Our Summary

This research paper examines the results of surgery on dogs and cats who experienced a ruptured adrenal gland, which was usually caused by a tumor. The study looked at 59 dogs and 3 cats who underwent this surgery between 2000 and 2021.

The results showed that 34% of surgeries were done as emergency cases, and these were more likely to need blood transfusions. The complication and death rates in the short term (14 days or less) were 42% and 21% respectively. Factors that made short-term survival less likely included emergency surgeries, low blood pressure during surgery, and having more than one surgical procedure.

The causes of the adrenal rupture varied, with 41% being malignant (cancerous) tumors, 12% benign (non-cancerous) tumors, and 5% undetermined. About 38% were caused by a tumor type called pheochromocytoma. There were also single cases of adrenal fibrosis and hemorrhage, and of a cancer type called hemangiosarcoma.

The average survival time after surgery was 574 days, or about a year and a half. However, if the animals that died shortly after surgery were excluded, the average survival time increased to 900 days, or about two and a half years. The type of tumor didn’t significantly affect survival time.

The study concludes that surgery for ruptured adrenal gland tumors had comparable short- and long-term outcomes to those reported for non-ruptured cases. It suggests that when possible, delaying surgery and limiting additional procedures could increase short-term survival.

FAQs

  1. What factors made short-term survival less likely for dogs and cats who underwent surgery for a ruptured adrenal gland?
  2. What were the common causes of adrenal rupture in the study and did the type of tumor significantly affect survival time?
  3. Does the study suggest any strategies to increase short-term survival for animals undergoing surgery for a ruptured adrenal gland?

Doctor’s Tip

One helpful tip a doctor might tell a patient about adrenalectomy is to follow all pre-operative instructions carefully, such as fasting before surgery and stopping certain medications as directed by the surgeon. Additionally, it is important to discuss any concerns or questions with the medical team to ensure a successful outcome. After surgery, following post-operative care instructions diligently, such as taking prescribed medications and attending follow-up appointments, is crucial for a smooth recovery.

Suitable For

Adrenalectomy is typically recommended for patients with adrenal gland tumors, specifically those that are causing symptoms such as hormone imbalances or are at risk of rupturing. In the case of this study, dogs and cats with ruptured adrenal glands due to tumors were recommended for adrenalectomy to address the immediate health risks associated with the condition.

Additionally, patients who are not responding to other treatments for adrenal gland tumors or who have tumors that are suspected to be malignant may also be recommended for adrenalectomy. The study found that a significant portion of the cases involved malignant tumors, indicating the importance of surgical intervention in managing these types of tumors.

Overall, patients who are experiencing symptoms related to adrenal gland tumors or who are at risk of complications such as rupture may be recommended for adrenalectomy to improve their quality of life and overall prognosis.

Timeline

Before adrenalectomy:

  • Patient presents with symptoms such as abdominal pain, weight gain, high blood pressure, and hormonal imbalances.
  • Imaging tests such as CT scans or MRIs are performed to diagnose the issue.
  • Blood tests are conducted to assess hormone levels and overall health.
  • Patient undergoes pre-operative evaluations and consultations with the surgical team.

After adrenalectomy:

  • Patient undergoes surgery to remove the affected adrenal gland.
  • Post-operative care includes monitoring for complications such as bleeding, infection, and hormone imbalances.
  • Patient may require pain management and hormone replacement therapy.
  • Follow-up appointments are scheduled to monitor recovery and hormone levels.
  • Long-term monitoring for recurrence of tumors or other complications may be necessary.

What to Ask Your Doctor

Some questions a patient should ask their doctor about adrenalectomy include:

  1. What are the risks and potential complications associated with adrenalectomy?
  2. How long is the recovery period after adrenalectomy and what can I expect during this time?
  3. Will I need to take any medications or make lifestyle changes after the surgery?
  4. What is the success rate of adrenalectomy in treating adrenal gland tumors?
  5. Are there any alternative treatment options to adrenalectomy that I should consider?
  6. How often will I need follow-up appointments or tests after the surgery?
  7. What is the typical survival rate for patients who undergo adrenalectomy for adrenal gland tumors?
  8. Are there any specific factors about my case that could affect the outcome of the surgery?
  9. Will I need to make any dietary or activity restrictions before or after the surgery?
  10. Can you provide me with more information about the specific type of tumor causing the adrenal rupture in my case?

Reference

Authors: Traverson M, Zheng J, Tremolada G, Chen CL, Cray M, Culp WTN, Gibson EA, Oblak ML, Dickerson VM, Lopez DJ, Maxwell EA, Ansellem P, Skinner OT, Selmic LE. Journal: J Am Vet Med Assoc. 2023 Sep 21;261(12):1-9. doi: 10.2460/javma.23.06.0324. Print 2023 Dec 1. PMID: 37734721