From:
"sukiedaviscrandall"
Date: 2010-07-11 00:42:11 UTC
Subject: [ferrethealth] adrenals and Addisons Crises
To: ferrethealth@yahoogroups.com
Someone needed this elsewhere and it was put together in a bit of a rush
but perhaps it can help someone here, too:
The meds used to avoid going Addisonian are:
Fludocort (or Florinef for which fludrocort is the generic) and Prednisolone
OR
Percorten and Prednisolone
There is TONS about this in the FHL Archives AND the FML Archives as well as elsewhere.
The Prednisolone replaces steroids normally made in the adrenal cortex that work on fluid management in the body, very important.
The Fludrocort (which is the generic of Florinef) OR the Percorten is used to maintain proper sodium-potassium balance and without that the cells all through the body begin to die. It replaces a different category of steroids that the adrenal cortex normally makes. It avoids unnecessary ferret deaths. This is the replacement that might call for a tiny pinch of salt to be added to the diet until the management level has been found.
At times throughout life the doses may need to be adjusted. The levels often need to be increased when there is a major stress in life later or if weight is gained, and here is why more may be needed if there is insulinoma:
http://ferrethealth.org/archive/FHL11630
and
http://www.ncbi.nlm.nih.gov/pubmed/20418760
Prednisolone by itself is NOT sufficient unless a bit of adrenal tissue remains after surgery (which can happen) and in that case sometimes none of the meds to replace those normal steroids are needed.
People often confuse debulking of an adrenal with complete removal but they are very different in that some adrenal tissue remains with a debulking. Adrenal tissue is also more likely to remain if cryosurgery is used. Sometimes cryosurgery or debulking is needed because full removal can not be safely done.
We always make sure that such meds are on hand even if just one adrenal is cleanly removed in case the other is atrophied, which is rare but does sometimes happen.
Besides the piece recommended in another of my posts today see also:
http://ferrethealth.org/archive/FHL10682
http://ferrethealth.org/archive/SG9938
http://ferrethealth.org/archive/FHL9451
http://ferrethealth.org/archive/FHL8142
http://ferrethealth.org/archive/FHL6332
http://ferrethealth.org/archive/YPG1017
http://ferrethealth.org/archive/YG8113
http://ferrethealth.org/archive/SG12954
http://ferrethealth.org/archive/SG11015
Notice that sometimes when one gland remains a temporary Addisons problem can sometimes happen:
http://ferrethealth.org/archive/FHL8717
http://ferrethealth.org/archive/YG8101
http://ferrethealth.org/archive/YG6005
Percorten timing (but note that we have had one who needed it every 20 days and I have read and heard of others who also did):
http://ferrethealth.org/archive/SG801
Some ferrets do well on EITHER Percorten every 20 days OR daily Florinef (for some twice daily) and the Prednisolone, but some do better on one rather than the other, and some few do better on Dex or another option rather than Prednisolone. DO use Prednisolone INSTEAD of Prednisone because if the liver is at all compromised the Prednisone will not work as well -- which is because the liver has to convert Prednisone to Prednisolone before the body can utilize it, so skipping that liver-processing step just plain makes sense.
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
"All hail the procrastinators for they shall rule the world tomorrow."
(2010, Steve Crandall)
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