Honey, 14 y/o lab/ridgeback - Adrenal tumor removed; now PDH?

[scottgoodwin]

Hi all,

New to the forum and happy to find it. Our dog, Honey, is 14, a lab/ridgeback mixed breed and has all the symptoms of Cushing's. She started showing joint stiffness and muscle loss in her hind limbs a couple of years ago and our vet prescribed Rimadyl and Tramadol. We also take her for acupuncture 2x/month, which helped a lot for about a year. Then, a few months ago we noticed her water intake increasing and the vet suggested we look into Cushings. The initial blood/urine tests came back negative.

Two months ago, she began experiencing new symptoms: incontinence (peeing in the house, peeing in her sleep) and needing to go out more often. We put her through more tests, and I believe her cortisol levels came back OK; her liver values were elevated, though. This led our vet to rule out Cushings and look at other possible causes. An ultrasound revealed a tumor on her adrenal gland and we sent her into surgery last week. They removed the tumor and her spleen, since they saw some bumps on it; and did a biopsy of the liver.

She had a rough time that night and needed a blood transfusion and compression wrap to deal with an elevated heart rate/low blood pressure. We brought her home Saturday and she was doing much better on Sunday. Then, yesterday, her behavior changed--she would wander the house, find a corner and just stand there. Outside, she'd just walk in wide circles. She also seemed to have a lot of trouble walking and stumbling. Concerned, we brought her back last night to the vet where we'd done her surgery; her heart rate was extremely high and they suggested, based on the behavior that it might be a pituitary tumor.

I'm waiting to talk to our vet this AM about possible next steps and am convinced that, if it's not Cushing's, whatever's troubling our girl is mimicking the symptoms. Any thoughts from the more knowledgeable group here?

[labblab]

Hello Scott, and welcome to our Forum!

I have taken the liberty of moving your reply to start a brand new thread of your very own. This way, our members will be able to reply to you directly with their feedback and suggestions.

Once again, welcome to both you and Honey.
Marianne

[lulusmom]

Hi Scott and welcome to the forum.

I am sorry to hear that you and Honey have been through such a rough time and that Honey is not doing well at the moment. I agree that the symptoms you mention are commonly associated with an enlarging pituitary tumor (macroadenoma) but those same symptoms, staring off into space, circling, lack of coordination when walking and even increased urination are side effects of more than a few drugs, pain meds and anti-inflammatory drugs in particular. I would think that a dog with a pituitary tumor large enough to cause neurological signs would have high levels of cortisol yet you say Honey's cortisol was normal. What medication is Honey getting right now?

Glynda

[Buffaloe]

My dog, Shiloh, had a very large adrenal tumor surgically removed back in 2006 at the age of 11 1/2. She stayed at my surgeon's facility for 3 days before coming home. That first week at home, she rested ALOT and just went outside to do her business and came right back inside. Then, she got better and better and a few weeks post-surgery, Shiloh was Shiloh.

I think it is highly unlikely that Honey has a pituitary tumor. If she did, her cortisol levels would have been significantly elevated prior to her surgery. BTW, it is common for dogs with functional adrenal tumors to test within the normal range for cortisol but not dogs with pituitary tumors.

Our board certified surgeon is really top notch and has performed scores of adrenalectomies. Once Shi got home, the only things she took were a baby aspirin to prevent blood clots, prednisone to replace the cortisol and vitamin A to promote healing. She took these three for two weeks. I know some surgeons have the dogs on pain meds, antibiotics, etc. for quite a while after adrenalectomies but I am really glad my surgeon takes the approach he does. I'm wondering if the meds are causing Honey issues, for now.

I think Honey is a pretty old dog to go through such a major, major surgery. She is obviously a very tough girl but it's going to take some time for her to heal up, recover and get back to her old self.

All of us here are really pulling for Honey.

Ken