From:
Caitlyn Martin
Date: 2004-07-27 03:36:06 UTC
Subject: Re: [ferrethealth] Bi-lateral Adrenal - Still declining
To: ferrethealth@smartgroups.com
Message-ID: <20040727033606.93162.qmail@web50805.mail.yahoo.com>
--- zevronn@erols.com wrote:
> I have my 8 year female ferret on Predisone and
> Florinef now (gave my vet the info from this group)
> since last Monday (pred) and since Thurs (Florinef).
That's promising if her electrolytes were out of
balance. What were the readings?
>
> She still doesn't get up on her own to eat.
Then she's still Addisonian.
> How does the vet know to adjust the meds if the
> ferret is still ailing? On the potassium of the
> bloodwork?
Actually, from the potassium and the sodium. Both
need to be at normal levels and at the proper ratio.
The way your vet tells is by doing follow-up blood
work to check the electrolytes and adjusting the meds
as needed.
This is a trial and error procedure. Some ferrets do
just fine on standard starting dosages. Many others
simply do not. It took a solid month for us to get
Ryo-Ohki's electrolytes in balance and she did not
improve at all in that time. If anything things got
worse.
This is why bilateral adrenalectomies are so hard on
both ferret and owner. You are going to be at the
vet's office a lot, probably every few days, until the
right dosages for the two meds are reached.
Since your ferret still has some adrenal tissue it is
possible her body may start producing hormones on its
own and then you'll have to adjust again. Even once
electrolytes are in balance you'll be checking them if
symptoms recur or else every 3-6 months. For example,
if she starts eating well again (let's hope) and puts
on weight she may need more of one med or the other.
Something else your vet should keep an eye out for:
resistance to pediapred/prednisone/prednisolone. The
reason Pertwee went into an Addisonian Crisis is that
no matter how much prednisone we gave him he simply
didn't respond to it. His body couldn't use it. In
the end we had to give him dexamethasone, which is far
stronger and has a greater risk of side effects. It
worked and thankfully he never had any problems
because of it. I should add that this is rare -- most
ferrets respond to pred, but it's one possiblility to
keep in the back of your mind.
>
> What should I try next? She is on 1 ml of Pred and 1
> ml of Florinef.
Keep checking those electrolytes every few days and
keep adjusting. Once your vet gets the sodium and
potassium levels right she should bounce back quickly.
For example, once we started Pertwee on dexamethasone
the improvement was obvious in a day or two.
Hang in there. This isn't going to be easy and the
solution may not come quickly. Let's just hope your
girl is strong enough to survive until it all gets
worked out. If so she may still recover fully and get
back to a good quality of life.
The usual disclaimer applies: I am not a vet. I've
just been where you are twice. We were able to get it
right both times, though metastais (rare: spread of
adrenal carcinoma) did take Ryo-Ohki in the end.
Pertwee, OTOH, had three and a half more very good
years after.
All the best,
Caity and the fantastic five
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