Sophia, our 14 year-old dachshund, has an adrenal gland mass

[doxy]

We have a beautiful and still very spunky standard dachshund named Sofia who turned 14 in November. She had a benign lymphoma that had grown slowly to a very noticeable size. It recently started to impede her walking by turning out her "elbow."

We took Sofia to a nearby Connecticut surgeon. He did a beautiful job removing the lymphoma, and Sofia is doing great...with some qualifications.

About two days after surgery, we had to take her back to the 24/7 hospital, and everyone at the time seemed to think she it was unlikely she would make it. Her heart rate and blood pressure had spiked massively, one pupil was a different size from the other, and she was very very "dumpy" as one person described it.

Over the next couple of days in ICU, the hospital came through in near-miraculous fashion. Right before our picking her up to go home however, they ran an abdomen scan, and the results were not so good. Here is the diagnosis:

Left adrenal gland mass and a mottled liver
1.5cm x 1.75cm
Cushing’s ACTH Test – Negative
Note: Sofia has Cushing symptoms (excessive drinking and eating is new since surgery; excessive begging has been for a very long time; significant hearing loss 3 months ago).

The surgeon is now recommending surgery in about a week or so to remove the tumor from her adrenal gland. We are learning that surgery to address the adrenal gland tumor is extremely risky, so we want to do as much research as possible regarding whether we should do surgery at all, and if so, who should do it.

Any input anyone has - including the name of a surgeon - would be greatly appreciated. We contacted chapmandou (Carol) through this website because she mentioned she had used a surgeon in CT, and she very generously shared with us that the exact same surgeon who did the surgery on Sophia a few weeks ago performed a very successful adrenalectomy on their dog, Sammy. We are strongly considering using this surgeon, especially since he was so highly recommended by Carol, but would like to consider getting one other opinion from another surgeon as well.

Thank you very much.
doxy

PS We want to thank gpgscott (Scott) again for helping us to make contact with Carol.

[Bichonluver3]

Sorry that we cannot help you with your search but still wanted to welcome you and tell you we are pulling for Sophia. what a face!! We will continue to read your thread and sent thoughts and prayers your way. There will be others withe experience you need dropping by shortly.
Carrol & Chloe

[Dave Ruske]

Decisions about surgery are hard, I know. The best you can do is gather as much information as possible, talk with the doctors, and see what you're comfortable with. There's no single right answer. Adrenalectomies can be challenging surgeries, but there are a lot of success stories.

In our dog's case, we're going to try medicating, because she has tumors on both glands and the best estimate we've received carries a mortality rate of 30-40%. That estimate doesn't apply to your Sophia, though, as she has only a single gland affected and it's the left one --- the right being somewhat riskier because of a nearby large vein, as I understand it. Like you, we're weighing the benefits and the risks and trying to reach decisions we can live with.

There are a lot of people here who know exactly what you're going through and how agonizing these decisions can be. I can't tell you what's best for Sophia and your family, but I can tell you we're in your corner, and praying for your benefit.

Dave

[Franklin'sMum]

Hi and welcome to you and Sophie,

I'm very sorry for the circumstances that brought you here, but so glad you were able to make contact with Carol. I'm including a link to a page for you to look up DACVIM's in your area (they're highly specialised, board certified) and it is recommended that you have a board certified surgeon perform the surgery, as it is beyond the experience and skill of regular gp vets.
http://www.k9cushings.com/forum/showthread.php?t=232

Dave is correct in stating that the left side is easier to operate on than the right hand adrenals, as sometimes the tumor invades the caudal vena cava, which is the main artery to the heart.
Usually, the docs remove the entire affected adrenal gland, and the pup goes onto a small daily dose of prednisolone to support their body, while the atrophied adrenal gland recovers.

