From:
"Sukie Crandall"
Date: 2007-06-01 18:31:26 UTC
Subject: [ferrethealth] Re: Propecia Help
To: ferrethealth@yahoogroups.com
In combination I think these answer all the questions you posed. These are from the FHL
Archives. I may have forgotten to date some, but am trying to find those so hopefully
don't miss any
.
http://ferrethealth.org/archive/YPG922
http://ferrethealth.org/archive/YPG942
http://ferrethealth.org/archive/SG6795
http://ferrethealth.org/archive/SG6389
http://ferrethealth.org/archive/YG4059
read
BEGIN QUOTES
2007:
Here is how to treat an enlarged prostate secondary to
adrenal gland disease.
1) Lupron. Yes, use the high dose of 500 mcg/kg once
every 4 weeks.
2) Melatonin. Yes, melatonin helps with adrenal gland disease, and
it also helps with the prostate. There was a melatonin article in the
Dec 1, 2006 issue of JAVMA. (This was the oral melatonin study from
the U of Wisconsin, and it does cover how melatonin helps with the prostate.)
3) Propecia or Proscar. Both contain the same ingredient finasteride.
Propecia 1mg once a day for the first 30+ days. After the prostate shrinks
and the
ferret can urinate well then the dose can be lowered to 0.1mg once a day.
4) Antibiotic. Zeniquin (Marbofloxacin), Baytril (Enrofloxacin), or
Trimethoprim-
sulfa for 4-6 weeks to clear up the bacterial infection.
Now if the prostate is really 3cm by 1cm, then you may need to do surgery
to fix the prostate (marsupialization or omentalization) and remove the bad
adrenal gland or glands.
By the way the valium helped by relaxing the muscles, so he could urinate.
It has nothing to do with his thinking. This is sort of like how Flomax works
in people with an enlarged prostate. I would not use ketoprofen in a ferret
because it may cause stomach ulcers. Metacam would be the safer
NSAID to use.
Hope that helps,
Jerry Murray, DVM
2007:
I do not understand why your vet wants to stop
giving Lupron. No logical reason that I can think of
to stop giving Lupron. I would go with the high dose
of Lupron! Likewise no logical reason not to give
melatonin. If neither vet has the melatonin implants,
then I would suggest using melatonin orally (1 to 3 mg
once a day about 8-9 hours after sunrise).
Now Propecia vs Casodex. I do not think there has been
any study to say which works faster. If your vet uses and likes
Casodex that is fine, but it should be used with Lupron.
Casodex is a DHT receptor blocker, so it only blocks the DHT
receptors on the prostate. However it does not lower the
DHT level. Likewise it does not lower the estrogen, andro,
DHEA, or progesterone level. Thus it should be used with
Lupron. Propecia and Proscar actually lower the DHT level
directly. They should also be used with Lupron to lower the
other adrenal hormones (estrogen, andro, DHEA, progesterone).
As to which vet to use, time to decide if you want to treat your
ferret medically or surgically. If you want to treat medically
then I would go with the high dose of Lupron (vet 2), Propecia
(vet 2) or Casodex (vet 1), a long term antibiotic, and melatonin.
If you want to go with surgery, then go with the one who has experience
with removing the right gland and fixing the prostate (vet 1).
BTW the suggested dose for Casodex is 5 mg/kg once a day.
Hope that helps,
Jerry Murray, DVM
2003:
Sorry to hear about your high rate of adrenal
problems. It was surprising to hear that you had
2 dogs with adrenal tumors, for that is truely rare.
Now to your questions.
Can Lupron or melatonin be used to hopefully prevent
adrenal gland disease? YES! (However I do not think
Casodex would be a logical choice as a preventative.)
2003:
Yes, finasteride (Proscar or Propecia) alone will help
to shrink the enlarged prostate. It works by preventing
testosterone from being converted to dihydrotestosterone
(DHT). DHT is what causes the prostate to enlarge.
Thus with no DHT, the prostate shrinks.
However Lupron will help lower all of the adrenal hormones,
including testosterone. By lowering the testosterone, there
is less DHT that can be made, so the prostate shrinks.
Thus it works best to use Lupron with finasteride.
Casodex works by blocking the androgen (DHT) receptors
on the prostate, so it will also work to reduce the
size of the prostate. Flutamide also works by blocking
those receptors. However the hormone levels do not change
with these 2 medicines. Again best to use with Lupron.
Melatonin can also be used to reduce the size of the prostate.
It is believed that melatonin reduces the adrenal sex hormones.
Plus there are actual melatonin receptors on the prostate,
so it may work by 2 different routes.
