In operable Adrenal tumor invading the CVC

[jenzaname80]

Hello, I'm new to the group and kind of distraut over some very unexpected news we received about my mom's neutered grand dog 7yo Boston Terrier - Romeo.

Romeo seemed to have what we thought injured one of his back legs or his lower back due to a small scuffle he had with his younger challenge rival a 5yo Boston Terrier Scooby who is also neutered .
For almost a week afterwards witnessed Romeo having rear extremities weakness going up the stairs after going to the bathroom and seemed to be a little crabby and not himself irritation. She took him to the doctor after x-rays showed negative besides 2 discs having some Arthritis.. it was obvious that it wasn't enough to cause the behavior after 2 weeks of not much improvement but seemed to almost be getting worse, my mom not settling for anything but an answer they decided to do a scan which resulted in
*Large Irregular Right Adrenal Tumor with CVC involvement- Irregularly shaped soft tissue Mass involving the right Adrenal. Measures 3-5 cm Large portion of mass invading into the CVC wall."

It also goes on to say that "These are most consistent with aggressive Neoplasia such as: Pheochromocytoma or Adenocarcinoma"

The prognosis is: POOR
*"Surgery and or Chemotherapy may be attempted but the prognosis remains very guarded".

The vet states they are reluctant to operate due to the location of where it is at, that they may not be able to stop the bleeding. They are afraid to do Chemotherapy due to not knowing how it will react. The veterinarian says that it either has to be surgically removed or shrunk because it is causing extra stress on his heart and even if its not Cancer that is will still kill him.

His labs came back great with only his Glucose 119 (63-114) slighly high
Phosphorus 2.1 (2.5-6.1) slightky low

There is no report of abnormal Intraluminal Material Noted.
The spleen is homogeneous with no discrete nodules or masses.
No evidence of Ascites or Peritonitis.
The liver and Gallbladder are normal.
Both Kidneys are WNL's.
The Urinary Bladder is unremarkable with normal wall layering noted.
The Intraluminal portion measures 14x28mm.
The Ventral aspect of the Lumen remains patent.
The (L) Adrenal is normal and there are no enlarged Lymph Nodes

He still acts like himself besides the rear legs barely display weakness (I barely notice this but my mom-who watches his every move... says she can tell) he plays, eats, acts like he is happy.. basically normal.. I haven't witnessed any kind of fussy attitude at all but he lives with my mom n step dad.. but I'm guessing that his mood may not be anything substantial.. my mom refuses to have him put down bc its my deceased brothers baby and because she does not believe in it.. I am with her on that.. for obvious reasons especially when he is acting normal.. that would be absurd to think of any such choice.
So i guess we are hoping for any kind of miracle so that we do not have to lose him.
Can anyone please offer some options we can look into or maybe shed some light on this heartbreaking situation please.

[DoxieMama]

Hi,

Welcome to you and Romeo (and your mom and step-dad). I'm so sorry for the reason you've joined us. I do not have experience or ideas to offer, but am hopeful that others will be along today that do.

Shana

[jenzaname80]

Thank you. I am hopeful too.

[Harley PoMMom]

Hi and welcome to you and Romeo!

I am sorry for the reasons that brought you to us but glad you found your way here.

An adrenalectomy can be a cure for a dog with an adrenal gland tumor, however, this type of surgery is very serious and expensive and should be perfomed from only a well seasoned board certified surgeon.

You really need to know what type of adrenal tumor that Romeo has as it can be a functioning or non-functioning tumor or a Pheochromocytoma, because treatment is dependent on the kind of tumor it is.

From a goolge search I found that there is a blood test that is used to identify pheo's, here's an excerpt from that article:
Measurement of serum inhibin concentration has recently desctribed as a valuable parameter to differentiaate pheochromocytomas from adrenocortical tumors in neutered dogs. https://books.google.com/books?id=RwujBQAAQBAJ&pg=PA541&lpg=PA541&dq=Inhibin+used+to+diagnose+Pheochromocytoma+in+do gs&source=bl&ots=e_a3lG7do1&sig=YNViuAUISWVqvYOXKBohbvE5GQ8&hl=en&sa=X&ved=0ahUKEwiNjKCe3dzOAhVMqh4KHTD3BVAQ6AEIQzAF#v=on epage&q=Inhibin%20used%20to%20diagnose%20Pheochromocytom a%20in%20dogs&f=false

I have no experience with adrenal tumors so unfortunately I have no words of wisdom :( but please know we will help in any way we can.

