My baby girl Gabby just saw Dr. Bruyette - Adrenal tumor malignant

[Heatherdo]

Gabby is a chow-terrier mix. She will be 16 February 1st and weighs 40lbs. She had an ultrasound this week that revealed town enlarged adrenal glands, one quite a bit larger than the other. Her liver levels have been slightly high for about two years but nothing that alarmed her vet. She was put on a liver protectant about 2 months ago to keep the rimadyl she is from harming her liver.
Her vet suspected she had cushings based on the ultrasound (no other real signs other than beggings incessantly for treats, this is a new behavior, only does it with me, not my partner). He then performed the Dex-test which he said pretty much solidifies that she has cushings, based on the cortisol levels.

Since confirming this I have found a cushings specialist to take her to in the Los Angeles area to find out if there are any tumors on her glands or is this is over active gland cushings. I have already ordered cushex drops and the vet wAnts her to start taking trilostane but not sure if I should put her on the trilostane until she sees the specialist and they determine what is causing the cushings.

Should I be doing anything else at this point. I want her to be as happy, healthy and comfortable as possible. She is currently on a balanced raw food diet, eats wells but doesn't overeat, has always been a good water drinker, does not have accidents in the house, and sleeps well.

Thank you for any help. Sorry for the long post, my head is just swimming at this point and I can't stop researching the subject.

[frijole]

I would go to the specialist and take the test results and ultrasound findings with me. The low dose dex suppression test (LDDS) that your vet did is a very good test except it can have false positives when another illness is present so you may want to confirm the dx by doing another test which is the acth test.

I would return the cushex drops for a refund if you haven't opened them. Sorry but we have tried multiple times to get scientific evidence that they work and they do not. To treat cushings you must lower cortisol and those drops don't do that. Save your money for the testing as it is expensive enough.

I wouldn't start dosing until after seeing the specialist. Did you vet say what dose he wanted to start your 40 lb dog on? You want to start LOW and tweek upwards if need be. Starting high can cause problems.

Kim

[Heatherdo]

Thank you Kim, for your response. I have not received the cushex drops yet so I will be sure to return them. I will definitely bring all the results to the specialist and make sure they do any test that can solidify the diagnosis. I want to make suremImam treating the correct illness. My vet did not discuss the dosage for Gabby, he actually didn't seem confident about the dose amount. Assuming she does have cushings and I can get the specialist to prescribe the correct dosage, have you heard positive things about this drug?

[labblab]

Welcome from me, too! I agree with Kim -- I would not start the trilostane before seeing the specialist because the drug can skew the results of certain additional diagnostic tests that the specialist may want to perform. If you do end up using the trilostane, though, you will be in good company since we have many, many dogs here who are being treated successfully with the drug. :)

Marianne

[Heatherdo]

Thank you Marianne. The trilostane does sound quite a bit better than other drugs I have been reading about, glad to know you guys are seeing success with it. I will wait to proceed with anything until I meet with the specialist. Thanks again!
Heather

[goldengirl88]

You can use trilostane from an online pharmacy like DiamondBack or Vetoryl from an online source as it is usually cheaper than the vet. Blessings
Patti

[Heatherdo]

Thank you Patti! I will make note and make sure I go to an online pharmacy. I imagine once I have the MRi done, I will need some cost cutting.

Heather

[lulusmom]

I'm a shopper when it comes to my pet meds because there can be great disparity in pricing, whether you are buying name brand or getting your meds compounded. For name brands, the best prices I've found on most of my meds is at California Pet Pharmacy. Nobody could touch their price for Metacam. My vet was astounded when I showed her the page. I did some comparisons for Vetoryl and they are also the cheapest I could find for 30 count 30mg capsules. A very close second, or possibly cheaper if shipping is less, is Valley Vet. I've provided a url to the Vetoryl page for both sites below.

http://search.californiapetpharmacy.com/search?query=vetoryl&x=0&y=0&vwcatalog=yhst-23671804106035

http://www.valleyvet.com/ct_detail.html?pgguid=057ae20c-efea-490b-b89e-562663425dfe&search=977rx&ccd=IGO050&gclid=CPCyg6DqnLwCFYdgfgodnTgA1w

[Renee]

Popping in to say I am getting my Vetoryl from California Pet Pharmacy too!

