13 year old morkie’s adrenalectomy coming up

[Jersey0812]

My 13 year old Morkie has been diagnosed with adrenal dependent Cushings. Jersey is 7.5 lbs. Her left adrenal gland has a 1.25 cm tumor without any CVC invasion. CT scan of the chest did now show any evidence of disease in the chest. Her spleen had 2 nodules, which were biopsied and fine needle aspirated were benign. She is scheduled for an adrenalectomy and splenectomy on November 13. Even though the splenic nodules were benign with needle biopsy, the surgeon thinks we should still remove the spleen to avoid any issues down the line. He said adding the splenectomy does not really add to the overall surgical risk of adrenalectomy.

Symptom wise, she is more food seeking and has had several skin infections, both of which the IM thinks are related to the Cushings. I’ve been a nervous wreck through this workup and hope I’m making the right decision for surgery. The surgeon said as far as the surgery goes, given the smaller size and no CVC involvement, it’s as straight forward as it gets with this high risk surgery. For those of you whose dogs had the surgery, how long did they stay in the hospital? How scary was the postoperative period during admission and then even at home?

[labblab]

Hello and welcome to you and Jersey! We’re so glad you’ve found us. Over the years, we’ve had several dogs here who have undergone successful adrenal surgery. Unfortunately, our active membership is now pretty small, and it’s been quite a while since anyone has posted here about their surgical experience. However, over the next couple of days I’ll try to find links to previous threads that may contain info and personal experiences that are helpful to you.

Overall, from what you’ve described, it does sound as though Jersey’s situation indeed presents the best case scenario for this type of surgery. And of course the beauty of the procedure is the fact that successful surgery provides a complete cure from Cushing’s.

So once again, we’re very glad you’ve joined us. And I’ll be returning once I can provide you with some more info.

In the meantime, best wishes to you and Jersey.
Marianne

[Jersey0812]

Hi Marianne,

Do you know if anyone’s dog had the surgery done laparoscopically? I’ve met with 2 different surgeons, one of whom is recommending lap procedure but I’m leaning towards an open incision. Surgery is scheduled for next week so any advice would be so appreciated.

Thank you so very much,
Tulsi

[labblab]

Dear Tulsi,

I’m so sorry I haven’t gotten back with you sooner, but I’ve been checking around with folks to try to find sites where members have reported more current experiences with adrenalectomies. Unfortunately, as I mentioned earlier, it’s been several years now since any folks here have had dogs who have undergone the surgery. So I’m afraid we can’t offer you any worthwhile guidance in terms of the state of the art at this time. We’ll surely be here to provide emotional support during Jersey’s surgery and recovery. But I’m afraid we’re striking out in terms of technical help :-(((((.

I still have a couple of inquiries out there and if I hear anything back, I’ll surely let you know. And in the meantime, all wishes for good luck and speedy healing for Jersey, no matter which route you decide to go.

Marianne

[labblab]

I’m popping back to add a link to a 2023 study I just found that analyzes comparative data for 70 dogs that underwent laparoscopic vs. open adrenalectomy. It’s pretty technical, but it may be useful to you. I think the good news is that, overall, it looks as though the results were good for both groups. They do seem to end up recommending the laparoscopic procedure in cases where it’s a suitable choice. But for any given dog, there may be reasons why the open procedure would be preferable, and that may certainly be the case for Jersey.

At this late date, I surely don’t want to muddy the water further for you, and you may have already seen this study anyway. But if not, I wanted to give you the option of looking at it. As I say, the good news to me is that the results were generally positive for both groups. And once again, wishing you the best of luck no matter what you decide!

https://www.frontiersin.org/journals/veterinary-science/articles/10.3389/fvets.2023.1156801/full

[Jersey0812]

Hi Marianne,

Thank you so much for the article; yes I have actually reviewed that article and both groups did comparatively well. They do recommend the laparoscopic procedure in the end because in general its considered less invasive and requires a shorter hospital stay if there are no complications. After speaking with the surgeon and our general vet, I have decided to go ahead with the open procedure. This particular surgeon has done "hundreds" of open adrenalectomies over the last 20 years and since Jersey is also having a splenectomy, he feels the traditional open procedure is the better option (at this hospital, none of the surgeons do laparoscopic adrenalectomies anyway). The surgery is scheduled for this Wednesday 11/13. This forum has been so helpful in terms of information but honestly, more for the emotional support of knowing there are so many others like us out there. Please send us some luck and love on Wednesday. I'll try my very best to log on to let you know how she's doing if I'm not a wreck during the whole thing! Thanks again so much-I really do appreciate all the support.