Hugs, Lori

[jenzaname80]

Thank you soo much Lori! We are fanatically looking for help so that we dont lose our boy. God bless you!!

[jenzaname80]

Do you know of a facility thay you could recommend. We are willing to go above and beyond to save him.

[lulusmom]

Hi and welcome to the forum.

I am assuming that the vet you mention is a gp vet and not a board certified surgeon, right? If so, I highly recommend that you get a referral to a veterinary surgeon who is very experienced with adrenalectomies. I know of two phenomenal surgeons in California who will do surgeries on dogs with tumors that have some invasion into the caudal vena cava; however, they or any other expert surgeon would need to take a look at the imaging to let you know if surgery is feasible. If you let us know which city you are in or near, we may have a member who can provide you with a name.

Don't give up hope just yet and know that we are willing to help in any way we can.

Glynda

[jenzaname80]

Glynda,

Hi.
Yes ma'am. He is a GP. But do you agree or am I misjudging my Vet that even with his credentials of a general vet.. if he has any doubt of his ability to help even if it's out of his means, you would think that any animal loving person.. much less what he chose to do as his profession because he I'm assuming loves animals and wants to help them that he would have recommended to get a second opinion or to try to talk to a more advanced oncologist. Instead even though Romeo is acting with very little symptoms he basically said we have a dead dog. If I wouldn't have done a little research which is not my expertise we would never have known that there may be with no guarantee other options just to give us a little slight bit of Hope. I can't imagine how many other people out there just take their professional peers advice and just let there for babies passed on that are no one there was an option maybe they could still be around to this day.
BUT THANK YOU i the site has been such a god-sent that even if we get nowhere it's still indoor comfort knowing that we tried all we could and didn't just give up.
We live in the st. Louis area period again any help is an answered prayer I can't thank you enough ♡

[jenzaname80]

I'm sorry for the sentences that were jumbled in my last post. I am trying to do 50 things at once and still try and research with no sleep. I'm sure you understand.

[Squirt's Mom]

You want to find a board certified surgeon who has successfully performed many adrenalectomies. A GP vet or even oncology vet won't be able to asses your precious baby as well as a board certified surgeon who actually does this type surgery. You want the expert in that field. ;)

[jenzaname80]

Thank you! That made my mothers and my day.. i just read this to her as she is bawling her eyes out.. and that actually made her stop. Again thank you.

[labblab]

Here's a link to a veterinary specialty website that gives a two-page listing of veterinary surgeons in Missouri. This may help you locate an experienced surgeon in your area:

http://find.vetspecialists.com/search_results?ttid=5&tid=14&location_value=Missouri%2C+United+States&adm_lvl_1_sn=MO&country_sn=US&location_type=administrative_area_level_1&swlat=35.995683&nelat=40.61364&swlng=-95.77470399999999&nelng=-89.09949399999999&lat=37.9642529&lng=-91.8318334&faddress=Missouri%2C+USA&place_id=ChIJfeMiSNXmwIcRcr1mBFnEW7U

I'd also just ask your GP vet directly if he knows a specialty surgeon who might have greater experience with adrenalectomies. The part that is difficult for us to assess is actually how severe the invasion into the caudal vena cava appears to be. Your vet may have had further discussion about this imaging with the radiologist or with another specialist, discussion about which we are unaware. If so, this may be the basis for the discouraging prognosis. But either way, I can understand and support your desire for a second opinion in order to give you more peace of mind about the genuine options. Since you live in a major metropolitan area like St. Louis, I'm hopeful that one of the surgeons listed on the website above will have the experience you are seeking. If not, and if you are willing to travel as far as Columbia, I am guessing that the Mizzou vet school would have that expertise.

Marianne

[judymaggie]

Hi! I note that there is a Blue Pearl Veterinary Hospital on the list that Marianne provided. When I googled Blue Pearl in Missouri there are actually three Blue Pearl locations, all near Kansas City. Although I am sure there is variation from one hospital to another, I did want to let you know that I have had excellent care by Blue Pearl veterinarians with my pups.

I would second Marianne's suggestion to speak with your GP first. Most, if not all, veterinary surgeons will want a referral from a vet unless one goes to a hospital for an emergency.

Hugs to you and your Mom and a big ar-o-o-o to Romeo from my beagle, Abbie!