[Heatherdo]

Thank you Lulusmom and Renee! I really appreciate the links!

Heather

[mitsua]

Hello, can you tell me the name of the cushings specialist in Los Angeles that you are going to see? I am with a local vet about 100 miles out from LA but she isn't a specialist and want to find one who is. Thanks.

[Heatherdo]

Hi Mitsua,
His name is Dr. Bruyette. From all the reviews I see about this particular VCA location, they tend to overcharge and not sure if Dr. Bruyette is going to have the best bedside manner, but he is an expert in his field. At this point I want to make sure she is seeing someone who really knows what they are dealing with and can give me all of our options. Overcharging or not, I know this facility has all of the latest equipment and they support homeopathic options as well. Here is a link:

http://www.vcahospitals.com/west-los-angeles/our-team/veterinarians

I hope this helps. I will also let you know what type of experience I have with him.

Has anybody had any dealings with Dr. Bruyette in Los Angeles?

Heather

[labblab]

Why yes, Dr. Bruyette is very, very well known to us via repuation, and he actually actively participated as a member on this forum for a short period of time. Here's the thread where he answered some questions for us:

http://www.k9cushings.com/forum/showthread.php?t=543

Also, one of our members' dogs, Lucy, was the pioneer for successful cutting-edge canine pituitary surgery coordinated by Dr. Bruyette at UCLA Medical Center a couple of years ago. We all felt as though we were front-row participants in Lucy's surgery and recovery! Gina ("lucygoo") has several threads about her Lucy here on the forum, but here's a link to one of her memorial threads that contains the news summary of Lucy's surgery and Dr. Bruyette's involvement. Lucy has now passed on from a non-Cushing's issue, but the surgery itself was a great success. Gina has not been active on the forum in recent months, but she may still respond to a PM if you want to try to contact her.

http://www.k9cushings.com/forum/showthread.php?t=4207

Marianne

[molly muffin]

Dr. Bruyette has also taken an active interest in one of our other members pups, Patti and Tipper and she regularly consults with him via email concerning Tippers treatment. He comes very highly recommended as a cushings expert.

Sharlene and Molly Muffin

[goldengirl88]

I have nothing but the very best things in the world to say about Dr. Bruyette. He has taken countless hours to help me with Tipper and has never asked me for a cent. He is an expert in the field and highly thought of by his colleagues. I would recommend him to anyone. He is a major contributor in the research on Cushings disease and had pioneered in the US a way to remove pituitary tumors thru the roof of the mouth. He has been a God send to Tipper and I and I consult with him on a regular basis, he always answers me promptly too not matter how busy he is. The charges at this hospital are probably warranted by the expertise of the staff and the state of the art facility. As far as Dr. Bruyettes' bedside manner, he has answered emails from me while up in a plane, and sifted thru scads of Tipper's records to help me. He has never ever been anything, but kind and sweet to me and so I feel I must say whoever said his bedside manner is bad they do not know him like I do, and everybody has a bad day maybe he had one. I would recommend him to anyone ,anywhere. He is totally professional and cares about animals. He is not in this just for the money like my vet.
Blessings
Patti

[doxiesrock912]

Patti,

I wonder if Dr. Bruyette would review Daisy's most recent bloodwork?
Please let me know what you think on my thread.

Thank you

[Meg_Elizabeth]

You can use trilostane from an online pharmacy like DiamondBack or Vetoryl from an online source as it is usually cheaper than the vet. Blessings
Patti

Great advice Patti! Cushing's can be quite expensive.

