Date: 2003-08-08 15:31:35 UTC
Subject: Adrenal Surgery/Charley
I thought I would share an experience we had this week. Unfortunately, we lost Charley in the process. Charley was a little naked guy who came to me in June after being found wandering the streets. On Wednesday, he had adrenal surgery; very unremarkable, a leftie. The right looked just fine and was left alone. He also had a few insulinomas removed from the pancreas. He was alert afterward, ate some baby food off my finger, was standing, was doing just great. In the middle of the night (he stayed at the vet's office), my vet was called in because Charley started going downhill. My vet worked on him for about 4 hours (about 2 a.m. to 6 a.m.) but was unable to save him. My vet (and I) was understandably shaken by this. What seemed so routine and easy turned into death for poor Charley. Doc spent most of yesterday on the phone calling specialists to try to figure out what happened. I thought I would share his findings so perhaps the next ferret can be saved, in Charley's memory.
Just to be clear, Charley was NOT a bilateral. But, it appears it was probably an Addisons crisis that killed him. Even though only the left adrenal gland was removed, it's probable the right had atrophied and didn't start functioning. One of the specialists Doc called is a well-known ferret vet. She told Doc that she was losing quite a few until she started giving Percortin (sp) during surgery. She does this with any gland over 1cm (the size is subjective on her part), even if only one is removed, and with all bilaterals. Once the crisis starts, it's usually too late, so she medicates as soon as she sees what's going on inside during the actual surgery. She said she had been seeing the crash 6-24 hours after surgery. Charley started crashing about 12-13 hours afterward. This vet said she hadn't lost any to AC since she started this protocol.
In these rapidly occurring cases that she's seen, once the crisis starts it's normally too late. My vet specifically asked her if he had treated it as an AC immediately when it started if he could have saved Charley. She said she doubted it. I believe she said she continues the injections for about a month afterward, if she feels they are necessary.
Most vets don't think twice about just removing one gland and don't plan for a possible crisis. Charley is pretty much proof that it should be a concern even when only one is removed. This is some good information you might want to share with your vet.
I would love to see some input from the vets on this list who have tried this protocol, or just general opinions about it (for my own knowledge as well as my vet).