Non functional adrenal tumor

[Katrin]

Hello everyone,

I have a 12 year old Spitz with one increased adrenal gland but no symptoms of cushings. Last December we did a ultrasound on her because of a pancreatitis she got from some meds she was allergic to and found one increased adrenal gland. Therefore, we had every possible test done: LDDT, cortisol/creatinin test, test for adrenalin and progesteron as well as an ACTH test. All tests were negative.

Six months later we did a check-up with ultrashound. Nothing really changed the tumor didn't grow that much maybe approximately 0,1-0,2cm since December. It is now 1,2cm in size (normal size 0,6cm) and she doesn't show any symptoms either. Which leads to the conclusion that it might be a non functional tumor. However, the tumor looked diffuse and inhomogenous (just like it did in December). That is why I am worried now that it might be a non functional carcinoma although, I always thought those kind of tumors were especially aggressive and fast growing or does the paste of the tumor say nothing at all?!!

Hope to find someone who I can talk to about this with experience.
Thank you for your answers.

[DoxieMama]

Hi Katrin, welcome to you and Spitz, though I'm sorry for the reason you have joined us.

Do you happen to have copies of any of the tests done in December? Those may help to provide insight into what is going on.

I'm sorry I don't have any answers for you, though. Hopefully someone with more experience will see your post and respond.

Hugs!
Shana

[Katrin]

Hey Shana, thanks for the welcome.

Here is the test result of the LDDT:

Base Value (0h) 30,8
Cortisol (4h) 9,5
Cortisol (8h) 8,2

Her liver is increased with elevated enzymes but you can't really pay attention to that because she suffered from a hepatitis and a pancreatitis at the same time. In March this year she got another pancreatitis because she was allergic to some meds. We also had a urine test done where we determined the cortisol/creatinin quotient. It was at 37 (normal would be 34) and suspicious would be at 80 something. We did the test three times and it was negative every time. Therefore, she is either at the beginning of this disease or she has a non functional tumor which would be most likely since she doesn't show any symptomps of cushings.

Just last week we did another ultrasound on her to see whether the tumor increased and I guess it did. It grew approximately 1-2mm since December. I hoped to find someone in this group who has more experience with adrenal tumors (carcinomas and adenomas) to share information. It would be very interesing to know how fast their tumor grew or how they knew what kind of tumor it was and how long the dog lived after the diagnosis.

Anything will help. Thank you

[molly muffin]

Hello and welcome. There is also a type of adrenal tumor which does not cause an increase in cortisol (cushings) but does grow and can invade the vena cava, and that is called a pheochromocytoma.

http://www.petmd.com/dog/conditions/...eochromocytoma

We do have a member whose dog has gone through surgery to have a pheo removed. She often isn't on till maybe the weekend though as she is in NZ.

We also have a member whose dog's tumor they think is a pheo and they are monitoring and making sure it doesn't continue to grow and become invasive.

I would probably if it were me, see a specialist IMS, if you aren't already. They can work with your regular vet and if surgery becomes a possibility, then you have already seen the specialist and can move to a surgeon easily.

[Katrin]

Hello Sharlene,

thank you for the information but we got her tested on a phecochromocytoma as well. The tumor is non functional as in it doesn't produce any hormones at all. No adrenalin, no progesteron, no cortisol no nothingI guess this is pretty rare as I haven't met anybody else with the same situation.

I'm hoping to find someone in this group though, who has experience with non functional tumors.

[lulusmom]

Hi Katrin. I'm glad to see you join here and start a thread for your girl.

I'd like to try to bring everyone current on the facts you presented on the facebook group as I understand them. I think it's important that folks know you really aren't even certain you are dealing with a tumor. Two abdominal ultrasounds show a left enlarged adrenal. No information on the right adrenal gland was presented but the most recent ultrasound sonographer could not see the right adrenal due to extreme amount of gas. The left adrenal was enlarged but notations indicate that enlargement could be considered normal and not indicative of a tumor. LDDS test which Katrin did not mention, is in reporting unit is ng/ml which converted to ug/dl is baseline 3.08 four hour .95 and eight hour .82. These results are normal yet Katrin's vet was on a mission to find a reason for the enlarged adrenal and did an HDDS. According to Katrin, he also tested every adrenal hormone, including those secreted by pheochromocytomas and all were normal. Katrin had discussions with two other vets who agreed that the LDDS test was negative for cushing's. At this point, Katrin has concerns about what the future may hold for her pup if, in fact, there may be a non-functional tumor that could cause problems down the road. I was hoping we might have members who may have experienced something similar.

I told Katrin that if it were my dog, I'd not spend more money on pursuing testing unless my dog were to become symptomatic. If I were very concerned, I would have a repeat abdominal ultrasound four to six months to see if there has been any change.

Glynda

[Katrin]

Hello Glynda,

thank you, you got pretty much everything covered. Also, I got information on the right adrenal gland now and it was normal in size and shape back in December. The left adrenal is diffusely increased and doesn't produce any hormones. The only hormone we didn't get to test was aldosterone, appearently because this condition is to rare to be even considered, although, I hardly think that she could have a conn's sydrome because she doesn't show any symptoms of that illness either.

Accordingly, the only indication that there might be something is the increased adrenal gland. Nothing else would let you suspect she has cushing's. Bloodwork is atypical for cushing's as well. The only thing I am worried about now it that the tumor might be a carcinoma. Not every tumor has to be functional. Although, I read that carcinomas of the adrenal gland are pretty aggressive and grow fast. This wouldn't fit the theory though, since our tumor is growing verly slowely. Furthermore, I don't think that my dog is at an early stage with this illness or with cushing's since we know about it for 6 months now, although the tumor must have been there for much longer.

I know you guys aren't vets or anything like that but I am hoping to find someone who has experience with adrenal tumors and would be so kind to tell me how they dealt with it. How fast it grew? How you noticed it? What size it was? What it looked like in the ultrasound? What you decided? Surgery or do nothing at all? I would really like to know if there is someone with a non functional tumor as well. Guess, not since these tumor cause no symtomps you'll never look for them.

- Katrin

[Renee]

Since it sounds like a tumor has not been explicitly identified by the ultrasound, maybe you should consider something like an MRI or CT scan in order to get much better imaging? I would think you may pursue this if your end game is to attempt an adrenalectomy.

I have to believe that if the adrenal gland is simply enlarged and you have a complete absence of symptoms .. maybe your time would be better spent just monitoring the gland every 3-6 months and carrying on with life. The body is an amazing thing. An enlarged adrenal gland may mean nothing at all right now.

[molly muffin]

Molly has a nodule on one of her adrenal glands that the specialist think is nonfunctioning. We monitor the size by ultrasound and it hasn't grown very much and she is now at the point where I won't consider surgery for it. She has had it for at least a year or more.