Flynn 11 y/o Foxie Cross - Right adrenalectomy- Good Bye Flynny We will miss you

Hi Trish and Flynn and welcome to the forum.

Well, he does have some mish mash results. My dog too has contrary results with the cushings testing and it's a very hard disease to diagnose. If Flynn Is suppressing fine on the LDDS then that isn't consistent with cushings. I've had two LDDS test on my dog in the last two years because some results seem to show cushings but she always suppresses on the LDDS. I'm thinking there could be other things going on with Flynn. Liver, Kidney, or something else. Hopefully the latest tests will give you some answers. It's very scary not knowing.
The good thing is that this forum has a lot of people with experience dealing with many of these items. At least you'll have others to bounce ideas off of who have been on the roller coaster too. :)

Don't hesitate to ask anything. Flynn has sure been through a lot already. He looks so happy in his picture. :)

Sharlene and Molly Muffin

Trish, My Annie was misdiagnosed with cushings - she had a pheochromocytoma. They are very rare and often not discovered til after death. If this ends up being the diagnosis feel free to ask questions and I will help any way I can. There isn't a ton of info out there. Kim

Where are you located at? I know of an outstanding surgeon (who performed my little ones adrenalectomy) amazing Internal Medicine doctor, good Nutritionist, and fairly impressive ophthalmologist. I do know folks come from all over the Nation to receive these doctors care and i can certainly understand why.
My little one had a tumor on her adrenal gland and thanks to the angels here.....we managed through it. You simply will not believe how amazing the support and knowledge is here.
I am almost wondering if there is also nerve type damage to the back......have back x-rays been taken? if he has back issues cosesquinn double strength sprinkle capsules are good, and so are the adequinn injections....have heard miracles about those. His posture is indicating discomfort.........but where all from is the big question.
Any chest x-rays of lungs and heart? combining with labs and such just wondering how the health of upper organs were doing.
what food are you feeding? any diet changes? treat changes? is he on a probiotic? (sorry not meaning to flood you with questions)
you are amongst the most amazing angels who will help offer their input every step of the way. Lots of experiences here and if i can help please let me know.

HI all and thanks so much for your replies, it seems most people except those that really love Flynn think it might be time to pull the plug :eek: We think he can fight a bit more and he has not come this far to give up on him now. He is still a such a happy dog, enjoys his life, playing, running and ripping up his soft toys.

I live in New Zealand and we see the vets at our national veterinary university and they do have maybe the best in our country. Unfortunately, they are 2 1/2 hrs drive away and Flynn does not particularly like to travel!

I had a message on my phone tonight when I got home from work, his vet said with the benefit of hindsight they can now see on the previous CT back in Nov 2011 that there was a little enlargement on right adrenal. His liver blood tests which have never normalised following his liver resection last November is still very similar from his last test in July. His ALP especially is high. She did not give me the numbers in the message and she never mentioned the histology on the biopsy from his lymph node and the liver nodule.

She wants to repeat his LDDS which was normal back in January.

His surgeon has been away this week so she is going to discuss with him next week the need for further CT, and whether proceeding to surgery is the right option.

He still has none of the more common Cushings symptoms such as drinking and peeing too much, his fur is beautiful! He is hungry but not to the stage of rummaging in the bin and will often leave his biscuits in the morning choosing the chicken part of the meal, he eats the biscuits later on :p

I think the symptoms he has developed starting about 18 mths ago, mainly trembling, panting, occasional lethargy could have been from the adrenal mass. She said it arises from the medulla which is why she is thinking pheochromocytoma.