As for giving finasteride to prevent prostate problems, it is a
very safe medicine even at high doses, so it might be a good
idea to give it to your males.
Hope that helps,
Jerry Murray, DVM
2003:
I'll try to answer your questions on Melatonin.
I am glad you and your veterinarian are interested
in melatonin and Lupron. Both are good options for
treatment of adrenal gland disease (when surgery is
not possible), and I think both will be useful to actually
prevent adrenal gland disease.
There was a lot of melatonin research done with intact
ferrets back in the 70s and 80s. Melatonin is the natural hormone
that is secreted by the pineal gland. Melatonin directly and
indirectly activates the breeding season (spring/summer)
during the "long day" photoperiods, and it terminates
the breeding season (fall/winter) during the "short
day" photoperiods. In the fall/winter there is more
melatonin released during the dark time, and less
released in the spring/summer. In addition to the
breeding season, the increased melatonin causes the winter
fur to come in and for the winter weight gain. Likewise
the low levels cause the summer fur to come in and the
summer weight loss. Your vet can review most of this
in Dr Fox's book (2nd edition, Ch22-23) and in Kirk's
CVT XIII..
Melatonin inhibits GnRH release, which decreses LH
and FSH and stops the stimulation to the adrenal glands,
(Adrenal glands have LH receptors) which decreases the
amount of adrenal sex hormones being produced.
The U of Wisconsin did the first study using melatonin
to treat adrenal gland disease (Melatonin use in Ferret
Adrenal Gland Disease, Proceedings of North American Vet
Conference,2001 p 897.) They were giving 0.5mg once
a day of a liquid melatonin product.
Texas A&M and I had both been using oral melatonin with
pretty good results, but it was hard for the owners to give
it every day, especially 8-9 hours after sunrise (1mg).
That is why we decide to try the male mink melatonin
implants. They are simply injected under the skin (SQ)
over the shoulder blades area. They are an FDA approved
implant for mink that slowly releases melatonin over
3-4 months. We started this study in the spring of 2002.
I hope that me and Dr Cathy Johnson-Delaney will be able
to do a second study to monitor hormone levels before
and after the implants over a full year.
There has been done a lot of human research with melatonin.
They have found melatonin receptors (mt1) on the prostate
(Inhibition of Androgen-Sensitive LNCaP Prostate Cancer
Growth in vivo by melatonin: Association of Antiproliferative Action
of the Pineal hormone with mt1 receptor protein expression.
The Prostate 46:52-61, 2001) and on human breast cancer cells
(Transcriptional repression of ROR activity in human breast cancer
cells by melatonin. Molecular and Cellular Endocrinology 176 p
111-120,2001). Plus melatonin has antioxidate and possible
antiviral properties. These may all be beneficial to the ferret
with adrenal gland disease, especially ones with prostatic
enlargement or mammary gland hyperplasia. If your vet
would like more info, or info on how to order the implants
please have her e-mail me.
Hope that answers your questions,
Jerry Murray, DVM
Dallas, Texas
PS as far as I know ther are no Lupron receptors on the
prostate. Lupron works at the hypothalamic and pituitary
level by stopping GnRH, LH and FSH from being produced. This
stops the stimulation to the adrenals, and they stop over producing
the adrenal sex hormones. Less hormones lowers the stimulation
to the prostate, but I also use Propecia to stop DHT from
being made. DHT is the hormone that causes the prostate to
enlarge. [Csodex or Flutamide can also be used to block the
adrogen (DHT) receptotrs on the prostate.] Melatonin may
also be helpful in shrinking the prostate.
2001:
Sounds like you are describing an enlarged prostate
secondary to an adrenal gland problem. The Lupron depot
will help lower the adrenal hormones that are causing the
enlarged prostate. Propecia can also be used to help shrink
the prostate (ie. use both Lupron and Propecia). Flutamide
can also be used to shrink the prostate, but Propecia is more
specific in its mode of action and effects on the prostate.
The infection can either be a simple bladder infection or a prostate
infection.
A prostate infection needs to be treated for a long time (1-3
months).
I would use the culture and sensitivity report from the urine sample
to determine which antibiotic(s) to use and use it for a long time!
Yes, an urethra obstruction from the enlarged prostate will cause
the BUN and Creatinine levels to be elevated (post renal azotemia)
and that sounds like what was going on with Oliver.
Prostate problems are frustrating but hang in there. Most will
respond to Lupron, Propecia, and antibiotics (Baytril, Clavamox,
etc.).
Hope that helps,
Jerry Murray, DVM
END QUOTES
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