Introduction: Roo and Java (13 y/o Labrador retriever x) adrenalectomy advice

[frijole]

Ask which specific surgeon would be assigned to Java and how how many of these procedures they have done.

Ask for particulars about the type of tumor, the size and their thoughts on the success rate. Not all adrenal tumors are operable due to either size or involvement with the vena cava.

Ask them for the pros and cons of doing the surgery.

Ask them, if this were your own dog what would you do.. and look them right in the eye when they answer.

After you go thru the dialogue I bet your gut will tell you what to do. Good luck - we'll be with you in spirit. Kim

[Buffaloe]

I'll try to answer your questions as far as Shiloh is concerned:

Shi stayed in the hospital with 24 hour veterinary care for 3.5 days. This is probably longer than most cases. As soon as I got her home I could tell she was feeling SO much better. Full recovery took over a month.
Cost will probably be somewhere around $4500 when it's all said and done.
I don't think the prognosis w/o surgery is very good although treatment with Trilostane or Lysodren will help with the symptoms.
Shiloh was just an extremely happy and healthy girl after her surgery.
Shiloh only took a baby aspirin, prednisone and vitamin A for two weeks after I got her home.

You definitely want to get a feel for how experienced the surgeon is with adrenalectomies. Ask what kind of long term success rate they have with similar adrenalectomies. You might want to ask their opinion of medical treatment rather than surgery. Try to make sure the surgeon has a copy of the ultrasound images and the written report prior to your consultation. Make sure s/he thinks Java is a pretty darn good surgical candidate and the tumor is definitely operable.

From my experience, these board certified surgeons are highly educated and impressive people. You are going to know so much more after your consultation.

Ken

[Roo]

Somewhat of an update: I have an appointment on 10/17 to meet with a surgeon in Canastota, NY - Dr. Bookbinder. Wish me luck. The first surgeon we tried to consult with, Dr. Macdonald will not do the surgery because she is not in a 24 hour facility. I am hoping that he will be able to sway us one way or the other with how to proceed, after he actually sees Java.

[Roo]

Also thanks for the questions that I should ask, all the well wishes, and the insight into what to expect and what could happen if Java is a good candidate for surgery. I'll come back after the consultation to let you all know how it went.

[Cyn719]

Thinking of you and Java - love and prayers - let us know how the appt goes! xo

[Roo]

I do have Java's test results now, I had to get them for her appointment Monday. I will just list the things that she tested abnormal on:

Superchem:
AST(SGOT) 202
ALT (SGPT) 350
Alk Phosphatase 1740
GGTP 17
CPK 4647
Comment - AST may be lower than reported due to a hemolysis 22+ but is still abnormal

CBC: Platelet count 424
Platelet EST Increased

Urinalysis:
Specific Gravity 1.013 (low)
Protein 2+ (high)
Blood 1+ (high)

Endocrinology

Pre-Dex: 3.44 ug/dL
Post-Dex 1: 3.80 ug/dL
Post-Dex 2: 3.84 ug/dL

Reason for consult: encapsulated left adrenal mass by ultrasound, LDDST suspicious of ADH;

Ultrasonographic findings:
GI Tract/Lymph Nodes - no abnormalities
Urinary Bladder - normal in appearance
Kidneys - each 6.2 cm; slighly hyperechoic
Spleen - normal on appearance; pancreas - normal
Liver - increased in overall size; parenchyma homogenous and hyperechoic; minimal sludge in gallbladder..
Adrenal glands - right small 2.0 x0.3 cm. Left enlarged with heterogenous parenchyma and foci of mineralization 4 x 2 x 1.4 cm; no vacular invasion.

Ultrasonic diagnosis
1. Left adrenal mass
2. Large hyperechoic liver
3. Hyperechoic kidneys

[Cyn719]

Hi Roo

Will be thinking of you on the 17th - sending WARM THOUGHTS - SUPPORT - LOVE - PRAYERS - HUGS - STRENGTH - AND ALOT OF BIG LICKS TO JAVA FROM PENNY!!! Its alot to handle but you are doing a great job - great mom!!!

[Skye]

Hello!!!! First let me say you have come to the most amazing place you could ever find! People here are amazing and have and still are carrying me through some hard times! Matter of fact, i was at Gulf Coast in Houston today speaking with specialist. it took almost two hours to get there when its only 56 miles away, traffic is horrific to get there. i looked into A&M biomedical and Gulf Coast. One is a university top of line and other private practice. Scheduling, days, times etc.......we landed Gulf Coast. i wrote all my questions down, and then used cell phone to record consult.
Ken is totally correct that the left is easier for them to get to, one part of the left is 50/50 of it being cancer the other part of the left is probably (like high 90% i think...) Most time is slow in growth. So with that being said, how large did they say it was? what part is it on? is it vascular?
as a pet parent it is important heart breaking and loving to realize quanity or quality and who for.
is the tumor blocking any blood flow? is it effecting any other organs? what are the conditions of the other organs
It is a risk surgery.........hands down, and it is a difficult decision, so with your pet childs health, where would doctor place them in the risk scale. will risk be lowered since your pet is strong? and MAKE SURE the doctor has performed many many many of these surgeries and how comfortable they are with them. What type of equipment is used, how prepared for the "what ifs" during surgery, how many years have they been there themselves, and their team that works in OR with them, what are the pros of and cons of surgery, vs pros and cons of not. As far as what meds are needed after surgery, i think they are steorids until they get result back of what sort of tumor was removed, and because other gland is making up for the bad one. Then they wean them off slowly or will know how to medicate based on lab findings of tumor. Recovery in hospital is about 2 days and at home 2 weeks, Cost of surgery, not sure about there but i would GUESS between 1800-3500(?????) is there 24 hour care afterwards there? how often will they be in contact, what type of incision will they perform? plank or stomach? (i would hope stomach, plank doesnt let them see very well) This is a very difficult and stressful decision, and you have reached some amazing people here, all things aside, focus on what is truly best for your pet child, and what decision do you feel you can handle? when you make this decision, search your heart, search your pets desire, listen with your eyes............the answer hits like a brick in the stomach and not matter the answer it is stressful,
I can not even begin to express all the emotions flowing through our day here....and now my little one is vomiting all evening. However there has been slight pieces of grass in it as well.
your primary vet is intelligent to stay neutral. No one knows that pet like you do, and no one knows your heart like you do.
I hope you consult with a very detailed, experienced specialist. Hope to hear back.

[Skye]

i think considering the hour and all, I believe i posted on things you already had info on etc........i think i must of read your post way earlier in thread then went to end and posted on that. i am so sorry. I will try and be more careful when i post to your thread so my replies dont ramble on.

[Roo]

i think considering the hour and all, I believe i posted on things you already had info on etc........i think i must of read your post way earlier in thread then went to end and posted on that. i am so sorry. I will try and be more careful when i post to your thread so my replies dont ramble on.

Hey, don't worry about that. I was just reading your post about your baby girl, sending good thoughts your way. We are all in this together, we all love our dogs with all our hearts, that is why we are here. Everyone here understands what we are going through.