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  1. #1
    Join Date
    May 2010
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    Default Macroadenomas

    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
    Last edited by ktzndgs; 11-15-2011 at 06:20 PM. Reason: clarity and accuracy

  2. #2
    Join Date
    Apr 2011
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    17

    Default Re: Macroadenomas

    Hello there

    My 5 year old staffie x was diagnsed with a macroadenoma in December last year. He did not have any signs of cushings and the 3 vets he is under the care of now (normal vets, spinal vets and oncology vets) all believe he hasn't got cushings.

    In September last year my mum who doesn't see him that often noticed him often sitting and starign off into space. Her 11 year old arthritic dog often seemed more energetic too.

    When I got back the staring became more apparent and he seemed to become very lethargic and loose his zest for life. He also started to have a problem climbing the stairs. On walks he would often stop and refuse to walk and want to take the shortest route home although he was always keen to go out. He also stopped playing with my other dog, they used to wrestle for hours. He had been slightly dog aggressive before (ok if left alone or with sensible dogs) but he became very good with other dogs, which improved after hsi treatment.

    I took him to the vets; he used to be a typical bouncy nutty staffy type and they instantly could see how subdued he was - they know him as he is regularly there due to an accident he had before.

    He has brain lesions and nerve damage from a serious accident he had when he was younger so wasnt' sure how much was from that .... was always advised he may have problems in the future from these.

    He has always had a slight tremour in his back leg at times and scuffing/ weakness of paws/legs on left side for years.

    The vets said they would try the simple things first, so he had a course of painkillers, a course of vivitonin to see if it was senile related from his earlier accident, and full bloods.

    He then had x-rays of all his spine and head, which showed nothing and then MRI.

    He had the MRI in december.... his diagnosis was quite quick I think having head and spine injuries made the vets take it seriously.

    In the week before his x-rays he went down hill alot, became very weak and would lean on me and fall over if I moved, had problems standing, refused to walk and try to run home and a couple of times I found him stuck in a corner in the spare room crying.

    He went onto steriods which made an amazing difference until he could start his treatment.

    HIs adenoma was 1.5cm; also at the time the mri showed he had had a spinal mini-stroke at the same time which really wasn't helping matters either and making him be all weak and wobbly.

    They don't do surgery in this country; so radiation was the only option which they said was pallative rather than curative; would shrink the tumour rather than completely 'kill it'.

    They didn't say what it would shrink back to; and that a year is agood result after radiotherapy and 15 months is excellent (its been 8 months) ; I spoke to someone else whose dog had the same and they said dogs had lived for much longer afterwards; my regime was once a week for 5 weeks, theres was the dog went in and stayed at the vets hosptial for a shorter more intense period.

    He as been fine since, had a funny turn about 2 months ago went very drunk and wobbly couldn't stand up was staggering about, was with it ... vets recon some kind of mini stroke or mini fit.

    He is like a different dog now, very quiet and mature and he isn't nutty like he was before. He used to be ball mad but likes carrying round cuddly toys now, he never plays really with our other dog they would wrestle for hours and he used tobe slightly dog aggressive and he isn't at all now. (Alot of this started before the radiotherapy) He is still really food obsessed which he was before but is much worse now.

    On a walk there is a part of the walk where there is often dropped food and he refuses to walk in any other direction apart from where this part of the park is, if you get in the park and try to turn right he refuses to walk etc.

    We were going to mri him again when he had the turn, but he was better the next day so we are going to wait to see if happens again and then do it.

    I am in england btw.
    Last edited by EmCHammer; 08-18-2011 at 01:14 PM.

  3. #3
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    Jan 2009
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    Ohio
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    222

    Default Re: Macroadenomas

    My boxer, Dexter, passed due to complications from a macroadenoma. I told the vet he had it after doing research and observing his symptoms. He was diagnosed with Cushing's and it was under control. Dogs with a brachycephalic head are more prone to develop this condition faster than non-brachycephalic headed dogs,,if that makes sense. Boxers, staffys, Lhasas, Bostons, Frenchies = brachycephalic. They don't have as much room in their heads due to the shape than say a shepherd, lab, dobe, etc..
    Christy

  4. #4
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    May 2010
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    Default Re: Macroadenomas

    Hi Christy. So sorry to hear about Dexter. Can you tell us exactly what the symptoms were that you saw? I found it really difficult to get my vets to pay attention to Macy's symptoms and connect them with the macro. I hope to help other dog owners if we can help them be aware of what symptoms we all saw.

    Kathy

  5. #5
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    Default Re: Macroadenomas

    Kathy, I am sorry about the problems you had. While my dog didn't have a macro, she has a pheo (adrenal tumor) and I too had problems illustrating/conveying what was going on with my vet. I ended up videoing the episodes. That helped a great deal. Hugs, Kim

  6. #6
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    May 2010
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    Default Re: Macroadenomas

    Video is a great idea! Thanks!

    Given the numbers of vets who saw Macy it amazes me that they never connected the dots. She had a long list of unexplained symptoms but nobody else ever looked at the items on the list as being related.

    Kathy

  7. #7
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    Default Re: Macroadenomas

    Quote Originally Posted by frijole View Post
    Kathy, I am sorry about the problems you had. While my dog didn't have a macro, she has a pheo (adrenal tumor) and I too had problems illustrating/conveying what was going on with my vet. I ended up videoing the episodes. That helped a great deal. Hugs, Kim
    Kim,

    I just reread this and wanted to respond. I got enormously frustrated with going from vet to vet to try to get a diagnosis for Macy. What I ended up thinking was that if the records had been kept differently Macy might have been diagnosed earlier. If there had been a column with a list of symptoms in it that were ticked off as they were satisfactorily explained I think the vets would have seen that there was an accumulation of symptoms that were not being ticked off that were adding up? Does that make any sense?

