Laszlo is a beautiful Hungarian Viszla, who is a regular visitor at Vet4life. He has been awarded a Big Bear Award for bravery following an extensive investigation for an insatiable thirst and consequently a major operation in May.
At 11 years old Laszlo had seemed to be doing amazingly well despite his old age. He still loved exercise and would run several kilometres daily. However, over several months his owners started to notice that Laszlo was suffering from an increase in thirst (termed 'polydipsia'). Then, in early 2013, Laszlo began to lose weight.
Although he was a little underweight, Laszlo's physical examination was quite normal. A blood sample was collected for a general health profile and hormonal testing. Hormonal diseases, such as the common condition 'Cushings', are a potential cause of increased thirst. An ACTH stimulation test was performed. This test measures the body's level of cortisol, the hormone which is overproduced in Cushings disease. The result was normal and therefore Cushings disease was considered unlikely to be the cause of Laszlo's signs.
A general health profile was performed. A blood test screens the overall health of a patient; including screening of the liver, kidneys, blood glucose and red and white blood cells. Many potential causes of increased thirst, including liver disease, kidney failure and diabetes, were therefore ruled out based on this test's normal results.
The general health profile however, did reveal that Laszlo had a low level of potassium in his system ('hypokaelmia') and an increase in sodium ('hypernatremia'). These alterations may be caused by a change in the body's levels of mineralocorticoids- the hormones responsible for the balance of electrolytes in the body. These hormones are produced by a small organ that sits next to the kidney- the adrenal gland.
To further investigate, Ian performed an ultrasound of Lazlo's abdomen. He identified a large mass in the region of the left adrenal gland which was likely to be the cause of Laszlo's excessive thirst.
An exploratory surgery was undertaken to remove the mass. The laprascopic equipment was initially used to make an assessment of the structures involved via key-hole incision. The adrenal tumour was found to be very closely associated with the kidney and involved several major blood vessels. The tumor was carefully removed from the surrounding structures and organs. At last, after an hour and a half of painstaking surgery, the mass was successfully removed. Laszlo made a smooth recovery from his anaesthetic and went home the same day. Incredibly, within days, of the tumour's removal his thirst had returned to normal!
A diagnosis of adrenal gland carcinoma was made on histopathology. Unfortunately this tumour is malignant so Laszlo will require follow up checks to monitor for signs of recurrence. The most likely diagnosis for Laszlo is hyperaldosteronism 'Conn's syndrome'. In this rare condition there is an overproduction of the hormone aldosterone by an adrenal gland tumor. The high levels of this hormone lead to excessive thirst, high blood pressure and changes in potassium levels- all of which were seen in Laszlo's case.
Despite an initial slow recovery Laszlo is now doing excellently. He has gained weight and returned to his daily runs. We wish him all the best in his recovery and congratulate him on his Big Bear Award. What a brave boy!