• 1.

    Anderson CR, Birchard AJ, Powers BE, et al. Surgical treatment of adrenocortical tumors: 21 cases (1990–1996). J Am Anim Hosp Assoc 2001;37:9397.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 2.

    Culvenor J. Surgery in the treatment of canine hyperadrenocorticism 1. Adrenalectomy. Aust Vet J 2003;81:3435.

  • 3.

    Scavelli TD. Endocrine system. In: Bojrab MJ, ed. Current techniques in small animal surgery. 4th ed. Baltimore: The Williams & Wilkins Co, 1998;539542.

    • Search Google Scholar
    • Export Citation
  • 4.

    Waters CB, Scott-Moncrieff JCR. Cancer of endocrine origin. In: Morrison WB, ed. Cancer in dogs and cats, medical and surgical management. 2nd ed. Jackson, Wyo: Teton NewMedia, 2002;573609.

    • Search Google Scholar
    • Export Citation
  • 5.

    Barthez PY, Marks SL, Woo J, et al. Pheochromocytoma in dogs: 61 cases (1984–1995). J Vet Intern Med 1997;11:272278.

  • 6.

    Kyles AE, Feldman EC, De Cock HEV, et al. Surgical management of adrenal gland tumors with and without associated tumor thrombi in dogs: 40 cases (1994–2001). J Am Vet Med Assoc 2003;223:654662.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7.

    Scavelli TD, Peterson ME, Matthiesen DT. Results of surgical treatment for hyperadrenocorticism caused by adrenocortical neoplasia in the dog: 25 cases (1980–1984). J Am Vet Med Assoc 1986;189:13601364.

    • Search Google Scholar
    • Export Citation
  • 8.

    Lucon AM, Pereira MA, Mendonca BB, et al. Adrenocortical tumors: results of treatment and study of Weiss's score as a prognostic factor. Rev Hosp Clin Fac Med Sao Paulo 2002;57:251256.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 9.

    Platt SR. Neuromuscular complications in endocrine and metabolic disorders. Vet Clin North Am Small Anim Pract 2002;32:125146.

  • 10.

    Gilson SD, Withrow SJ, Wheeler SL, et al. Pheochromocytoma in 50 dogs. J Vet Intern Med 1994;8:228232.

  • 11.

    Meyer DJ, Harvey JW. Laboratory medicine testing: specimen interferences and clinical enzymology. In: Meyer DJ, Harvey JW, eds. Veterinary laboratory medicine: interpretation and diagnosis. 2nd ed. Philadelphia: WB Saunders Co, 1998;321.

    • Search Google Scholar
    • Export Citation
  • 12.

    Reusch CE. Hyperadrenocorticism. In: Ettinger SJ, Feldman EC, eds. Textbook of veterinary internal medicine: diseases of the dog and cat. 6th ed. St Louis: Elsevier Inc, 2005;15921612.

    • Search Google Scholar
    • Export Citation
  • 13.

    Mitchell IC, Nwariaku FE. Adrenal masses in the cancer patient: surveillance or excision. Oncologist 2007;12:168174.

  • 14.

    Kintzer PP, Peterson ME. Mitotane treatment of 32 dogs with cortisol-secreting adrenocortical neoplasms. J Am Vet Med Assoc 1994;205:5461.

    • Search Google Scholar
    • Export Citation
  • 15.

    Feldman EC. Hyperadrenocorticism. In: Ettinger JE, Feldman EC, eds. Textbook of veterinary internal medicine: diseases of the dog and cat. 5th ed. Philadelphia: WB Saunders Co, 2000;14601488.

    • Search Google Scholar
    • Export Citation
  • 16.

    Guyton AC, Hall JE. Adrenocortical hormones. In: Guyton AC, Hall JE, eds. Textbook of medical physiology. 11th ed. Philadelphia: Elsevier Inc, 2006;944960.

    • Search Google Scholar
    • Export Citation
  • 17.

    Welch TJ, Sheedy PF, Stephens DH, et al. Percutaneous adrenal biopsy: review of a 10-year experience. Radiology 1994;193:341344.

  • 18.

    Barthez PY, Nyland TG, Feldman EC. Ultrasonography of the adrenal glands in the dog, cat, and ferret. Vet Clin North Am Small Anim Pract 1998;28:869885.

    • Crossref
    • Search Google Scholar
    • Export Citation

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Evaluation of prognostic factors in the surgical treatment of adrenal gland tumors in dogs: 41 cases (1999–2005)

Pamela SchwartzAnimal Medical Center, 510 E 62nd St, New York, NY 10021.

