From:
"Sukie Crandall"
Date: 2007-07-11 15:30:04 UTC
Subject: [ferrethealth] Re: Lupron as a preventative for adrenal recurrance-data?
To: ferrethealth@yahoogroups.com
I think that some past vet posts should help clear
up some confusion about prevention and why it is
not a matter of masking.
http://ferrethealth.org/archive/YPG79
BEGIN QUOTE
Hi everybody,
Seems there has been some interesting comments about
adrenal gland disease and how to treat adrenal gland disease.
So lets clear up some of the terminology and confusion.
Ferrets develop hyperadrenocorticism (ie adrenal gland disease),
and their adrenal glands overproduce the sex hormones and
the adrenal androgens (DHEA, ANDRO, PROGESTERONE,
AND ESTROGEN). Dogs and people develop hyperadrenocorticism
(Cushing's disease), and their adrenal glands overproduce cortisol.
Cushings is the correct term for cortisol overproduction, and
it is a good term for dogs and people.
Because ferrets rarely overproduce cortisol, Cushings is not an
accurate term for ferrets.
Likewise since ferrets do not overproduce cortisol, some of the
drugs used for dogs do not work well for ferrets.
Vetoryl (trilostane) is a good drug to use for dogs, but it may not
be a good drug for ferrets. Vetoryl will increase the amount of
progesterone produced. Progesterone is one of the hormones
that ferrets with adrenal gland disease can over produce (see
above). Thus Vetoryl is not the best option for ferrets.
Lupron depot (also called Lueprorelin in Europe) (Leuprolide acetate)
is a VERY SAFE product. I have been using it for more than 8.5
years now. It does not cause any liver damage or have any side
effects on the liver in ferrets! It works by stopping the stimulation
(LH) to the adrenal glands. Then the adrenal glands stop over
producing the sex hormones and adrenal androgens. If Lupron
is used with cases of hyperplasia and adenomas, it may
shrink the size of the adrenal glands. It may also help keep
carcinomas from getting bigger.
Suprelorin implants (deslorelin acetate) is another product that
stops the stimulation (LH) to the adrenal glands and then the
adrenal glands stop over producing the sex hormones and
adrenal androgens. It is not yet available here in the US, but
it is available in Australia, New Zealand and a few other countries.
The 4.7 mg implant is the recommend dose
Melatonin (implants or orally) is another option. Melatonin should also
lower the LH level and the sex hormone and androgen levels. The
big question with melatonin is whether the ferret will become
refractory to it when used over a long time. Melatonin should also
help prevent the adrenal gland from becoming larger as was shown
in the U of Wisconsin oral melatonin study.
Yes, Lupron and melatonin can be used together! In my opinion
using melatonin and Lupron together gives you the best of both
worlds and is the best option for medical management of adrenal
gland disease in ferrets.
Hope that helps,
Jerry Murray, DVM
END QUOTE
http://ferrethealth.org/archive/SG7883
BEGIN QUOTE
No. Lupron lowers the LH (and FSH) level. This stops
the stimulation to the adrenal glands. In case of hyperplasia,
you would expect the adrenal glands to return to normal.
Likewise some of the early cases of adenomas, may
also reduce in size. Carcinomas are less likely to
shrink in size, but Lupron may prevent some of them
from enlarging. Thus Lupron does more than "just mask
the signs!"
Hope that helps,
Jerry Murray, DVM
END QUOTE
http://ferrethealth.org/archive/SG7669
BEGIN QUOTE
Yes, spaying and neutering is a big part
of the problem! Quite simply when a ferret
is spayed or neutered the LH levels increase
(up to 10 times the normal amount of an intact
animal). The reason that spay/neuter at an early age
(<1 year old) increases the risk is because there is
no "set point" established, so the LH receptors become
functional. Plus there is more time with the elevated LH
level stimulating the LH receptors in the adrenal glands.
In Dr Schoemaker's article he estimated the prevalence of
adrenal gland disease in Holland at 0.55%, with the average age
at onset of 5.1 years old. In Holland ferrets are typically fixed at
1 year of age. (That's right less than 1%.)
Of course here in the US, adrenal gland disease is a very, very
common problem with prevalence estimated anywhere from 20-75%.
Here the ferrets are typically spayed/neutered at an age of 4-6 weeks.
It really is the high LH levels stimulating the LH receptors in the adrenal
glands that leads to adrenal hyperplasia and neoplasia. There really
is no virus involved. Remember Lupron works by lowering LH levels,
and Lupron does not have any antiviral properties.
Hope that helps clear things up,
Jerry Murray, DVM
PS Early spay and neutering leading to adrenal gland disease is
also common in mice.
END QUOTE
http://ferrethealth.org/archive/SG7637
That is a great question, and we are just
now getting the answers! Recent research by
Dr Nico Schoemaker at the Utrecht vet school
in Holland has helped answer your question.
Ferret adrenal glands have both LH and FSH
receptors on them just like the ovaries and the
testicles do. When ferrets are spayed or neutered
(as neonates by all of the major ferret farms) then the
adrenal glands start to respond to the high levels of LH
in the bloodstream. Keeping pet ferrets indoors under
"long day photoperiods" also adds to this problem. When
the adrenal glands are over stimulated, then they become
hyperplastic or neoplastic (cancer). So the short answer
is spaying and neuter pet ferrets at a young age is the major
cause of adrenal gland disease (just like it is in mice). Plus
keeping them in long day photoperiods adds to the problem.
That is why keeping a natural photoperiod or keeping them
in 14-16 hours of darkness per day is sometimes recommended.
There is also a possibility of a problem with the tumor suppressive
gene which is the 'genetic problem" that may add to the problem.
This problem has not been verified as of yet, but it is possible.
A viral cause is very unlikely.
Remember Lupron works by lowering the LH and FSH levels,
which stops the stimulation to the adrenals. Thus it may also be
useful to give Lupron to young ferrets to help prevent adrenal gland
disease!
Hope that helps,
Jerry Murray, DVM
END QUOTE
There are more.
Both melatonin and Lupron Depot have different routes through
which they decrease the LH overproduction that is causing the problem.
Without the constant aggravation, when it can be decreased enough,
the body has time to defend itself and to reduce inflammation. I don't
know if either of those also has any direct effect but if a growth is new
enough or small enough they might not need to. Bodies seem to be
regularly dealing with cellular mistakes and tend to manage well usually
if they don't have extra things going against them such as genetic
problems (See past posts on the start of work on this regard by Dr.
Michelle Hawkins' team.), a growth too large, an immune system too
weak, lousy luck, etc. Removing the constant causative aggravation is
a major improvement. Melatonin can help on that score and in testing
Lupron or Suprelorin appear to be stronger.
It is also possible to increase the body's own natural production of
melatonin by providing a lot of darkness. Dimness doesn't cut it anywhere
near as well; light greatly reduces the production of melatonin by the
pineal gland. Not all light colors as bad, though. Blue is the worst,
followed by green in studies. But amber has minimal effect in reducing
the desired melatonin production compared to other light colored tested
when reaching the eye.
Sukie (not a vet)
Recommended ferret health links:
http://pets.groups.yahoo.com/group/ferrethealth/
http://ferrethealth.org/archive/
http://www.afip.org/ferrets/index.html
http://www.miamiferret.org/fhc/
http://www.ferretcongress.org/
http://www.trifl.org/index.shtml
http://homepage.mac.com/sukie/sukiesferretlinks.html
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