From:
"April Armstrong Campbell"
Date: 2005-10-14 06:02:49 UTC
Subject: [ferrethealth] re: both adrenal glands out and age of ferret for surgery
To: <ferrethealth@smartgroups.com>
1. As a vet tech and pet owner, I wholeheartedly agree that health has more to do with deciding whether a pet is a good candidate for surgery thN age-I have had 5 and 6-yr-olds far healthier and better surgical candidates than some of my 2 and 3-yr-olds.
2. Removing both adrenal glands: Some vets would recommend against ever removing both, perhaps removing one and debulking the other. I have had two ferrets now (both age 4 when first affected, incidentally) with both glands removed. One needed both out at once, and had an Addisonian crisis a week later (which we were watching for), and then we started him on Florinef and prednisone.
He lived happily and normally for another couple of months, (was weaned off the steroids after the first month), and did great, till he died unexpectedly while boarding at my hospital, probably of an Addisonian crisis. He died less than an hour before I went to pick him up, and had been perfectly fine and active all week. He was not an easily stressed animal, had boarded before, was used to going places, and was in a familiar environment with all of his cagemates.
Upon posting to VIN (Veterinary Information Network, a vets-only forum), we learned too late that animals in his situation, even if they aren't normally stressful animals, can have just enough shock to their system that their absent adrenal glands leave their bodies unable to kick in enough adrenaline to deal with such a change in their routine, and should be put back on the Florinef and pred any time they are in such a situtation.
NONE of the literature by the experts, etc, that we found-and we read a lot of texts, articles, studies, etc, in addition to what we already knew about these guys-mentioned the need for pred/Florinef postop for such a possibility, and much of it didn't even mention the possibility of an Addison's crisis, though of course _WE_ knew that was possible and we were watching for that postop, and got Florinef into him right away when he crashed the first time (along with dexamethasone and pred). However, we didn't know that once we weaned him off the pred and Florinef, we should restart it whenever he'd be in a situation such as boarding. (In fact, the few places that did mention possible Addison's crisis almost brushed off the seriousness or possibility of it happening-really downplayed it and it was like an aside.)
Now that we learned the hard way (no conclusive cause of Nicodemus's death on necropsy, but we strongly suspect an Addison's crisis, which especially sucks since his meds were two feet away from him when he died-it was there in case he had a crisis, which he had less than an hour before my hospital opened and I showed up to work and then take my guys home after vacation), my Cora had to have her second gland out in a year, about a month after my Nicodemus died, and now I put her on pred and Florinef any time there is any change in her routine at all. This includes traveling, boarding, visiting friends, meeting new ferrets. So far we have had no problems, and it has been about 8 months. (And she might not have gotten 8 months with an adrenal tumor left in, even with Lupron.)
Long and short of taking both adrenals out: I personally would like to give my ferret the chance to live a little longer by removing a gland if it turns out to be cancerous, for example, if taking out a second adrenal will do that, and it is feasible to remove it.
But GET the FLORINEF and use it-it is only $20 for an 80-day supply of Florinef (aka FLUDROCORTISONE) if your ferret needs 1/4 of a tablet once a day (20mg, I believe), and use it post op in combination with prednisone for a few weeks. You can then gradually wean them off it and use it as needed before and during and right after any changes in their routine. I would not recommend taking them both out if you aren't going to do this postop.
My two cents from my own experiences!
-April
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