Our current understanding of adrenal function is still at its infancy at best. It is therefore very difficult for any health professional to have a good grasp of the Adrenal Fatigue condition from a purely pathological and physiological perspective. The number of physicians with true expertise in advanced Adrenal Fatigue is very small. Those who are good in this gain their expertise not from textbooks, but from years of clinical experience. There is no short cut, because text-book cases are few and far between. Because the full recovery cycle can take years to complete in severe cases, practitioners with little experience will find it hard to handle cases other than the most mild and straight forward ones.
In a study of 40 dogs by Kyles, the short-term mortality rate was evaluated in regards to the presence of caval tumor thrombus. Reportedly, tumor thrombus was seen in 25% of all dogs. Eleven percent of adenocarcinomas had tumor thrombus and 55% of pheochromocytomas had tumor thrombus. As mentioned there was no difference in the perioperative death rate regardless of presence or absence of tumor thrombus. The perioperative death rate was 21% for adenocarcinomas and 18% for pheochromocytomas. Previously, pheochromocytomas patients have a high perioperative mortality rate, but the addition of protocols that include administration of high doses of phenoxybenzamine (as high as mg/kg twice daily) have reduced the death rate.