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Old 06-07-2009, 10:26 PM
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Default Little Katrina Has An Adrenal Tumor (Katrina has passed) 8/19/2009

I am so relieved to have found this forum! We were in Europe from April 17th till May 21st. Our two little doxies were with us as always. On May 13th our doxie Katrina suddenly started panting heavily with rapid respiration. It got so bad that she was collapsing. We rushed her to a veterarian who stabilized her. The next day the same thing happened and we took her to a specialty clinic. She was there for three days and nights. The German doctors said she had pneumonia. Somehow that didn't seem right because she was eating like a little fiend and running and playing with her sister when not having a panting, breathing attack. They released her so we could fly home. The night before we were to come back she had another attack at 2 AM. We called a taxi and the driver flew down the autobahn at 120 miles per hour to get us to the emergency clinic. The young woman vet sedated her and the next morning ran extensive tests. The ultrasound showed a 24mm adrenal tumor. Doctor ran tests to verify Cushing's as well.

We flew back home with Katrina sedated and the next morning took her to a board certified surgeon at a large clinic in Akron, Ohio. The German doctor and our regular doctor recommend the tumor be taken out. I have a medical background and my research indicates that it is most likely a functional pheochromacytoma. Needless to say, my nerves are in shards and I am very concerned about my sweet little Katrina. I would appreciate any information and comfort, especially from owners that have experienced their dogs having adrenal surgery. Her surgery is to be June 12th.
Candy
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Old 06-07-2009, 10:44 PM
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Default Re: Little Katrina Has An Adrenal Tumor

Hi Candy,

I would like to welcome both you & Katrina to our forum. I'm certainly sorry to hear that Katrina is facing a cushing's diagnosis, but I'm very glad you found us.

We have a few members that have had their pups adrenal tumor successfully removed. The wekends can be a little slow sometimes but I am sure they will be along to help you sort thru this.

Can you tell us anymore about the cushings test that were performed?
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Old 06-08-2009, 01:57 AM
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chapmandou chapmandou is offline
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Default Re: Little Katrina Has An Adrenal Tumor (possibly a functional pheochromocytoma)

Hi Candy,
First of all, welcome. I'm so glad you found this forum, but sorry to learn about the panting episodes Katrina has been having. They sound so similar to the attacks that our Beardie-mix, Sam, had, which turned out to be caused by a functional pheochromocytoma in his right adrenal gland.

I don't have a medical background as you do, but when Sam was diagnosed with an adrenal tumor, I got on the internet and read everything I could about adrenalectomy in dogs, during the course of which I discovered that pheochromocytoma was probably what had been causing Sam's particular episodes of panting w/BP spikes. It probably also explained why his Cushings tests had come back negative, even though he seemed to have most of the Cushings symptoms. (In fact, it was while researching the Cushings part of the equation that I found this forum.)

I should mention that Sam's tumor had also invaded the caudal vena cava, making it a daunting presentation for any surgeon. However, we were extremely fortunate to have a highly-skilled, board-certified surgeon here in CT who was able to take the case and successfully remove the tumor and repair the vein.

Your surgeon may already have told you that as challenging as the surgery can be, the post-op care is critical as well. Sam was in hospital for 6 days after the operation. He had a couple of complications but the skilled staff and 24/7 care got him through it all. Needless to say, my husband and I could have used 24/7 care ourselves just to get us through all of it, but that's another story

As you know, this is not a trivial operation, but the good news is that it's done with much greater frequency and success nowadays by specialty and teaching hospitals. These state-of-the-art facilities are really pretty extraordinary.

I know this is going to be a very hard week or two, but if you have any questions, please fire away. You have the support of everyone on the forum behind you, any time, day or night. We'll be thinking about you and little Katrina, so please keep us posted, okay?

Carol

Last edited by chapmandou; 06-08-2009 at 10:01 AM.
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Old 06-08-2009, 11:49 AM
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Default Re: Little Katrina Has An Adrenal Tumor (possibly a functional pheochromocytoma)

Hi Candy and welcome to you and Katrina!