The liver problem came to a head last November when he suddenly collapsed, he was immediately seen by our local vet and was quite shocked, they did ultrasound and found the liver tumour which was then resected the week later. The surgeon was 95% he got it all plus it was a low grade tumour so all good there. It was big though, 650g which is a huge for a litte foxie. But now I am remembering when the surgeon rang me straight after surgery he mentioned they had trouble stabilising his blood pressure it was going way high then low. Now of course in my reading up on phae they have to be so very careful with anaesthetics to limit release of the catecholamines which can cause BP problems. So now in retrospect I am thinking it was probably his adrenal tumour causing the problems all along, when he collapsed, he had not had a bleed as they suspected from the liver and the vet told me at the time he was not sure of reason for collapse. So MAYBE the liver tumour just happened to be picked up and then all attention turned to that. Postop he was so stressed, shaky and whimpered pretty much for the two days he spent there despite having good pain relief. They were so concerned postop that they re scanned him to check he was not bleeding. I sat with him both days in a separate room trying to calm him down but the only time he was happy was when I took him out for a wee. I am thinking now it is only by the grace of god he did not have a stroke or worse!! Tough wee boy, I love him so :D

In the past year, they have tried to find the cause of his abnormal blood tests and continued trembling, panting, hunger etc and were focussed on Cushings, his ultrasound scans have shown adrenals on large side of normal but no lumps. But nothing positive has shown up and they have taken the watch and wait till something declares itself. Well now it has :(

His BP is high, 200 systolic, protein in his urine changes in his eyes... I am upset this has been going on so long that he is developing hypertensive complications. But he is on tablets now, an ace inhibitor which is not the drug I see mentioned in the literature. Plus I am upset this tumour has likely been present for 18 mths and spread goes knows where ie lymph nodes. :confused:

So as you most likely can tell from this novel, my mind is all over the place and I will be much better next week when we hopefully have a plan in place. I hope surgery is an option for Flynny he was so tough getting over his major surgery last year I just think he deserves a chance to get back to his normal happy self and enjoy his remaining time with us.

Thanks for your support, it is great to be able to tell people that know what I am talking about instead of those that possibly think I am a little crazy fighting so hard for a dog haha I will keep you updated
Trish xx

Sorry Skye I meant to answer your questions before I went off on my ramble!! I am so pleased your furbaby got through it ok, it gives me hope :D

He has not had a chest xray, she said his heart sounded ok but that was just stethoscope testing. He is panting more with stress, but rests quite comfortably. No puffiness I can see anywhere to indicate any heart problems?!?

He has had long standing back pain, he was a typical foxie and would leap in the air time and time again like a pogo stick! He had xrays about 4 years ago that showed arthritis in both hips. Then maybe 3 yrs ago was acutely sore one night, in his back, half way down about T12 if that helps. An xray showed a disc was slightly protruding, he got over that with anti inflammatories but I have been able to tell over the years when it is a little sore. He is tender in this area now, the vets palpating were able to pinpoint the sore spot. He can run around outside like a pup, but goes up the step into the house real gingerly.

I took him to our local vet 2 weekends ago as he started vomiting, they thought due to something bad he ate. He had loose bowels as well, not real runny diarrhea though. He only vomited a few times on one day, but his bowel took a week to get back to normal.

Food: Here is where I feel like a bad dog Mummy! Before his liver surgery he was putting on weight, quite a lot... we started him on diet r/d dog biscuits - Hills brand and he did lose some weight, this was when he started with the increased hunger. Little did we know that he was not getting fat because of being a hungry porker but he had that massive liver tumour!! Ohhh the guilt... mine not his :confused: AFter his surgery when I guess we were spoiling him as he did looks so much skinnier with that mass gone, he overate and put on a kilo in a couple of months. So he has been on the R/D biscuits, but he has never really liked them so I recently took pity on him and changed him to a chicken mince frozen food that we get in our local pet food store, this is what the vet thought cause his recent stomach upset. So now I have changed his biscuits to a different version of hills science diet light plus I mix it with chicken which is his favourite. If you have any thoughts on his diet and how I can improve it I would appreciate it.

His current meds are half a Previcox to help with his aches, a supplement for bone health and benazopril hydrochloride his new BP med that he has been on for only two days.