[jenzaname80]

Thank you for responding Marianne. It definitely helps the anxiety and worry every time someone even gives their thoughts, it helps not feel so alone and helpless. You definitely helped put that into perspective about my vet's reaction. But honestly I guess what I'm trying to say is unless my dog or anyone's dog for that fact is already gone my expectations of just being compassionate and if I'm still digging and looking and trying whether it's useless or not I'm just thinking that it kind of is his job the kind of steer me in the right direction at least humor me that way I can say if it doesn't work that at least we tried. There was never an option of a different doctor a second opinion nothing basically I'm going to have a dead dog. I mean if I'm wrong I really would like for someone to tell me that I'm overreacting or maybe thinking wrong and I'm definitely not trying to insult him or degrade him in any way at all. I'm just thinking that compassion is just something that naturally it's either there or it's not, granted we all have bad days and he is a good doctor and is always been there for my mom even though she has paid enough to his practice 2 where he can retire. Lol
But I guess it was just meant for me to come across this site with all of you awesome big-hearted special and extremely helpful people. Through it all I'm honestly glad but I've had the pleasure of talking with everybody. I guess what's meant to be will be but it definitely helps knowing that there are such awesome people. I don't know what to say.

[Harley PoMMom]

Unfortunately most GP vets are not that knowledgeable about Cushing's or the endocrine system. While a GP vet may see a couple cases of canine Cushing's in a year an IMS would see many more and an IMS will have the experience in handling a dog with multiple health issues.

With my boy, Harley, I had an IMS on board that worked with my GP vet. I used the GP for testing purposes (ACTH stim, blood panels etc...) when another complication would arise than the GP would confer with the IMS and we ALL would talk and agree with a plan of action. With this disease you really need a GP that will work with you and be a team player.

Hugs, Lori

[jenzaname80]

See I didn't know that. But that makes complete sense. Thank you for clearing that up. It sure makes a difference when you can wrap your head around certain situations. It makes me feel bad that i was so mentally upset at my Vet but in my defense, its a lot to take in. I just assume that he shoukd know how to handle people that have been blessed and not haf to deal a whole bunch with this type of situation. But i do love my vet.. I'm just worried and thinking the worst and it can't be fixed soon enough.. If even possible. I did call and schedule an appointment with MU Veterinary Health Center and schedule an appointment next Tuesday
It's 2 hours away but I'm hoping for the best. I just hope there is a small miracle amd blessing waiting for us.
You guys are wonderful! :) ♡♡♡♡♡

[jenzaname80]

Oh and thank you Judy H.

[jenzaname80]

I hate to be a pain but in regards to my Romeo I have an appointment Tuesday in Columbia at Wash U.& its kind of far off (unsure how fast these things grow), does anyone know if there's anything that we can do in the meantime? He is really starting to have issues with his back leg.. I'm guessing from the pressure of the tumor. Any ideas or and put would reallybe appreciated.

[Harley PoMMom]

We never get annoyed when members have questions, you are your baby's advocate and we certainly understand the love and devotion you feel for your furbaby so please do not ever hesitate to ask all the questions you want. Now, we may not be able to provide answers to the questions but we are definitely here for support and to help in any way we can. ;)

Since we don't know what exactly is causing the rear leg weakness it's kinda tough to suggest anything that will help. This type of issue is common with our cushpups and some of the things recommended are: acupuncture or hydrotherapy, also walking backwards starting with a few steps at a time.

Wishing you both the best of luck with the vet visit on Tuesday, keep us updated, please!

Hugs, Lori

[labblab]

Definitely good luck on Tuesday! You probably would be doing this anyway, but make sure to gather up copies of all the test results and imaging interpretations that you have available to you. This may save them from ordering a bunch of repeat tests, and will also give them the most accurate idea as to where things stand for Romeo.

I wish I could help re: the back leg weakness, but as Lori says, it's hard to know exactly what the problem is. Hopefully you'll learn a lot more about everything on Tuesday.

I do want to mention one other thing, though...I know you are having some doubts about your GP vet right now, but there may be an advantage to letting him know you are seeking this second opinion. He might be able to directly book an appointment with a surgeon for you there at the Vet School, and could probably transmit the actual ultrasound image for them to look at. I'm somewhat afraid that you'll only get to see a "gatekeeper" on Tuesday, and then have to wait and go back again to see a surgeon. It's entirely up to you as to whether or not you want to discuss the referral with your vet, but in the long run, they will probably want to talk with him anyway. So I just thought I'd throw this out to you on the front end, especially since it's a long drive and also time seems to be a genuine issue here in terms of tumor growth. :o

Marianne