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Risk factors influencing death prior to discharge in 302 dogs undergoing unilateral adrenalectomy for treatment of primary adrenal gland tumours |
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| Authors: | Hunter J Piegols Brittany E Abrams Janis M Lapsley Megan T Cray Josephine A Dornbusch Christina Murphy Brandan G Wustefeld-Janssens Carlos H Souza Marine Traverson Pierre Amsellem Elroy Williams Owen T Skinner Julius M Liptak Julie A Stephens Laura E Selmic |
| Institution: | 1. The Ohio State University Veterinary Medical Center, The Ohio State University, Columbus, Ohio, USA;2. The Ohio State University Veterinary Medical Center, The Ohio State University, Columbus, Ohio, USA
Ryan Veterinary Hospital, Unviersity of Pennsylvania, Philadelphia, Pennsylvania, USA;3. The Ohio State University Veterinary Medical Center, The Ohio State University, Columbus, Ohio, USA Angell Animal Medical Center, Boston, Massachusetts, USA;4. Angell Animal Medical Center, Boston, Massachusetts, USA;5. Texas A&M University Small Animal Teaching Hospital, Texas A&M University, College Station, Texas, USA;6. UF Small Animal Hospital, University of Florida, Gainesville, Florida, USA;7. NC State Veterinary Hospital, North Carolina State University, Raleigh, North Carolina, USA;8. The University of Minnesota Veterinary Medical Center, University of Minnesota, St. Paul, Minnesota, USA;9. University of Missouri Veterinary Health Center, University of Missouri, Columbia, Missouri, USA;10. VCA Canada Alta Vista Animal Hospital, Ottawa, Ontario, Canada;11. Center for Biostatistics, Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, Ohio, USA |
| Abstract: | Adrenalectomies for canine adrenal tumours are associated with peri-operative morbidity and mortality. Objectives of this study included assessing the prognostic value of tumour- or surgery-related variables in predicting peri-operative mortality and overall survival in dogs undergoing adrenalectomies for primary adrenal tumours as well as pre-treatment with phenoxybenzamine on survival to discharge with pheochromocytomas specifically. A multi-institutional retrospective cohort study was performed across nine institutions. Electronic medical record searches identified 302 dogs which met the inclusion criteria. Data collected included dog-related, tumour-related, treatment-related, surgery-related, and outcome variables. Univariate and multivariable logistic regression and cox proportional hazards models were used to identify variables associated with death prior to discharge and tumour-related survival. Overall, 87% of dogs survived to discharge with a tumour-related survival time of 3.96 years. Post-operative complications were reported in 25%. Increased surgical time (p = 0.002) and pre-surgical medical treatment other than phenoxybenzamine (p = 0.024) were significantly associated with increased peri-operative mortality while ureteronephrectomy (p = 0.021), post-operative pancreatitis (p = 0.025), and post-operative aspiration pneumonia (p < 0.001) were significantly associated with decreased overall survival. Phenoxybenzamine pretreatment had no effect on peri-operative mortality. Thirty-seven of 45 (82%) dogs with pheochromocytomas not pretreated survived to discharge, and 50 of 59 (85%) dogs with pheochromocytomas pretreated with phenoxybenzamine survived to discharge (p = 0.730). This study provides information on risk factors for death prior to discharge and tumour-related survival that may help guide clinical management and owner expectations. In addition, the study findings challenge the previously reported benefit of phenoxybenzamine for pretreatment of dogs undergoing adrenalectomies for pheochromocytomas. |
| Keywords: | adrenal glands adrenalectomy dogs phenoxybenzamine pheochromocytoma |