I am so sorry to hear of the troubles your little baby has already suffered. How scary all that must have been for you and hubby. And a trip at 120mph down the autobahn!!! Did you breath at all during that ride? It sounds like she got good care in Germany, tho.

We have several folks here who have been down the adrenalectomy path and I'm sure they will be along soon to offer their experience and support along with Carol's. I do know that you will want a board certified surgeon to do the surgery as I'm sure you also know. Be sure to check out the Resources section where you will find some links on adrenal tumors and the surgery.

K9C Resource section:
http://www.k9cushings.com/forum/forumdisplay.php?f=10

I am glad you are here and hope to learn more about the both of you in the future. We will be with you all the way, Candy. You don't have to take this journey alone.

Hugs,
Leslie and the girls
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Old 06-08-2009, 03:21 PM
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Default Re: Little Katrina Has An Adrenal Tumor (possibly a functional pheochromocytoma)

Hi Candy,

I am just welcoming you to the forum. There are a number here with experiece in this area, I am not one of them.

I am so sorry you and Katrina are dealing with this but I am glad you are here, we will stay by you as you try to find the best treatment path for your pup.

Scott
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Old 06-08-2009, 08:08 PM
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Default Re: Little Katrina Has An Adrenal Tumor (possibly a functional pheochromocytoma)

John, Carol, Leslie and Scott,
Thank you so much for answering quickly! This forum is great! I have read all through it.
Carol----How is Sam doing now? Was it a long recovery? From everything I have read, the surgery has a high mortality rate and that really concerns me. Post surgery can have serious complications as well. Neither my husband nor I can remember hardly anything the surgeon said because we had terrible jet lag combined with high anxiety over Katrina. We are sure though that he did not mention any surgery complications. I am thinking of making another appointment with him before allowing the surgery on June 12th. Also, I did not care for the internal medicine doctor that the surgeon had us speak with. She did not seem to know enough about Cushings and adrenal tumors. My research verified it. Any advice from you or other members would be much appreciated.
Hugs from Katrina, Heidi, Candy and Joe
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Old 06-08-2009, 10:05 PM
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Buffaloe Buffaloe is offline
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Default Re: Little Katrina Has An Adrenal Tumor (possibly a functional pheochromocytoma)

Hi Candy,

A warm welcome to you and Katrina. My dog, Shiloh, had her adrenalectomy in October, 2006 and is truly doing great today at 14 1/2 years old. She had a very large, malignant cortical tumor (adrenocortical carcinoma) removed by a very highly skilled and experienced board certified surgeon. He was assisted by another wonderful bcs who interned under him. I had to wait a full two weeks for him to return from Germany to perform Shi's surgery. I really believe you want to be sure you have the very best surgeon you can find for Katrina. This is a serious surgery. My surgeon said they have an 85% long term success rate with surgeries such as Shiloh's. He probably does 6-8 adrenalectomies a year and I'm sure he has performed scores of them.

Shiloh didn't have any problems in post-op and she recovered uneventfully. She stayed at the hospital for 3 1/2 days after her surgery. She was kinda in a daze for the first 3 days. She would go outside and walk with me, do her business and come back in and drink a bunch of water. She was happy to just stay there. I went to visit her late the night of the third day and she totally changed. She was wagging her tail, kissing me, she ate and she clearly told me she wanted to go home.

As soon as she got home I could tell she felt better and was much happier than she had been for several months before the adrenalectomy. Then, she just continued to get better and better and better month after month. As you know, a successful adrenalectomy provides a complete cure. I'm sending you just one link to a pretty good site:

http://www.vin.com/proceedings/Proce...A2002&PID=2557

We will be here for you in every way we can. My only suggestion is for you to not be in a big hurry....make sure you have the most skilled and experienced surgeon you can find in a state of the art facility with 24 hour veterinary care.

Ken
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Old 06-08-2009, 10:10 PM
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chapmandou chapmandou is offline
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Default Re: Little Katrina Has An Adrenal Tumor (possibly a functional pheochromocytoma)

Hi Candy,
Sam succumbed to another illness almost two and a half years after his surgery. In fact, he actually had a second adrenalectomy almost two years after the first. That surgery was easy compared to the first one -- no vein invasion, the tumor was NOT a pheo, and it was the left adrenal. (The right is trickier to access.) Ultimately, it was a brain tumor that took him from us.

