Can you advise?

[Mandy t]

Hi I have a 9 year old boxer who has lived with Cushings for over 2 years. she has monthly ACTH tests and is on vetoryl 60mg twice daily and incurin twice daily. she lives quite well with it apart from getting me up at least three times in the night to wee. we decided to have a CT scan yesterday to see how bad the tumour is and the oncologist told me it now covers most of her brain :( she has asked I consider radiotherapy but my vet does not feel this is worthwhile for Nellie. just wondered if anyone had been through anything similar?

[DoxieMama]

Hello and welcome to you and Nellie, though I'm sorry for the reasons you've joined us. There may be someone here who has had that done; hopefully they will see your post or one of the others might remember and contact them on your behalf.

In the meantime, can you share a bit more about Nellie's history with us? The more information we have, the better we can help support you. What were the results of her last ACTH test?

[Mandy t]

thanks for replying, I will get her latest ACTH results tomorrow when the oncologist rings me so will post them then. Normally they are quite good and within range to increase the vetoryl if need be. She manages so well in the day just seems to be night times she wants to drink and wee more. I am used to getting up with her now so that does not bother me. She has all the classic symptoms, hunger, thirst, loss of hair (she almost turned into a chinese crested now) pot belly. Lost a lot of muscle, weights 30.7 kg. looks a little thin due to muscle loss, skin turned black and does not have much energy. Saying all of that her quality of life is good I think, she is very happy but has become very clingy with me recently and really does not like her continuous trips to the vets. Her thyroid is also boarder line so she on tablets for that and also has paracetomal morning and night to help her back legs. Had a couple of UTI's recently but latest results on that are all clear now. How she copes with all of this is amazing, she takes it all in her stride and carries on. My vet has always said it is about managing the symptoms as we will never cure her I just worry if I don't try the radiotherapy then I am not doing the best for her. The oncologist was honest and said she could not guarantee it would work but warned me the next stage for Nel could be seizures. The radiotherapy would be 12 sessions over a four week period, with another CT scan before starting to make a mould for her head and one after to see if it has worked. Living with Cushings is part of our life now, we have adapted to her needs, of shorter walks and not leaving her for more than three hours and of course getting up at night with her but my main concern is the next step. Do I follow my vets instructions (he is amazing and really knows Nellie well and can tell when she if off) or follow the oncologists advice. So unsure at the moment.

[Mandy t]

results from 1st Aug pre test 51post ACTH 81.

[Squirt's Mom]

Hi and welcome to you and Nellie! :)

I am sorry to hear this report from her vet and have some questions about it. Based on the signs you have described, Nellie is not exhibiting the things we normally associate with a large pituitary tumor but rather just the normal signs like appetite, drinking, peeing, etc. A tumor that covers the "whole brain" would be causing some pretty strong, unusual, and scary signs to my way of thinking. It is not uncommon in breeds like the Boxer, Bostons, and others with that smushed face profile to develop the larger pituitary tumors called macroadenomas but again there are signs that usually indicate that tumor is growing beyond the normal cush signs. To help you, here is a link to a thread one of our members started where parents of cush babies who did have the macros develop have shared their experiences. Read and see if you see things in Nellie that have been reported here - http://www.k9cushings.com/forum/showthread.php?t=3567

If you don't see Nellie in that thread, I would be seeking a second opinion today. I hope you don't see her in these other pups and that this vet is simply wrong. It does happen sadly - our GP vet who is quite good did xrays on one of my babies which showed her heart was 6x normal size. But his machine and film were off and her heart is fine. If I hadn't taken her to another vet she would probably not be here now because she had pneumonia and we were treating for heart disease. ;)

Here is a thread from one of our members who's baby developed a macro tumor and underwent radiation laser treatment. Our precious Buttercup is no longer with us but she and her mom taught us all a lot and her story may help you and Nellie. The discussion about this treatment starts with post #36 (found to the right of the dark banner at the top of each post) - http://www.k9cushings.com/forum/showthread.php?p=127635

I'm glad you found us and look forward to learning more very soon. I also want you to know that you and Nellie are no longer alone- we will be with you every step of the way.

Hugs,
Leslie and the gang

[Mandy t]

Hi Leslie, thanks for that information. I have had a read of it and Nellie does not have those extra symptoms. I did ask the oncologist to tell me the measurements of the tumour and she said she would give them me when She calls me with the ACTH results tomorrow. I have spoken with my regular vet this morning as he has also asked the oncologist to call him tomorrow with all the results. The oncologist mentioned yesterday that boxers are more prone to this due to the shape of their heads and I asked about surgery and she said they did not do it there but she could refer me to a surgeon but it would be risky. Nellie has had many scans and X-rays and so far her heart and liver are normal, he asks quite often whether she is pacing, twitching or acts like she has a headache but so far she has none of these signs. My vet today seemed surprised she could say the tumour covered her brain as he also thought she would be showing some more serious signs. I asked if she could now have an MRI as this would be more detailed than a ct scan. He advised we wait for the measurements first and take it from there. it's all very confusing at the moment.

[hollyb]

Nellie, My dog Nola is 6 months post-radiation for a macroadenoma. Let me know if there is anything I can help with! Holly