From:
AFERRETVET@cs.com
Date: 2003-12-07 17:59:19 UTC
Subject: Re: Lupron confusion
To: ferrethealth@smartgroups.com
Message-ID: <15.1e0b9e5d.2d04c477@cs.com>
Hi everybody,
I think there is some confusion with Lupron because
it is in a relatively new class of drugs, and real new to
most vets. It is not a drug that we use in dogs and cats.
Mostly it is used in ferrets and in birds (chronic egg layers).
In peolpe, it is used for uterine leiomyomata (fibroids),
endometriosis, endometrial stromal sarcoma, breast
cancer (especially in premenopausal females), polycystic
ovarian disease, functional bowel disease (progesterone
related irritable bowel syndrome), prostate cancer, and
giant multilocular cystadenoma of the prostate (very similar
to the prostatic cysts in ferrets). These are diseases that are
hormone responsive (ie a hormone(s) stimulates the
tissue to grow). If you take away the hormone(s), the tissue
no longer grows and most will regress with time (ie take
away the hormone and the tissue gets smaller). This has
been documented in people with uterine fibroids, endometriosis,
endometrial stromal sarcoma, breast cancer, ovarian cancer,
polycystic ovarian disease, prostate cancer, and cystadenoma
of the prostate. It has also been documented in rats with
prostate cancer and mammary cancer. It has also recently
been documented in ferrets with adrenal gland disease!
It is sort of like turning off a light switch. Electricity no longer
stimulates the light bulb. The light bulb no longer produces
light. In ferrets, Lupron is like that light switch. It turns off
LH. LH no longer stimulates the adrenal gland. The adrenal
gland(s) no longer produces the sex hormones.
In cases of adrenal hyperplasia and adenomas, they are not
likely to spread or get big enough to cause any "space occupying
mass" problem. Only carcinomas will grow into those large tumors.
Usually only the right gland is going to spread to the liver and mainly
when that gland becomes big. Thus for cases of adrenal hyperplasia
and adenomas, stopping the stimulation with Lupron, stops the production
of adrenal hormones, and prevents the gland from becoming bigger.
Thus the adrenal problem is solved. Some of these will actually get
smaller while on Lupron! It is the carcinomas that may continue to
enlarge and continue to oversecrete the hormones (ie the "non
responders") that are the problem. These need to be removed
surgically when possible.
My recommendations for treatment are still surgery as the first
choice for healthy ferrets. Lupron as my second choice and for
those that are at high risk for surgery/anesthesia. Melatonin is
my third choice. Unfortunately too many people and vets still
think that Lupron just regrows the hair while the tumor continues
to get worse, and the ferret ends up dying a horrible death.
This is just not the case! Unfortunately some of the carcinomas
do not respond as well to Lupron, and some of them will continue
to grow and continue to oversecrete the sex hormones. Then surgery
becomes the best option, even though it is a higher risk surgery.
That is why I use the monthly version of Lupron, so I can check
the adrenal glands and the respnose monthly. Not responding or
gland(s) getting bigger, then time for surgery before they become
inoperable.
Hope that clears up the confusion,
Jerry Murray, DVM
End of ferrethealth Digest
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