Suspected pheochromocytoma

Hello, The abdomen ecography of my dog (zwergschnauzer, 12.6 yo, PU/PD and tachypnoea since April 2024) has shown an adrenal mass (right suprarenal gland) invading both the caudal vena cava and phrenicoabdominal vein+left adrenal gland is larger than normal. It’s been excluded that the mass produces cortisol, so the next step is to verify pheochromocytoma. If this was the diagnosis, I’m first of all afraid of having my dog undergo CT scan with a pheochromocytoma, as it requires anesthesia… then I would be worried about Fine Needle Aspiration… should I look for an oncologist before doing all this? Is my dog risking more without doing anything than having surgery? What would you do? Thank you.  

Hello I dont know much about your dog, their condition or your vet, so I am not the best person to ask.  However, I can tell you the questions that will help you to organise your thoughts.  Here they are: 1) Why is the sample needed? Are you already sure that this is a phaeochromocytoma? What else could it be? 2)  How might knowing what the sample is, change what you do next?  (Ie The benefits of finding out.  If it turns out not to be what they think it is, what will they do differently?  How does that affect the likely survival chances?) 3) What might the potential costs of the procedure be?  How would having a specialist involved at this earlier time affect those costs?  - I'm not just talking about money here, although we know that that's important and vets will usually be direct about money if you ask them, because it needs to be discussed.  But there are also costs such as:  will referral to a specialist for these tests result in a better job being done?  How confident is your vet in their ability to cope with the anaesthetic and take those samples as the specialist would like them?   Will you have to travel to see a specialist? Likely there is no 'right' and 'wrong' answer, but a delicate decision to be made.  If you meet the specialist, you will likely go through this again.  Clinically, there are big advantages to getting a specialist involved as soon as possible, as they will have more experience with which to answer any questions you have eg about medium to long term outlook.  In light of this, if money were no object and it were offered or encouraged, I would generally be keen to see the specialist as early as I could.  But of course I do not know the vets concerned or the circumstances and the answer would be very different if my general vet was very experienced or well advised, or if there were to be huge differences involved and so on.  Please do let me know what happens next in this interesting case.