Dear Karen:
 
>First off, lets take care of the medical stuff.  What is the accuracy
>of the Tennesee Panel?  How much does it cost.  The reason I am asking
>is that my vet is very cautious when it comes to adrenal and going for
>surgery.  He will rarely go on symptoms alone (I know, I know, but other
>than that he is VERY good) and always wants to do an ultrasound first.
>I asked him about the TN panel and he said he had heard it was not very
>accurate.  Same thing I heard about the ultrasound and it is over $100.
>Also he has much more faith in his ultrasound guy than I do.
 
Cost of the adrenal panel - $60 bucks to your vet.  Anything more is going
to his/her pocket.  Sure, there should be some markup to cover blood
drawing and processing, and the cost of shipping an overnight frozen
sample.  $80-100 is probably acceptable.  I recently heard of a vet in
the NW that was charging $180 - now I consider that gouging!
 
Accuracy - off the top of my head I remember it was around 95% predictive
with a very low false negative rate, but when I looked around today to find
that source, I couldn't come up with it.  I probably have it at work (was
home today with a leaky ceiling and a sick toddler) - if I can locate it,
I'll post the actual numbers.  But it's very good.
 
Regarding ultrasound, it just isn't that good for adrenal tumors.  If the
person is experienced with ferrets, it tends to have a low false positive
rate if you are looking simply for enlarged adrenals, but has a relatively
high false negative rate in which an enlarged adrenal isn't imaged with the
probe, or a functional adrenal lesion is too small to result in enlargement
of the gland.  Plus, there is always obvious bias when the ferret who is
undergoing the ultrasound is bald and has a swollen vulva.  This bias is
not seen in the blood test, as frozen serum is frozen serum....
 
I can understand not wanting to rush in to do adrenal surgery based on
clinical signs, and I used to feel the same way.  But if you ask me, or any
of the other vets that work with a lot of adrenal ferrets, the alternate
diseases that can cause diffuse hair loss are simply rare enough to be
eminently forgettable.  I strognly encourage early surgical intervention
as soon as clinical signs become apparent.  If the case is borderline, the
Tennessee panel usually will sort it out.
 
With kindest regards,
Bruce Williams, DVM
[Posted in FML issue 3286]