Thanks again

Also thanks to Sharlene and Kim for your replies, so nice to have your support and experience in dealing with these things! I love that pic too Sharlene, we were walking that day on a march to support prostate cancer fundraising hence his "blue" colouring :D I will sure be glad for the day when he can make sense of his mish mash results too! This waiting does your head in :eek: Oh to have a plan so we can start to move forward!

One final question from me tonight, I was just outside with him playing... he loves tennis balls and playing fetch... then likes to peel all the green fluff off the ball. He gets so excited playing that game... is it safe??? I don't want to get him overexcited and put his BP up, how much exercise to you think is good for him at this stage. He came inside after our rather shortened game quite disgusted with me and he lay straight back down on his side only a little puffed. This is a dog that never knew walking existed, he never went slower than a quick trot... now he walks. If I take him for an off leash outing, he still runs like the wind... just for not as long.
xx

Exercise will do him good as his muscles will start wasting. It really depends on how active his tumor is. My Annie's pheo tumor at first was only active once a month but it gradually became more active. In later stages there were times when I feared she was in cardiac arrest but the episodes only lasted a few minutes. IT is my understanding that when pheos are active the blood rushes to the brain and it leaves them exhausted. (I read this on a human pheo forum) This did match what I saw with my girl.

She too had off and on cush symptoms but Pheo's are not cushing's so I wouldn't spend money on an ldds test. You might see some cushing's symptoms - more like atypical cushings (hair loss/skin issues) over time.

The risk of surgery is exactly what you mentioned - if the bp goes high during the operation. My girls' story is very long and it took us a good year to conclude it was a pheo (she had alot of false positive cushing tests) ... By the time we figured it out surgery wasn't an option. You can read her story if you'd like. You can also view the photos. I set Annie free late February of this year. It wasn't her heart that did her in - it was weight loss that resulted in muscle wasting. When the pheo is active the body loses weight. She became skeletal but just like you described she was always very happy and alert. In the end she lost the strength in her legs. It was the saddest day of my life. I know she had this thing before I noticed the symptoms but she lived 2 yrs after I did notice them. And they were good years.

Pls do keep an eye on Flynn's eyes. Annie ended up with ulcerated cornea - I'm sure from the pressure from the tumor.

I know that drive to the specialist is a long one but so worth it! I had to drive 5 hrs each way. I wish I would have gone that path sooner than I did - I would have saved so much time, money and stress.

Sending love your way. Kim

Hi Kim
Thanks for the info on exercise, I will keep him playing but maybe just a little more gently than normal and on leash walks only. He will be disappointed.

I have noticed today he is not trembling as much, it is nice to see him resting without the shakes. He is lethargic though, I am hoping it is his body getting used to the BP meds. He needs to go and have his blood pressure checked early next week. Before that I need to talk to vet about why she wants repeat LDDS, I agree with you, seems little point?!?

You mentioned your dog had intermittent symptoms, I think Flynn is the same but not so pronounced... I had thought recently he was better but the trembling certainly never went fully away.

You mentioned to keep a check on his eyes as your pup had corneal ulcers. They looked in his eyes the other day, noted change likely due to his hypertension so I will keep that very much in mind thanks. A couple of months back he broke a tooth and the vet gave him an anaesthetic to remove it, she noted he had two areas of ulceration at the back of his mouth sort of at the bottoms of his gums under his tongue, she cut them out. I am wondering if this is somehow related. I am cringing now at him having that anaesthetic with the risks... he was very stressed that night, whimpering most of the night. Poor baby.

I am going to read Annie's story now. I hope we are not to late to operate but if my feelings are correct and he has had it for 18 mths it may be too late :(
xx

The reason the shaking is intermittent is because the tumor isn't always active - meaning emitting adrenaline. After the episodes dogs (and humans) are exhausted - just like we are after adrenaline rushes from exercising. Another symptom is nausea. My girl rejected all kinds of food and it was different every day. So if your guy is eating well do yourself a favor and try to add some lbs. Trust me, it'll help up the road. Kim