lauren! SO glad your sweet boy has recovered so much of himself.
    "May you know that absence is full of tender presence and that nothing is ever lost or forgotten." John O'Donahue, "Eternal Echoes"

    Death is not a changing of worlds as most imagine, as much as the walls of this world infinitely expanding.

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