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Janet R. KovakAnimal Medical Center, 510 E 62nd St, New York, NY 10021.

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Alexandra KoprowskiAnimal Medical Center, 510 E 62nd St, New York, NY 10021.

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Lori L. LudwigVeterinary Surgical Care LLC, 930A Pine Hollow Rd, Mt Pleasant, SC 29464.

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Sebastien MonetteAnimal Medical Center, 510 E 62nd St, New York, NY 10021.

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Philip J. BergmanAnimal Medical Center, 510 E 62nd St, New York, NY 10021.

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Abstract

Objective—To identify preoperative predictors of survival and assess intraoperative and postoperative complications and survival rates for dogs undergoing adrenalectomy.

Design—Retrospective case series.

Animals—41 dogs that underwent adrenalectomy.

Procedures—Records were reviewed to collect data regarding preoperative variables. Intraoperative and postoperative variables were also recorded. Variables were evaluated for association with survival duration via log-rank analysis for categoric variables and by use of Cox proportional hazards. Median survival times were calculated by use of Kaplan-Meier life table analysis.

Results—9 (22.0%) dogs did not survive to discharge. Intraoperative mortality rate was 4.8%. Overall Kaplan-Meier median survival time was 690 days. Variables significantly associated with shorter survival times included preoperative weakness or lethargy, thrombocytopenia, increased BUN concentration, increased partial thromboplastin time (PTT), increased aspartate transaminase (AST) activity, hypokalemia, intraoperative hemorrhage, and concurrent nephrectomy. Postoperative variables significantly associated with shorter survival times included pancreatitis and renal failure. In multivariate analysis, preoperative hypokalemia, preoperative increased BUN concentration, and concurrent nephrectomy were significantly associated with a shorter survival time.

Conclusions and Clinical Relevance—A high mortality rate was associated with adrenalectomy in dogs; however, those that survived until discharge from a hospital had long survival times. Preoperative factors associated with a shorter survival time were weakness or lethargy, thrombocytopenia, increased BUN concentration, increased PTT, increased AST activity, and hypokalemia. Studies are needed to evaluate how treatment for these factors may affect or change outcome after adrenalectomy. Dogs with adrenal masses that require concurrent nephrectomy and cause intraoperative hemorrhage have a guarded prognosis.

Abstract

Objective—To identify preoperative predictors of survival and assess intraoperative and postoperative complications and survival rates for dogs undergoing adrenalectomy.

Design—Retrospective case series.

Animals—41 dogs that underwent adrenalectomy.

Procedures—Records were reviewed to collect data regarding preoperative variables. Intraoperative and postoperative variables were also recorded. Variables were evaluated for association with survival duration via log-rank analysis for categoric variables and by use of Cox proportional hazards. Median survival times were calculated by use of Kaplan-Meier life table analysis.

Results—9 (22.0%) dogs did not survive to discharge. Intraoperative mortality rate was 4.8%. Overall Kaplan-Meier median survival time was 690 days. Variables significantly associated with shorter survival times included preoperative weakness or lethargy, thrombocytopenia, increased BUN concentration, increased partial thromboplastin time (PTT), increased aspartate transaminase (AST) activity, hypokalemia, intraoperative hemorrhage, and concurrent nephrectomy. Postoperative variables significantly associated with shorter survival times included pancreatitis and renal failure. In multivariate analysis, preoperative hypokalemia, preoperative increased BUN concentration, and concurrent nephrectomy were significantly associated with a shorter survival time.

Conclusions and Clinical Relevance—A high mortality rate was associated with adrenalectomy in dogs; however, those that survived until discharge from a hospital had long survival times. Preoperative factors associated with a shorter survival time were weakness or lethargy, thrombocytopenia, increased BUN concentration, increased PTT, increased AST activity, and hypokalemia. Studies are needed to evaluate how treatment for these factors may affect or change outcome after adrenalectomy. Dogs with adrenal masses that require concurrent nephrectomy and cause intraoperative hemorrhage have a guarded prognosis.

Contributor Notes

Dr. Bergman's present address is BrightHeart Veterinary Centers, 80 Business Park Dr, Ste 110, Armonk, NY 10504.

Presented in part at the 2007 American College of Veterinary Surgeons Veterinary Symposium, Chicago, October 2007.

Address correspondence to Dr. Schwartz.