Dear Ferretsey:
 
>I have lost two of my darlings last year.  Sara may have adrenal disease;
>however she just had surgery--I hate to subject her to another surgery.
>I know that the best way to diagnose adrenal gland problems is with a
>sonagram.  However none of the vets in my town have one.  Is there another
>way to treat adrenal gland disease?  I remember hearing something about
>using Lupron.
 
Actually, ultrasound is a very poor way to diagnose adrenal disease
problems.  While it may pick up lesions that cause gross enlargement of the
adrenal glands, it tends to miss all those which are secreting estrogen,
but are not large enough to cause gross enlargement of the gland.  I still
prefer a good clinical examination as the best way to identify signs of
adrenal disease, and in borderline cases, I recommend using the Tennessee
blood panel.
 
I don't think that ultrasound really adds anything except money to the
bill.  If the animal has clinical signs, but the ultrasound is negative,
you still have to go in.  So why bother?  Yes, it may tell you which side
(right vs.  left), but that should have no bearing on whether you do
surgery or not.  All adrenals are potentially curable vs.  surgery,
regardless of location or involvment.
 
There has been tremendous discussion about Lupron as a treatment for
adrenal disease on this list and on a number of sites on the Internet.  I
generally recommend it only for non-surgical candidates, because it does
little to prevent continued growth and functioning of the adrenal tumor,
it simply treats clinical signs.
 
In the interest of time and space, for more info on Lupron, I would suggest
a search of the FML archives (insturctions above.)
 
With kindest regards,
bruce williams, DVM
 
Bruce H. Williams, DVM, DACVP
Chairman, AFIP Dept. of Telemedicine
Armed Forces Institute of Pathology
Washington, DC 20306-6000
(202) 782-2392
 
Ipsa scientia potestas est.
[Posted in FML issue 3294]