Message Number: YG5143 | New FHL Archives Search
From: Alicia D. Beth
Date: 2001-07-04 15:35:00 UTC
Subject: Vets: Need advice on difficult adrenal case (vascular
surgery, caval ligation, cryosurgery, etc.) -- PLEASE HELP!

Hello to all ferret-lovers,

This post is lengthy, but we are in a bit of a dire situation and would
appreciate absolutely *any* feedback...

One of my ferrets, Florian, is an altered male silver-mitt who just turned
3. Since about December 2000, my husband and I have suspected an adrenal
problem, due to a tiny bit of hair loss at the tip of his tail (no other
symptoms). After 3 trips to our veterinarian (and 5 normal glucose
levels), an adrenal panel indicated that our suspicions were
well-founded. On Monday (7/2/01), Florian went in for what we thought
would be an adrenalectomy. While in surgery, the vet called me to let me
know that Florian has a tumor in a very precarious place on the right
adrenal (nothing on the left and no insulinoma that we know
of). Apparently, the tumor is wrapped around his vena cava and may even be
invading it. The vet offered me 3 choices. He could:

1. attempt to remove the entire tumor (he suggested a very high risk of
hemorrhage and/or death).
2. de-bulk the tumor (he suggested a high risk of hemorrhage/death even
with this option).
3. biopsy the tumor and refer Florian to a vascular microsurgeon.

Our vet suggested that the safest and best chance for Florian was option
#3, so this is what we chose to do. In the end, our vet was not even able
to biopsy the tumor, as he thought it too risky to even attempt since the
tumor is buried under the adrenal, wrapped around the vena cava, and all
*approachable* tissue appeared normal.

So... after an exhausting and painful surgery (Florian's on .04 cc's
torbutrol/pettinic every 8 hours), nothing was accomplished, and my ferret
was closed back up. This is quite frustrating to us, since we've been
trying to get this fixed for about 6 months and have spent $700-800 in the
process (although money is not the issue, as my husband and I are both firm
believers that the responsibility of adopting animals requires that one
also adopt the financial and emotional responsibility of caring for them

Now, our vet is referring Florian to another vet (who, I'm assuming, has
experience in vascular microsurgery) at the 24-hours clinic that his
veterinary hospital uses for after-hours care. I've been researching
Florian's situation, however, and am wondering a few things. I suppose my
questions are these:

1. Is traditional vascular surgery the best/safest route, or should we
pursue someone who might be able to perform a caval ligation, cryosurgery,
or some other procedure?
2. I understand that caval ligation is only possible if collateral
circulation has been established, so we would need to find a veterinarian
in our area (Austin, Texas) who is experienced in identifying whether this
has happened. Any ideas on how to go about doing that? Would it ever be
the case that we should *wait* for collateral circulation to develop before
attempting surgery?
3. How accepted a procedure is cryosurgery? If we decided to go that
route, what are our chances of finding an experienced cryosurgeon in our
area? And how would we go about finding one?
4. Is anyone aware of any other medical/surgical options that would give
Florian a good chance for life? We're open to absolutely *any*
suggestions, and we'd love to hear as many perspectives as possible (either
on- or off-list).

We're just not ready to lose our sweet boy! Thanks so much for reading
this lengthy post,
Alicia and Bradley Beth