codyspeople
11-04-2018, 10:42 PM
Hello! We have a 12 year old Pomeranian named Cody who appears to have an adrenal tumor of some sort. For the past couple of years, he had some anomalous lab results, including slightly elevated ALT, elevated potassium, and low sodium, as well as low urine specific gravity going back for about four years at this point. The results were always very stable and he showed no outward symptoms, but given their persistence over time we wanted to get to the bottom of the matter and make sure there wasn't something going on.
After settling down in Arizona our new local vet ran a test for Addison's which came back negative, and a subsequent referral to a specialty clinic determined via ultrasound that one pole of his left adrenal gland was enlarged to 1.1cm. An LDDST test for Cushing's came back negative as well. However, follow-up ultrasound has shown changes and a CT scan indicates that the 1.1cm pole on the previous ultrasound is now 1.5cm based on the CT report after waiting two months to gauge the growth. Surgery has been recommended by the specialist because of the growth even in the absence of clear clinical symptoms and they're going to give us a surgical referral. We intend to go through with the adrenalectomy as Cody is in really good health. He has an activity level of a far younger dog and no known major health issues at this time (he appears asymptomatic, his test results are actually improving, though there is concern that he might have some low level kidney disease that isn't showing up yet based on imaging of the kidneys). In the absence of a major health issue like this one he seems like he likely has a good few years of quality life ahead of him, so despite the potential risk of the surgery, we feel like we should give him a chance rather than take all those years away because we're afraid of losing him right now (in the absence of surgery the prognosis is that he might make it anywhere from a few months to a year).
However, we're not sure what kinds of questions to ask after the referral to make a decision regarding the surgeon or facility that we'd want to have do the operation. We're based in the Phoenix area but travel quite a bit, and we're aware of both local facilities that may offer the procedure as well as ones further away (UC Davis comes up a lot, and VSH in San Diego is only a few hours from us in Phoenix). We'd appreciate any suggestions on what questions to ask to help us make a choice about the specialist and facility, and if anyone has any recommendations we would appreciate those as well.
Thanks!
John and Ashanna (and Cody)
After settling down in Arizona our new local vet ran a test for Addison's which came back negative, and a subsequent referral to a specialty clinic determined via ultrasound that one pole of his left adrenal gland was enlarged to 1.1cm. An LDDST test for Cushing's came back negative as well. However, follow-up ultrasound has shown changes and a CT scan indicates that the 1.1cm pole on the previous ultrasound is now 1.5cm based on the CT report after waiting two months to gauge the growth. Surgery has been recommended by the specialist because of the growth even in the absence of clear clinical symptoms and they're going to give us a surgical referral. We intend to go through with the adrenalectomy as Cody is in really good health. He has an activity level of a far younger dog and no known major health issues at this time (he appears asymptomatic, his test results are actually improving, though there is concern that he might have some low level kidney disease that isn't showing up yet based on imaging of the kidneys). In the absence of a major health issue like this one he seems like he likely has a good few years of quality life ahead of him, so despite the potential risk of the surgery, we feel like we should give him a chance rather than take all those years away because we're afraid of losing him right now (in the absence of surgery the prognosis is that he might make it anywhere from a few months to a year).
However, we're not sure what kinds of questions to ask after the referral to make a decision regarding the surgeon or facility that we'd want to have do the operation. We're based in the Phoenix area but travel quite a bit, and we're aware of both local facilities that may offer the procedure as well as ones further away (UC Davis comes up a lot, and VSH in San Diego is only a few hours from us in Phoenix). We'd appreciate any suggestions on what questions to ask to help us make a choice about the specialist and facility, and if anyone has any recommendations we would appreciate those as well.
Thanks!
John and Ashanna (and Cody)