From:
Dr. Bruce Williams
Date: 2001-03-05 13:02:00 UTC
Subject: Re: Bob C: Question for *ALL* the Vets regarding Adrenal
Disease (And anyone else with the knowledge)
Bob - Believe it or not, I didn't know the specifics of your thesis.
Very interesting.
I'm afraid I won't be too helpful on the subject of hairballs - as a
consultant pathologist, it is something that I rarely see - no one
needs to get an opinion on a hairball - I get lots and lots of
adrenals, but if the hairballs are there, I'm lucky to get a mention
of it in the clinical history. In fact, your numbers are somewhat of
a surprise to me - approximately 33% of your study animals have
hairballs - far more than my experience would show. Your assessment
makes logical sense, and perhaps laxatone administration (or the
previously mentioned idea of using a flea comb to collect loose
hairs, this time on adrenal cases, would be cost-effective.
Regarding the loss of bone mass in adrenal ferrets - it is very
difficult to ascertain bone mass via radiographs in clinical practice
due to the great variation in radiograph quality. This is magnified
in my instance, as I see radiographs from many practices - some
overexposed, some underexposed, etc. It is difficult to quantitate
bone density when radiograph quality is a significant variable. But
perhaps in a single practice where ferret radiographs were taken with
a very stringent exposure protocol.
It would be difficult to prove that bone loss is the direct result of
adrenal disease. Hypoestrogenism (the opposite of what happens in
ferrets) acounts for osteoporosis in humans. Most ferret adrenals do
not secrete appreciable amounts of cortisol, which might account for
some bone loss, if ferrets developed true Cushing's which they don't.
Other factors that need to be factored into bone loss in ferrets with
adrenal disease would be age, a sedentary lifestyle, and diminished
nutritional capacity associated with chronic inflammation of the GI
tract, etc. Plus, as you mentioned, intercurrent diseases like heart
disease and systemic neoplasia may also result in catabolism of
structural components, so those are additional variables to consider.
A difficult proposition at best!
I'll have to consider the part about the hairballs, though - soundw
like you are definitely onto something there.
With kindest regards,
Bruce Williams, DVM, DACVP
Join the Ferret Health List: http://groups.yahoo.com/group/Ferret-
Health-list
--- In Ferret-Health-list@y..., RRC <rrc961@m...> wrote:
> As some of you know, I a working on a morphometrics 'test' which
will
> separate populations of polecats from feral ferrets and pet
ferrets. As
> a result, I have taking hundreds of measurements from ferret
skeletons,
> which are duly donated for that purpose (they will be donated to the
> Smithsonian when the research is finished). I am also creating
a "photo
> catalog" of various bone pathologies. One shelter (which I leave
unnamed
> to prevent the type of animal activist letters I get on occasion)
> regularly donates between 20 and 40 ferrets a quarter, along with
notes
> to cause of death (when known).
>
> The first thing I do is a quick gross necropsy (they have all been
> frozen, so I am rather limited in what I can do), and measure things
> like body fat percentage, presence of lesions or lumps, skeletal or
> anatomic malformations, etc. The skeletal processing is as benign as
> possible, but I won't detail it here for obvious reasons of taste.
One
> of the things I do is open the gastrointestinal tract to look for
> hairballs or foreign objects, as well as try to see the volume and
> location of contents. Which brings me to my questions.
>
> I have notice a disproportionate number of ferrets suffering from
> adrenal disease to have hairballs present in the stomach (or
portions of
> hairballs in the intestine). My limited research: N = 187 ferrets;
> ferrets with adrenal disease = 79; ferrets with identifiable
hairballs 5
> mm or larger = 52; ferrets with adrenal disease AND hairballs = 36
(I
> once might have made mention of these data to some who read this
list;
> if they look different from these, it is because I redefined what I
> would call a hairball, causing some numeric changes). This makes
sense
> to me; ferrets losing hair from adrenal disease would have a high
> probability of ingesting more of it while grooming. Usually the
> hairballs are rather small, pea- or bean-sized or smaller (but
still 5
> mm or larger), but I have recovered nine monsters of the thumb-sized
> variety. In one single case, I believe the cause of death was due
to the
> hairball. It was a thumb-sized monster, trailing through the pyloric
> valve into the duodenum. A single 18 mm tear extended from the
pyloric
> region into the duodenum, and the abdomen was full of partially
clotted,
> reddish blood. Food contents also filled the abdomen. There was no
> obvious signs of infection or inflammation. The ferret was reported
to
> have died quickly, without warning.
>
> So, the first question is, has anyone noticed a higher incidence of
> hairballs in ferrets with adrenal disease?
>
> One other thing I have noticed in adrenal ferrets is some degree of
> osteoporosis, the degree of which appears to correlate to the
severity
> and length of the disease. I notice it immediately when cataloging
the
> processed skeleton (which includes final cleaning, replacement of
loose
> teeth, numbering for identification, etc.). I haven't yet taken
> density/volume measurements, but it appears that from gross weight
> measurements the loss in density could be as much as 15-40% (weight
is a
> very rough estimate and one I feel is unreliable, so these results
> could/should be in error). In terms of gross pathology, I have
noticed
> ferrets with extended adrenal disease (1.5 + years) to have
> microfractures in the femoral and humeral heads, microfracturing,
> crushing or distortion of the lumbar and thoracic vertebrae, extreme
> thinning of the ribs (on sectioning, some appear hollow, with few
> trabeculae), and thinning of the Os coxae, including the acetabular
cup.
> I have selected a number of these bones for viewing under the SEM,
but
> have yet found the financing to pay for the gold spattering and
machine
> time (which means I'll have to donate my services to paying
customers to
> earn free time when I can find the time to do it). Again, the loss
of
> bone density is not surprising; I have noticed it in several ferrets
> (and other species) who suffered from various cancers, so I am
making
> the possibly erroneous assumption adrenal cancers act like calcium
sinks.
>
> So, the second question is, has anyone noticed a similar incidence
of
> decreased bone density in ferrets with adrenal disease?
>
> If, by some quirk these data are true (my observations are a far cry
> from a standardized research program), would it be appropriate to
> recommend weekly doses of a hairball remedy, or add supplemental
calcium
> to the diet for ferrets suffering adrenal disease? Could skeletal
> density be used as a cheap and rapid screening agent for adrenal
disease
> (x-rays or density photometers)?
>
> Discussion? (Feel free to make me look silly; I learn best when
making
> mistakes. I guarantee criticism will not bother me!).
>
> Bob C