Our Summary

This research paper explores the risks and results of dogs undergoing surgery to remove adrenal tumors. The researchers looked at medical records from multiple institutions and found 302 dogs that met their criteria for the study. They had two main goals: to identify factors that might predict which dogs were at higher risk of dying during or shortly after surgery, and to examine how well dogs survived in the long term after having the tumor removed.

The study found that 87% of dogs lived to be discharged from the hospital, and on average, dogs lived for roughly 4 years after having the tumor removed. However, 25% of dogs experienced complications after surgery. The researchers discovered that dogs were more likely to die during or shortly after surgery if they had a longer surgery or if they received certain types of medical treatment before surgery. They also found that dogs were less likely to survive in the long term if they needed additional surgery on their ureter and kidney, or if they developed pancreatitis or aspiration pneumonia after surgery.

An additional part of the study looked at the use of a drug called phenoxybenzamine before surgery in dogs with a specific type of adrenal tumor called pheochromocytomas. Results showed that this pretreatment did not affect whether dogs lived to be discharged from the hospital. This challenges previous beliefs that this drug could be beneficial for these dogs.

In simple terms, this study helps us understand what factors might increase the risk for dogs undergoing surgery for adrenal tumors, and it also questions the usefulness of a specific drug in treating a certain type of adrenal tumor in dogs. This information could help vets better manage these cases and set more accurate expectations for dog owners.

FAQs

  1. What factors were found to be associated with increased peri-operative mortality in dogs undergoing adrenalectomies for primary adrenal tumours?
  2. Did pre-treatment with phenoxybenzamine have any effect on peri-operative mortality for dogs with pheochromocytomas undergoing adrenalectomies?
  3. What percentage of dogs survived to discharge after undergoing adrenalectomies for primary adrenal tumours, according to this study?

Doctor’s Tip

One helpful tip a doctor might tell a patient about adrenalectomy is to carefully follow all pre-operative instructions provided by the medical team. This may include specific dietary restrictions, medication protocols, and lifestyle adjustments to ensure the best possible outcome from the surgery. Additionally, it is important to communicate openly with the medical team about any concerns or questions before and after the procedure.

Suitable For

Patients who are typically recommended adrenalectomy include dogs with primary adrenal tumours, specifically pheochromocytomas. Other factors that may warrant adrenalectomy in patients include the presence of symptoms such as hypertension, hyperadrenocorticism, or other hormone imbalances. Additionally, patients who have failed to respond to medical management or have large, potentially malignant adrenal tumours may also be candidates for adrenalectomy. It is important for veterinarians to consider the overall health and prognosis of the patient when recommending adrenalectomy as it is associated with peri-operative morbidity and mortality.

Timeline

  • Before adrenalectomy:
  1. Initial diagnosis of primary adrenal tumour in the dog.
  2. Assessment of tumour-related variables and potential surgical treatment options.
  3. Pre-treatment with medications such as phenoxybenzamine in cases of pheochromocytomas.
  4. Evaluation of the dog’s overall health and suitability for surgery.
  5. Surgical planning and preparation for adrenalectomy.
  • After adrenalectomy:
  1. Peri-operative mortality and survival outcomes are assessed.
  2. Monitoring for post-operative complications such as pancreatitis and aspiration pneumonia.
  3. Follow-up care and management to ensure proper healing and recovery.
  4. Long-term monitoring for tumour recurrence and overall survival.
  5. Evaluation of the effectiveness of pre-treatment with medications like phenoxybenzamine on survival outcomes.

What to Ask Your Doctor

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

  1. What are the potential risks and complications of adrenalectomy?
  2. How long is the recovery process after adrenalectomy?
  3. Will I need any special medications or treatments before or after the surgery?
  4. How will adrenalectomy impact my overall health and well-being?
  5. Are there any alternative treatments to adrenalectomy that I should consider?
  6. How often will I need follow-up appointments after the surgery?
  7. What is the success rate of adrenalectomy for my specific condition?
  8. Will I need to make any lifestyle changes after the surgery?
  9. Are there any long-term effects or complications associated with adrenalectomy?
  10. How experienced is the surgical team in performing adrenalectomies?

Reference

Authors: Piegols HJ, Abrams BE, Lapsley JM, Cray MT, Dornbusch JA, Murphy C, Wustefeld-Janssens BG, Souza CH, Traverson M, Amsellem P, Williams E, Skinner OT, Liptak JM, Stephens JA, Selmic LE. Journal: Vet Comp Oncol. 2023 Dec;21(4):673-684. doi: 10.1111/vco.12931. Epub 2023 Aug 31. PMID: 37652746