Brando has joined Snuggles at The Bridge; PHEO - Need Info and Advice Please

[Woodydog]

Hi and a belated welcome from me. I have been reading your thread with interest as my boy has a possible adrenal tumour my IMS diagnosed as endocrine cancer so I will be waiting to see what your IMS says see if the info will help my boy x

[beaglemom3]

Hi and thank you for the welcome, I am so sorry to hear that your boy may have endocrine cancer, I pray it is not so. I hope you find the answers you need!

[frijole]

Just got home and checked out Dr Appleman the IMS and her bio isn't very long but she does specialize in endocrinology which is just what you want and she was an honor student at Stanford I believe. My brother always said "remember Kim 50% of docs graduated in the top half of their class" So she's got them beat.

Meanwhile onto Dr Scavelli. WOW. First off write your questions out in advance - I'd have a hard time concentrating after seeing his photos. I read quite a bit and that story about Patrick that he rescued is unreal. That coupled with the fact he just did the operation on his own dog tells me he knows exactly the shoes you are in right now so he should be compassionate that way.

Can't wait to hear what he says. Fingers crossed. Kim

[beaglemom3]

Thanks Kim,
I already saw Dr Scavelli two nights ago, and the report I posted is Dr Scavelli's report to my local vet.

"Symptoms: Ultra sound preformed for pancreatitus and adrenal gland identified. No specific tumors relative to adrenal mass.

Diagnostic Tests: Right adrenal gland tumor 2.5 cm in size Elevated urine catecholamines.

Clinical Impressions: Right adrenal tumor-pheochromocytoma suspected

Recommendations: I recommended CT scan to evaluate for potential vena caval involvement. Risk of adrenalectomy were discussed. Owners decided to discuss at home prior to performing CT scan and performing potential adrenalectomy."


He recommended doing the surgery and doing the CT scan first.
He gave us an option of waiting 4 months and redoing the ultrasound but said there's a chance if we wait, my baby could collapse and bleed to death since it is so near that vein.
Unfortunately I didn't have yours and Trish's list of questions yet. He will be back in the office Saturday and I am calling him to ask more questions over the phone.

My local vet Dr Cohen said if it was his dog he would and redo the ultrasound in a month or 2. But I am not sure how much he knows about pheo tumors.

[molly muffin]

I am super impressed with your vet and your surgeon, what a really great group you have on your side and now to add Dr. Appleton to the team, well, it seems that whatever decision you end up making, that you are going to be in good hands.

We see way too many vets, who don't have the knowledge and won't look any further into it than reading the insert on cushing medicine. Very sad really, so it just makes me more impressed when some good ones come along. (we do have some good vets on board with the people on this forum too )

Sharlene and Molly Muffin

[frijole]

Trust me most regular vets know very little - in fact you and I know more than most because of our situations. They are very rare. We have had more cases in the last year but when Annie was diagnosed a few years back you couldn't find an article to read on google - well hardly anything. Most dogs were diagnosed after they died. So there isn't alot of experience in the general vet community - you have to trust the specialist and the surgeon.

So your next visit is with the IMS right? I think that would be wise - kind of a tie breaker to get an opinion from someone who is a specialist but not making the money doing the surgery.

Trish's list is solid. Good you have time to review it and talk to him on Saturday about questions. I'm interested in his thoughts re the vena cava involvement - more specifics like how close. Why did he say your dog could drop dead - what specific risks - are they specific to your dog or just a generality? Why did he say now or wait 4 months vs now or wait 2 months? Just curious.

Will the IMS have access to all filmwork done already as that would be helpful to her and really necessary to give an opinion.

Kim

[beaglemom3]

I agree with you on trusting the specialist and the surgeon. Yes my next visit is with the IMS. I am not sure why he said that about bleeding to death, I think it was a general statement for tumors on the right adrenal gland but I will be sure to ask him was it meant directly for Snuggles situation or a general statement.

He was giving us all the options there are.
1. To do the surgery which is what he said he would and did do if it was his dog.

2. or wait 3 months and redo the ultrasound to see if it grew, and watch for symptoms. Danger of that he said was collapsing and bleeding to death while waiting. (I am not sure why Dr Scavelli picked 3 months)

3. To have a CT scan done to see if the vein is involved but he said if we are not considering surgery there is no point to doing the CT Scan.

He was basically giving us options but he clearly was for doing the surgery.

Yes I will be bringing the same referral pack with over 50 pages of tests and results from June of this year to now plus a disc with Snugs ultrasounds.

[beaglemom3]

Thanks so much Sharlene and all of your opinions on the Doctors I am speaking with is comforting to me since you are all much more knowledgeable with this than I am it reassures me I am going in the right direction, where the vets are concerned.

[Trish]

Yep, Dr Scavelli can join our Dr McDreamy vet club!! Great credentials too, as they all have.. I think your team is great!! It is a wonderful thing to have trust in the people who you are trusting your baby's life with. Trust and excellent communication are two requirements super high on my list of what we require in our vets Oh, and the ability to make a good plan and listen to our never ending questions and take them seriously!! Hmmm I think that's it! Ohhh and kindness to the dogs, melts my heart when my vet gives Flynn a kiss on the top of his head like he did the other day when Flynn was feeling poorly, just to see they really care for the animals in their care is big plus!!

Pleased to hear about the appointment next week with Dr Appleton. I really value the opinion of the internists as they are great at looking at everything, not just the surgical options. Hopefully after she goes over his case she will be able to help you decide what to do, but if surgery is the final choice I would be very happy with Dr Scavelli. x

[labblab]

Did someone mention another Dr. McDreamy?????

I've off to have a look at that link....!!!!!!!!!!!!!!!!!!!!!!

Marianne

P.S. OK, I'm back again and yup, if you opt for the surgery, I'm thinking you'll be needing LOTS and LOTS and LOTS of consultation!