From:
Sukie Crandall
Date: 2011-02-25 19:30:15 UTC
Subject: [ferrethealth] one of the most common causes of confusion in relation to melatonin and fur
To: FML List <ferret-l@LISTSERV.FERRETMAILINGLIST.ORG>, fhl <ferrethealth@yahoogroups.com>
This is a little scattered because i had to write it between doing other things and i sorely lack spare time, but it should help with the FML discussion on the topic.
One of the most common fallacies with adrenal disease is that you can supposedly monitor improvement of the disease from the fur. That is partly WRONG. Bilateral fur loss, especially on the trunk or head, is a useful indicator to look for adrenal disease and it does worsen often as the disease advances, BUT -- this time we will talk about a HUGE "but" -- fur regrowth from melatonin given in any form can be influenced more than one pathway. The thing about melatonin is that it helps fur regrow through TWO separate pathways, BUT -- another huge "but" -- you can not afford to forget its other influence for fur regrowth is through the pathway that is dermal rather than affecting the adrenal hormonal output. So, if people make the MISTAKE of thinking that fur growth tells all then melatonin can give the best fur appearance while doing the least to treat the adrenal disease. Opps! See:
http://jhc.sagepub.com/content/44/4/377.full.pdf
http://ferrethealth.org/archive/YG1766
Remember these two things:
1. Adrenal disease does not need to be terminal except in special situations like a right adrenal carcinoma that has grown into the Vena Cava. Those situations happen but are not the majority of cases. Whether by using effective enough meds or surgery -- depending on the ferret and the vet -- death from adrenal disease is not necessary for the vast majority of ferrets with adrenal disease. That is GOOD NEWS. Welcome the options. Embrace them.
2. The much more effective class of medications is the one containing Suprelorin implants, and Lupron depots.
MORE GOOD NEWS! Since that class of meds and melatonin work through different pathways they can be given together for an even better cumulative effect.
YES, YOU CAN USE MELATONIN ALONG WITH SUPRELORIN OR LUPRON.
There is also surgery.
It is NOT a contest between surgery and meds; instead the truth of the situation is that there are OPTIONS so that the choice of treatment can be selected depending on the needs of the individual ferret. That is a good thing. Don't get stuck in a rut. Do what serves the individual ferret the best.
Oral melatonin is better than nothing, but providing enough complete darkness (not dimness) all along if possible (and in small homes it is not always possible) would have worked even better since the body probably does not become refractive to the melatonin it produces itself in response to darkness, though once adrenal disease appears if a person can't afford anything but oral melatonin then definitely go with that route because it is at least something. It also won't hurt to give oral melatonin if a person has mis"diagnosed" on her or his own unless the person is missing a different serious medical problem with overlapping symptoms. (DANGER ALERT for missed illnesses and conditions!) BTW, oral melatonin needs to be given after about the same day length for Winter sunset to have maximum effect. See:
http://ferrethealth.org/archive/YG4477
which is from before the ferret implants (which are cleaner and made better and more carefully than the fur farm mink ones).
The melatonin implants for ferrets, Ferretonin, is affordable and very useful, we find. Our vets are currently giving one of ours both Suprelorin and Ferretonin implants. She is the second of two ferrets, one of whom passed last year, whose first appearance of adrenal symptoms turned out to be a huge R carcinoma. The first ferret could not safely have surgical removal; the tumor was too involved with her Vena Cava. The current ferret turned out in presurgical testing to be in early dilative cardiomyopathy. Ultrasound makes it look like the tumor is not yet involving her Cava, but her heart condition makes the surgery much tricker so we are opting for the medical approach. Carcinoma of an adrenal can be slowed with the medications but not stopped. There is a surgeon in our area who has special services for animals who are at high surgical risk and our vets like his work very greatly, but we are feeling gun shy. Right now we are not emotionally ready to risk her in surg
ery when the meds might slow her adrenal disease for about as long as her heart disease may last. (BTW, with her getting dilative cardiomyopathy that makes every ferret we have had who has had clean and complete white mitts and bib getting dilative cardiomyopathy in ages 5 to 7, despite coming from multiple breeders over a space of decades, so something to test a bit more for with those markings.)
The body becomes refractive toward oral melatonin the easiest. That means that the value of giving it goes away in most (not all) ferrets the easiest. It also means that when going with provided melatonin the implant is a better choice. Again, oral melatonin is better than nothing but never assume that regrowing fur indicates much since it does that through two pathways, and one of those pathways means nothing in relation to adrenal disease. Avoid that fallacy!
Two other things to consider:
Surgery is the best option for a number of adrenal ferrets, but combined meds for others, and some may do as well with either approach. It is wonderful to have options.
Second:
Don't diagnose adrenal disease yourselves. Suspect it but don't diagnose it; use a ferret vet. Seriously, there have been too many people who are not vets who "diagnose" adrenal disease in their ferrets and then "treat" at home. Sometimes their diagnosis is right but -- and this is a big "but" -- sometimes the ferrets actually have something else going on like tail acne, or a rapid shed, allergies, fleas, ring"worm", mites, malnutrition, or something else. Heck, we had one long ago with hypertrophic cardiomyopathy and no adrenal disease (confirmed by necropsy and pathology after death) who lost fur because of peripheral circulation impairment!
It is important for people who read posts on lists to take into account whether the ferret mentioned had a real or accurate diagnosis in the first place -- or perhaps didn't -- and the risk of an erroneous "diagnosis" is much higher with the do-it-yourselfers who did not go to veterinary school. Sorry, but medicine is a field which needs a LOT of background and then concerted, organized study with experts. It can not be duplicated by random reading in spare time, despite popular desire and myth. (and that is one reason I use the sig line that I use, so that people always remember that grain of salt)
With adrenal disease that can not be sufficiently treated (such as a large carcinoma involving the Vena Cava), or which is not sufficiently treated because of lack of funds (unavoidable) or lack of veterinary care (sometimes avoidable and sometimes not) there is an increased risk of life threatening complications developing. Then additional meds or even prostatic surgery (cyst drainage) may be needed, so prostatic disease and anemia are also subjects to look into:
http://ferrethealth.org/archive/FHL11305
http://ferrethealth.org/archive/SG13972
Remember in some of those posts that Suprelorin implant was not as available before as now so sometimes not mentioned for that reason in past posts. It is in the same class of meds as Lupron depot.
Possible prevention or delay of onset often uses the same meds:
http://ferrethealth.org/archive/FHL9686
Here are some basics but I did not have time to find you many expert resources so use the archives yourselves.
http://ferrethealth.org/archive/FHL9453
I will copy this to the FHL where it might help some others, also.
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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