Dear X:
 
It is always better to go in before the situation becomes critical, while
the patient is the best surgical candidate.  If the diagnosis has been
made, and you are committed to eventually doing surgery, sooner is always
better than later for a number of reasons.  Medical treatment allows the
neoplasms to grow larger and increases the chance of post-surgical
complications.
 
If the surgery only involves one adrenal, then Addison's is not an issue.
(And Addison's is certainly not the end of the world.  I have a bilateral
adrenal at home who gets a monthly shot of Percorten and bounces around
happily,her old normal self.) Post-surgical diabetes is a rare
complication, whose incidence is markedly increased in animals with either
long-standing insulinoma or prolonged medical treatment (another reason
to do surgery early).
 
The theory that these tumors "seed" is unproven, and an
oversimplification.  Yes, 40% of cases recur within 10 month, but this is
not due to metastasis, but an unchecked (and as yet unidentified)
metabolic condition which causes hyperfunction of islets of Langerhans.
If your vet believes that these neoplasms tend to metastasize around the
body, well that has been disproven in ferrets.
 
Bottomline - an early surgery in the vast majority of cases, has the best
chance of prolonging quality of life.
 
With kindest regards,
Bruce Williams, DVM
 
[Sukie note: insulinoma is different from the possible pancreatic
malignancy options for a different ferret which BAO discussed in another
cross-post sent out tonight.]
[Posted in FML issue 3608]