djndobby
01-13-2015, 11:19 PM
Hi Everyone,
Like many of you, I found this forum after doing numerous hours of research online desperately looking for information about an adrenal gland mass found on the right side of my 11.5 year old chihuahua mix, Dobby. Dobby was diagnosed with congestive heart failure based on detection of a mild to moderate heart murmur in July of 2013. Despite the CHF, his blood works showed that everything else was normal and we decided not to do any further testing/screenings until other symptoms came up. Since then he has been on 12.5 mg of Salix once a day, 1.75 mg of Enalapril once a day, fish oil and glucosamine. We also started him on a low sodium diet consisting of Primal raw food mixed with steam chicken and rice. We have been advised by the vet that his water intake and urination will increase. Since then, we have been experiencing accidental leaks here and there. Over the last year, we’ve noticed that his energy level have decreased and thought it was due to him getting older. I’ve also decreased the amount of food in hopes of controlling his weight. He was at 12lbs the same time last year! Then during mid November 2014, he was being super picky about his food and therefore not taking his meds. He appeared to be lethargic, loss of appetite, depressed and had an episode of shivering after a shower. Took him in on 11/21/14 to do blood works and x-rays. Results from the blood works indicated that his kidneys were failing.
RBC 3.98 M/µL LOW
HCT 28.9% LOW
HGB 10.3 g/dL LOW
PLT 616 K/µL HIGH
BUN 124 mg/dL HIGH
CREA 3.4 mg/dL HIGH
PHOS 6.8 mg/dL HIGH
GGT 7 U/L HIGH
AMYL 1887 U/L HIGH
LIPA 5477 U/L HIGH
X-rays results of the thorax and abdomen revealed
1. Mild diffused bronchial lung pattern
2. Narrowed thoracolumbar intervertebral disk spaces
The vet recommended an ultrasound for 11/24/14. The ultrasound indicated that the kidneys were normal and the summary:
1. Small right adrenal mass (1.3 cm thick, 1.8 cm length)
2. Mild to moderate degenerative mitral valve disease with moderate mitral regurgitation and no left atrial enlargement
3. Incidental mild gallbladder debris
Conclusion:
No cause for recent gastrointestinal signs is determined. The differential diagnosis for the small right adrenal mass includes benign and malignant neoplasia and the mass could be functional or non-functional. The mild to moderate mitral valve disease and moderate mitral regurgitation is not clinically significant since no left atrial enlargement is present at this time.
***Full report is also included in pdf
From here, we went to another vet that was able to perform the low dex test, urine analysis and more comprehensive blood works. ***The full report is included in the pdf but according to the vet, Dobby is having early stages of kidney disease and was put on a supplement called Azodyl. The low dex test shows that he is right on the border at 1.4 but because he doesn’t have any other signs such as pot belly or hair loss, it is hard to diagnose him with Cushings. They concluded that the LDDS reveals no evidence of a functional adrenal mass.
We were then referred over to 1 of the 2 board certified surgeon in the state for a consult on 12/17/14. First impression of Dr Courtney Watkins was great! She was patient and explained as much as she could in terms that I could understand. They did a blood pressure test and it was normal. They were also able to do a quick recheck of the mass that now grew to 1.5 cm thick and 1.8 cm length. She explained that the mass appeared to be hetergenous and mottled textured which they were concerned to be a more aggressive mass. Her recommendation is adrenalectomy. I expressed my concerns about his age, CHF, and kidney disease. She assured me that the findings on the ultrasound for his heart and kidney are stable enough where they are not too concerned. They are more concerned that the mass is malignant and may start to invade the vascular area or other organs in the future and removing it before it grows bigger is optimal. ***Her full report is attached that includes what we discussed in detail.
We made the decision to have the mass rechecked tomorrow and try to come up with a decision from there. At this point no medication is needed prior to surgery based on previous lab works and a CT scan will only be recommended if they find vascular invasion on the ultrasound. My concern is the high risk of this surgery. I lost my first fur baby in May 2013 and was devastated! I’m deathly afraid of losing Dobby but I know that I would really regret it if I don’t do anything now while I have the chance. Dr Watkins seems very knowledgeable and confident but I also noticed that she only got her board certification in 2012. She also mentioned that prognosis for this surgery in her experience is pretty good. Being in Hawaii, I don’t have any well-known animal hospitals that I can go to… I was hoping that you folks could take a look at the records and see if you can spot anything or give me any advice.
