Dear Paula:
 
>I have a 5 year old female who had surgery for insulinoma and left adrenal
>two years ago.  The insulinoma has returned and I suspect the right
>adrenal.  I had made the decision to not do another surgery because my vet
>has retired and decided to put her on prednisone about 2 weeks ago.  Is it
>now "impossible" to have surgery done after she has been on pred or can I
>change my mind if I decide I want it done?
 
It certainly is not impossible - and it is more appropriate to do it
sooner than later.  Medical treatment is generally a stopgap measure for
insulinoma - it generally puts off surgery for a while, but surgical
treatment becomes an eventuality.  The longer you wait, the poorer a
surgical candidate a ferret becomes.  My recommendations are generally to
do surgery, and followup with prednisone if needed, in the post-surgical
period, for ferrets in which surgery is not successful, or for non-surgical
candidates.
 
>Or after the use of pred does it suppress the immune system so much that
>it is not a good idea to go through surgery???
 
Ferrets are actually a considered a steroid-resisstant species, as opposed
to dogs, cats, and humans.  Appropriately dosed prednisone has minimal
effects on the ferret immune system, and is not ulcerogenic as in other
species.  I generally try to avoid high-dosese o prednisone in the
immediate post-op period, for its effects on wound healing.  Because your
ferret is currently on prednisone for insulinoma, and the dose will get
continually higher over time to offset insulin excretion by the pancreatic
tumor, this would be another reason to contemplate surgery at an earlier
date before the daily dose gets into the high ranges.
 
>Also, just wanted to let everyone know that I have owned 6 ferrets over
>the past 10 years and they have all been vaccinated with FERVAC with no
>reaction.  Hope this will help to determine a percentage.
 
While I think I would discourage anyone who is trying to use the FML to
determine a percentage for Fervac reactions - your report is appreciated.
 
With kindest regards,
Bruce Williams, dVM
[Posted in FML issue 3242]