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I'll try to answer some of your questions and try to clear up some of
the inaccurate statements over the past few days about Lupron.  Lupron is
way more than merely "masking the signs." It may be a cure!  I have been
using Lupron for almost 6 years now.  Roughly 80% of the adrenal ferrets
respond real well to Lupron depot at a low dose of 100mcg/kg monthly.
Another 10% respond well to a higher dose 200-500 mcg/kg monthly.  The
other 10% have a mild to no response to even high doses of Lupron.  Most
of these "non responders" have been carcinomas.  Some have spread to the
liver and some have also had lymphoma too.  However just because a ferret
does not respond to Lupron does not mean it is a carcinoma.  Just more
likely to be a carcinoma that needs surgery before the gland gets any
bigger.
 
When Lupron is used 3 different things can happen to the adrenal gland.
1) It can become smaller! (ie if it is hyperplasia or adenoma, Lupron
may cure it!)
2) It can remain the same size and NOT get bigger!  This is also good
news.  As long as the tumor is not "big" and does not get bigger, and
it is no longer overproducing the sex hormones then it is no longer a
problem.  Lupron is not a chemotherapy drug, so it will not destroy the
adrenal gland.  But as long as the gland is not big and is not getting
bigger, it is not a problem.
3) Only a small percentage of the time will the gland actually get
bigger.  This is bad news.  Fortunately only a very small percent of
adrenal tumors become those large "fist size or bigger" tumors.  This
can happen whether they are on Lupron or are not receiving any treatment.
These large tumors are going to be carcinomas.  They need surgery before
they get big!.  Remeber ~90% respond to Lupron.  Unfortunately there is
no way to predicate which one of those 3 outcomes will happen (ie we can
not predict the future).
 
Now as for surgery, the right side is generally harder to do because of
its location.  It is under a lobe of the liver, and next to or attached
to the vena cava (ie the biggest vein), so if your local vet does not
like to do these, then it is probably best to go to someone with more
experience with this surgery.
 
In Quebec there is a vet school at the University de Montreal.  Perhaps
they can do the surgery of refer you to a "ferret vet" in Montreal or
Quebec.  There is a vet at the Univeristy de Montreal (Manon Paradis).
She is the dermatologist, but she is also very ferret savy.  She may
also be able to refer you to a ferret vet near you.  Another vet school
is located at the University of Guelph (Guelph, Ontario).  They may be
able to do the surgery or refer you to a ferret vet for the surgery.
If you are still afraid of surgery, then try Lupron and monitor the size
of the adrenal gland frequently (ie with each monthly injection).
 
Good Luck with Cookie,
Jerry Murray, DVM
Dallas, Texas
[Posted in FML issue 4355]