New Member with 3 years of Cushings "cured" (Update: Macroadenoma)-Jackson has passed

Dear Robin,

The dog of one of our other members was actually a pioneer in 2009 for Dr. Bruyette's surgery performed by the Cedars/UCLA teams. Lucy survived the surgery and enjoyed nearly two more years of life before succumbing to unrelated abdominal cancer. Lucy's mom, Gina, remains a member but does not have the chance to visit the site very often any more. However, if you send her a private message, I'm hoping she'll see it and respond to you. I know she'll be very happy to answer any questions she can. In the meantime, here are links to a couple of threads about Lucy. The first details her experiences leading up to and through the surgery:

http://www.k9cushings.com/forum/showthread.php?t=1009

The second provides a series of updates after the surgery:

http://www.k9cushings.com/forum/showthread.php?t=534

We have had other members whose dogs have been treated via conventional radiation therapy. Some have done well, with extended periods of quality time afterwards. Some have not done as well. We are also aware of some other experimental approaches that are being tried elsewhere in the country (both surgical and shorter-term radiation). But Dr. Bruyette will be well aware as to which options are available in your area or are most appropriate for Jackson.

I can imagine what a difficult decision this is for you. At the time that we suspected a macro in our Cushpup, conventional radiation was the only option. He was very ill at the time we were faced with the decision, and my husband and I did not want to put our dog through that many general anesthetics, nor be placed in a situation where he would have to be separated from us for lengthy periods of treatment. He was a very sensitive dog who did very poorly when at the vet's or around strangers of any type :o. But had he been of a different disposition and stronger at the time of treatment, our decision might have been different. I'll try to find some links to threads of other dogs here who have undergone radiation therapy. But you can also look for some threads yourself by utilizing our "Search" option to look for threads that discuss a "macroadenoma."

I think the bottom line is that you know your dog the best of anyone. You also know your own family circumstances, and whether the high cost of treatment will place a burden that is just too difficult, especially when there are no certainties about the outcome. Whatever you decide, we know that you love Jackson dearly. Of that, there is no doubt!! And we will stay right here to support you.

Marianne

There was a study done, last year in The Netherlands by a student of the Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, The Netherlands. The complete study (thesis) is over 200 pages and Glynda (Lulusmom) has a copy of it.

Since surgical removal of the pituitary gland in canines with a pituitary tumor has been done here for a lot longer, there is more experience and there are more long term and effectiveness results and they are described in this thesis. So I will copy that specific part here, just for your info and to possibly discuss with the treating specialist:


From: Recent developments in canine Cushing’s syndrome by Sara Galac, 2010.

8.1. Surgical treatment

In hands of a skilled neurosurgeon transsphenoidal hypophysectomy is an effective treatment for canine PDH (Meij et al. 1998, 2002). It is the only treatment that can eliminate the causative pituitary adenoma, but in the dog this requires complete removal of the pituitary. Following hypophysectomy, hormone replacement therapy consists of lifelong administration of cortisone acetate and thyroxine and temporary administration of desmopressin, a synthetic vasopressin analogue. The major complications are postoperative mortality, hypernatremia due to acute AVP deficiency, prolonged central diabetes insipidus, keratoconjunctivitis sicca, and residual or recurrent hypercortisolism (Meij et al. 1998). A recent study of the 10-year follow-up results in 150 dogs with PDH confirmed that it is effective, especially in the long term, with remission for up to seven years (Hanson et al. 2005). However, the survival and disease-free periods decrease and the incidence of central diabetes insipidus increases with increasing pituitary size. Hence, transsphenoidal hypophysectomy can be expected to have the best outcome as the primary treatment in dogs with nonenlarged or only moderately
enlarged pituitaries (Hanson et al. 2007).


Saskia and Yunah.

Hi Robin,

Adding our thought, prayers and support for you and sweet Jackson.

Hugs,
Leslie and the gang

Thanks everyone for the info. I've been reading about LucyGoo and her trials and tribulations. Dr. Bruyette said only 10 dogs have been done here, in the Netherlands many more, but all those dogs had small tumors. My biggest concern is post-op quality of life. I am going to try and get more info on the other 9 cases re post-op issues.
Jackson is so playful and happy (when he's not having tremors) If his appetite was normal you'd not know he was ill. As it is, I have to feed him while he sits on my lap, usually putting the tail end (pardon the pun!) of the meal on my finger.
The secret I found to getting him to eat is to shave some frozen marrow (I've popped out of a cut shank bone) on the top of his food. I'm feeding him raw beef from the pet store. Earlier vet wasn't keen about the raw, but my understanding is it's best nutritionally.
I'll stay on this thread and keep you posted. Thank you for all your kind words and thoughts.
Robin & Jackson.

Robin - I have your little one on my prayers and sending you lots of love support strength and comfort xo

Hi Robin,

not all those dogs had small tumours, they say that dogs with small tumours have the best outcome after surgery. But initially they started with surgery on the macro's here as well. But due to the results they now use surgery especially to treat the small tumours.

Just thought these results and findings might be of interest to you and your vet...would be worth to check those references named in the thesis...since they were the source for what was written. In those references one should be able to find the amount of dogs with large tumours and the amount of dogs with small tumours, how many surgeries were done on each type, etc. Your vet should be able to access those references.

Wishing you and Jackson all our best,

Saskia and Yunah.

Thank you, I will research the info you provided and let you know my findings.
Robin & Jackson

I had several questions for Dr B, all regarding outcomes for a dog as small as Jackson (less than 10 lbs) with a tumor over 1cm (his is 1.5 cm) and the answer was quick--of all the dogs done--over 170 world wide, none have been as small as Jackson (he is less than 5lbs). He adds that without surgery Jackson has less than 3 months, which doesn't surprise me as he is soooo thin. So, to cut or not to cut, that is the question. I'll take a few days and I'll let you know
Robin

Hi Robin,

We have a member, Dottie, in the Los Angeles area who chose to have radiation treatments for her Yorkie mix, Tess. It was a tremendous success. If you have time and want to read Dottie's thread, here is the link: http://www.k9cushings.com/forum/show...ghlight=sammie

Robin - Our thoughts and prayers are with you for Jackson - It is so hard to make a decision about our little loved ones but whatever decision you make it will be the right one - remember that