[3-part post combined into this one]
 
We've done more bi-lateral adrenals than I can actually put a number to
without digging through a lot of old records.  I've never noticed any
distinctive relation of bi-lateral adrenal and GI tract or stomach
ulcers.
 
A few from memory:
 
Sniffles had bi-lateral adrenal surgery at 18 months old and died at
age 5, no post op meds other than amoxicillin, then 2 weeks later begin
Lysodren.  Lysodren for 2 years following the surgery
 
Boomer had bi-lateral surgery at aprox. 2.5 years, amoxy post op, was
also on Lysodren for 2 years following surgery.  Died from a ruptured
spleen after a fall at age 6.
 
Both these had both removed at the same time.  (a stump of right adrenal
was left and Lysodren was the adrenal tumor drug of the time) (Lysodren
can contribute to low glucose and must be used with extreme care, if at
all.)
 
Rascal: bilateral at age 7, amoxy post op, a more 'complete' bi-lateral
than those above.  No Lysodren.  Developed kidney disfunction which
contributed to fatal decline from stomach ulcers at age 9.
 
Chiquita: right adrenal age 4, left adrenal/insulinoma 15 months later,
amoxy and pediapred post op, decline & death from isulinoma 13 months
later.
 
More currently:
 
Misty: bilateral at age 4, amoxy, Florinef 6 weeks, dexamethasone
(steroid) 3 weeks post op.  Still thinks she runs the joint 11 months
later.
 
Scruffy: left adrenal age 2, right adrenal/insulinoma age 7, amoxy,
Florinef 6 weeks, dexamethasone (steroid) 3 weeks post op.  Somewhat
"elderly" but still wardances occasionally 11 months later, 0.5cc
pedia pred once daily since second adrenal surgery.
 
Charlie: right adrenal aprox age 5, left adrenal 6 months later, amoxy,
Florinef 6 weeks, dexamethasone (steroid) 3 weeks post op.  9 months
later is still wardancing.
 
GI tract perforation and concurrent adrenal surgery cases:
 
Angelfish died of peritonitis due to intestinal tract ulcer perforation
following single adrenal surgery.
 
Roxie died of an ulcer perforation of intestinal tract post single
adrenal surgery at age 7.  Technically, death was due to shock... fresh
blood from the adrenal incision (more than the usual surface vessel leak)
prompted us to reopen the incision.  An intestinal tract re-section was
done, post op recovery seemed fine, brought her home, tucked her into a
blankie on the couch & walked to kitchen for a cup of coffee, and she
died before I got back to the couch.
 
Joey: left adrenal at 6 months, right adrenal/insulinoma at 4 years
amoxy, Florinef 6 weeks, dexamethasone (steroid) 3 weeks post op.
Pediapred thereafter for insulinoma.  Was returned to shelter after a
year's adoption due to chronic stomach ulcers and intestinal tract
infections, enlarged prostate due to adrenal tumors.  Joey was hand fed
baby food every 4 hours for 18 months before finally conquering the
stomach ulcers.  Lived another year of quality time with occasional
wardancing.  Died after brief decline from insulinoma.
 
These cases are just a small sampling of adrenals old and new that we've
been through... we average 3 to 10 adrenal surgeries a year.
 
If you've ever watched an adrenal surgery and have seen how the organs
are pulled out of the incision & pushed around as the surgeon digs down
to the adrenal glands you have to wonder if the intestinal tract might
be getting some stressed tugging that could cause damage.  There's not
a lot of room for a surgeon to work in there.  Fat ferrets (yes, those
bouncy, pudgy fuzzies) are even more difficult as there are fat deposits
to dig through... yes... I think dig is a very descriptive word to use.
 
My vet agrees that this may be very possible, especially in cases where
a stressed intestinal tract may be already present prior to surgery.
This scenario is really the only link between adrenal surgery and GI
tract perforation that I personally make... I'm not a vet, though, and
don't pretend to be.
 
The factors of a good surgery recovery in my experience are:
 
- No more than 4 hours without eating pre-surgery.
- Pre-surgical steroid and fluids.
- Pre-surgical Vitamin K for ferrets that have been on pred for more
  than 3 months.
- No more than 45 minutes under iso or sevo anesthetic.
- No pain meds prior to post op recovery.
- Incubator or warming pad post op.
- Eating small amount of soup no sooner than 6 hours, no later than 8
  hours after surgery (must wait for digestive system to 'restart' before
  feeding)
 
We don't 'test' for adrenal tumors.  We diagnosis by bilateral hair
loss, aggressive behavior, etc.  We do an ultrasound to check more for
additional problems than to 'find' an adrenal tumor.  We've never gone
in for an adrenal tumor and NOT found one.
 
Debi Christy
Ferrets First Foster Home
www.ferrets1st.com
[Posted in FML issue 5121]