Tipper - adrenal tumor/breathing issues

I'm sorry if am being dense...is it too large or not? (the tumor)

So glad they called and straightened this out and the increase was small! Maybe think about the urine test that I just had Snuggles and Brando take at least it is not invasive. I am not sure which is better a CT Scan or MRI but it would show a lot more than an US, on the 4D US it didn't show vena cava invasion on Snuggles tumor but on the MRI with contrast it did, but they do need to be put under anesthesia for it.

Having a consult with a surgeon experienced in adrenal gland tumors might help you get more information to help you decide what to do. I know exactly how you are feeling its a horrible choice, to operate or not. My thoughts and prayers are with you and Tipper.

glad to read that the increase was not as bad as you thought it was.
maybe an operation is not necessary right now?
what a tough decission.
it seams she has so much energy, and loves to make long walks.
take a rest, and i hope those doctors will email you back soon.
did they give you anything to calm down tipper during the thunderstorms?

Hi Patti, I am very glad to hear that the increase was very small. So, that at least gives you some breathing room to find out information and think about things without as much pressure as it would be if it had increased a great deal.

It still isn't easy and I know you are still very worried, but it's better than it was earlier today.

hugs
Sharlene and molly muffin

OH, sweetie! I am so glad, for once, to know a mistake was made and the tumor has NOT grown like first thought. ~~whew~~ That was my first reaction on reading that post. The second was GET IT OUT NOW before it does grow too large and this option is lost! :D This would be my reaction were this Squirt and there was any way I could pull it off financially. ;) A great deal of this response of mine comes from dealing with the tumors I have so far. Squirt's spleen tumor had to come out; it was too late for Tasha; then poor little Grace's "benign" tumors suddenly growing so massive; plus several others who have been here a very short time due to cancers. Tumors now scare the crap outta me and I want them REMOVED. :o I do realize this is not always an option but it is still an option for our Tipper. So find that surgeon you feel comfortable with, talk to them in depth, then make the decision you can best live with regardless of the eventual outcome.

But first, please take a day or two to rest and try to relax every now and then. Let your mind rest a bit so it is fresh and ready to tackle this issue without as many emotions clouding your thoughts (as if that is really possible to any degree ;)). Your health is not the best and getting worse with all this stress - you cannot help Tipper if you are going downhill physically and mentally. So please take a minute for yourself, honey.

Hugs,
Leslie and the gang

Hi Everyone:
Please excuse me if I do not post on your threads today. This has made my Lupus in overdrive and I am not well today. When I got out of bed, I felt like I could vomit, and then did. I will give them credit at the hospital they owned up to the mistake, but it did little good for me. To make sure they were not covering something up I went to Tipper's file and got all her ultra sounds immediately. When I looked at the numbers the hospital was correct in that the IMS wrote the last number down wrong. This is a terrible mistake to make as if it were not for me catching it I could have made a different decision. I know she has a tuff job and is under a lot of pressure, but making a mistake on a tumor measurement is bad, especially when it is my Tipper. So that being said I am going to let go of that. Thank God I keep a meticulous file on Tipper and that I always recheck whatever anyone tells me. So the tumor did increase by .31 centimeters, but was smaller on the other measurement so could it have moved around making one measurement smaller than before and one larger? That does make sense to me. I still may opt for the ct scan to know where we stand. Dr Bruyette did get back to me and told me if this surgeon is the same one that trained with him, I have no worries and can trust her. That makes me feel a little better if I have to go that way. I have decided for now that I will go and talk to the surgeon, if she has done many of these operations but I will not take Tipper to the appointment as they want. She has had enough and I am putting my foot down. If I decide to go that route I will certainly take her there for the surgeon to evaluate her. For now she does not need the stress any more. Vicki I will ask the surgeon which I should have the ct or the MRI. I know the MRI is the gold standard for everything so it will probably be that. I must know all information before deciding what to do, I must protect my girl at all costs. I will fight to the death to keep this disease from taking her. I will post later, and I want to thank each and everyone of you for you concerns as I cannot do this without your help. I felt you all with me yesterday and it did bring a sense of comfort to me. Blessings
Patti

Dear Patti,

I'm praying for you and Tipper and it pains me to think what you must be going through right now. Tipper may not realize how lucky she is to have you as her mom but to me she is one of the luckiest pups I know. I know you by now that you will some how, some way make the best possible decision for Tipper after weighing everything in like what you've been doing it for a long time. As what Leslie said try to take care of yourself as Tipper needs your fighting spirit and energy to tackle whatever lies ahead, right by her side.

