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Thread: Little Katrina Has An Adrenal Tumor (Katrina has passed) 8/19/2009

  1. #11
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    Default Re: Little Katrina Has An Adrenal Tumor (possibly a functional pheochromocytoma)

    Quote Originally Posted by SaxLady View Post
    Carol, I am so sorry that Sam is no longer with you! His story brought tears to my eyes. Poor guy had to go through two adrenal surgeries. From what I have researched, I think that is quite unusual.
    Hi Candy.... You're right, it's very unusual, not to mention unlucky, but so was Sam . He had been in two no-kill shelters for a total of 6 months before we found him on Petfinder. We adopted him after we learned that someone had adopted him and "returned" him the next day, poor baby. He didn't have the best of luck, our sweet Sammy, but he had a good long run with us until health issues caught up with him. It was horribly unfair.... he deserved a longer life, and we were devastated after all we'd been through together to lose him. We loved him so and were glad we could at least give him the home he deserved for the second half of his life. Even today, he's never far away...

    Quote Originally Posted by SaxLady View Post
    Katrina is 11 1/2 years old and weighs 9 1/2 pounds. She is very active and a great little watchdog. The tumor is 24 mm and is in the left adrenal gland. It is very likely a pheo.
    Right off the bat, you're better off that it's in the left gland, and apparently contained? Also good news. Whether or not it's a pheo, they will go in prepared for any eventuality, which is why beta blockers are useful beforehand if possible. In Sam's case, he was on them for only a few days since the vein invasion was a bit of a ticking timebomb and could have proved catastrophic, so there was more of a sense of urgency to get the surgery done as soon as possible.

    Quote Originally Posted by SaxLady View Post
    You will be pleased to know that I have cancelled the surgery for Friday in order to have her begin beta blockers. The surgeon will call tomorrow and discuss it with me. Also, I requested a different internist because the first one never discussed beta blockers or many other vitally important issues. We have an appointment with the new internist on Friday.
    That's very good news. Now that you've had time to do some research, I'm sure you'll feel better going over everything in more detail with both the surgeon and the new internist. Oh, BTW, were Katrina's tests indeed positive for Cushings? It still may be a cortical tumor, in which case the surgery should be relatively straightforward. Serious, yes, but a bit less fraught. Again, most dogs with left-side tumors on this list have done pretty well.

    Thanks for keeping us posted. I'll be interested to hear how you like the new internist!

    (((hugs))) to you and Katrina
    - Carol
    Last edited by chapmandou; 06-09-2009 at 09:36 PM.

  2. #12

    Default Re: Little Katrina Has An Adrenal Tumor (possibly a functional pheochromocytoma)

    Good evening everyone!
    I am very disappointed with the surgeon. He was to call me yesterday to discuss a few questions I needed answered. He did not call, so I called the clinic today and I was put on hold. His secretary came back and said that he would call me shortly after 2 PM when he completed surgery. It's almost 10 PM and no phone call. I am upset and don't know what to think or do.
    Alison, I hope the new internal medicine doctor will be more knowledgeable than the last one. Thanks very much for the link.
    Carol, yes, the German doctor verified Cushings. I really wish I was back in Germany so that clinic could do the surgery. The American surgeon (one who is not returning calls) said the tumor appears to be contained. Do you know if 24 mm, which is less than one inch is considered large? Would you be able to tell me more about a cortical tumor?
    To all------I will post tomorrow how the visit went with the new internal med doctor.
    Hugs!
    Candy, Katrina, Heidi and Joe

  3. #13
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    Default Re: Little Katrina Has An Adrenal Tumor (possibly a functional pheochromocytoma)

    Hi Candy,

    Sorry things are not going smoothly and I hope you do better today. Looking forward to your post.

    Scott

  4. #14
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    Default Re: Little Katrina Has An Adrenal Tumor (possibly a functional pheochromocytoma)

    Quote Originally Posted by SaxLady View Post
    Good evening everyone!
    Do you know if 24 mm, which is less than one inch is considered large? Would you be able to tell me more about a cortical tumor?
    Re: Size - according to the previously linked article (by Ken):

    The first consideration is to be certain an adrenal mass exists. Abdominal ultrasound should always be repeated to confirm the mass is a repeatable finding. An adrenal mass is suspected when the maximum width of the adrenal gland exceeds 1.5 cm, there is loss of the typical 'kidney bean' shape of the gland, and there is asymmetry in shape and size between the affected adrenal gland and the contra lateral adrenal gland.
    Katrina's tumor is 2.4 cm.

    Adrenalectomy is the treatment of choice if the mass is malignant and has not spread but adrenalectomy may not be indicated if the mass is benign, small, and hormonally inactive. Unfortunately, it is not easy to determine if an adrenal mass is malignant or benign prior to surgical removal and histopathologic evaluation. Guidelines to suggest malignancy include size of the mass, invasion of the mass into surrounding organs and blood vessels, and identification of additional mass lesions with abdominal ultrasound and thoracic radiographs. The bigger the mass the more likely it is malignant and the more likely metastasis has occurred, regardless of findings on abdominal ultrasound and thoracic radiographs.
    Since Katrina's tumor is apparently functional and possibly a pheo, removal is the treatment of choice.

