Left Adrenalectomy - Please Help

[Kelley314]

Hi my name is Kelley, my moms dog name P is a 11 yr old Boston Terrier. She was diagnosed with Cushings in late may and was put on Trilostane. She continued to worsen. After a ton of vet appointments, bloodwork, and dosage change, our vet told us to see a specialist. We got an X-Ray and Ultrasound and found out she had Adrenal Dependent Cushings and the only way she had a chance was for surgery. She was getting weaker so they said it needed to happen asap, however, we had spent thousands the past two months on all her treatment and meds. We were able to gather enough to start the surgery, which happened on Tuesday, July 7. Two days later she went DKA and they told us she's not diabetic. I have a lot of diabetic knowledge, being my cat is diabetic. They flushed the ketones and had a tube in her nose draining stomach fluid. Yesterday, we had to take her home, as our bill is so high and we haven't been able to pay the balance. At the Animal Hospital she was not eating, drinking, or sleeping - every time we visited, which was A LOT she was standing or sitting uncomfortably. When we brought her home she seen her furbuddys (her other pets) drank a lot of water, took a look nap, and even ate some mashed potatoes. She even wagged her tail when the garage door opened (all the dogs get excited when they hear it.) At the animal hospital and here, she has been regurgitating.. a lot of time her meds. Last night she was crying and shaking we stayed up all night rubbing her until she fell asleep. :-(

Currently i'm praying someone has been through this and can give us
some advise!
- How can we get her to stop regurgitating?
- How can we get her to eat - we've tried rice, baby food, mashed potatoes, noodles, broiled hamburger, broiled chicken.. She did eat about 2 noodles an hour ago
- Her left leg - she won't put down like it hurts?
- What do we need to do to help her?

I have gofundme where I have uploaded her current bill so it shows ALL the treatment broken down she had at the hospital. You can find this in her update - if this helps www.gofundme.com/savep

If any other paperwork would help let me know and I will upload it...

This is the meds they have her on below
http://oi57.tinypic.com/33zad74.jpg
http://oi57.tinypic.com/2z8rn7o.jpg

Please any suggestions.. we are mentally and physically exhausted and we are trying everything we can do

[Trish]

Hi Kelly

Sorry P is having such trouble getting over her surgery, it sure takes a bit to get over such a big operation, now having diabetes in the mix too :( pleased to hear you have experience with that. My dog had an adrenalectomy couple of years back and he took a bit to get over it as well.

There is another dog on the forum Kaibo that has had adrenalectomy and also has diabetes, I cannot remember when the diabetes first appeared but you could go read their thread, I will send Nikki a msg and see if she can pop in with any words of wisdom. http://www.k9cushings.com/forum/showthread.php?t=4648&highlight=kaibosmom

Are her blood sugars getting down into a decent level? I guess it will be hard to normalise when she is feeling so bad postop. I see the vets suggested small amounts of boiled chicken and rice... that is standard fare here for our pups that are unwell, make sure you boil the rice till it is real mushy and offer her little bits often. I think I would be checking those sugars pretty regularly to make sure they are not getting out of control.

She is on prednisone which is standard following adrenalectomy for a functional tumour, that can mess with sugars too. As well as during the surgery the pancreas can be handled and pancreatitis can be an issue with these pups. Plus that can also mess with the sugars.

The poor girl is probably knackered after going through the surgery and not resting well. I would be giving her all the recommended meds, including the tramadol to try and get her comfortable. Flynn would draw his back legs up, I think it stops the pulling in their tummy, so that sounds like postop pain to me so do make sure she gets her meds. But keep in mind sometimes the meds themselves can make them feel a bit funny, one of the drugs Flynn was taking made him cry and shake too... and a few dog owners have reported similar with tramadol so discuss that with your vet. They may have an alternative if they think that contributing to her feeling miserable.

If she was still vomiting, then I would be discussing with the vets about cortisol levels, they can plummet following this surgery especially if it was an active adrenocortical tumour, which it sounds like this was requiring trilostane preop. She may need an ACTH to check her levels are OK.

Has she pooped yet? That might be making her feel a bit sick to, so I would be taking her outside to make sure she is doing ok in that department. Check her tummy is soft.

I would keep her on floor level, so she is not tempted to jump and pull any stitches. As long as she is taking a bit of food and drinking and getting lots of rest hopefully she will turn the corner soon, I see they were wanting to check in with you today so I hope the news from the vets re histology is good and she starts to feel a lot happier.