[labblab]

We definitely send you and Jersey all our best wishes for tomorrow!!! And please do update us whenever you’re able. We’ll be anxiously awaiting your news.

Sending tons of hugs to you both,
Marianne

[labblab]

Hi again, Tulsi. Surely hoping all went well for you guys yesterday. Continuing to send you all good wishes for the best possible outcome and rapid healing.

[Jersey0812]

Hi Marianne,

The surgery went well yesterday; he said there were no surprises when he opened her up and removed the spleen and L adrenal gland. The pathology results will take up to a week. She was still in ICU this morning recovering. She has no interest in eating and has some anxiety-pulled her IV out so they are going to try to get her to drink water today to avoid replacing it. He is overall pleased with her progress. I am hoping she eats a little and things continue on this path so she can come home soon. Thanks so much for checking in. I will keep you updated on her progress as I hear more

[labblab]

Thanks so much for this news, and all fingers crossed that she starts drinking and eating on her own!! You get well now, little Jersey!

[Jersey0812]

We brought Jersey home last evening. She finally ate and has been resting at home. She has a pretty sizable abdominal incision and is quieter than usual but I’m sure the pain medications are meant to do that. We are so relieved to have her home! Pathology results should be back in the next week or so.

[labblab]

Yay Jersey!!! I’m soooooooo glad to know she’s home, and yep, the pain meds are undoubtedly doping her out a bit. Thanks so much for sharing this good news with us, and we’ll be so interested in those pathology results, right alongside you.

More hugs incoming!
Marianne

[labblab]

Hi Tulsi! Been thinking about you guys and surely hoping all is well. If you have a chance, we’d love to get a report. In the meantime, continuing to send healing wishes to sweet Jersey!

Marianne

[Jersey0812]

All the pathology came back benign ( left adrenal, spleen and liver biopsy) so we are thrilled about that! She is off all pain meds and prednisone as well. We had a little hiccup last week where she had diarrhea, shaking and refused lunch-she was just off so we brought her back to see the surgeon. They checked her cortisol and it was 3.9 so no concern for Addisons. She had gotten into some peas and potatoes the night before (she usually is only allowed prescription hydrolyzed protein diet due to her IBD) and he thinks maybe the diarrhea was from eating things she doesn’t normally eat. She recovered nicely and is back to normal now. She is still pretty food seeking and I wonder how long after surgery it takes for those Cushings symptoms to improve. Her ALP liver enzyme is still elevated at 476; he said it can take a month or 2 for those numbers to normalize. It’s only been 2.5 weeks so far so hoping over time it improves. But overall she’s doing really well and has an appointment to see internal medicine in early Jan 2025.

[labblab]

Oh, this is all such good news — thanks so much for sharing! We’ll be grateful to know that maybe we can call upon you in the future should another new member arrive with questions about adrenalectomy. There’s nothing like real-life experience in terms of offering guidance and support. So it’s a gift to us to have you and Jersey here as members of our family.

Best wishes as always!
Marianne

[Jersey0812]

Yes absolutely! I would be happy to answer any questions. This process was very stressful but I found a lot of support through this forum!

[Squirt's Mom]

Hi Tulsi,

Just following up on Jersey's journey. Hope you have some good news to share?

Hugs,
Leslie

[Jersey0812]

Hi Leslie,

Jersey has recovered very nicely from the surgery! There were some abnormalities in her last set of labs in January; her platelets are increased at over 1000 and her alk phos was a little over 200. The internal medicine specialist isn’t worried about the liver numbers but said if the platelets continue to rise, we may have to start her on a blood thinner, plavix. I’m not sure if this is directly related to Cushings ( which in theory should be “ cured” after adrenalectomy) or the fact that she had a splenectomy but her next appointment is on 3/13/25 and I will certainly keep you posted.

The surgical incision has healed beautifully. She does still have some issues with skin infections but the dermatologist said it’s likely due to allergies and not related to cushings. She is still very food motivated, though I think that’s just her personality. Her energy and demeanor are the same as always and you would never guess she had such a big surgery 3 months ago. I am so grateful for how well she’s recovered. We are actually celebrating her 13 and a half birthday on Wednesday!

[labblab]

Happy belated celebratory wishes to sweet Jersey on her 13 and a half birthday!!

And thanks so much to you, Tulsi, for once again updating us. I’m so relieved to hear that our girl is doing so well, and I surely hope that things will stay that way!

All best wishes to you both, as always.
Marianne

[Squirt's Mom]

Wonderful update, Tulsi! I am so glad to hear she is doing so well in recovery. Jersey has been thru the wringer lately and has come thru like a champion! Keep up the good work, Mom!
Hugs,
Leslie