    Adreno-cortical tumor is the more common adrenal tumor found and causes Cushings (this is the type of tumor Ken's Shiloh had removed)

    An adrenal tumor may be functional (i.e., producing and secreting a hormone) or nonfunctional. Excess secretion of cortisol, catecholamines, aldosterone, progesterone, and steroid hormone precursors has been documented. A cortisol-secreting adrenal mass causing hyperadrenocorticism is the most common functional adrenal tumor identified in dogs and cats. In addition to the typical clinical signs and clinicopathologic findings associated with hyperadrenocorticism, abdominal ultrasound should reveal a small or atrophied contra lateral adrenal gland; atrophy is a result of suppression of pituitary ACTH secretion. Tests of the pituitary-adrenocortical axis (i.e., ACTH stimulation test, low dose dexamethasone suppression test, endogenous ACTH concentration) are used to confirm adrenal-dependent hyperadrenocorticism.
    No doubt your new internist will explain all of this when you meet with him/her today. We look forward to hearing the results of your visit!

    How has Katrina been feeling this past week? Any more attacks?

    Carol

  5. #15
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    Default Re: Little Katrina Has An Adrenal Tumor (possibly a functional pheochromocytoma)

    Candy,
    Haven't posted to you before, but have been following Katrina's story.
    Just checking in to see how your visit with the new vet went. And if the surgeon ever got back to you. Sometimes doggie surgeons are just as bad as people surgeons with bedside manners, but they are skillful surgeons. Hoping this is the case.
    Katrina is tiny but mighty. I know you will provide her with the best chance possible, and in turn, she will give it her best fight.
    Healing thoughts & prayers.
    ~ Mary Ann

  6. #16

    Default Re: Little Katrina Has An Adrenal Tumor (possibly a functional pheochromocytoma)

    Good afternoon Carol, Mary Ann and everyone,
    Carol----Thanks for posting the information. Katrina's tumor is 24 mm, not 2.4 cm, thank goodness! She hasn't had any more attacks. Grateful and crossing my fingers.
    Mary Ann----The surgeon never called. That might be a blessing. I will explain why below.
    Katrina's visit with the new internal medicine doctor was encouraging. The doc was very thorough and spent one full hour with us, asking dozens of questions. She examined Katrina extensively and took her vitals. Her blood pressure is OK. One of her own dogs has an adrenal tumor and she is treating it with meds. She explained the high risks of surgery, especially with a dog as small as Katrina. Doctor ordered more blood chemestries and hematologies. Blood was also drawn for a adrenal panel to be sent to Dr. Oliver. She also called Dr. Oliver to ask if there is a definitive test for a pheochromacytoma and he referred her to a doctor in Utrect, Netherlands. Some of the test results will be ready Monday or Tuesday. Adrenal panel results in 10 to 14 days. I would really like to know if anyone here decided to treat their dogs adrenal tumor with meds instead of surgery and what the results were.
    Hugs from Candy, Katrina, Heidi and Joe

  7. #17
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    Default Re: Little Katrina Has An Adrenal Tumor (possibly a functional pheochromocytoma)

    Quote Originally Posted by SaxLady View Post
    Good afternoon Carol, Mary Ann and everyone,
    Carol----Katrina's tumor is 24 mm, not 2.4 cm, thank goodness! She hasn't had any more attacks. Grateful and crossing my fingers.

    Hi Candy -- Just to be clear, I believe you'll find that 24 mm IS 2.4 cm.


    One of her own dogs has an adrenal tumor and she is treating it with meds. She explained the high risks of surgery, especially with a dog as small as Katrina.
    True, it is trickier to remove the gland in a smaller dog. And yes, you can treat an adrenal tumor with meds, as several have opted to do on this forum (I'm sure you'll be hearing from them).

    The advantage to surgery, of course, is that it can provide a complete cure. If you're dealing with a cortisol-producing tumor, treatment with Cushings meds can be effective for some dogs. If the tumor is a pheo, I'm not sure treatment with meds is recommended, but that's for your internist to address.

    The dosage for treating adrenal tumors is higher than for pituitary-based Cushings, so it becomes a management issue, requiring very close monitoring. However, it can be life-extending.

    I'm so glad you have a good specialist to advise you! Makes all the difference.

    Best,
    Carol
    Last edited by chapmandou; 06-14-2009 at 06:23 PM.

  8. #18

    Default Re: Little Katrina Has An Adrenal Tumor (possibly a functional pheochromocytoma)

    Carol---Thanks for telling me the size in cm's. I hope other members that have had their dogs adrenal tumor treated with meds will post. I need all the information possible in order to help little Katrina.
    Hugs,
    Candy

  9. #19
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    Mar 2009
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    Default Re: Little Katrina Has An Adrenal Tumor (possibly a functional pheochromocytoma)

    Hi Candy,

    The only case I can think of right now where the pup was treated medically is Nikki, but I don't think her mom, Michelle, has made it here yet. Nikki was treated with Lyso for over a year and did quite well.

    One thing I want to mention to you...an IMS is not a surgeon. They don't have the education or surgical experiences that a surgeon does, tho they are specialists. Before I decided against the surgery for Katrina, I would talk with a board certified surgeon who has several adrenalectomies under his/her belt. An experienced surgeon is the only one who can tell you with any degree of accuracy whether she is a candidate or not and whether surgery could offer a cure for her.

    I'm glad you liked the new IMS! The first one we dealt with was awful. I really like the one we use now, tho.

    Hang in there! You are doing a wonderful job for your baby.
    Hugs,
    Leslie and the girls
    "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.

  10. #20

    Default Re: Little Katrina Has An Adrenal Tumor (possibly a functional pheochromocytoma)

    Hi Leslie,
    We did consult a board certified surgeon three weeks ago and he did not explain anything at all about complications. I have called him three times over the past two weeks requesting he call to explain surgery and post surgery complications. He still has not called! I just don't know what to think! He is part of the same group as Katrina's new internal medicine doctor.

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