Macroadenomas

[EmCHammer]

It seems that many of the dogs who have the macros also have cushings wheras they don't think my boy has.

He does have an insatiable appetite and will run off to scavenge but none of the other symptoms ...

The vets didn't think he needed to be tested as didn't have any symptoms. He has really quietened down and is a odd butnot anything to be overly concerned about. he has got brain lesions in addition to his macro tumour don't know what radiotherapy does to the brain.

[JacksonsMom]

Hi Everyone
I've posted on the main Forum that after 3 years of Cushings treatment, those symptoms abated and the vet was puzzled. I sought a second opinion and this new Dr suggested an MRI. I was reluctant as Jackson would have to be sedated and he was so anorexic (4 lbs instead of 6) I was worried he might not survive the MRI. Well he did and I got the results today. The tumor is 1.5 cm and probably causing headaches (he trembles seizure like even when sleeping.) It looked huge compared to the surrounding tissue. My options are: Do nothing (if it weren't for the headaches I would go that route I think)
Radiation: Daily for about a month and he would be sedated each time (cost $8,000)--no cure, buys 1-2 yrs.
Surgery: Using minimally invasive Vitom--here is the link http://www.cedars-sinai.edu/About-Us...hance-Too.aspx
Survival rate is 85% after 2 years (but the sample is small--only 10 dogs) and he would be on thyroid, steroid and hydration meds.
He's 12 years old and I wonder what else might soon go wrong--he has elevated liver enzymes and his adrenals are large--as seen on sonogram. Surgery cost is $8,000. If anyone has any insight, I would love to hear it.
Robin and Jackson

[labblab]

Hi Robin, I'm really glad you've posted this same info on your personal thread about Jackson. I'm going to reply to you there rather than here, so as to make it easier for folks to follow Jackson's entire treatment options/history all in one place. In order to make it easier for everybody to find it, here's a link to your thread:

http://www.k9cushings.com/forum/showthread.php?t=3710

Marianne

[JacksonsMom]

Thank you, that makes sense. Waiting to have a few questions answered by the vet and I'll post on the thread you referenced.
Thanks,
Robin and Jackson

[Bgoods]

I have been posting on Rolo's case on another thread at:

http://www.k9cushings.com/forum/showthread.php?t=3868

Some thoughts reading through this thread. Rolo was diagnosed last week with a macroadenoma. Today, he started radiation for that here at UT. I am sitting in the library at UT waiting to hear from them to go pick the little guy up.

Some information here is slightly different than what others have presented -- so I will offer it as food for thought from the Dr.'s here:

Rolo will have 16 radiation treatments. Starting today and each day this week. Because of holidays and equipment upgrade, next week he will have 3 treatments. Five the following week. Three the last week.

They took him off all Cushing's meds (Trilo) during the treatment.

They said if he develops some edema this week, they would prescribe a low dose of prednisone to counter that. It would likely only be for a few days to specifically counter the edema.

My GP vet thinks that one reason we saw the recent bounce in Rolo was his being prescribed the Prednisone for a respiratory infection/swollen lymphs. From reading in this thread, the combination of Pred and Trilo is not unheard of.

The oncologist quoted a median survival of 1400 days. It is a median. There is a limited study that because of a very large tumor in relation to pituitary/brain size, there is a decreased expectancy. Since Rolo's tumor exceeded the "ideal" size and was quite large (will see if I can get actual measurement this week), we are choosing to ignore that study as only anecdotal at this point.

30% of dogs post-treatment will require no Cushings medications. Giving him a pill or two a day for six or eight years would be fine though!

Tumors are very reactive to radiation. Slow growing and there is essentially no difference between adenoma and carcinoma in treatment behavior.

Today, is the first day of the rest of his life. We cherish every moment of it!

[Lvmtjessie]

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

[Maya]

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

[Squirt's Mom]

**bumping up**

[Squirt's Mom]

Bumping this thread up for our members dealing with macros. Please feel free to contribute your experiences to this thread for future members.

[pansywags]

I will be adding Pansy's story to this thread - it's very long as, in hindsight, I believe she exhibited her first symptoms a full two years before she left us last week. I won't beat myself up because I did the very best I could for her, but I do wonder whether she might have been treatable had she been diagnosed earlier. I hope that by putting down the details of her symptoms and progression, some other dog might be saved.