Our Summary

This study reviewed the medical records of 53 dogs that had surgery to remove a specific type of adrenal gland tumor called pheochromocytoma between 2010 and 2020. The researchers looked at many factors, including pre-surgery care, imaging results, heart issues during surgery, complications and other procedure details. They also noted how long the dogs lived after surgery and the cause of death if applicable, whether the tumor came back or spread, and any issues after surgery.

The study found that many dogs experienced high blood pressure and irregular heartbeats during anesthesia. A large number of these dogs had been given a medication, called an alpha-blocker, before surgery. Interestingly, those dogs who were given an alpha-blocker before surgery experienced even higher blood pressure during the operation. However, all dogs survived the surgery and most were still alive when they left the hospital. The follow-up period varied from 6 to 1653 days, with a median of 450 days. The median survival time for dogs that left the hospital was about 3.2 years. Only a few dogs had the tumor return or spread.

The conclusion of the study was that most dogs survived both immediately after surgery and in the long term, with a low chance of the tumor coming back or spreading. The medication given before surgery, the alpha-blocker, did not seem to increase the dogs’ survival. Therefore, this study does not support giving alpha-blockers before surgery for this type of tumor. The good results from this study should be kept in mind when deciding on treatment options for dogs with this type of tumor.

FAQs

  1. What is the survival rate of dogs undergoing adrenalectomy for pheochromocytoma?
  2. Does preoperative alpha-blocker therapy influence the outcome of adrenalectomy in dogs with pheochromocytoma?
  3. What is the incidence of tumor recurrence or metastasis after adrenalectomy in dogs with pheochromocytoma?

Doctor’s Tip

A helpful tip a doctor might give a patient about adrenalectomy for pheochromocytoma is to discuss the potential benefits and risks of preoperative alpha-blocker therapy. While this study found that preoperative alpha-blocker therapy was not associated with increased survival, it is still important to have a thorough discussion with your doctor about the best treatment plan for your individual case. It is also important to follow all postoperative care instructions and attend follow-up appointments to monitor for any potential recurrence or metastasis.

Suitable For

Patients who are typically recommended adrenalectomy for pheochromocytoma are those who have been diagnosed with the condition and are experiencing symptoms such as hypertension, arrhythmias, and other cardiovascular instability. In this study of 53 dogs undergoing adrenalectomy for pheochromocytoma, all dogs survived surgery and most survived to discharge, with a median survival time of 3.2 years. The study found that preoperative alpha-blocker therapy was not associated with increased survival. Overall, the study suggests that adrenalectomy can be a successful treatment option for patients with pheochromocytoma, with low rates of recurrence or metastasis.

Timeline

Before adrenalectomy:

  • Diagnosis of pheochromocytoma
  • Preoperative management, including potentially receiving alpha-blocker therapy
  • Imaging studies to determine the location and size of the tumor
  • Intraoperative cardiovascular instability, such as hypertensive episodes and arrhythmias
  • Surgical procedure to remove the adrenal gland

After adrenalectomy:

  • Immediate postoperative period with monitoring for complications
  • Survival to discharge from the hospital
  • Long-term survival with follow-up ranging from 6 to 1653 days
  • Monitoring for recurrence or metastasis of the tumor, suspected in a small number of cases

Overall, most dogs in the study survived the immediate postoperative period and achieved long-term survival with a low reported incidence of tumor recurrence or metastasis. Preoperative alpha-blocker therapy was not found to be associated with increased survival. These findings can help guide treatment decisions for dogs with pheochromocytomas.

What to Ask Your Doctor

  1. What are the risks and benefits of undergoing adrenalectomy for pheochromocytoma?
  2. How will my preoperative management be handled, including any necessary imaging studies?
  3. What potential intraoperative complications should I be aware of, such as cardiovascular instability?
  4. Will I need to take an alpha-blocker before surgery, and if so, what are the potential effects of this medication?
  5. What is the expected outcome in terms of short-term and long-term survival after adrenalectomy?
  6. What is the typical recovery process like after adrenalectomy?
  7. What follow-up care or monitoring will be needed after the surgery to check for recurrence or metastasis?
  8. Are there any alternative treatment options for pheochromocytoma that I should consider?
  9. How experienced is the surgical team in performing adrenalectomies for pheochromocytoma?
  10. Are there any lifestyle changes or medications that I will need to take after the surgery to manage any ongoing symptoms or complications?

Reference

Authors: Enright D, Dickerson VM, Grimes JA, Townsend S, Thieman Mankin KM. Journal: Vet Surg. 2022 Apr;51(3):438-446. doi: 10.1111/vsu.13771. Epub 2022 Feb 9. PMID: 35141905