Lola is a 13 years young adorable Labrador that came for a visit to London Vet Specialists as she was not feeling quite right. She had been having polyuria and polydipsia (increased thirst and urinations) and the owners were concerned she may have a urinary infection. Her primary care veterinarian, Dr. Chris Maguire, from Highbury Village Vet performed blood and urine tests and then Lola was referred for advance imaging with our specialist, Dr. Ian Jones. An abdominal ultrasound and CT scan revealed much more than a mild urinary infection. Instead an invasive mass of her right adrenal gland (first image) as well as a large splenic mass (second image) was identified.
This was scary news for the owners, so they turned to specialist surgeon, Dr. Janet Kovak Mcclaran for advice on how best to proceed. They weighed the pros and cons of surgery and decided to remove both masses, rather than risk them growing, bleeding or spreading. Adrenal tumours can be tricky to remove due to the location (between the kidney and the caudal vena cava), with a risk of life-threatening bleeding. Additionally, they secrete hormones that can affect blood pressure and adrenaline levels making general anaesthesia a challenge.
Surgical planning involved most of our specialists: Dr Jones created a 3D reconstruction of the images from the CT scan to create a visual map for the procedure; Dr Hannah Darcy our specialist in Internal Medicine created an extensive protocol for medical treatment before and after surgery to stabilise her hormone levels; Dr David Nelson, anaesthesiology specialist, deftly prepared for the complex procedure, administering multiple intra-operative infusions to manage her blood pressure, hormonal changes and pain during surgery as we can see in this picture:
Finally, our Soft Tissue Team, led by Dr Janet McClaran, performed the delicate procedure to remove the spleen and carefully tease the adrenal mass away from the caudal vena cava.
The procedure was a success and Lola spent several days recovering in hospital and with lots of medications and TLC. Finally, she was able to go home and within a week, the good news arrived from the laboratory: both of Lola’s masses were benign and surgery was therefore curative for Lola!