Adrenal Tumor Cushings

[LaurieLee]

Hi, I'm new here and overwhelmed!
I have a 11-12 year old, 36 pound mixed breed spayed female dog, named Blackberry. She is in very good health aside from the Cushings. She has textbook symptons: excessive drinking/urinating, ravenous appetite, a potbelly, and some panting.

We just got diagnosed this week with the probability of adrenal gland tumor Cushings, through a LDDS test. These were her cortisone levels: pre 7.7, after 4 hours, 8.5, and after 8 hours 8

We have started her on Vetoryl (trilostane) 10 mg; 2 capsules by mouth 2x a day. She will go through an ACTH stimulation test in 2 weeks.

We are considering an ultrasound and surgery with a specialist. Trying to sort through all the information...I'm starting to understand that the medicine will only manage her symptons, not extend her life? Does anyone have any input or advice? I'm also seeing that the cost of a year's medicine is approximately the cost of the ultrasound AND surgery...
Any input will be greatly appreciated. I've had this dog since I was 18, and she is my dog-of-a-lifetime. We have always been together, she's my shadow.

[Dave Ruske]

Welcome to the forum; you've found a good group of people, here. Sorry to hear about Blackberry's diagnosis.

Our English Shepherd was diagnosed with adrenal dependent Cushing's, but it was a long road to get a diagnosis that everyone believed, as both her adrenal glands were enlarged, but with no pituitary cause. In her case, the ultrasound was a very useful diagnostic: it not only gave us good images of the tumors on her adrenal glands, but turned up a small mass in her liver. By knowing the size of the adrenal tumors and how close the right one was to a major vein, we were able to get some estimates of the risk of surgery, and make an informed choice about treatment options.

This is some scary stuff, and the tests and treatment are expensive, but I've found reading up on the disease and its treatment to be helpful. There is a lot of good information in this site's resources (http://www.k9cushings.com/forum/forumdisplay.php?f=10). I've also found some good material in the Files section of the caninecushings-autoimmunecare Yahoo group (http://pets.groups.yahoo.com/group/caninecushings-autoimmunecare/).

There's no single "right" treatment, and everyone here understands how hard these choices can be.

Dave

[Buffaloe]

Hello and welcome,

My dog had a very successful adrenalectomy about 4 1/2 years ago after a lengthy diagostic process. She had just turned 12.

The results of your low dose dex. test indicate that Blackberry may have an adrenal tumor. The way to find out with certainty is to have a top quality ultrasound performed. If there's an adrenal tumor, you need to know which gland it is in, its size and its involvement with area blood vessels.

There is no reason to jump to any conclusions now. An abdominal ultrasound with a high resolution machine will give you your answer. Surgery is the treatment of choice for an adrenal tumor. I hope you will get Blackberry an ultrasound performed by an excellent ultrasonographer pretty soon. Then, you can take it from there and we will be right with you every step of the way.

Ken

[Wolfpak]

Hi LaurieLee,
based on your LDDS test results the medical literature says there is a 50-50 chance you're dealing with adrenal disease vs. Pituitary based. It's advisable to have the ultrasound to determine type before treating.
There was no suppression, so its a complete guess at this point as to type of Cushing's.
Suppose you could see if the treatment helps at all, but mostly you would want a better idea of what's going on with the adrenals first. The doses are different, much higher for adrenal, with surgery most often done for treatment of this type vs. drug therapy.
It's a whole lot to absorb and learn about this disease! Best to you and your fur-baby.

[LaurieLee]

Dave, Ken, and Wolfpak,
Thank you for your responses and for references to other information (which has been very helpful)!
It still amuses me slightly that I've joined what amounts to is a support group for this (the forum), ha ha, but this is a confusing disease to sort out. It's also interesting to me that unless I figure out the-right-questions to ask the vet... it's hard to know what direction to take. Especially if my furry friend could have many more happy years, aside from the Cushings.
My husband and I have decided to schedule an ultrasound with the specialist. Our regular vet is very confident that it's an adrenal tumor (we had some xrays done..?). But we're just going to see what's going on.
Has anyone had their dog go through the surgery successfully? Especially an older dog, like ours?
Thank you for all your responses.
Laurie

[lulusmom]

Hi Laurie and a belated welcome to the forum.

I just wanted to say that the results of the LDDS may not indicate pituitary based disease but that sure doesn't mean your girl has an adrenal tumor. Opting for the abdominal ultrasound as your next step is a wise move as it can make the distinction between pituitary and adrenal as well as give your vet a look see at the surrounding internal organs. Will be looking forward to hearing about the findings.

Glynda

[Altira]

If you don't mind pages and pages of reading and a less then brave owner, you can read my thread about my "Kira 10 yr old husky". She just had this surgery about two months ago.. The surgery went extremely well, the result so far has not been the best.

[Buffaloe]

Hi Laurie,

Lots of us felt overwhelmed when we were in your position, I know I sure did. It can be a difficult diagnosis and a difficult disease. But, you are doing everything exactly right. Thank goodness for modern veterinary medicine; whatever the diagnosis, you will have options. I know you love Blackberry deeply.

