Hi,
I'm thrilled to have found this group as it seems like such an informed, helpful and loving group of people.
Lola is a 6 year old bulldog and the light of my life. She is perfectly healthy, happy and energetic (no symptoms of anything). On Christmas Eve I received a shocking call from my vet telling me Lola had a large tumor on her adrenal gland. Since then we have done several tests and talked to several docs (internists, surgeons, etc)
Why did she have the ultrasound done if she was so well, was there something going on and that you suspected a problem and did the scan? How big is the tumour? What side is the tumour - left is easier to operate on but never fear Flynn's was on the right and his was ok. Any sign of local invasion?
and here are the "facts" about what we know/don't know.
- We can't do the full biopsy needed because of the dangers associated with surgery.
Yes indeed, unfortunately the adrenal gland where it is located makes biopsy a tricky procedure.
- It "looks" like a pheo on the ultrasound.
Often they get a pretty good idea of the likelihood of the tumour type, a pheo is usually seen arising from the medulla of the gland.
- An experimental blood test (they have a pretty good track record) done at UC Davis suggests it is NOT a pheo.
I would be real interested to hear the specifics of that test, there are urine tests that have been done on dogs, but studies do not have many participants to it is difficult to just rely on them. We have had quite a big discussion on testing for pheos on Snug's thread which is the one Sharlene has copied above. UC Davis is a well respected institution so it would be great to hear what they are doing. Was Lola seen by them or was the blood test just sent there?
- A low dex test has shown that it is not Cushings or a cortisol producing tumor.
Same as Flynn, he had two of these and suppressed on both. But Kim, another member here had false positives on her pheo dog Annie who ended up with the pheo diagnosis.
-- Despite the good news from Davis, Lola's vets aren't convinced it is not a pheo...they suspect it is but admit that they really just cannot know for sure.
That is the difficulty with diagnosing these tumours, often they can only tell for sure is by taking it out and looking at it under a microscope.
The surgeon has told me (and it has been confirmed by another surgeon) that Lola's best bet for survival (and to really understand what this darn thing is) would be to have this thing out BUT her chances of surviving the surgery are a little bit better than 50/50. And realistically *if* she survives the surgery, *and* the cancer doesn't return, etc. I can expect it to extend her life roughly 1 to 1.5 years.
Are these board certified surgeons? If surgery is proposed you need the big guns that have a lot of experience with adrenalectomy. If you get to that stage I have a list of questions that might help you when you are speaking with them. 50/50 seems kinda high to me, the studies I have seen have success rates 80/20. Flynn's tumour was invading his vena cava and that makes it more tricky. We have had several dogs have this surgery successfully (not always for pheo) but unfortunately we have had a couple not make it and that has been very sad. I would also respectfully disagree with the prognosis of 1 - 1.5yrs after surgery, they can do very well for a number of years following this surgery and Lola is young too which would stand her in good stead. I have info to back this up if you would like it.
http://www.vetsurgerycentral.com/oncology_adrenal_tumors.html
http://www.vsso.org/Adrenal_Pheochromocytoma.html
Given that Lola is perfectly healthy, happy and energetic in every way. I just cannot bear the idea of taking her in and having her die on the table. The surgery seems to be a HUGE gamble with what is currently a "perfectly healthy" life.... for a relatively small payoff. Compounding the decision is that they really don't know WHAT this is and have said that there's an outside chance it could be a benign mass.
That is something you really have to be at peace with before going into any surgery for Lola. I told myself if Flynn died during surgery at least it would be quick and he would die peacefully, but you do have to weigh it all up and considering she is well now, but that would be one of my questions to your team... if we do nothing how soon would be expect to see deterioration in her condition?
For a month now I have been beside myself with worry, grief, and confusion. I don't know what sort of advice, if any, I'm actually looking for, I just know that the people I have seen here will understand what I'm going through and hopefully will be able to provide hope, strength, information, experience and mostly support during what I anticipate to be a very rocky road that lies ahead.
Well it is lucky you have found us then!! What is the plan for Lola at this stage?
I'm sorry this is so long, I'm just trying to balance so much information and it all seems excruciatingly relevant .... and yet so iffy and vague.
Don't worry about how long it is, some of us are more long-winded than others they are all acceptable though especially when you are trying to get info on your sweetie Lola!
Erika