Macroadenomas

[ktzndgs]

My most important point here is that the longer you wait to diagnose a macroadenoma, the less likely you are to be to be able to treat it. My goal here is to encourage you to get a full diagnosis before you go too far. Cushing's and macro's can be managed if you treat the right problem at the right time.

When Macy was sick I tried so hard to track down information about Cushings and macroadenomas but this tumor causes so much stress to us as owners I just couldn't read through everything to find the pertinent info. I finally found there is a place on this site with some macroadenoma information . Here's the link....

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

Vets will tell you that a pituitary tumor isn't a macroadenoma until it reaches 1 cm but one of the doctors I've read recently said that a dog's tumor should be considered a macroadenoma when it can be seen on ct scan or mri or when it's 8mm. That's very important because a dog's head is so much smaller than a human's head. In the past a dog's tumor wasn't considered macro until it reached the size of a human macroadenoma - 1cm. They suspect that up to 75% of dogs with a tumor that can be see on ct or mri will end up with macroadenoma's so early screening once the dog is diagnosed with Cushing's is incredibly important. Based on the size of Macy's macroadenoma it was already a macroadenoma when she was diagnosed with cushings! It sounds to me as though the reason they're not caught is that the dogs normally get this later in life and the symptoms are mistaken for dementia among other things. I was told Macy was developing dementia even though she was just 7 years old at the time.

Another pet owner with a dog who had Dr. Bruyette's surgery said Dr. Bruyette recommends an mri as soon as a dog is diagnosed with Cushing's in order to check the size of the tumor. Apparently early mri's are also done in some areas in Europe. Doing an early mri would have saved me a lot of money and I really wish it had been done for Macy. I can't help thinking that we would have done radiation immediately and Macy might still be with us. I also would not have spent so much money on vet visits and unnecessary tests and medication while we chased after the symptoms nobody seemed to recognize.

One of the first threads I finally found was by Gina about her dog LucyGoo. I wish I'd found them sooner as they shared some of the same weird symptoms and would have pointed me in a direction. I'm learning there are symptoms are common to macroadenomas.

Macy experienced the following......
- diagnosis with Cushing's took almost a year and symptoms included panting, extreme water consumption, inappropriate urination, hair loss, dull coat, mental dullness, increased appetite
- even before the Cushing's diagnosis she stopped eating favorite foods
- UTI's
- choleseterol went up
- white count went off

After Cushing's diagnosis but before macroadenoma diagnosis.....
- trilostane only worked *well* when the dose was kept low.
- she lost the ability to perform previously well executed tasks
- personality changed in barely perceptible ways
- developed muscle twitching
- repeated vaginitis
- lost interest in things she loved
- developed the tendency to arch her back "like a cat" as Gina described Lucy did.
- stopped lifting her head
- paced (or circled as some call it) relentlessly
- periodic foot drag
- intermittent neck involvement
- became anorexic
- trilostane/Vetoryl eventually caused vomiting
- displayed weakness in all four legs

When Macy became anorexic 9 months after being diagnosed with and treated for Cushing's I finally stopped giving it to her. That's when her general practice vet and I decided it was time to have an mri done to determine whether the stiffness we were seeing was her spine or caused by her illness. We also decided at that time to forego the full spine mri and look only at her neck and brain in order to see the tumor. I had finally reached the point where I had to see the tumor and know how big it was.

The first feedback I got about the tumor was that is was so small they could barely see it. A few weeks later my husband insisted on seeing the full report so I picked it up at the vet's office and was horrified. It clearly said Macy had a large tumor. The short story is that Macy's tumor was so large it was referred to as "giant". One option was radiation which would reduce the tumor by 30% and give us maybe another year with her. At a 30% reduction it would still have been a macroadenoma which means she would still feel sick. Eventually we stumbled on the surgical option.

At first I thought they did the same surgery on Lucygoo & Macy but Lucygoo's surgery was VITOM while Macy's surgery was done by the veterinarian from Holland who goes in through the roof of the mouth. While Lucy survived Macy only survived the surgery. She was allowed to return home too soon and the stress of that was too much for her and she died the day she came home.

Macy's surgery was Tuesday, she was released to wards on Thursday and released from the hospital Friday. Friday was the first time I'd spent any significant time with her and it was absolutely horrible. Her stress level was thru the roof. I'd never seen her walk before and as I recall she had a once sided shuffle indicating to me that she'd had a stroke but I thought I'd get time at home to see the real Macy. She didn't live long enough. We were sent home with her for a drive of several hours. She was so stressed by the time we got home she never recovered.

I've spoken to the vets about allowing owners to spend as many hours as possible with the dogs IN THE HOSPITAL to see what they're dealing with and learn how to cope after such huge surgeries. What's normal???? Also, it's very feasible to skype (or something) so that the vets can see what's going on at home at 10pm when you call them. We should have done that. Finally, Macy should not have been released to me on Friday. She just was not ready. At best I should have stayed near the hospital with her rather than bringing her home but hindsight is 20/20. I was not familiar with her new stress reaction to life. I was not able to comfort her. She barely knew I existed. I didn't realize how little she ate in the hospital. She did not have a normal appetite at all.

The surgery that was done to Macy caused a very raspy throat. I don't know if VITOM surgery does the same. I'd love to know how long most dogs who have VITOM surgery are hospitalized after surgery. I do know that in comparing notes with Gina she definitely said Lucy was in the hospital a lot longer than Macy so the price tag on the surgery had to be quite a bit higher than the $9k we were billed. Then again, with all of Lucy's hospitalization she also survived.

At one point I really wanted this surgery to work but now I know it's more important for owners to understand early diagnosis is key! I also want owners to be very aware of the symptoms of the tumor and not put off an mri. A small tumor is much easier to remove than a large one and an mri to confirm a problem is a lot less expensive than treating for a wide variety of symptoms.

At this point I won't be returning to the the k9 Cushings group very often as it's still emotionally very draining for me and this post covers most of what I have to offer. I do hope other's with macro dogs will join in and provide information about the symptoms their dog showed. It might help someone else.

Kathy