I am really glad you will be getting an ultrasound and that it will be performed by a specialist. Adrenal tumors rarely show up on x-rays. You will want to glean all of the information possible from the ultrasound. Hopefully, you will receive a detailed written report. Pick the brains of every veterinary professional you are in contact with. Read and study everything the veterinary textbooks/manuals say about cushing's disease. A couple of them are available on-line. Again, if there's an adrenal tumor, you want to know which gland it is in, its size and its involvement with area blood vessels. You also need to be sure Blackberry is a good surgical candidate if it comes to an adrenalectomy.

Let's not jump the gun, though. Even with no suppression, the LDDST cannot definitively diagnose an adrenal tumor. We will be looking forward to hearing the results of Blackberry's ultrasound.

Ken

[LaurieLee]

Wow, thanks for all the responses. It has helped me be more matter-of-fact about everything.

The ultrasound and 2-hour consultation is all set up for Monday (the 28th). I feel apprehensive, but at least we're moving forward.

Altira, I have read some of your postings, and found it to be helpful. Keep on keepin' on; best wishes to Kira.

Thanks for the welcome, Glynda.

And for the ongoing info, Ken.

I will let your know the results of Monday. Keep your fingers crossed... I'm also working on a blog post about Berry which I'll include a link to if anyone would like to "meet" the creature-in-question here...

So thanks again for the reply posts; that has, at the least, been encouraging to me!

[Squirt's Mom]

Hi LauraLee,

How is your Blackberry doing? What did you learn from the ultrasound?

Hugs,
Leslie and the gang

[LaurieLee]

Thanks for the inquiry!

And computer viruses aside, we're still trudging.

At any rate, the ultrasound revealed that her adrenal glands did not have tumors. So given her age, I guess I can be thankful that we do not need to consider putting her through surgery.

I discontinued Vetoryl due to the cost... Berry weighs 37 lbs and 8 days worth is $58. The Lysodren is much more affordable; about 1/3 of the cost.

We are on Day 3 of loading lysodren withou any problems. Any thoughts on Lysodren, folks? Is the general consensus that the drug helps for a better quality of life, more than it damages?

If anyone is interested I posted a posting on my blog with alot of pictures of Berry and "her story".
http://merrilyaswego.blogspot.com/2011/02/blackberry-pie.html

And she seems to be enjoying her life right now, aside from having a potbelly and being ravenous! lol.

[Cushpup]

Thanks for the inquiry!

And computer viruses aside, we're still trudging.

At any rate, the ultrasound revealed that her adrenal glands did not have tumors. So given her age, I guess I can be thankful that we do not need to consider putting her through surgery.

I discontinued Vetoryl due to the cost... Berry weighs 37 lbs and 8 days worth is $58. The Lysodren is much more affordable; about 1/3 of the cost.

We are on Day 3 of loading lysodren withou any problems. Any thoughts on Lysodren, folks? Is the general consensus that the drug helps for a better quality of life, more than it damages?

If anyone is interested I posted a posting on my blog with alot of pictures of Berry and "her story".
http://merrilyaswego.blogspot.com/2011/02/blackberry-pie.html

And she seems to be enjoying her life right now, aside from having a potbelly and being ravenous! lol.

Um, where do you get your Vetoryl/Trilostane?
I had mine compounded in 100mgs/ml in a 30ml bottle for $84.00, Beef flavor. I was giving mine 30mg a day which lasted me 90 days! As you can do the math it was 94 cents per day, not $7.24/per day like you paid.

Roadrunner Pharmacy
711 E. Carefree Hwy Ste140
Pheonix AZ 85085
1-877-518-4589

Having the liquid was so easy to use and adjust. A third of a cc syringe was a piece of cake to administer ;)

I know that many pharmacies rip people off. You gotta shop around.
M

[LaurieLee]

I got the Vetoryl directly from our vet's (here in PA). Thanks for the lead on how to find it more reasonable priced...
On Friday, she'll be tested after her first week of Lysodren so I guess we'll have to see what that brings.
I should have posted sooner about the vetoryl (and the high price)m lol. ANyway, thanks!

[LaurieLee]

To anyone considering how to go through with treatment for their cushings dog:

After putting Blackberry on Lysodren...the results are incredible. I have my dog back; she is enjoying her life immensely. Her potbelly has improved, her ravenouse appetite has normalized,a mong many other things.

And the financial burden..the money for the Lysodren prescription is much less than the situation of us going in to the vet's frequently for the bladder infection diagnosis and the resulting prescription prior to her being diagnosed with Cushings.

Sure, the negative possibilities of the medicine are always there..but for us, even for the short time of these past few months and how Blackberry's quality of life has improved..it's worth it! The "wag" is back!

I'd just like to encourage others out there to consider the medication. :-)

And thank you to everyone who cared about our plight and read my posts. :-)

Best wishes, Laurie

[littleone1]

Hi Laurie,


I'm so glad to hear that Blackberry is doing so well. Even though Corky is taking Trilostane, his treatment has also been successful.

Thank you for posting these positive results.