Hi Everyone:
Just a quick post. Dr. Bruyette just emailed me again and gave excellent references for the surgeon where Tipper goes. One thing he has not answered is if she has done any of these procedures, how many, and the outcome. Without those answers I am not seeing her. I hope I hear back from him. I have one thing going around in my mind and maybe one of you can answer for me. I know this is a question for the surgeon and IMS, but I want an unbiased answer so I am asking you. If this tumor is removed, it is on the left adrenal that only then leaves the right one, what are chances of a tumor then developing on one adrenal that will be overworked without the other? If that is a good possibility would I then be better off leaving the tumor on the left one, which is further away from the vena cava?? It has taken about a year for this tumor to grow .31 cm could she conceivably go on without this being removed at this rate? I need to ask the surgeon whoever it is how much time this operation would give her as opposed to leaving it in. I have trouble trusting a surgeon as their first rule is cut and remove and get it out, they are told that in training. I feel so bad and I have to go to the cardiologist Monday, I will be there all morning so I have to call the sitter for the babies. I do not really feel like another trip, I am really wanting to just rest, but I have to go and see if I have anything else I have to deal with. Blessings
Patti

Hi Patti,
Been off the board for a few days so just read your news and got a sinking feeling until I came to the post that says the increase is NOT a big one but a very small change in size..so that is great news!

I think getting opinions on leaving it alone as opposed to operating is a good idea. It actually did not grow much over the course of a year, is that correct?

Maybe doing the CAT scan or MRI, if you are able to, will give a more definite report on location, size etc...and that could help you know what to do, you may end up with clear decision that you feel is right if you have better information.
Hoping Tipper is having a good day today.

Barbara

Hi Everyone:
I guess I am just posting as things happen. The owner of the hospital called me. He said the IMS told him of Tipper's situation, and that I would only consider the most experienced surgeon if I did opt for surgery. He said the Dr.explained try that this dog is everything in the world to me. He said he would offer himself for her surgery and would like to talk to me. I told him after next week as I need to see how my own cardio appointment goes. He told me to call when I was ready and he will see me. I was kind of taken by surprise and really did not ask him anything as I still want it know how many of these his has done. In a way if this is what I opt for I thought I would want a woman as they understand emotions more than a man does, and let's face it I am very emotional when it comes to Tipper and that won't ever change. Just wanted to put this out there as I do want all your opinions. Barbara thank you for telling me why you would do, it does help me to know this. Blessings
Patti

Sweetheart, you can't let something like the gender of the surgeon influence your decision. Some of the most empathetic docs I have known are male. The worst vets I have dealt with were all female. ;) Go talk to him next week. Sit down face to face and you will get a much better feel of who and what he is. Don't let YOUR emotions guide you. ;)

Hi Pattie, sorry to hear your Lupus has flared. Stress is so bad for Lupus and you've had plenty lately.

I am guessing that Dr. Bruyette wouldn't know how many surgeries the female person has done and her statistics since leaving his facility. It is probably good though that they have referred you to their senior surgeon?

You'll need to make out a list of all the questions to ask him when you meet.

Get some rest.
hugs
Sharlene and molly muffin

I agree with what Barbara said and I wouldn't worry to much that the surgeon is male, some female doctors I have seen are colder than any male doctor, but the main point of talking to the surgeon is to get facts. and with those facts you will decide what is best for Tipper, so IMO even if the surgeon is not as empathetic as you would like, as long as he gives you accurate facts and options, that is the main thing.

My advice is not to pre judge him based on his sex.

so, you have a lot to think about. i agree with the other posters; gender has nothing to do with the skill of the surgeon.
go and meet him and ask him a whole list of questions.
0.3 cm is not much growth in a whole year.
but remember surgeons do want to operate, it is what they do to earn their money.
i hope the thunderstorms are over so you can relax and walk the dogs and have a good night sleep.

Very difficult decision i must say...

Try to get some first...a tired body makes a tired mind (and vice versa)

Hi Patti,

I do agree with the others as gender should not play a part in deciding who will be Tipper's surgeon. Experience in this type of surgery would be the first important thing to me in picking a surgeon.

I do believe Trish's list of questions are excellent ones and I will include them here:

Quote:

---

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 know whatever you do decide will be in Tipper's best interest as you and only you know Tipper best.

