What happens when adrenal disease is not treated?
 
The ferrets suffer; and it is abusive.  Why and how?  Read below.
http://ferrethealth.org/archive/browse.php?msg=SG5054
 
START QUOTE
Actually tonight I am working on a promised article to Ferrets Mag
about adrenal disease.  But I think that Melissa and Sukie have
covered the dire possibilities very well (and they are very real.)
 
However, even under the best conditions, when there is no malignancy,
there is no bone marrow toxicosis, there is no prostatic cystic
disease - even the most mild prediction is a sad one.  Ferrets
with adrenal disease have a diminished quality of life - they have
progressive muscle loss, low grade anemia, they tend to redistribute
weight to the abdomen, further making it difficult to walk, they have
an increased incidence of gastric ulcers as a result of the stress
of chronic illness, decreased bone density - none life-threatening,
but all life-compromising.  Even medical treatment, which is not my
preferred way of treating adrenal disease, gives slight releif to
symptoms.  Doing nothing is not kind and not in a ferret's best
interest.
 
With kindest regards,
 
Bruce Williams, DVM
END QUOTE
 
Now, let's get into the more serious results:
 
Gastric ulcers were mentioned above and I know a number of people here
can tell you that those can become fatal at times, and can be very hard
to manage when they get bad.
 
Urinary blockage: Fatal if the bladder bursts and usually fatal if the
urine backs up the kidneys and causes hydronephrosis; extremely painful.
(BTW, ferrets with adrenal disease can also be more prone to UTIs, too,
esp.  females and bad enough ones can block through inflammation though
that is rare.  Urinary blockages are usually of males with enlarged
prostates..
 
Anemia from bone marrow toxicosis: Usually fatal; very hard to treat
once it begins.
 
Possible further alteration of the growth to become malignant
 
Less commonly there can even be fat in the thoracic cavity, impinging on
the function of the heart, lungs, or both.  Ferrets with adrenal disease
can do some very non-standard fat patterns.  Most common is that they
become emaciated around the thorax but fat in the abdomen.  (This also
is lousy for body heat management and discomfort from that -- not just
from not being able to move around well.)
 
Approaches for ferrets with adrenal disease: surgery (usually best);
Core meds: Suprelorin/deslorilin in countries which have it, Lupron, and
melatonin.  Approaches when there is anemia from bone marrow toxicosis:
if safe enough get that diseased adrenal out pronto; bone marrow
transplant can be done (See FHL Archives) but it takes a few days to
kick in; blood transfusion preferably from a large ferret (Ferrets do
not have blood types.).  Meds: Lupron and melatonin to stop stimulation
of adrenal by pituitary, Arimidex to inhibit estrogens (Both genders
have both androgens and estrogens; estrogens are the usual culprits
for marrow toxicosis and for prostate swelling secondary to adrenal
disease.), Epogen and Procrit to stimulate the bone marrow to make more
marrow cells, supplementary iron and B vitamins.  Those are NOT
either/or.  A ferret with bone marrow toxicosis should be expected to
need all stops pulled out to get the ferret well enough to undergo
surgery.  (If the ferret is among the less common ones who have excess
androgens then Casodex can be considered, but that is more commonly
useful in male ferrets with enlarged prostates or aggressiveness, or
both.  Other things to do, besides Casodex, when a swollen prostate from
adrenal disease results in urinary blockage: have vet remove urine with
a needle and do emergency adrenal surgery.  Left too long if it is not
blocking fully, the prostate may form a cyst and those require much more
tricky surgery so that they can drain constantly.  Meds: Propecia/
Proscar, Lupron and melatonin.  Sometimes Flomax may be tried (Not an
established use but one vet has mentioned trying it for when the
situation is dire.)
 
-- Sukie (not a vet)
Ferret Health List co-moderator
http://www.smartgroups.com/groups/ferrethealth
FHL Archives fan
http://ferrethealth.org/archive/
replacing
http://fhl.sonic-weasel.org
International Ferret Congress advisor
http://www.ferretcongress.org
[Posted in FML issue 5112]