[Heatherdo]

Patti, Sharlene and Marianne, thank you all so much for telling me your experiences with Dr. Bruyette, I can not tell you how much it has helped my piece of mind. We have our first consultation with him on Thursday and I am assuming he will be setting up an MRI for her over the next week or so to see exactly what we are dealing with.

I am trying not to freak out too much, I am very fortunate that Gabby is a very healthy 16 year old with little to no external symptoms. I just want my baby to be happy, healthy and comfortable.

No further than I am in to this, this forum has been amazing and I thank all of you for your support and insight.

Heather

[molly muffin]

We'll all be very interested to hear your report and what you think about Dr. Bruyette.
We just want your baby to be healthy and happy too. :) We want that for all our furbabies. :)

You're doing great!
hugs,
Sharlene and Molly Muffin

[goldengirl88]

Heather:
I am hoping you get a good report as I am anxiously awaiting the results too. Blessings
Patti

[Heatherdo]

Thank you again! This is scary and as much as my friends and family are trying to be supportive, their comments tend to lean towards "she is 16, she has HAD a great life", maybe you should just let her ride this out. I see a healthy looking and acting 16 year old that with some help may live another 2+ years and leave this world just an old lady who's time has come, due to age not an illness.
I would never do anything to prolong her life if she was suffering but if I have the means and there are remedies for her to be healthy and happy then I am going to do all I can.

Thank you again for the support, it means the world.

heather

[Renee]

Heather, I am amazed by how many people, including 'dog lovers', that have acted as though I should just put my pug to sleep because she has cushings. It is a scary disease, no doubt about that, especially in the beginning, but it is so treatable. I don't know why people think it is a death sentence?

[Heatherdo]

Dr Bruyette was very nice and very knowledgeable, unfortunately for gabby and I the diagnosis is very bad. She has a malignant tumor on her left adrenal gland that has spread a little in to the tissue around her gland. Her other gland is so small it almost isn't visible. Surgery is possible if it hasn't spread to her lungs or liver (we don't know yet), but it would require chemo and radiation after surgery and even then he said he didn't know what her prognosis would be. I am not sure I could put her through surgery and chemo and it possibly not help her.
I honestly don't know what to do, I am pretty devastated at this point. Not knowing how aggressively it will spread leaves us completely in the dark as to how she will fair. She is 16 years old and the doctor says at her age other conditions could arise, just from old age.
Any insight would be much appreciated.

[molly muffin]

Hi Heather, I merged your post into Gabby's original thread so we can keep all of her information in one place and changed the title to reflect the new diagnosis of adrenal tumor and malignancy.

Okay, that isn't ever what we want to hear, but unfortunately it does happen sometimes. Are they doing any further testing to determine if it has invaded lungs or other areas yet?

My initial thought is that you have a lot to weigh. Prognosis without treatment and prognosis with treatment and whether she is even a good candidate for surgery. It sounds like Dr. Bruyette has some concerns about that option? Her age and what the outcome would be.

We have a list of questions that Trish, whose dog, Flynn, has undergone an adrenalectomy put together when surgery is being considered.

This hopefully will help you to have those discussions with Dr. Bruyett and come to the best informed decision possible under the circumstances.


