Introduction: Roo and Java (13 y/o Labrador retriever x) adrenalectomy advice

Hi, I'm Roo...I'm new to this board. My 13 year old labrador retriever mix Java was just diagnosed with Cushing's Disease. An ultrasound revealed that her left adrenal gland is enlarged with a tumor, and the right one has shrunk to compensate for the enlarged left one.

I am at the point now where I have to make a decision where to go with her treatment. There is a board certified veterinary surgeon locally, who can remove the adrenal gland, but the question is, do I want to put her through this? Her regular veterinarian said that she is in good shape to withstand surgery, but of course there are risks.

Right now her main symptoms are panting, seeking cooler places to lie in, sleeping very deeply and more often.(she used to wake up if the mailman put mail in the box, or if UPS knocked on the door, but now she will sleep through it. She has a ravenous appetite; she is constantly begging me for food and it's hard to get her to stop begging...she must be very hungry because she is so persistent; before the Cushing's she would give up if I ignored her, but not now. She seems pretty happy and not in pain for the time being, so I don't know if it's better to try to manage her symptoms without the surgery, or to get her the surgery and give her possibly two more years.

Currently I am feeding her The Honest Kitchen's Force, a digestive supplement, a supplement for her liver, Milk Thistle, and Vitamin E. I have noticed improvement in some of her symptoms with the change in diet (I was feeding her Orijen before this, but little did I know that the high protein was probably the worst think she could have been eating with this condition.)

Anyway, I have a hard decision to make, and I'll be reading the board so that I can know what to expect, depending on which route I go.

Hi Roo welcome to you and Java - sorry to hear Java has Cushings but you have come to the right place!! I have a shephard mix who is 11 1/2 and was diagnosed at 7 1/2 - 8ish with cushings and began treatment at 11 and is being treated with Vetoryl and is doing good -- and all my thanks goes to this forum. Roo these people know there stuff!!! I tell this story to all the new comers - if it wasnt for these Cush Angels on this forum my Penny would not be here right now - they set the right path for me and I followed and she is good right now -- they put me in touch with two vets and they were here for me every minute I need them even when it was midnite and Penny was very sick they were here for me - I know they will all be coming on soon to give you advice - Leslie - Deb - Kim - Addy - Glynda etc etc they are some of the most fantastic people around!! Penny had symptoms Java has - Penny lost her coat - drank tons of water - need to go pee all the time - was always hungry and never gave up till she got something - slept alot - panted all them time - looked for cool spots - went into deep sleeps - didnt bark like she use to - got the pot belly - but she did still seem happy and had her spunky days - she did not have surgery - I havent heard of any dog having the gland removed but that doesnt mean it hasnt been done - just the post I read didnt mention the surgery - that sounds kind of harsh for an older dog - but like I said the experts will be here to guide you soon!!!!!! Will be checking in on you and Java - if you need anything or have any quesitons I am here for you!!:)

Roo forgot to mention the members are going to ask you for Java test results - anything you have especially anything that was flagged as high or low and the results of the ACTH stim test if Java had it yet and if not they will test you that Java need to have a ACTH test to check the cortisol levels - so post what you have:)

Hi Roo,

We have a fine group of caring, knowledgeable people that will stop by and ask questions and offer comments, share experiences, etc.

We have some members that were successfull with removal of their pup's tumors. I am sure they will offer their stories and opinions.

Some of our members who were not able to consider surgery elected to treat with Trilostane.

I use Honest Kitchen Embark and just started the Zeal. I love the food!!!

Hugs,
Addy

Hi Roo,

I am sorry you have to deal with Java's adrenal tumor. My dog had a very large tumor removed from her left adrenal gland when she had just turned 12. She was doing very poorly for a couple of months prior to her surgery. Her adrenalectomy was very successful and she lived for another 3.5 years with an excellent quality of life.

We had a great board certified surgeon. He once told me that all he cares about is the size of the tumor and its involvement with area blood vessels. Tumors in the left gland are easier to remove than in the right. At 13, Java is getting up there a little bit. However, if she is a pretty strong, healthy girl for 13 I think you should consider an adrenalectomy. All of my veterinary professionals thought Shiloh was a very good surgical candidate. As you know, it is a big surgery with risks. Your other option is to treat the tumor with Trilostane or possibly Lysodren. For me, there was absolutely no question but to proceed with the surgery and I knew if Shi knew the situation, she'd want to go for it. But it was difficult and every situation is different. I don't think you need to be in a big hurry in making your decision. Do your research and discuss it with every veterinary professional you can. All the best.