Hugs, Lori

Hi Patti - I am checking in on your thread after having been absent a while.

I am so sorry about that mistake. What a terrible mistake to make, but at least it turned out for the better and not the worse.

I actually believe CT's are used more for the planning of surgery in removal of tumors, but I could be wrong.

I urge you to meet with the surgeon, without Tipper there (so you can focus 100% on them). Ask your questions and then go home and process.

You'll make the right choice, whatever it is.

Patty,
I've had bad and good femaie and male doctors so in my opinion, gender doesn't play a role at all. Qualifications and experience all the way. Hugs.

Since the tumor has only grown a small bit, is surgery necessary or is that what you'll be trying to determine once the surgeon examines Tipper?

I hope that you feel MUCH better soon.

HUGS

Hi Everyone:
Thank you all for your help.. Renee thank you for checking my thread I appreciate your input, and Vicki, and Leslie, Sharlene, Lori, Valerie, Iraklis, Iris, Barbara, and Lori thanks for posting the questions for the surgeon.
I have sent the IMS a list of questions since she was not able to talk to me the day of Tipper's ultra sound. When she answers I will post all of it as it could help someone else in this situation. Tipper has been drinking a lot of water the last two days, I am hoping the cortisol is not climbing. She had as bad episode of tremors when going to sleep last nite, I could not get to my tablet in time to video it! Just my luck! I am playing catch up, as wen I am away for a whole morning the work is still here waiting when I get back! I have food for the critters to do, and clean up etc. I need to get my stuff ready for Monday morning for the cardiologist appointment as I am usually there all morning. Then next week is my regular Dr. Appt in Pittsburgh again. The week after is when I am thinking I will go back to Pgh. and talk to the surgeon about Tipper so that is a lot of trips and a lot of stress. In the midst of all this I look out the window and see the sheriff at Deloras house. I saw my nosey neighbor run out and start asking him what was going on. Then he ran to the nursing home on a pretend visit to Delora hoping she would tell him what was going on. I called her and she told me her house was being taken over and will be sold. I am assuming the son either put a mortgage on it and did not pay, or did not pay the original mortgage note. The sheriff put the papers in the door. All Deloras clothes and personal belongings are still in there! They will pad lock the house too! She is so upset, she said her son told her not to tell anyone!! This poor woman has had enough, the social worker has been visiting her daily!! She said she misses her house and her cat, it is just pathetic what she has been thru, and I feel so bad for her, but there is nothing I can do. I must now concentrate my energy on Tipper's well being. I do know one thing, I will fight this disease with a vengeance. I will find some way to help my girl no matter what. I am hoping the IMS answers me in a timely manner as I am stressed about all this. This is definitely a good time for them check my heart as I am stressed to the max with this. I am not really worried about the gender of the Dr., just thought I would have preferred a female. All I want if I decide this is experience with a good record of outcome. I don't care if this Dr. owns the hospital, all I care about is his record. I did tell the tech for my IMS to not set me up with anyone except the most experienced surgeon you have with this particular procedure, so we shall see. Blessings
Patti

wow...Patti, the Delora story never ceases to amaze. How is she doing with her cancer? Is she being treated at all? After reading what's gone on with her, her house, her son..I have to admit I'm so curious about what will happen next.
Does the neighbor still have the cat? What a shame this poor woman has had a lousy life the last number of months. It's a sad story.
I hope surgery will not be necessary for Tipper though if it is I think you should be confident with the Dr. Bruyette trained vet, especially as you think highly of Dr. B.
Has Tipper been out a lot after the rain storms...maybe the exercise has increased the water intake??

Barbara

I'm gonna find this AH's church....

Hi Everyone:
Leslie does have a way with words! I am going to call poor Delora, and see how she is. Barbara they are not treating her cancer with anything! She told me yesterday morning her bed was covered in blood and that is a first. Then she said it was all over the floor in her room. She also told me she heard someone out in the hall say to her son when are you going to pay this bill?? How about that one?? I can just see Leslie going to Sunday service, and choking him!! It isn't funny, but I have never seen such a terrible person. I am taking a break from catching up. Blessings
Patti

He's a pastor at a church!? Seriously? That's her only family? Ugh...what a horrible situation. How old is she??

