Thank you Dr. Bruce, for all of your info re: Fang's dilemma.  I was
extremely confused after reading your last response, but was grateful for
the education.  My final (you hope) questions to unclog my cluttered,
frustrated, (and sad) head:
 
You believe that if the vet had taken a small biopsy of some of Fang's
tissue, we would know whether or not the Pred would help or hurt.  You also
stated that you were pretty sure it was NOT insulinoma related with his BG
at 200 now (on the pred).  We know that pred helps insulinoma, but in what
condition does Pred HURT?  (other than the nasty side effects) The only
experience I've had with it doing harm is when he was in his diabetic
phase.  I know it is very bad for a really high BG.
 
Your first guess was that the tumor might be a metastatic adrenal tumor.
Could this happen in the liver area if the remaining adrenal didn't look
that bad, and Fang has minimal adrenal symptoms?  Just a thinning of the
hair around his rump.  (No real balding), but he does have increased
lethargy, and some litter box confusion.  No aggression or personality
changes.  The vet said that he didn't think the adrenal condition looked
bad enough to cause swelling of the prostate.  So the adrenal gland itself
doesn't have to be in a horrible condition in order for a metastatic
adrenal tumor to go to the liver?
 
If the tumor IS metastatic adrenal, would going with lupron do any good?
I know it just treats the symptoms, and not the tumor.  My vet wanted to
save me the money, due to the fact that he sincerely believed he only had
a month to live.
 
I feel I should explain (and in a way, defend) the minimal explanations the
vet shared the day we found the tumor.  He has followed Fang's health since
his major surgery last Feb.and knows how emotional and concerned that I am
about Fang.  That day that he found the tumor, I had told him not to touch
the liver in any way due to his bleeding episode last Feb....(we believe it
had been due to the biopsy of the liver at that time; he didn't clot, and
we almost lost him).  The vet said this time there was no safe way to take
a piece of the tumor on the liver, especially since I was adamant about not
putting Fang at risk.
 
I do wish he had taken a tissue sample, but the bottom line was that he
didn't see the use of putting Fang and us through any more pain, stress,
and (yes, money) than we needed to, due to the fact that the tumor was so
large; there was no use in raising false hopes of any cure.  Now, after
talking with you, I wish that he had taken a biopsy of something!  (would
a tissue biopsy have done any good if not taken directly from the tumor
itself?) Couldn't the tumor on the liver be totally unrelated to any teeny
nodules any where else that might have been biopsied?  (We had originally
opened him up to do a nodulectomy on the pancreas)..
 
I don't know what our choice of treatment at this point could have been,
other than pred.  I wouldn't have put him through any radical lymphoma
treatment after all that he has suffered in his little lifetime.  As the
vet and you agreed, I just need to make him feel the best that he can.  If
you feel that raising the pred back up to one ml.  twice a day is the best
thing, then that is what we'll do starting today.  Please forgive my
misunderstandings and ceaseless questions.  I know I should be asking my
vet these things, but since we found the tumor, we didn't beat it into the
ground anymore.  More of an acceptance kind of thing.  (Then, I get home
and decide to bombard you instead).  I am sorry, but so grateful for all of
the time you have taken for little Fang.
 
God Bless you,
lizzi
[Posted in FML issue 3297]