I think this is a good example of how an ultrasound early in the diagnosis process is really helpful. You could have gone straight for the surgery, saved some money along the way. I know its all very well in hindsight but we often say a scan is a really good option to distinguish which type of cushings you are dealing with.

Hope that helps and P starts perking up real soon
Trish :)

[Squirt's Mom]

How is Peanut feeling today?

[kaibosmom]

Hi! I'm Nikki, Kaibo's mom. Trish gave me a heads up about your pup. I don't have too much time now to write and read your posts but I do have experience with both the adrenalectomy and the diabetes. Kaibo got the diabetes before his adrenalectomy. I will stop in again soon but I just wanted you to know I'm here along with everyone else for lots of support and advice. We've had many struggles with Kaibo's diabetes in two years. Take care.

Nikki

[kaibosmom]

As far as the regurgitating goes, you may need a stomach pill for a bit...like for stomach acid...I'm not sure if that would help but worth asking the vet.

[Squirt's Mom]

And if you are not a member of our sister site, please go register with them asap -

http://www.k9diabetes.com/forum/

[molly muffin]

Hello I just want to say hi and welcome you. Trish and Nikki, are definitely the two who have been down this road.

I wonder if the back leg is just sore, or feels tight perhaps? Is P putting any weight on it yet? Kept any food down? Good point Nikki made that it could be the meds actually also upset her tummy. An anti nausia drug from vet or even just pepcid an hour to 30 minutes prior to feeding her might help.

[kaibosmom]

Hi. I had more time to look at the pictures and discharge notes. I she on all of those meds? There were 2 on there to stop vomiting and one for her stomach so if you have all of those meds then those bases are covered. I also noted that you were to call the vet today. Did you do that? What were the biopsy results? How is P doing now? I am sure it is hard to check in on here when you are worried so much about P.

Now, I want to ask some questions about the diabetes. It says to check the blood sugar regularly, so I assume you have a blood glucose monitor at home. If she is not eating, she should not be getting insulin. Insulin needs to be given with food…unless your vet has told you otherwise. I know when Kaibo is going for surgery or is fasting, he gets half of his normal dose just to keep him lower without the risk of going hypoglycaemic. So, I question what is happening with the vomiting and whether or not she is getting insulin.

I agree with Trish as well about the prednisone. You mentioned she is often vomiting her medications so is she getting the prednisone? Dogs who have had a functioning adrenal tumour need to have the prednisone post op then weaned off of it over time. Although it will cost more money, an ACTH should be performed, in my opinion.

The diabetes takes time to get under control and the antibiotics and prednisone make it more difficult to treat. Good luck to you. I will check in again to see if you have any more answers, questions, etc. Take care.

Nikki

[Kelley314]

Hi P went from not walking - throwing up - not eating - barely drinking and crying :-( to EATING, Walking (not a ton she is still weak), and drinking. She also seems comfortable, not in pain, just tired. She still hasn't went poo though.. I cut back on her pain meds and the throwing up stopped.. I also gave her pepcid AC as it helped my diabetic kitty when he wasn't eating...

She still is NOT using her back left leg.. she doesn't put in on the ground when she walks.. I told the vet this and they didn't really say anything :-/ when they did the ultrasound on her weeks ago that same leg was very sore from how they had her positioned.. but not to the extreme of her not using it...

Also her biopsy came back as the tumor was cancerous but they got it all out... our "normal" vet is going to look at the results as the specialist said ... "it could come back... it could not come back.. it could come back in a year.. it could not come back" which left us very confused....

I am just very excited as she has been walking around.. got up when we walked in the house.. and was walking around outside .. also so happy she is licking her plate clean.. she is still only really eating noodles.. but thats better than before, which was nothing!

I will also join the diabetic forum....

Please keep any suggestions coming as well as thoughts to her back left leg and biopsy results.. Thanks :)

Updated Pic - SO Much better.. http://tinypic.com/r/dg09g/8

[kaibosmom]

Good news. I'm not sure about the leg. It could be damage from the position P was in during surgery. I read an article about this happening and how sometimes doggy chiropractors can help. I think that's the only thing the vet can say....it may come back, it may not. You never know and vets can't make promises when it comes to that sort of thing. For now just enjoy the fact that the tumour is out and P is starting to feel better :). Good luck.

P.S. How old is P?