Barbara;
She only has one son and he is a pastor ( from Hell). She is about 80 years old. I just talked with her. She said her son is taking the furniture out before they lock up the house so that should be interesting. When I called Delora the rude daughter in law answered her phone, she said who is this and I said Patti, she said this is Deloras daughter in law real smart like so I said and your point is??? She gave Delora the phone and said to her I'm leaving. They told Delora today that she has no more money left and that she will not even be getting 1 cent for a hair cut or anything. Delora is so upset, she feels like a prisoner she said. Got to go get my laundry out. Blessings
Patti

Oh my god! that is elder abuse! how can they just be let to do this to her? Why hasn't any of the social services stepped in. :( That SOB of a son will have a meeting with his maker he won't like some day. I fully believe in karma and what goes around comes around, I hope his old age is just as lovely as he has made his mothers.

I hope the IMS replies to your questions soon, so you can at least have some facts to work with and maybe some options.

It is so hard to try and figure out when there doesn't seem to be any one perfect answer. I do think though that having the facts is better than not. You know what you are dealing with and that is what you need. You need something to so you can make a decision or several decisions as things may not be black and white and if not, look at the shades of grey. Whatever is best for Tipper and you.

hugs
sharlene and molly muffin

Hi Everyone:
I am getting all Tipper's pills and stuff together for the dog sitter for Monday. I am making some chicken noodle soup so when I get home I do not have to cook. I will give some to the neighbor man. Tipper has been tired and not her spunky self the last two days. I hope they did not hurt her doing that US, sometimes they press so hard to get good view. I will be gone all Monday morning so I hope there is nothing going on that needs addressed as I have enough with Tipper's problems. It will probably take a few days for the IMS to answer me, as her schedule is really busy. I sort of expect a wait every time I send her something. At least I have time to think this through, dependent on her answers then I will have a better picture. You can never catch a breath it seems with this Cushing's. Whatever it takes I will gladly do for her, I need her as much as she needs me. Blessings
Patti

Oh my God rolling thunder alert!!! Tipper is in the closet.

Yikes, hope you both do okay through the Thunder. I'm looking outside and it's rather rainy here today but no thunder so far.

hugs
Sharlene and molly muffin

Hi Everyone:
Well I had given Tipper the herb concoction suggested by Leslie about 2 hours before the storm hit. When it started she sat on the bed then layed down and was dealing with the hard pounding rain and some low rumbles of thunder. Then all of a sudden loud cracking rolling thunder, one right after the other, she went to the closet. I got a small fan and put it on low and sat it in the doorway with the door ajar. It is very hot in there and she must have air. The small sound of the fan, and my TV were on. I could not check her as she would really start up seeing me, so I left her alone. At the end of the storm, we got 50 mile an hour wind for like 10 minutes, it was the craziest thing then it all stopped. Normally she stays in the closet and will not come back out sometimes all nite. She came out in about a half an hour, got on the bed, was on storm watch for about 10 minutes then went and layed on her pillow on the bed. This mixture did not completely put her at ease, but somehow it calmed her down and did help. This is a major breakthrough!!. Thanks to Dr. Leslie another happy patient!! She is very calm right now, was a little edgy when we went out to go potty, but this stuff gets 4 paws up from us!! It's nice to have brilliant friends! So it is getting light and dark again so we may have another round coming. I got so stressed when I heard the thunder, it made my face beet red. Blessings
Patti

now i am curious what you have given tipper to relax.
maybe others can benefit from it too.
so far, so good!
maybe you should use it too.....to prevent high bp.
good luck with your appointment on monday.

That is wonderful! I'm so glad that you found something that finally helps Tipper deal with the storms.

Write a letter to the editor of the newspaper where that loser son is a pastor in detail about Delora and her story. Refer to him as a "local pastor" and name the church. I bet that everyone else will be on that nursing home for not treating her and her son will be bombarded with bad karma from his parisioners.

I am so glad you found something to help Tipper get through storms, that is wonderful!

Oh, YAY! I am so glad it helped a bit! :cool:

For those curious, the herbs are Passionflower (Passiflora incarnata) and Skullcap (Scutellaria lateriflora). The Latin names are important when you search as there are different varieties of these plants, of all plants, so the Latin allows us to be sure we have the correct herb for the intended purpose. ;) Do not, under any circumstances, gather Passionflower from the wild to use - there are 100's of varieties and some are very toxic...and they all look very much alike. Passionflower is a wild weed around here so most folks know what it is when they see it....just don't ingest any if you see them around you. Look, touch, smell, and enjoy - they are gorgeous! - just don't ingest any part of the plant. It takes a skilled botanist to tell them apart. ;)

This combo is what I have been using with mine for storms and it has been effective. The Passionflower is also part of Squirt's night time CCD protocol - helping her keep those terrors and the anxiety at bay. ;)

A reliable source for these and other herbs in the US is Mountain Rose Herbs in Eugene, OR. A four oz package lasts us quite a while!

