From:
Sukie Crandall
Date: 2009-08-06 14:48:04 UTC
Subject: [ferrethealth] Meds that are DIRECTLY anti-estrogenic and ferret safe? Specimens will go to MSU.
To: fhl <ferrethealth@yahoogroups.com>
I sent the a parred down version of the following to a ferret vet
friend who is also a pharmacologist, and am including it here with
hopes that someone somewhere will have some ideas.
Also, having had the last lab mess up her specimen (and having heard
since of another case of a specimen mix up, and two or three cases of
that same large Eastern commercial lab having not looked for Eimeria
(a small and severe coccidia genus in ferrets)) we have asked that the
specimens go to the Ferret Health Advancement group at MSU (URL in my
sig lines). There is no better lab, especially for unusual things,
and she certainly is unusual...
Whizbang is 6 and a rather strange individual whose problem screams
"estrogen" but the origin of the estrogen has not been found despite
our having excellent ferret vets (and after close to 30 years with
ferrets in our family and some ones with strange and difficult medical
problems we do know who is good). Her vulva is huge and she keeps
getting severe infections draining through it. Right now culture
allowed us to hard hit the last one and that cleared up so she is in
exploratory today.
She is 6 years old and albino. Left adrenal came out cleanly maybe 3
years ago and had mild hyperplasia. At that time she had a very early
insulinoma which also came out cleanly with no recurrence.
Months after that she began acting "wrong" on and off, as if she were
fighting infection and a string of enlarged mesentary nodes was found
on the right, but those have remained unchanged ever since so probably
in the noise.
Then her vulva began going up with infections on and off.
Ultrasound suggested twice that the right adrenal was enlarged but TN
Panel kept saying it was fine.
Her symptoms would worsen with Lupron (larger vulva and then she would
lose fur, too), but not improve after the worsening wore off. That
happened repeatedly. The higher the dose, the more she worsened
without improvement once the worsening wore off. After the final high
dose she never re-grew some fur lost after that Lupron shot. That's
not a big thing; her follicles probably gave out and it appears to
just be cosmetic. Her vulva would swell incredibly each time she had
that. It hits the floor now too often so getting it yet larger would
be really worrisome.
Given the constant infections we had the right adrenal out in case she
had an aberrant tumor that would not mess up the TN Panel readings,
like a teratoma. The lab lost the specimen, but two ferret vets saw
it and it was clearly the right adrenal and it came out cleanly, plus
neither could find any other adrenal tissue in the area, including
under the Cava, and there was no sign of any tissue from the
previously removed left one.
Placed on Fludrocort and Prednisolone because we know too well what an
Addisonian Crisis can do.
The swelling did not respond and infections resumed but became
antibiotic resistant. The vulvar pus would sometimes get incredibly
severe and then something black but nondescript would emerge (perhaps
a desiccated clot, perhaps foreign matter) and there would be improved
drainage and then some shrinking of the vulva. This happened
repeatedly -- maybe 4 to 6 times but nothing black has emerged since
the last (successful round of antibiotics).
Oh, and between infections we had tried removing a wide series of
things in case this is allergy related but with no change.
Finally she stopped draining well and her vulva is possibly the
largest one I have ever seen on a ferret personally. It is also now
speckled with red dots. A culture found an antibiotic that worked so
that was used with success for the infection but her huge size remains
so she can't keep herself clean by herself inviting new infection
(which we've luckily avoided with cleanings so far). The shape and
size are symmetrical. At least that huge infection is past.
On ultrasound it looks like a possible stump pyometra MIGHT be there.
Today she is exploratory to correct that if found and to look around
for other possible causes (missed or re-grown adrenal tissue, missed
tissue when her breeder had her spay done long years ago, etc.) Her
vulva will also be examined carefully again in case anything there
shouts for biopsy.
The infections get so severe that we really want to be able to avoid
her having more of them.
If we can't find the origin of the estrogen -- for example, if the
cause is not a stump pyometra, or if some reproductive tissue or
adrenal tissue remains but is small enough to not be able to be
spotted even by ferret savvy surgeons -- are there any ferret-safe
meds that are directly anti-estrogenic?
Because we keep getting replies to try what has already been tried --
usually repeatedly tried -- please, FHL members, notice that surgery,
Lupron, TN Panels, ultrasound/sonogram, and antibiotics -- oh, and
melatonin, too, along with Lupron -- have all been tried repeatedly
without success, and please note that our vets ARE incredibly ferret
savvy and that with close to 30 years with ferrets we know who is and
isn't ferret savvy, and that Whizbang has been discussed here before.
We have not tried importing deslorelin (People can see the FHL
archives -- URL in my sig lines -- on people doing that and how to do
it legally.), but that med is in the same class of meds as Lupron.
Hopefully, today's surgery will work. Non of us know if it will or
not. If not, then we really could *possibly* be helped by learning
about directly anti-estrogenic meds that ferrets can have.
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/
http://www.ferrethealth.msu.edu/
http://www.ferretcongress.org/
http://www.trifl.org/index.shtml
http://homepage.mac.com/sukie/sukiesferretlinks.html
all ferret topics:
http://listserv.ferretmailinglist.org/archives/ferret-search.html
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