We have a member here, Ken (Buffaloe) whose girl Shiloh underwent this surgery I think 3 years ago. I don't remember which adrenal gland was affected though.
Here is the link to their story- http://www.k9cushings.com/forum/showthread.php?t=1332
You're doing everything right by asking questions and researching :)

Jane, Franklin and Angel Bailey xxx

[Squirt's Mom]

Hi Doxy and welcome to you and Sophia! :)

We have another member who's Husky just underwent an adrenelectomy. Here is a link to Kira and Janis' thead:

http://www.k9cushings.com/forum/showthread.php?t=2742

And here are some links on AHD to help in your research:

ADH
Newman Veterinary*
http://www.newmanveterinary.com/CushingSx.html#Adrenalecto my
***Note: This website contains informative illustrations and diagrams - scroll down for ADH info

Mar Vista*
http://www.marvistavet.com/html/body_adrenal_treatment.html

Diagnostic Approach to the Incidental Adrenal Mass
Richard W. Nelson, DVM, Diplomate ACVIM
http://www.vin.com/proceedings/Proceedings.plx?CID=WSAVA2002&PID=2557

Hugs,
Leslie and the girls - always

[littleone1]

Corky and I also want to welcome both of you. Corky has a right adrenal tumor which is invading his inferior vena cava. Because of his age and other medical issues, he is not a good candidate for an adrenalectomy.

I hope you find the information and links that were given by other members to be very helpful.

Terri

[Buffaloe]

I came to this message board shortly after Carol's dog had his second adrenalectomy. I clearly remember how she thought her surgeon was really top notch.

My dog had a very successful adrenalectomy in 2006 at the age of 12. Our surgeon was absolutely great but we live in Phoenix. A second opinion is always a good idea.

Sophia's tumor is not large (Shiloh's was 4.5 cm x 5.8 cm) and it is very good that it is in the left gland. I realize that Sophia is 14 but if she is in good health for her age, she's probably a pretty good surgical candidate. My surgeon said they have an 85% long term success rate with these surgeries.

I'm sure you know, a successful adrenalectomy provides a complete cure. But, it is a very serious surgery. They cut right into the middle of the dog and remove the tumor in one piece among a maze of blood vessels. Medical treatment is generally less effective in treating adrenal tumors than pituitary.

All the best to you and Sophia. I don't think you have to be in a huge hurry in making your decision.

Ken

[apollo6]

Welcome to you and your sweet Sophia



Left adrenal gland mass and a mottled liver
1.5cm x 1.75cm
Cushing’s ACTH Test – Negative

Does the ultrasound report notate if both adrenal glands are similarly enlarged? Don't see any mention of the right adrenal gland.
Also not sure what a negative reading means. Normally it would show if the results are within the norm.
We are hear to help you. If Sophia is stable right now, please give us some more info. The senior members can give more input.
My Apollo, 12.5 mini dachie has the pituitary cushing, both adrenal glands are similarly enlarged.

Wish I could give more input.
Hugs Sonja and Apollo

[doxy]

Thank you so much for all your support. We did get a second opinion today from another surgeon, who feels very confident that Sophia has pheochromocytoma. Unlike the left, the right adrenal gland appears to be normal. The Negative reading on the Cushing's ACTH test implies that Sophia does not have Cushing's disease. Over the next few days, we will continue to do more research and thinking about what is best for our little Sophia.

Candace and Jeff

[apollo6]

We are hear to help.
Sonja and Apollo

[gpgscott]

Hi Candace and Jeff,

I am glad you have some answers now.

It sounds like you have consulted with two very good Dr.s who are mainly in agreement, that would give me some measure of confidence. Is removal of the pheo being considered?

Best wishes.

Scott

[Squirt's Mom]

Hi Candace and Jeff,

Please know that you are family now and we want to know how things go with your sweet Sophia. If we can help with info, research, or just to listen, we are here for you. So don't hesitate to post anytime, ok?

Hang in there!
Hugs,
Leslie and the girls - always

[Buffaloe]

Hi Candace and Jeff,

Shiloh's tumor was a cortical adrenal tumor. I don't have any experience with pheochromocytomas. It sounds like you have two great professionals helping you and I know you will make the best decisions for Sophia.

Ken