Hi, Ann, and everyone else,
 
Your situation, or ones like it, are all too familiar.  I think our vet
would, like yours, get the ferret stronger so that she'd be a better
surgical candidate.  He'd probably go after the pancreatic mass and
whichever adrenal gland is most urgent first, then let her recover and
rebuild her strength for six to eight weeks, and then go after the second
gland.  When he did the right he'd ligate the vena cava.  I've had one
ferret, Lady Ayeka, go through combined insulinoma/adrenal surgery like
that (left gland) and she came through with flying colors.  I've had
three ferrets have their right gland removed with vena cava ligation and
all came through just fine.  Podo was seven and a half when he had his
right out and lived to be just about 10.
 
The reason for separating the two surgeries is that the combined surgery
is rough enough on the ferrets and when our vet did bilateral adrenal
surgery and possibly insulunoma surgery all at once his success rate
dropped.  It was just too much for some ferrets.
 
When the second adrenal gland comes out that will be an even rougher
recovery.  If the starting dosage of medications to replace the missing
adrenal products the ferret will start showing symptoms of surgically
induced Addison's Disease.  We had that with both Pertwee and Ryo-Ohki.
Once the medications were right and their electrolytew were in balance
and, in Pertwee's case, another medical issue was dealt with, they
rallied.
 
Make sure you educate yourself about Addison's after bilateral
adrenalectomies and expecially about how to recognize an Addisonian
Crisis, which is life threatening.  The Ferret Health List archives
have tons of great material.  You can find them at
http://fhl.sonic-weasel.org
I'd also recommend subscribing to the FHL if you don't already.  The
more you know the better you can recognize potential problems that may
need immediate vet care.
 
I wish you and your little one the best of luck.  Pertwee lived for
almost four years with no adrenal glands and was our most crazy,
frenetic, and absolutely wired weasel pretty much that whole time.
 
The usual disclaimer applies: I am not a vet.  I just have been where you
are now.
 
All the best,
Caity and the fantastic four
[Posted in FML issue 4714]