Leslie:
Hope you are feeling better, and that that tooth is fixed. Yes this is the only success I have had with Tipper. Is there any problem with using this too much? Like if you give it before a storm and it never comes? How much should I be dosing her? She weighs 18 lbs. Thank you as nothing else ever helped her. Blessings
Patti

Hi Everyone:
Tipper and Toby have walked and I have all my stuff together for 4 am to leave here. I have to go to the pet store afterwards to get some food for the cats and then right home. It makes me nervous leaving Tipper even though she has a sitter. It is dark here and looks like we are in for some more storms. I will give Tipper some of the new storm meds with her lunch in case it comes. I did not notice any tremors last nite as she slept away from me on the bed. I hope there is no rain tomorrow while I am gone. It was cold here again this morning and not to be out of the 50s next week. I am anxiously awaiting the answers to my questions I sent the IMS. I hope she gets to them soon, I hate waiting for stuff. I just turned the weather on and it shows rain tomorrow nite, hope they are right and I am home. I have started on the long process of cutting Tippers hair. I noticed certain areas I trimmed her white hair Haas a very cast to it. I noticed that a while back just looking at her. People used to remark how white she was, and now there is a very grey cast to her hair. She has no problem with it growing
though. It does grow real fast on the top of her neck for some reason. Blessings
Patti

I never give it more often than every 6-8 hours...and then only on those days when the storming is just about constant. Sophie is the only one who will need that much during storms - she is my worst. She weighs around 20 lbs and gets 2-3ml depending on the severity of her reaction. Squirt (12lbs) gets 1ml usually every 12 hours on bad days, Brick (4lbs) gets .30ml every 12 hours. Most of the time, one dose is enough for all of them. It's only during constant storming that they get more. I don't look for complete resolution of their phobia, just a lessening of the reactions to the storms. Sophie will still bark and sometimes run toward the doors and windows - but she doesn't throw herself against them. Brick may still pace a bit, but it's not a frantic, crashing-into-things pacing. Squirt may still be on alert, but she's not shaking, whining or hiding. ;)

The tea shouldn't cause any problems other than making her a bit sleepy if given and not needed but I try not to give them anything until I'm pretty sure it will be needed. I am sure you are like me and watch the weather reports and go out to stare at the sky often when storms are in the area. I try to get them dosed at least an hour before things get going. The herbs will make things like melatonin and other sedative meds more potent so if you use anything like that as well, cut the tea dose back. You will be able to tell fairly quickly how much is the effective dose for Tipper.

Thanks Leslie, yes I am a nut at watching the sky and weather reports. I cannot look up at the sky when Tipper is with me as she knows why I am doing it and will get rattled. I am waiting to see what happens today the weather said rain, and it is dark, but I am holding off for a while. The things you have to do in this weather!! That is why I prefer winter even though it was bad, Tipper has peace of mind then and not worried about storms. Hope you are well, how did it go with the tooth? Blessings
Patti

Well low and behold thunder again, oh give me a break please!!! Well I went to the refrigerator and got out our storm meds and put some in a dish with a few pieces of dog food. The is a great way to get her to drink it. She has heard the low rumbles a few times, but maybe not loud enough to alarm her yet. Normally it would only take one small sound of it to get her crazy. I have gone to my room with her and she is laying on her pillow on the bed. I am anxious to see her reaction this time. I am hoping this continues to help her. I just cannot thank Leslie enough, the woman is a genius!! I will caution anyone who is going to use this first, if you have an allergic dog like Tipper, when you get the mixture brewed, take some on a cloth and put on your dogs belly where there is no hair. Wait dfor about 2 hours and see if there is any reaction. I am so glad Tipper did not react to it. Blessings
Patti

Wonderful!! I hope it continues to calm her, Leslie is great! I agree :)

Patti I have just read your posts, I am so sorry about everything. Your Lupus Tippers tumor and Delora's situation.

Have you seen your cardiologist yet?
Any desicisions on whether to have an op on Tipper

you have so much all at once, you need a break..... I am thinking of you all.

Much Love Diana & Teddy xxx