From:
Caitlyn Martin
Date: 2002-08-04 15:53:19 UTC
Subject: Re: [ferrethealth] Re: Kodi and adrenal tx
To: ferrethealth@smartgroups.com
Cc: damico@bellsouth.net
Message-Id: <20020804115319.1249832a.whiteweasel@earthlink.net>
Hi,
> Dr. Jerry Murray DVM writes: " ... in my practice both adrenal glands
> usually end up being a problem and the right adrenal gland is harder
> that the left to remove completely.
> That is why I would seriously consider treating to prevent the problem
> from developing on the right side."
>
> I have to agree with that - some of my ferrets had one adrenal out
> (usually the left, but sometimes the right), the other gland appearing
> completely small, smooth and normal, then a year or so later, the
> other had to be removed. Some needed BOTH at the same time - but all
> (12) ended up needing both removed
Omigosh.... Am I reading this right? Are people (including a vet)
advocating removing both adrenal glands even when only one is diseased?
Please tell me it isn't so.
Joanne, I'm sorry all 12 of your ferrets are bilateral. Of the six of
mine that have needed adrenal surgery only one is bilateral, and one
other died of widespread metastasis of adrenal carcinoma a few months
after a second adrenal surgery. Of the other four, none have had a
recurrence. Ker Avon is coming up on three full years since his adrenal
surgery now with no further problems.
What's the big deal about removing both? IME, it is sometimes *very*
difficult to get the a ferret's electrolytes balanced after a second
surgery. During the period of electrolyte imbalance the ferret suffers
through the symptoms of Addison's Disease. *Suffers* is the important
word.
Also, I have one ferret, Pertwee, who is completely non-responsive to
prednisone at any dosage. The net result was an Addisonian Crisis. He
nearly died. Dexamethasone proved to be the right answer for him, and
he's still here and happy. Still, he had *weeks* where he suffered, in
part, from surgically induced adrenal insufficiency.
Is it worth risking a ferret's life because they *might* have a
recurrence of adrenal symptoms? Even if the liklihood is quite high,
there is also a chance that it simply won't be necessary. Making a
ferret dependent on medication lifelong is not a good idea.
In addition, bilateral adrenal ferrets are, according to our vet, far
less able to cope with stress. Adrenalin is an adrenal product. What
does the body produce when under stress? Adrenalin.
> ... I always request a biopsy (to tell if
> it is cancerous or not), and all have confirmed either hyperplasia or
> cancer.
We do the biopsy too, but only three of six have had carcionomas. The
rest have had adenomas (benign tumors).
> I am thinking it might be sensible to take them both at the same
> time, and spare the trauma and expense of the second surgery - since
> most of the right adrenal surgeries have been tough, with growth into
> the liver and vena cava.
Even in the case of a carcinoma, one (Nyssa) is now well past one year
with no recurrence. Considering the risks and problems I have outlined,
and that a ferret year is like 10 years for us, I would consider
removing a healthy adrenal gland anything but sensible.
There was a similar discussion some years back on FML. I mentioned it
to our vet at the time, and his reaction was quite angry that any vet
would consider this. He considers "making Addisonian ferrets" a very,
very bad idea unless it is absolutely necessary.
> My vet is a whiz, hasn't lost one yet, and
> they have all done well without the adrenals with low doses of
> florinef and pred - I have had them live for years after, barring
> other problems.
That's great, and our vet has done every bit as well as yours. Pertwee
needs dexamethasone instead of pred, but he's fine over two years later.
The question you can't answer is how long they would have lived with
one adrenal gland instead of none.
Also, you have an underlying assumption in your post that isn't always
correct. The left gland is not always the first to be diseased. Our
Podo has had one adrenal gland out -- his right. The left is still
fine.
>
> I'd like to hear what others (vets and fuzzy caretakers) have
> experienced ...
I rarely get upset at reading a post. The concept of removing healthy
adrenal glands and putting ferts through what Pertwee or Ryo-Ohki went
through unnecessarily upset me greatly.
All the best,
Caity and the non-stop nine