From:
Caitlyn Martin
Date: 2002-05-12 15:32:00 UTC
Subject: Re: PLEASE-Need enlightenment -- addison's disease
Hi,
I am not a vet, but I've had two ferrets have Addisonian symptoms and
one o into full blown crisis and almost die.
> of 28. She received a 0.2cc Percorten injection that day, and we
> were instructed to increase the pediapred to 0.3cc once a day. She
> had begun showing symptoms of lethargy by this time.
My vet uses a different regimen than yours, specifically pediapred and
florinef (fludrocortisone) both administered orally. He does not use
percoten. We've had excellent results. Also, he worries about normal
range values of sodium and potassium rather than the ratio.
Lethary is the first symptom of Addison's Disease (surgically induced,
of course) so at this point you should have become concerned.
>
> In fact, she got worse. She slept more,
> became uninterested in play, and stopped eating and drinking.
Addisoninan symptoms were increasing.
>
> Her levels again were checked the day following. They were: Na-134,
> K-6.1, giving a ratio of 22. On this day, she began showing signs of
> improvement.
Her potassium was outside the normal range at this point.
> First, why didn't the first shot of percorten work?
Different animals react differently to medications. My Pertwee
(bliateral adrenal for two years now) did not respond to pred at all.
He takes dexamethasone in lieu of pred and since we started that and got
his florinef dosage right his electrolytes have stayed blissfully
normal. Most ferts react just fine to pred. Go figure.
>
> One thing I have not mentioned is that one vet and one vet tech said
> that we DON'T want a high ratio (in the 30's)-- we want a low ratio.
> This contradicts what my primary vet has told me -- low ratios call
> for treatment (i.e. 28 and below).
Again, my vet does not talk about the ratio. He worries about being in
the normal range, preferably near the middle of the normal range.
>
> I am confused and frustrated. I fear that Pixie's recovery is only
> due to the dex and is a false indication of an adequate ratio.
That could be. Adding dexamethasone, which is stronnger than
prednisone, is tantamount to increasing the pred a whole lot. OTOH, if
the percoten wasn't working her potassium level would be way high and
she would be in trouble. It sounds like that isn't the case.
> Additionally, this whole situation leaves me baffled as to what the
> treament will be in 3 weeks. Will I need to include dex among the
> pediapred and percorten? And how much percorten?
You can't know yet. After a second adrenal surgery my vet gives a
typical dosage of prednisone and florinef. For many ferrets that dosage
is fine, but for both Ryo-Ohki and Pertwee it was not. What my vet does
then is monitor electrolytes frequently and adjust the dosages until the
proper amounts are found. It is very much trial and error because no
two ferrets are exactly alike. In both of our bilateral babies the
proper dosages were found and the electrolytes were at proper levels
within two to three weeks of surgery and stayed there.
>
> By the way, she continues to improve. Today she
> played, and ate, and drank. The only bad sign is her sudden dislike
> of pediapred, which she normally considers a treat.
That sounds like her electrolyte levels are at or approaching normal
levels. Only bloodwork can tell you for sure, of course. It does
sound, though, like your vet is getting it right. Trust me, she will
let you know when things aren't right.
All the best,
Caity and the notorious nine