Buddy, The Mighty Lizard Hunter - Suspected Pituitary Macro Tumor

Aw Buddy you are so cute and always the hunter, I still think there should've a book series called "The adventures of Buddy the Lizard hunter" take care Kathy, glad you can relax today!

Kathy:
I have emailed back and forth with Dr. B. I am under the understanding this method does not give them much longer, and is really a tuff surgery, as it is brain surgery.I emailed him when my Tipper was first diagnosed and I was scared to death of this disease. I am glad that you decided to give Buddy the Vetoryl and prednisone. That is what my choice would have been also if it were Tipper. I think you are making well informed smart choices. I also think you are a lot stronger than you give yourself credit for. To add to Letti's comment I think Buddy should do a reality t.v. series, then come out with the book. That way when he gets better, he could go on a book tour, and take his mom. God Bless You Both. Special prayers are going out for Buddy.
Patti

Maybe that's why Dr. B said he didn't think surgery would be an option for Scoop. With all his problems and if the surgery is tough, it might be too hard for Scoop.

Kathy, I sure hope Dr. B can help Buddy. Prayers and best wishes to you both.

Good morning angels,:)
I have been thinking about Trilostane dosing. In the case of a suspected macro, I would think that once a day trilo dosing would be better than twice. Trilo is supposedly out of their system within 12 hours. That would give the cortisol time to rise to some degree before the next dosage 24 hours later. That could help the growth of the macro a minute amount. Anything being better than nothing. I will be emailing Dr. B soon to ask him about adding Prednisone to Trilostane. I also want to ask him about Buddy's head tremors and a few other things. Poor man. I am bursting with questions!:confused: Now that I've moved from devastation mode, there is no stopping me! I am a mother on a mission, so watch out!!:D

Patti - Buddy's not likely to get better, so we move on to what's next. Unless Mel works her magic of course.;) She has a direct line to Mother Nature herself!:) I have the number too, but always end up as the 50th call waiting. I wait longer than trying to talk to a live person at the DMV. LOL!:D

Hugs,
Kathy

I have prepared a rather lengthy email for Dr. B. Below are the questions that I am asking.
My questions...
I would like to know if head tremors are a macro-tumor symptom

What is the best drug protocol available when surgery is not an option?

What is your take on continuing Trilostane while adding Prednisone? The trilo would hopefully keep the Cushing symptoms under control while the Prednisone attacks the tumor, hopefully slowing down it's growth. Have you heard of this combination? Is it viable and what are the dosages?

I'll let you know if/when I hear from him.
Hugs,
Kathy

I would come right out and say "here is the testing I have had done and the docs I have seen (specialists)" and they believe it is a macro tumor. I cannot afford a $3500 MRI. Is there any other way I can be 100% sure it is a macro? What are the key signs of a macro and how can I tell if it is progressing?

Heck get as much free advice from this expert as you can. Make sure you let him know you are a school teacher, single and that Buddy is your world. Don't laugh but he does have the ability to do procedures for free. :o:D:o

Kim

Thank you Kim. I added those things to my email. ;):). I will send it after I get home from work. I would feel more comfortable sending it from through my home wi-fi. By the way, I am sleeping somewhat better. :)

Hugs,
Kathy

Great news. You keep on sleeping so you are awake and better able to cuddle that cute dog of yours! :D

Kathy, I think it's great that you are emailing Dr. B.

FWIW, though, I don't think there is any way to know for certain that it is a macrotumor without either a CT or MRI. At least, that's what we were told with Barkis. You can make an educated guess on the basis of symptom progression, but you can't know for sure without the imaging.

Also, just to clarify what I think I know about the prednisone, I don't think it directly attacks the tumor itself. I think it may help relieve swelling and inflammation of the tissue around the tumor which can help blunt the tumor's impact on the brain. It also may have some beneficial effect on altering the ACTH-feedback loop which is the thing that may keep the tumor from growing as quickly. I do not understand the ins-and-outs of that feedback loop, but that is the issue associated with Cushing's treatment and pituitary tumor growth. I'll try to come back later and add some more info about the feedback loop (or you may already have read about it yourself during your own searches...).

Marianne

Here's the quote I was looking for:

Quote:

---

Because most chemotherapeutic agents have no effect
on the pituitary itself, they do not inhibit ACTH secretion,
which may actually increase with therapy.This phenomenon,
known as Nelson’s syndrome, has been well
documented in humans with pituitary tumors treated
with bilateral adrenalectomy. Nelson’s syndrome refers
to rapid enlargement of a pituitary mass that occurs after
loss of negative feedback from adrenal cortisol production,
which has an inhibitory effect on ACTH release...

---

http://www.k9cushings.com/forum/showthread.php?t=229

So what I don't know is whether, in this regard, adding a controlled amount of prednisone would be better/worse than discontinuing or altering the trilo and letting the cortisol naturally elevate. But I'll bet Dr. B will have an opinion.