Part I - Questions to ask when considering if surgery is an option for your dog’s adrenal tumour:
1. What type of tumour do you suspect, ?functional, ?non-functional, pheochromocytoma, benign, metastatic
2. Expected life span for my dog in a normal situation. If your dog is close to, at or past his expected lifespan for his breed is surgery going to be of any benefit?
3. Prognosis for my dog if we treated medically i.e. with Cushings medications. AND if we do not proceed with surgery how long do you think it would be before the tumour started adversely affecting his quality of life?
4. If he is miserable now, does the benefit of potentially risky surgery outweigh his current quality of life?
5. Are there any other health problems that could impact on a positive surgical outcome, for example: if your dog is overweight or has heart, BP, liver, kidney or lung conditions
6. Is there any sign of tumour spread – imaging should be done, including ultrasound and on advice of specialists either CT or MRI to check whether there is local invasion around the tumour, into blood vessels including vena cava or spread further away in the body to lungs etc
7. Surgeon recommendations – would he/she do it for their own dog?
8. Psychological impact for the owner: It is important to understand this is risky surgery, sadly current guidelines indicate 1:5 dogs do not make it, and some recommendations are not even that high. Can you accept it if your dogs dies during or in the postoperative recovery period surgery? This is where it is important to weigh up whether the benefit of your dog being fully cured is worth the risk of possibly losing him.
9. Financially – can you afford it? Find out estimate of costs.
10. Hopefully this will not happen, but if your dog collapses, e.g his heart stops either during his surgery or afterwards what emergency measures should be undertaken, do you want your dog to have CPR, how far are you (the owner) willing to go for your dog to be saved in such circumstances

Part II - Surgery has been recommended as treatment for your dogs adrenal tumour, here are a few suggestions on what questions you should ask your surgeon:
1. Are you board certified? How many operations of this type have you done? What complications have you experienced? What were the outcomes?
2. Please explain to me how you will do the surgery, which part would likely give you the most trouble? Will you be doing the actual surgery or a resident in a teaching situation? If so, is their close supervision?
3. Will there be a specialist anaesthetist available for the surgery?
4. If it hasn’t been done, do we need a CT/MRI scan to look at the tumour more closely to check for vena cava involvement or any other tumour spread?
5. What are the risks associated with this surgery, including
• Bleeding (including trauma to blood vessels or other organs during surgery)
• clots
• Blood pressure or heart problems such as arrhythmias
• pancreatitis
• pneumonia
• kidney failure
• infection
• wound problems
• bowel problems
• anaesthetic risks
• adrenal insufficiency or electrolyte abnormalities
• death (sorry but you have to ask that risk too)
6. If we proceed with surgery does my dog need preoperative treatment with Cushing’s meds, antihypertensive if high blood pressure is a problem – phenoxybenzamine recommended preoperatively for dogs with pheochromocytoma, anticoagulants or anything else?
7. How will you treat to prevent clots postoperatively?
8. What would you do if you found anything else during the surgery i.e. nodules in other organs e.g. spleen, opposite adrenal, liver, kidney. Would you remove them and what are the risks associated when doing additional abdominal surgery together with adrenalectomy
9. How long will it take and when will you contact me so I know all is OK, when can I visit after surgery?
10. How will the postoperative period go, how long would you anticipate he would need to stay in hospital? How will we manage pain?
11. What monitoring would be needed, e.g. heart monitoring, oxygen levels in the postoperative period
12. If your dog has an adrenocortical tumour affecting cortisol production will he need to be on steroids following surgery and for how long?
13. If there are problems when I take him home, who do I contact? Hopefully the surgical team until all is stable.

I absolutely Hate that this has been the determination for Gabby. It is a horrible and scary place to be in for you. She doesn't know. All she knows is that she is loved and has wonderful people in her life that bring her joy every single day. That she loves you unconditionally and you love her the same way. So, when going through the options, remember that and keep it close in your heart.

Big hugs,
Sharlene and Molly Muffin

[Heatherdo]

Thank you Sharlene (and Molly Muffin).
No, this is not at all what I was hoping for...she is so healthy and exhibits no signs of cushings. To say the least I am floored and scared to death.
I am not sure Dr. Bruyette thinks that this type of surgery and then having to administer chemo and radiation to a dog that is 16 years old would not be the best route. I am getting the impression that he wants me to hope that it doesn't spread too aggressively and hope we get some quality time together. I flip flop back and forth because I know she is a strong dog and healthy but I would hate for her to spend months on such harsh medications and going in and out of the vet (which absolutely terrifies her). Its so hard.
I will read over the insert you posted.

Thank you!

