So we’re told this afternoon’s abdominal ultrasound of Cassie the Corgi shows a large tumor on an adrenal gland. So that comes under the heading of “the last act.” The vet proposes that we not put her to sleep just now, since she seems to be doing fairly well — except for the cough (which she started with), all the other symptoms (which I still believe to be induced by the Valley fever drug and the prednisone) are going away. He says these symptoms will come and go, and he thinks she’ll last about three months, at the most.
I remain skeptical. Why? Because…
a) Cough and wheezing are NOT symptoms of adrenal gland tumors.
b) The symptoms she’s had that could be explained by an adrenal tumor also are classic side effects of fluconozale and of prednisone.
So what do we have here? The following potential symptoms for adrenal cancer:
- Excessive water intake (polydipsia) Cassie: yes. But it’s also a prednisone side effect
- Increased urine output (polyuria) Cassie: yes. What goes in must come out.
- Increased appetite and food intake (polyphagia; affected dogs are often ravenous): Cassie: Yes: she lost two pounds in the coughing episode, so I’ve been feeding her more.
- Weight gain, frequently to the point of obesity: Cassie: no
- Abdominal enlargement (pendulous, distended abdomen; “pot-bellied” appearance) Cassie: no
- Hair loss (alopecia; usually patchy and symmetrical on both sides of the body): Cassie: no
- Darkening of skin (hyperpigmentation): Cassie: unknown
- Excessive panting; often when lying down and appearing to be resting quietly: Cassie: yes
- Skin bruising: Cassie: unknown
- Clitoral enlargement in females (clitoral hypertrophy) Cassie: unknown
- Testicular enlargement in males (testicular hypertrophy) Cassie: n/a
- Loss of normal reproductive cycling in females (anestrus) Cassie: n/a
- Infertility (males and females) Cassie: n/a
- Weakness: Cassie: possibly
- Lethargy, listlessness Cassie: no more than usual
- Exercise intolerance Cassie: unknown
- Muscle atrophy Cassie: no
- Thin, fragile skin that tears easily Cassie: no
- Poor coat condition Cassie: no
- Lack of coordination (ataxia) Cassie: no
- Neurological signs (circling, aimless wandering, pacing, bumping into walls or furniture, falling down for no apparent reason) Cassie: no
- Poor wound healing Cassie: no
That’s pretty ambiguous. Yes, she does have some of the signs. But she also doesn’t have a lot of the signs. Some of the signs can be explained by whatever sickness caused the coughing, which was severe (and is now, finally, gone). Some of them can explained by her age, which is rather advanced. Two can be explained by the effect of the prednisone.
There are two types of adrenal tumors in dogs: functional and nonfunctional. This squib is a little clearer. A functional tumor is a malignancy, but a nonfunctional one is not. Apparently there’s really no well to tell without $urgery. Nonfunctional tumors need no treatment. If the thing is “functional” and it hasn’t metastasized, you can operate and get from 16 months to 3 years of extra life. I’ve already spent almost a thousand bucks on this. Looked at the bank account and almost fainted when I saw the balance. At this rate I’m going to run out of money for living expenses LONG before the end of the year that this year’s RMD covers. I’ll have to get a job. And at this age: fat chance!
So I’m going to try to get a second opinion, as a kind of last-ditch thing. Because, to tell the truth, after my Adventures in Medical Science I’ve learned to always get a second opinion every time some doctor (or vet) delivers a dire opinion. But I don’t hold out much hope. She is old. And obviously the vet saw something on her adrenals. Whatever it is, it ain’t likely to be good for her.