[Altira]

Wow, cool! So nice to hear of your success. I have no experience with this medication but Cushing's can be a scary thing. It's nice to know it can work so well.

[Squirt's Mom]

Hi Laurie,

What a great report! It is so nice to hear how well Blackberry is doing with treatment. :D We always love good news!

My Squirt is also on Lyso and, like you, I have seen a renewal in her. It sure does the heart good to see, huh? ;)

Thanks so much for coming and letting us know how she is doing.

Hugs,
Leslie and the gang

[LaurieLee]

Hello everyone!
Berry is still doing well on her medication. Experiencing symptons from simply being old. :) So it goes.

At any rate, since many of us on here have a senior dog, you may have had troubles with doggy incontinence.

I finally posted instructions on my blog of how to make your own, inexpensive dog diaper as a solution for fecal incontinence (could be experimented with for urinary incontinence).

Here is the link:
http://merrilyaswego.blogspot.com/2011/08/easy-dog-diaper-tutorial.html

I use the dog diaper that I've made for one of our dogs everyday; it has been a real life-saver. I encourage you to give it a try, if you have the same problem.

Best wishes to all and caring for our furry friends.

[terreh1]

Hi there,
I saw that you had an adrenalectomy done on your dog and was wondering if there were any complications? Which adrenal gland was it? My dog has a mass on his left adrenal gland and they're recommending surgery. He has Atypical Cushings (tumor is producing too much progesterone). He is around 13 1/2 and I was feeling a bit scared to have this surgery done at his advanced age. I would love to hear about your dog.

Thanks!
Terre Harrison



Hello and welcome,

My dog had a very successful adrenalectomy about 4 1/2 years ago after a lengthy diagostic process. She had just turned 12.

The results of your low dose dex. test indicate that Blackberry may have an adrenal tumor. The way to find out with certainty is to have a top quality ultrasound performed. If there's an adrenal tumor, you need to know which gland it is in, its size and its involvement with area blood vessels.

There is no reason to jump to any conclusions now. An abdominal ultrasound with a high resolution machine will give you your answer. Surgery is the treatment of choice for an adrenal tumor. I hope you will get Blackberry an ultrasound performed by an excellent ultrasonographer pretty soon. Then, you can take it from there and we will be right with you every step of the way.

Ken

[Buffaloe]

Hi Terre,

I am sorry your dog has an adrenal tumor. You are doing the right thing to gather all of the information you can before making your decision.

Shiloh had her adrenalectomy in October, 2006 at the age of 12. It was a very large tumor (5.5 cm. in diameter) and was in her left gland. She was doing poorly before the surgery, just hanging on. A highly skilled and experienced board certified surgeon performed her adrenalectomy and he was assisted by another wonderful bcs. As soon as I got her home I could tell she was feeling much, much better. She lived with an excellent quality of life for another 3.5 years. Although she was 12, all of my veterinary professionals thought she was a very good surgical candidate. Shi was a healthy dog; just that nasty adrenal tumor was doing a number on her.

If you and your surgeon feel Max is a good surgical candidate and you have the money, surgery should probably be considered. He is not a young boy and it is a very serious surgery. My surgeon told me all he cares about when doing an adrenalectomy is the size of the tumor and its involvement with area blood vessels. He said they have an 85% long term success rate with these surgeries. I know there are plenty of dogs he will not operate on because they are too old, sickly, etc. Tumors in the left gland are easier to remove than in the right.

Your other option is to treat the tumor with Lysodren or Trilostane. It is a tough decision. I'll tell you this...the day of Shi's adrenalectomy was the toughest day I've gone through for many years. If you decide to proceed with the adrenalectomy, you can't look back. You have to know you can handle it, no matter what the outcome. All the best to you and Max.

Ken

[LaurieLee]

The decisions are agonizing, aren't they Terre. Let us know how you're doing.
Best wishes.

[terreh1]

Ken, thank you for your response. I am talking to the surgeon tomorrow to get some more questions answered. She had said that she thought Max was a reasonable candidate for the surgery.
I want to do the right thing and if the surgery would improve his quality of life, even if for a couple more years, then I will do it. I know there are no guarantees, but it is promising to hear about your story.
If we do go through with surgery, I know it will be the hardest/worst day of my life too. All I can think about is how I'd be putting my little baby through such torture without being able to explain it to him!

LaurieLee, thanks for your reply too. Every bit helps!

I will keep you all posted....

Terre and Max

[MBK]

Hi, Terre,

I'm sorry you are going through all this with Max. It is so hard to know what the best thing to do is. You are so right about it being even harder not being able to explain to them what you are doing and why. I do think they know they are loved and understand that we would not hurt them without good reason. You will make the right decision for Max and he is lucky to be so loved.

My Alivia (13 year old Jack Russell Terrier) possibly has a right adrenal tumor. We've had differing opinions on two ultrasounds and she also suppressed during the LDDS test, which with an adrenal tumor is not supposed to happen. Nothing with Alivia is ever clear cut, but I love her dearly. I also have another 11 year old Jack Russell named Maxwell.

I hope your meeting with the surgeon today went well. Anyway, I will continue to check your thread for Max updates and wish you both the best. Hang in there!