From:
Pam Sessoms
Date: 2002-03-03 21:26:00 UTC
Subject: Addison's after unilateral adrenalectomy?
Hey all,
I have a sweet little ferret named Nana; about 5 yrs old or so, has become
quite obese over the last few months and started losing hair from the butt
up. She had adrenal surgery on Friday. The surgery went well and seemed
routine. A large left adrenal was removed uneventfully - it had a good
blood supply but came out with minimal blood loss. Nana appeared to be
making a routine recovery, and I took her home. Late Friday night, she
started getting weak and lethargic. Her temp was all over the place, from
a high of around 104 to lows around 97, and I had her on and off a heating
pad all night. I gave her some Ringers, because she seemed
dehydrated. She was at the vet's office first thing in the morning,
basically a dishrag and also an interesting shade of reddish-purple all
over, even her ears.
Her circulation was very poor, capillary refill over 3.5 seconds, looking
very shocky. She was nauseous. Her PCV was fine at 69%, so it doesn't
seem to have been a bleeding event. BUN and creatinine normal. Even
though only one adrenal was removed, she just really looked for all the
world Addisonian, and my vet did a sodium/potassium ratio and found it to
be 24.5. Sodium was 143, potassium was 5.83. It's recommended that in
bilateral adrenal removals, that hormones need to be supplemented if the
ratio is below 25.
Anyway, we've been treating her as though she is Addisonian, and it seems
to be working. She has been improving all weekend at my kind, wonderful
vet's home. She's eating willingly tonight on her own and has been off
the heating pad since last night. Now, though, isn't that odd? Diseased
ferret adrenals are putting out sex hormones, not large amounts of
cortisol. So, why would the remaining gland have shut down normal
cortisol production? I think I remember someone (Sukie?) having one years
and years ago that was similar, and someone early in the FHL with a ferret
that had a cortisol-producing adrenal tumor but no typical signs of hair
loss, etc, like Nana had.
Other things we have considered are:
- some kind of weird reaction to something she had that day. All that
went in was: atropine as a pre-med, isoflurane, torbugesic, paralube for
her eyes, saline, tissue glue, and sutures. Her incision is gorgeous and
didn't even bruise. The red color she was all over her body seems
suspicious for an allergic reaction. I just haven't heard much about that
occurring, and it was delayed from the surgery time. She's been getting
steroids as part of her treatment so they may have helped if this is part
of it too.
- underlying heart disease, but it appears normal on x-ray and sounds
normal to my vet. It has been a bit fast at around 280, though. I am a
bit concerned about hypertrophic cardiomyopathy since it's harder to
diagnose, but she's improving while we're doing nothing that should treat
that.
- My vet had other ideas but they're *vanished* from my brain for now.
Anyone have any input about the possibility of Addison's with a single
adrenal coming out?
Thanks in advance for any anecdotes or ideas!
-Pam S.