Thank you for reading this lengthy thread.
dj
https://docs.google.com/file/d/0B57mNZQKrU_mbFZKekpxRFV3dzA/edit?pli=1
Like many of you, I found this forum after doing numerous hours of research online desperately looking for information about an adrenal gland mass found on the right side of my 11.5 year old chihuahua mix, Dobby. Dobby was diagnosed with congestive heart failure based on detection of a mild to moderate heart murmur in July of 2013. Despite the CHF, his blood works showed that everything else was normal and we decided not to do any further testing/screenings until other symptoms came up. Since then he has been on 12.5 mg of Salix once a day, 1.75 mg of Enalapril once a day, fish oil and glucosamine. We also started him on a low sodium diet consisting of Primal raw food mixed with steam chicken and rice. We have been advised by the vet that his water intake and urination will increase. Since then, we have been experiencing accidental leaks here and there. Over the last year, we’ve noticed that his energy level have decreased and thought it was due to him getting older. I’ve also decreased the amount of food in hopes of controlling his weight. He was at 12lbs the same time last year! Then during mid November 2014, he was being super picky about his food and therefore not taking his meds. He appeared to be lethargic, loss of appetite, depressed and had an episode of shivering after a shower. Took him in on 11/21/14 to do blood works and x-rays. Results from the blood works indicated that his kidneys were failing.
RBC 3.98 M/µL LOW
HCT 28.9% LOW
HGB 10.3 g/dL LOW
PLT 616 K/µL HIGH
BUN 124 mg/dL HIGH
CREA 3.4 mg/dL HIGH
PHOS 6.8 mg/dL HIGH
GGT 7 U/L HIGH
AMYL 1887 U/L HIGH
LIPA 5477 U/L HIGH
X-rays results of the thorax and abdomen revealed
1. Mild diffused bronchial lung pattern
2. Narrowed thoracolumbar intervertebral disk spaces
The vet recommended an ultrasound for 11/24/14. The ultrasound indicated that the kidneys were normal and the summary:
1. Small right adrenal mass (1.3 cm thick, 1.8 cm length)
2. Mild to moderate degenerative mitral valve disease with moderate mitral regurgitation and no left atrial enlargement
3. Incidental mild gallbladder debris
Conclusion:
No cause for recent gastrointestinal signs is determined. The differential diagnosis for the small right adrenal mass includes benign and malignant neoplasia and the mass could be functional or non-functional. The mild to moderate mitral valve disease and moderate mitral regurgitation is not clinically significant since no left atrial enlargement is present at this time.
***Full report is also included in pdf
From here, we went to another vet that was able to perform the low dex test, urine analysis and more comprehensive blood works. ***The full report is included in the pdf but according to the vet, Dobby is having early stages of kidney disease and was put on a supplement called Azodyl. The low dex test shows that he is right on the border at 1.4 but because he doesn’t have any other signs such as pot belly or hair loss, it is hard to diagnose him with Cushings. They concluded that the LDDS reveals no evidence of a functional adrenal mass.
We were then referred over to 1 of the 2 board certified surgeon in the state for a consult on 12/17/14. First impression of Dr Courtney Watkins was great! She was patient and explained as much as she could in terms that I could understand. They did a blood pressure test and it was normal. They were also able to do a quick recheck of the mass that now grew to 1.5 cm thick and 1.8 cm length. She explained that the mass appeared to be hetergenous and mottled textured which they were concerned to be a more aggressive mass. Her recommendation is adrenalectomy. I expressed my concerns about his age, CHF, and kidney disease. She assured me that the findings on the ultrasound for his heart and kidney are stable enough where they are not too concerned. They are more concerned that the mass is malignant and may start to invade the vascular area or other organs in the future and removing it before it grows bigger is optimal. ***Her full report is attached that includes what we discussed in detail.
We made the decision to have the mass rechecked tomorrow and try to come up with a decision from there. At this point no medication is needed prior to surgery based on previous lab works and a CT scan will only be recommended if they find vascular invasion on the ultrasound. My concern is the high risk of this surgery. I lost my first fur baby in May 2013 and was devastated! I’m deathly afraid of losing Dobby but I know that I would really regret it if I don’t do anything now while I have the chance. Dr Watkins seems very knowledgeable and confident but I also noticed that she only got her board certification in 2012. She also mentioned that prognosis for this surgery in her experience is pretty good. Being in Hawaii, I don’t have any well-known animal hospitals that I can go to… I was hoping that you folks could take a look at the records and see if you can spot anything or give me any advice.
Thank you for reading this lengthy thread.
dj
https://docs.google.com/file/d/0B57mNZQKrU_mbFZKekpxRFV3dzA/edit?pli=1