[Heatherdo]

Sorry Sharlene, I forgot to answer your other question.
Dr. Bruyette has suggested a CT scan to see if it has spread to her organs, if I decide to do the surgery. I am want her to have the CT scan even if she doesn't have the surgery just so I know what we are dealing with.

Heather

[doxiesrock912]

I would do the same Heather, you'll have more information and be able to make an informed decision about what to do next.

Praying for you both!

[Heatherdo]

Thank you Valerie. I appreciate that.

Heather

[goldengirl88]

Heather:
I know this is little consulation, but I faced this with my Tipper too, and realized I must know what is going on in order to make a plan. I was scared to death to learn what was going on inside her. I have to go thru this every 3 months, and it is torture sitting and waiting to hear if my girl will survive this. I know she has this tumor and it is always on my mind. I know you are in the most scary of places right now and my heart goes out to you, especially with a 16 year old dog. No one can make that decision for you, but we are all here to support you in whatever you do. I am so sorry this is the diagnosis you got, I can feel your pain, and know how I would feel if it were my Tipper. I will be praying for you both. I hope your Gabby gets a miracle from God. Blessings
Patti

[Heatherdo]

Hi Patti,
Thank you for the kind words. I am hoping for a miracle too. I just want to do what is best for her. I am able to provide her with surgery and chemo and any other procedure that can be done, I just question whether I should put her through that. I am leaning towards not doing it in hopes of giving her as much stress free time as possible and just pray everyday that the tumor isn't too aggressive. I will be visiting a homeopathic vet to discuss ways to keep her immune system up and ways to combat any pain that may arise. All of this could change if the CT scan shows the tumor has not spread past the small fatty area around her adrenal gland. As I am typing I am even questioning everything I just typed. I am all over the place and just hope that in the next week or so I will comfortably make a decision that I know is right for her and the best thing for her (not me).
She is happy right now, in no pain and completely clueless that anything is wrong with her and I love that. I just dread the day that the changes start to occur and she does start to hurt. I don't know if that is two months from now? A year from now? Does anyone have any idea how aggressive these tumors are or how long I can expect her to stay like she is now?

Thank you again,
Heather

[goldengirl88]

I know the feeling believe me. Dr. Bruyette does not beat around the bush so why don't you just ask him if it were his dog what he would do? This may give you some peace of mind. If it were me I would have to know for sure if it spread. My Tipper's did not and that was a deciding factor in no operation for now. So I would want the scan done to know where I stood. The best part of all of this is what you said. The dog does not have a clue what is going on inside them, nor would I ever want them to. They are so innocent in the horrible disease. It is a shame there is no cure. Blessings
Patti

[AngelToto]

How do you tell if tumor is malignant l?

[labblab]

That is a really good question that I was wondering myself -- how does Dr. Bruyette know it's malignant in the absence of a biopsy and tissue pathology? Can he just tell by ultrasound that the tumor has an appearance that is classically malignant?

Marianne

[goldengirl88]

I think because he has seen so much of this that Dr. Bruyette knows a certain way a tumor looks can mean it is malignant but wants the test to confirm. I am sure he has a good idea what he looked at or he would never tell you that ever. Blessings
Patti

[labblab]

Oh, I totally agree with you, Patti. I don't think he would have made the diagnosis unless he had good reason to support it. I am just curious as to what he saw, specifically, that differentiated it as a malignant tumor.

Marianne

[molly muffin]

From what I read, a tumor is malignant and you can tell because it spreads. Dr. Bruyette said that this one had spread to surrounding tissue in his diagnosis. So I think that is what he is basing the "malignancy" diagnosis on. :(
That is not good, the question does not appear to be, has it spread, so much as in, how far has it spread, hence the need for a CT scan to answer that question.

Sharlene and Molly Muffin

[Heatherdo]

Hi All,
Sharlene is correct. If a tumor is benign it doesn't spread, it may grow in size but not spread out. According to Dr. Bruyette her tumor seems to have spread into the fatty area around her adrenal gland. The CT scan will let me know if it has spread in to any other organs, at which point I would know for sure that surgery is not the right choice.
How long have you been aware of Tipper's tumor?

