ADRENAL TUMOR
“Happy” Lopata is a friendly spayed lab/shepherd mix. At almost 12 years of age, her owner brought her in to see Dr. Ballard for coughing and loud breathing noises of a 2-3 week duration. Sneezing and nasal discharge had been noticed recently as well. Upon physical examination, Happy had normal aging changes to her eyes, (lenticular sclerosis), and a moderate amount of tartar/gingivitis present orally. Multiple warty growths could be found on her skin, but this too could be attributed to her maturity. Dr. Ballard was concerned at this time, about the possibility of Valley Fever, (Coccidioidomycosis), allergic bronchitis, or the potential of neoplasia, or cancer.
A blood sample was drawn and submitted to the lab for a Valley Fever titer and organ function check. Happy was placed on a regimen of doxycycline in the interim, an excellent antibiotic for both upper and lower respiratory infections. This medication was soon discovered to cause intestinal upset for Happy, so the switch to Clavamox was initiated. The lab results indicated mild elevation in her liver values, but negative for both valley and tick fevers. Chest radiographs were then taken, but no significant cause for the coughing was found. The Clavamox yielded slight improvement, so it was continued.
One month later, Happy was escorted into the hospital by pet sitter, Stevie, for vomiting. Happy had a history of eating inappropriate items, and had been off her diet and somewhat lethargic the last few days. Dr. Lannen examined her, suspecting a possible intestinal blockage. Happy seemed very quiet, but no pain or abnormalities were palpated abdominally. Dr. Lannen did discover an abnormal rapid heart rhythm with weak femoral pulses not present a month ago. She ordered staff to perform an in-house ECG and results were expedited to a cardiologist in Florida for interpretation. Happy was soon diagnosed with ventricular tachycardia, with a rate of 200 bpm, where normal for her should range between 90-120. The specialist concluded that this could result in heart failure or sudden death for poor Happy, and instructed Dr. Lannen to administer lidocaine IV slowly over 5 minutes. The ECG was repeated 10 minutes later, and the infusion of IV fluid therapy was initiated. The concern was that Happy may be suffering from dilated cardiomyopathy, (enlarged heart with thin walls), inflammation of the heart due to an undetected tick-bone disease, or a splenic tumor. Happy was then placed on a medication to slow down the heart rate, and follow-up radiographs were taken, with no significant heart changes.
Permission was next granted for abdominal radiographs, still hoping to find the source of Happy’s discomfort. A suspicious looking mass was found in the middle of her abdomen, closer to the kidneys than the spleen. An abdominal ultrasound was ordered. Drs. Lannen and Faver concluded that a mass was indeed present, on or near the left kidney, with possible splenic involvement. An exploratory surgery was performed to obtain a better visual of the condition. With Happy’s owners out of town, the decision not to biopsy the kidney was made, not wanting any unnecessary surgical complications. Happy was awakened from anesthesia and her surgical recovery was uneventful.
Happy’s case was ultimately posted on the Veterinary Information Network, which consists of board certified specialists, where diagnostics can be viewed and advice offered. A suggested diagnosis of an adrenal gland tumor was made. A CT Scan was conducted, revealing the existence of this tumor, along with location, size, and present condition of the heart. Results were then sent to a specialist in Colorado, and the diagnosis was confirmed.
A 4th doctor from our practice, Dr. Prevatt, performed the surgical excision of the adrenal gland tumor, assisted by Dr. Lannen. The procedure proved to be both difficult and lengthy, but the tumor was successfully and skillfully removed with no apparent surgical complications! Only time will tell . . .
Happy was seen mid-August for her routine examination and we are pleased to report she is doing wonderfully and continues to enjoy her life! A very happy ending for “Happy”.