Sam's recovery from the first surgery, once he was home, was remarkably quick given how complex the operation and the post-op period had been. (It's the first 48 hours after surgery particularly that requires careful monitoring, longer if the tumor is a pheo.) Needless to say, it was a very tough week for us all, but we soon had our boy back for the next two years, healthy and happy. Without surgery, he would have died, so we really felt it was the only choice and were glad we had put our faith in the doctors who saved him.

Like you, I was worried sick after reading (in 2003) of the risks involved in the removal of a pheo. (Sounds like you've read some of the same articles!) Our surgeon, on the other hand, while certainly mindful of all the potential complications, was very confident and had performed numerous such surgeries before. He was the kind of surgeon who clearly rose to the challenge of a difficult case. In Sam's case, love and good hands saved the day.

Could you tell us which adrenal gland is affected in Katrina's case, and how old she is? Does the surgeon, himself, suspect a pheochromocytoma, and if so, have they started her on beta-blockers to better prepare her for surgery? As a board certified surgeon in a large clinic, I would imagine that he has considerable experience performing adrenal surgery. Did he discuss it with you? If you do meet with him again before the scheduled date, these are some of the things I would ask about.

As for Cushings tests, which ones did Katrina have and what were the results? As I mentioned previously, Sam's were all negative, since his tumor's release of catecholamines and the like were the cause of all of his symptoms, and not the usual over-production of cortisol that causes Cushings. It helped that Sam's internal med specialist was an expert in the treatment of adrenal-based disease. In fact, he wound up assisting our surgeon (among other staff) during the 3-1/2 hour surgery.

Your surgeon can tell you more about possible complications, but in Sam's case, they were mostly heart and BP-related -- arrhythmias and BP spikes. (He also refused food his entire stay at the hospital, soon rectified at home!) He was on heart meds for some time after the operation, but eventually was weaned off. His energy level returned within a week or so of being home, so that we really had to keep him down a bit so that he could heal properly.

There are a number of others on this forum who have experience with adrenalectomy, most of which I would say have been quite successful. None as successful as Sam, however, having had TWO .... (if you can call that success!) But at least he's a testament to the fact that adrenalectomy, even with a pheo, can be extremely rewarding.

Carol
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Old 06-09-2009, 07:36 PM
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Default Re: Little Katrina Has An Adrenal Tumor (possibly a functional pheochromocytoma)

Good evening everyone!
Ken, Thank you for sharing the story of Shiloh. It's very encouraging and heartwarming as well as amazing. A sweet girl now 14 1/2 years! I printed out the link you gave. I know not to rush into the surgery. Read my message to Carol here. The doctor is board certified and performs 3 to 4 adrenalectomies per month.
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. 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. 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.
We are grateful for all the caring people on this forum!
Hugs,
Candy
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Old 06-09-2009, 08:00 PM
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AlisonandMia AlisonandMia is offline
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Default Re: Little Katrina Has An Adrenal Tumor (possibly a functional pheochromocytoma)

I'm glad you are getting her on stabilizing medication before doing the surgery. Last year there was a dog here with a "normal" adrenal tumor (ie not a pheo - just cortisol/steroid hormones) and he was put on an alpha and beta blocker 10 days or so prior to the surgery.

I don't know whether the IMS and the surgeon in question always liked to do this with all adrenal surgeries (makes sense) of if there was something about the size and shape of the tumor on imaging that made them feel that this was necessary. Possibly they weren't sure if there wasn't a pheo component to the tumor. His surgery went really well (pathology showed that it was not any sort of pheo) and he made a full recovery and his Cushing's was cured. He did, nevertheless (if I'm remembering correctly), have a bit of a BP glitch at one point during the surgery - this seems to be quite common in adrenal surgeries even without a pheo.

Here's a link to some info on pheo surgery and medication in humans: http://emedicine.medscape.com/article/124059-treatment - although you have probably found it or something equivalent already!

Does sound like you need another IMS, unfortunately.

Alison
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