I did ask Dr. Bruyette what he would do if this was his dog and didn't get a firm answer. he did say he was inclined to be conservative. I will have another round of questions for him when he gets the results of the ACTH test back (even though we already know what they will say) and then schedule the CT scan.
I did ask him if he could give me an approximate guess as to how long before the tumor begins to spread and cause problems and he said we could have a year before that happens. At this point I am very thankful for any time that she has that is good and pain free. At 16 years of age, another year pain free would make me very happy.

[Trish]

Hi

Sorry you have got this news about Gabby, it is an awful time while you decide what is best for your girl. I wanted to say my dog had an adrenal tumour that was also locally invasive from his adrenal gland to his vena cava, it was a pheochromocytoma. Tumours can be benign (ie do not usually grow into adjacent tissue or organs) or malignant. You are right the malignant ones can be locally invasive such as my dogs and also by the sound of it Gabby. But whether they are metastatic and spread anywhere else will be shown up on the scans.

Luckily Flynn's was not metastatic, he had CT to check that out including lungs, and he proceeded to have successful adrenalectomy and removal of the tumour thrombus from his vena cava 14 months ago, he was 11 at the time. They take a lot of the fat surrounding the gland during the surgery so I hope if surgery is an option for Gabby they could still get it all. I really hope the CT scan is clear for your girl. If you have any questions about it I am happy to help! :)

[goldengirl88]

Just wondering if you have thought about the CT scan? I hope you are doing well, I am sorry you have to go thru this. I know how hard this is to have your best friend diagnosed with this. We are hear to support you thru this, so vent anytime to us. Blessings
Patti

[Heatherdo]

Hi Trish,
What was the condition of Flynn's other adrenal gland? Gabby's has shrunk so much it is almost doesn't exist. I haven't taken surgery off the table if it hasn't spread but more than likely opt not to do it. Dr. Bruyette says it could be another year before the tumor starts to cause her problems and at 16 years of age, another pain free, happy year would be a blessing. Not sure I can put her through the surgery and recovery knowing she has little time left due to her age. I am so glad Flynn has such a good outcome, that is awesome news and is good to here.

Thank you so much,
heather

[Heatherdo]

Hi Patti,

She should be having her CT scan towards the end of next week. I am still waiting on the test results from the ACTH. He doesn't expect it to show anything different than what he has told me but he wants to wait.
Yes, this is just devastating and so glad she is clueless. She is already spoiled rotten but its going to get even worse :)

Thanks for your kind words.
heather

[Trish]

Hi Heather

His other adrenal was normal size, but it also has a nodule on it that has not been biopsied. But the surgeon took a good look at it during surgery and does not think it is nasty so it has just been left. Flynn also had a liver resection just over two months back and they checked it out again with the same opinion. So I am putting it out my mind and they will just review it when he has his followup scans which is due in a couple of weeks.

I agree with you that if they think Gabby would have another year and surgery is not going to gain much then just let it be and take the smother her with love approach!! Especially if she has minimal symptoms now, I think you said the main one is she is hungry? Can never spoil them too much :D so loads of treats would be called for! I see Gabby is a terrier mix, same as Flynn... he is mainly fox terrier but some other stuff thrown in that we are not sure of, tough little things for sure :)

Hope the CT later in the week does not throw up any more worries :)

[Heatherdo]

Thanks again Trish.
She does have a very good appetite but has never been an over eater. Loves her treats though and she will get plenty. I will let you now what the results of the CT scan are.
Have a good weekend.

Heather

[goldengirl88]

Heather:
Wishing you good luck with the scan. Please tell Dr. Bruyette Patti and Tipper said hello. I am praying this is not as bad as thought and that Gabby will be with you much longer than you think. I totally feel your pain and know how you are feeling. Blessings
Patti

[Heatherdo]

Thank you Patti!
Still waiting for the test results of the ACTH test, which is taking quite long to get back... once that result is in we can schedule the Cat Scan. Getting anxious and hoping I have more time with her than I think too.

