Message Number: FHL5039 | New FHL Archives Search
From: "Sukie Crandall"
Date: 2008-05-28 16:53:04 UTC
Subject: [ferrethealth] Re: That old question again - adrenal disease, surgery vs Lupron?

--- In, "Tressie" <tressiedu@...> wrote:
> Cannoli had an ultrasound on Monday by a radiologist veterinarian
> specialist who travels into our area regularly. I was able to watch
> the whole procedure. A cyst on his right kidney was identified and 3
> swollen lymph nodes but nothing remarkable about his adrenals. He
> took a needle aspirate urine sample from the bladder after 3 attempts
> with 3 different sized needles before he was able to pierce the
> bladder wall. I was glad Cannoli was heavily sedated!
> I am assuming the renal cyst is innocuous?

Unless the kidney kicks up a renal cyst isn't a problem. We have
one with one.

She also has swollen mesentery nodes but in her case her right
adrenal is kicking up and she has had persistent infections (though
they seem to be gone) with her needle aspirate of the nodes just
showing that they are reactive. In case out options are the same
as yours, here is what they are:
1. Deworm and wait and see
2. Deworm and use a heftier combo of antibotics for along run
and wait and see
3. Do exploratory surgery.

We don't know if she is dealing with lymphoma that is somewhat
hidden, a chronic infection, or some sort of hidden internal
parasite. She's 5 years old, BTW.

> At present he is on antibiotics Amoxicillin 0.6 ml every 12 hours
> until the rest of the culture report comes back. Cytology report
> confirmed blood in urine as had the emergency clinic on Saturday.

Okay, so in your ferret's case it pays to also consider uroliths. There
are several types ferrets can get.

One test you can even do at home. Ferret urine should be pretty
neutral (pH 6.5 to 7.5 if I recall the range right).

I don't think that calcium oxalate uroliths affect pH but i could be
wrong. When possible the oxalate portion of the diet is controlled
for those. That's one type I don't know much about.

If the urine is alkaline then the ferret is getting too much plant
material in the diet. There have been reports of some people with
the MacKay rescue ferrets having old struvite uroliths still present
so their urine is no longer alkaline but they still have the reminders
of a past cheap diet at that location.

If it is acidic then cystine uroliths are a risk factor. Steve and I have
two ferrets who get cystine uroliths if their diet goes above 35%
protein. At 35% protein or lower they are fine and have been for
many years. My suspicion is that on the typical past foods that
were available it didn't show up when farms had ferrets with this
genetic vulnerability because they were not getting enough of the
COLA grouping of amino acids (Cystine, Ornithine, Lysine, and
Arginine) for the cystine to precipitate out. As a result that
vulnerability went unspotted. In recent years there have been
higher protein diets, though people studying this (reports expected
in the future by a team formed by Dr. Michelle Hawkins of UC Davis
who noticed the sudden upward shift in rate) point out that even
with the increase in rate the problem is still not a common one.

In males if there are uroliths there is a risk of urethral blockage,
which our male with cystine stones had. He was lucky, and repeated
emptying of his bladder allowed him to avoid a penile amputation
and urethral rerouting. Sadly, the site which explained that procedure
in detail seems to not be up. Does anyone know if there is a new
URL for that?

A bladder infection is also certainly among the various possibilities
and some bacteria are hemolytic so will easily lead to bleeding (if
ferrets can be infected by any of those types).

> In terms of further assessment for adrenal disease because the
> ultrasound was inconclusive - we are waiting for the 1 month Lupron
> Depot effects to wear off and then will be doing the Tennessee panel.

A TN Panel makes sense when things are uncertain. If it is too early it
can return a false negative, but I have never read of an actual false

A CBC and Chemistry Panel at the same time could make sense to see
if any other values are off.

> My vet's approach is far more conservative and he prefers to wait
> until the adrenals enlarge (confirmation via another ultrasound). I
> don't want to wait for the adrenals to enlarge. This doesn't make a
> whole lot of sense to me. My vet wants absolute confirmation via some
> test before proceeding with surgery. Note Cannoli has been aggressive
> towards the sprites - an aberrant behaviour for him and he is quickly
> losing patches of hair on his tail. I would seek a second opinion
> but there are no other ferret knowledgeable vets in this area - he is
> it!

Hmmmm, what about a possible exploratory surgery? Question: have
you had this ferret long enough to know whether there might be a
retained testicle?

> As well I am not prepared to have regular ultrasounds done to monitor
> the adrenals. Never mind the incredible expense entailed but from my
> understanding ultrasound is only accurate 50% of the time in
> identifying adrenal problems. My vet's argument is that it depends on
> the skill and level of training of the technician.

Ultrasounds and the ferret-knowledge for using them have both improved
markedly over time and they are a far, far better tool than they once
were for ferrets, including for adrenal imaging.

> I will be speaking to my compounding pharmacist to see if she can
> make up a Deslorelin Depot. Deslorelin is available here but my vet
> is not certain whether its the kind that is suitable for ferrets.

If you look up the papers of Doctor Nico Shoemaker and of Doctor
Bob Wagner you will find detailed information which will let you
determine that.

It sounds like there might be more than one possibility for him.

Best of luck to you! Ferret health is something where we all continue to
constantly learn (and appreciate learning).


Yahoo! Groups Links

<*> To visit your group on the web, go to:

<*> Your email settings:
Individual Email | Traditional

<*> To change settings online go to:
(Yahoo! ID required)

<*> To change settings via email:

<*> To unsubscribe from this group, send an email to:

<*> Your use of Yahoo! Groups is subject to: