Message Number: SG15360 | New FHL Archives Search
Date: 2005-09-15 14:14:18 UTC
Subject: Re:Adrenal and renal cyst
Message-ID: <>

Hi Dr. Murray and everyone else,

Unfortunately, the operation had been postponed to today, and I'm afraid I =
don't have very much good news...
The left adrenal has been removed and she came through surgery just "fine" =
We found several other things, besides the adrenal tumour...:

-her right kidney had a cyst, as we already knew from the ultrasound, but d=
idn't look particularly bad. Her left kidney though, was shriveled. =

--> I guess this explains the high BUN...
BUN 106mg/dl definitely TOO HIGH
Creatinin 0,44 mg/dl

-her liver showed a huge cyst, which was drained. There were also several =
very small hard nodules, with a lot of pigment in them
--> Could this explain the AST? Although this isn't VERY high, is it?
Gamma-GT 7U/L
ALK PHOS 29U/L normal but on the high side

-her pancreas showed a group of several white nodules, too many to take the=
m away, as she wouldn't keep enough pancreas left...
--> They didn't think these were insulinoma's per se, they thought it could=
just be hyperplastic nodules. =

Her GLUCOSE was 68mg/dl after a 4 =E0 4,5 hour fasting period, they thought=
this wasn't indicative for insulinoma. But I AM worried that this might be=
a bit too low after all...?

-the pylorus of her stomach was severely thickened, they were thinking of a=
n adenocarcinoma. The gastric (?) lymph node was also very much swollen. =

--> Is there anything in the bloodwork that can point us to this? They were=
talking about a surgery procedure, used in cats and dogs, in which the dis=
eased part is removed and the remaining part of the stomach is connected to=
the duodenum, but they didn't know immediately if this had been done in fe=
rrets before, or even if this would be feasible...? Does anyone know what t=
o think of this? =

Could helicobacter play a role in this? =

So the left adrenal has been removed, and they have taken a biopsy from the=
stomach and the liver. But I'm quite taken by surprise right now and don'=
t really know what to do... I had hoped she would've been fine with removin=
g the adrenal and supporting the kidneys in the way Dr. Murray indicated (m=
aybe even in combination with enalapril or benazepril?). But they even see=
med reluctant to treat the kidney right now, when I asked them about it(may=
be in order to not put too much stress on the liver?) =

All help/insights are and will be very much appreciated!

thanks in advance, once again


PS: I have included the entire bloodwork below, in order to make it more ea=
sy to maybe check things out

-Hemoglobin 11,4 g/dl TOO LOW (but not as low as a month ago)
-PCV 39,0% slightly TOO LOW according to some references, normal accoring t=
o others)

-erythrocytes 6,72 10^12/l (slightly?) TOO LOW
MCV 58,1 fl
MCH 16,9pg
MCHC 29,1g/dl
RDW 13,1%

-WBC 3,2 10^9/l normal
-neuthrophils 0,0% (these are the ones with the non-segemented nucleus, I d=
on't know how to translate it)
-neutrophils (segmented) 60,7% TOO HIGH according to some??
-lymphocytes 33,7%
-Monocytes 2,1%
-Basophils 0,2%
-Eosinophils 3,3%
-Morphology RBC/WBC/PLT normal

(the different WBC's are also listed in 10^6/l and /cmm instead of as%, if =
you need to see those also, please ask)

-Reticulocytes 2,5%

-Sodium 151mEq/l
-Potassium 4,8mEq/l
-Chloride 116mEq/l
-BUN 106mg/dl definitely TOO HIGH
-Creatinin 0,44mg/dl normal
-Tot. Protein 6,0g/dl or 60g/l normal this time, although on the high side
-Albumin 2,64g/dl or 26,4g/l normal or TOO LOW???

-Gamma-GT 7U/L
-ALK PHOS 29U/L normal but on the high side
-Glucose 68mg/dl normal according to the refs, but maybe TOO LOW according =
to me... ?? She doesn't have symptoms though, she fasted for 4 hours before=
the bloodwork was done)

Estradiol 920pmol/l or 250pg/ml DEFINITELY MUCH TOO HIGH