Heather

[molly muffin]

The only thing I can say at this stage, and it is really true for all stages of life with our furbabies, is to take one day at a time, one hour at a time and just enjoy it all in the best ways possible. That might be a head on the lap as you massage her ears or anything at all.
Just enjoy. Waiting for test results is always almost unbearable, and these more so.
Hang in there!
hugs,
Sharlene and Molly Muffin

[goldengirl88]

Just checking in to see how your Gabby is today. I hope things are going ok for you both. Blessings
Patti

[Heatherdo]

Hi All,
Thank you for your continued support. Gabby finally had her CT scan today and it has been unbearable waiting for that call from Dr. Bruyette to find out if it had spread into other organs.
This is what he said....
It does not look like the tumor has spread into any organs (thank the lord) it is however a large tumor and is has invaded her vena cava a bit. He is still saying at 16 he does not recommend surgery and didnt even recommend any sort of chemo or radiation. Her cushings has no symptoms so he is putting her on Plavix to hopefully help keep any blood clots at bay and that is it. She is healthy for her age and I believ he is trying to give her as much quality time as he can. He explained that she probably has 6 good months left and after that I may start to have problems with internal bleeding from the tumor rupturing areas. He assumes that the internal bleeding will be what eventually kills.
This all seems sureal...on one hand I am so glad that the cancer has not spread but on the other I now know the facts and I probably only have a year left with my baby.

I am meeting with a homeopathic vet in a week or so to go over any remedies that may help and then heading to meet an oncologist to get their perspective. Other than that I don't know what to do other than to spoil her.

Does this prognosis sound correct? I know every dog is different but I am trying to wrap mu head around this time frame and maybe I shouldn't do that.

Thank you as always.
Heather, Gabby's mom

[goldengirl88]

AllI can say is if you got it from Dr. Bruyette it is correct. He is the top of the line in this,and I would consider that a concrete answer from him. He said you were very nice by the way. Blessings
Patti

[mitsua]

Hi, to concur with Dr. Bruyette's prognosis re cancer, my former dog passed not from the cancer itself, but from internal bleeding when the tumor ruptured. Agreed, if it's coming from Dr. Bruyette, it's a solid diagnosis. Hope this helps your confidence in Dr. Bruyette. My mini is 15 and we just had the cushings meds adjusted by Dr. Bruyette -- he is very very knowlegeable and experienced.

[molly muffin]

Vicki is going to be trying out a holistic herb mixture and she also has an appointment with a specialist for her Snuggles, to see if they can get something going to shrink his tumor, (surgery is not a good option for him either) allow him to have good quality of life going forward. (he is fine right now too) So you should check out her thread and maybe compare notes.

http://www.k9cushings.com/forum/showthread.php?t=5904&page=47

hugs,
Sharlene and Molly Muffin

[Trish]

:)Hi Heather

I am sorry to read of the tumour diagnosis from Dr Bruyette. I think I would do the same as you are, pretty big surgery for a 16 year old to get through.

Flynn's tumour went into his vena cava, I remember when discussing this with my specialists that they can be slow growing and sit there for a long time. Plus there only needs to be a very narrow gap around the tumour for the blood to be able to get through and back to the heart. If it starts blocking off there could be oedema in the tummy so keep a look out for that. If that happens then the blood has the potential to pool a little which is why the anticoagulants he has put Gabby on will stop clotting. My specialist said that is more common than internal bleeding, although all tumours can and do act differently.

I hope you have many many more months with Gabby feeling well and you both loving on each other!! Do call in if you have any questions for us and we will do our best to help. CANCER SUX and is such a plague for our pups, but sometimes they can be managed for a long time too, so keep the faith in your Gabby!