Ken

I don't have a copy of the blood results, I will have to ask for a copy.
Her liver enzymes were high at her last routine appointment. We called the vet to see her again, because she had some growths that we wanted checked out. When we mentioned the other symptoms (pot belly, panting, thirst, begging, bony appearance to head, etc.) the vet suspected Cushings and ran a full senior blood panel, they had her there all day taking blood tests. All I remember about the test is the vet saying that her adrenal levels were very high, 3 point something when they are supposed to be below one.). At that point our vet suspected a tumor on the adrenal gland so she ordered the ultrasound, and that's when they found it, on the left gland.

I talked to the vet today about our options, and she said based on the tests that she ran, Java is healthy enough to have surgery, even as a senior dog. I am a little frightened though by the procedure, it sounds dangerous; but I suppose not doing anything is also dangerous to her. I think I am going to schedule a consult with the surgeon and get his opinions.

It's so hard to know what the right decision is. I have to always ask myself am I doing this for her or am I doing it for me? If anyone out there has had experience with this type of surgery I would be interested to hear; bad or good, so I can make my decision. What Ken said is encouraging, it does give me some hope.

Right now Java is taking:

425 g Denosyl 1x per day
Vetri-Science Vetri-Liver supplement
Honest Kitchen's Perfect Form digestive supplement
Vitamin E 200 mg
Milk Thistle 3x per day

She weighs 68 pounds, which is overweight for her. She is a small lab mix, should be around 58 pounds.

Hi Roo and welcome to you and Java! :)

When I first started learning about Cushing's, I wished Squirt had ADH - the adrenal based form, meaning the tumor was on the adrenal gland instead of the pituitary gland. Why? Because that meant a cure was possible. ADH is the only form of true Cushing's that can be cured successfully via surgery here in the USA. ;)

Ken is our resident expert on adrenalectomys....he and Shi shine with what is possible with ADH. His advice to seek and talk in depth with a board certified surgeon is the most important thing you can do. Talk to several if need be in order to learn all you can about the procedure, risks, outcome expectations, and what they have to say about Java's case in particular. Dogs can and do live well after these surgeries. Dogs can, and do, live with one adrenal gland or with adrenals that don't function at all. Medications can do wonders. ;)

We have several members who are treating adrenal tumors medically with either Trilostane or Lysodren, too. Most of the pups were not candidates for surgery, tho, so this was the only choice for treatment available to them. It sounds like Java has a chance of being cured via surgery - which is a goal we would all like to have.

When you talk to the surgeons, take someone with you to help remember what is being said. Or take a recorder with you and record the conversations. If you are like me, my mind won't be still long enough to absorb and remember conversations like this because I would be so stressed. :rolleyes: If you get home and realize you have questions that weren't asked, you can start a list of those and make another appt. to discuss them or perhaps send an email if the surgeon is open to that.

We are all here with you regardless of what path you choose.

Hugs,
Leslie and the gang

Roo - leslise just made me realize why I didnt hear much about the gland being removed - its because pennys turmor is on her pituitary gland so all my discussions had to do with that. Ken is expert!! Ken so happy you shared that with us - we learn something new everyday!!! So glad you had good sucess and had 3 more years with your dog - this is really nice to hear:)

Roo - Scheduling the meeting with the surgeon is the absolute best thing you can do. And if you don't like that surgeon find out if there is another in your area.. for this surgery which is delicate you want someone who is very seasoned. A good one will review the options with you and guide you thru this. If you tell us where you are located perhaps someone can help with names if you need them. Take care, Kim

I live near Syracuse, NY. The first surgeon I want to meet with is Dr. Macdonald at Stack Veterinary Hospital. She is board certified, and graduated from Cornell. My husband visited the facility when Java had her abdominal scan and was impressed with the staff and facility. The other names my vet gave me are Dr. Bookbinder and Dr. Robinson, I don't know as much about them.

I hope that the meeting will provide some guidance or a better feeling of how to proceed. My vet is good about answering questions, but I sense that she is cautious and does not want to try to influence me one way or the other. I am hoping that a consultation will help to clarify some things, as I still have some reservations.

Are there any questions that you can think of that I should ask during a consultation?

I've thought of these:
What is the recovery time of this type of surgery.
Cost (I already know it will be high, but if that is the best option, we will still consider)
What is her prognosis without surgery.
What changes can I expect after surgery
What kind of medication will she need after surgery