    I discussed this with Dr. McDonnell and hope to get the chance to talk to him about it again. Vets have enough to deal with in trying to read the minds of their patients who, try tho they do, don't speak! I think if the charts were easier to read it would help.

    Kathy

  8. #8
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    Aug 2012
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    Mount Pleasant Tennessee
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    Default Re: Macroadenomas

    Hi, I am new to the forum. I have a shih-tzu named Bart who has cushings and diabetes. Within the past month he has started exhibiting odd behavior. Star gazing, lethargic, his right eye appeared weak. Through this month I feel as if he has been declining. I work in a vet office (I am a licensed veterinary medical technician) and I went to a continuing education conference in Birmingham Alabama ". The conference I choose was on cushings. To my amazement, when the Veterinarian started talking about macroadenomas, she mentioned a lot of symptoms Bart was exhibiting. I mentioned it to the vets where I work and they shrug their shoulders and say; "maybe, but doubt it".

    Within the last 2 weeks, Bart has gone blind. On physical exam there is no obvious reason for him being blind. Now ( this is weird) but when I call him, he can hear me, but he cannot distinguish where the sound is coming from. Even being 1 foot in front of me he cannot find me with me calling out his name loudly.

    He has been potty trained, but within the past 3-4 weeks, he just lifts his leg and urinates where he stands. I won't lie, I am scared that I am losing my baby. His decline is fast.

    I wonder if I should stop the trilostane since it suppresses the cortisol in his body. Maybe the over production of cortisol is what kept the tumor in check. I have not had a CT or MRI done. I am sure this is what he has. I won't treat because of his diabetes. The diabetes will make it hard for him to recover. I have been talking with an associate professor at Texas a&m who specializes in internal medicine and macroadenomas. She is certain that Bart has this.

    Has anybody else have one of their dogs experience weird stuff like this?
    __________________________________________________

    Administrative Note: For anyone who wishes to reply directly to this post with feedback or suggestions, please follow this link to Bart's personal thread:


    http://www.k9cushings.com/forum/showthread.php?t=4438
    Last edited by labblab; 08-26-2012 at 02:14 PM. Reason: To add Administrative Note.

  9. #9
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    Default Re: Macroadenomas

    I thought that it was best to post this in here too.
    I had been treating Maya with trilostane for about a year when she gradually started to have weird symptoms round about march this year. First it was her appetite-she just went off her food and water. I noticed she had an unusual expression on her face-a kind of dreamy look.....almost vacant. One side of her face looked slightly different. Her left eye seemed to bulge out a bit and later I realized that she couldn't see out of it. I would go to poke her in it (just testing, obviously) and she wouldn't even flinch. She started to circle and pace aimlessly throughout the house, especially at night and she would pant heavily. She seemed disorientated. She would pee constantly everywhere and anywhere. She started to lose her balance, crash into things, miscalculate corners, doors. She would stagger all over the place as if she were drunk I could see that at times she wanted to eat and drink, but she was not able. It was like her tongue didn't work anymore. I'd give her a biscuit and she's just hold it in her mouth and slobber before just letting it fall out onto the floor. She would try to drink but her tongue wouldn't reach the water. She drools a lot. I had to hand feed her and hold the water bowl right up to her mouth which helped a little, but her water intake was almost zero.She had this weird kind of shivering across her shoulder blades-kind of like a cringing. Her condition worsened and she became very weak and lethargic to the point were she actually collapsed and was totally out of it. She had a very slow heart beat. All this had been going on for a couple of months and during that time we had taken her to the vets countless times. We had had blood work done and 3 ACTH tests all of which were fine, except for her liver levels and cholesterol. We stopped and restarted her trilostane two or three times, then eventually just kept her on a half dose because we all thought that it was that which was making her ill. I had a bad feeling about the trilostane and took her off it all together a couple of weeks later. She seemed to be getting better, then one night she just crashed. I had to carry her into the vets the next morning in a comatose state. The vet started to assume Addisons and gave her a huge dose of prednisone and sent us home. over the nest couple of days she got better-lot's better. It was incredible! She started acting almost normal, so we carried on with the pred. I wanted to have more tests done to see what the hell was going on, so Maya was scheduled for an ACTH and more bloodwork. We withheld the pred for 48 hours before the test, just as were instructed to do. The vet called and told us that her levels were that of a normal dog (without Cushings) This was very weird as she hadn't had any trilo for a month. No more trilostane for Maya!
    We went to see a specialist who reviewed Maya's whole case file. The first thing he said was she most definitely had a macro tumor. It was a textbook case. That would even explain the odd ACTH readings, all symptoms etc. To be honest he didn't tell me anything that I didn't already know. My gut told me it was a macro right from the beginning....guess I was just in denial...
    He was a decent guy, and told us that ,yeah...... we could do an MRI blah,blah, but he would bet his house, car and money on it. He'd seen it so many times before, same story! Maya is too old to go through that and to be honest I don't think I'd go down that road even if she wasn't. We have no pet insurance and that kind of grueling treatment costs thousands-which we haven't got. We are keeping her on the pred for now-she's doing pretty alright..I suppose! No more testing and no more trilostane-I think she's had enough.


    Hugs from Leah and Maya
    Last edited by Maya; 09-29-2012 at 03:02 PM. Reason: To add more information.

  10. #10
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    Default Re: Macroadenomas

    **bumping up**
    "May you know that absence is full of tender presence and that nothing is ever lost or forgotten." John O'Donahue, "Eternal Echoes"

    Death is not a changing of worlds as most imagine, as much as the walls of this world infinitely expanding.

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