This is a little scattered because i had to write it between doing
other things and i sorely lack spare time, but it should help with
the FML discussion on the topic.
One of the most common fallacies with adrenal disease is that you can
supposedly monitor improvement of the disease from the fur. That is
partly WRONG. Bilateral fur loss, especially on the trunk or head, is
a useful indicator to look for adrenal disease and it does worsen
often as the disease advances, BUT -- this time we will talk about
a HUGE "but" -- fur regrowth from melatonin given in any form can be
influenced more than one pathway. The thing about melatonin is that it
helps fur regrow through TWO separate pathways, BUT -- another huge
"but" -- you can not afford to forget its other influence for fur
regrowth is through the pathway that is dermal rather than affecting
the adrenal hormonal output. So, if people make the MISTAKE of thinking
that fur growth tells all then melatonin can give the best fur
appearance while doing the least to treat the adrenal disease. Opps!
See:
http://jhc.sagepub.com/content/44/4/377.full.pdf
http://ferrethealth.org/archive/YG1766
Remember these two things:
1. Adrenal disease does not need to be terminal except in special
situations like a right adrenal carcinoma that has grown into the
Vena Cava. Those situations happen but are not the majority of cases.
Whether by using effective enough meds or surgery -- depending on the
ferret and the vet -- death from adrenal disease is not necessary for
the vast majority of ferrets with adrenal disease. That is GOOD NEWS.
Welcome the options. Embrace them.
2. The much more effective class of medications is the one containing
Suprelorin implants, and Lupron depots.
MORE GOOD NEWS! Since that class of meds and melatonin work through
different pathways they can be given together for an even better
cumulative effect.
YES, YOU CAN USE MELATONIN ALONG WITH SUPRELORIN OR LUPRON.
There is also surgery.
It is NOT a contest between surgery and meds; instead the truth of the
situation is that there are OPTIONS so that the choice of treatment can
be selected depending on the needs of the individual ferret. That is a
good thing. Don't get stuck in a rut. Do what serves the individual
ferret the best.
Oral melatonin is better than nothing, but providing enough complete
darkness (not dimness) all along if possible (and in small homes it
is not always possible) would have worked even better since the body
probably does not become refractive to the melatonin it produces itself
in response to darkness, though once adrenal disease appears if a
person can't afford anything but oral melatonin then definitely go with
that route because it is at least something. It also won't hurt to give
oral melatonin if a person has mis"diagnosed" on her or his own unless
the person is missing a different serious medical problem with
overlapping symptoms. (DANGER ALERT for missed illnesses and
conditions!) BTW, oral melatonin needs to be given after about the
sameday length for Winter sunset to have maximum effect. See:
http://ferrethealth.org/archive/YG4477
which is from before the ferret implants (which are cleaner and made
better and more carefully than the fur farm mink ones).
The melatonin implants for ferrets, Ferretonin, is affordable and
very useful, we find. Our vets are currently giving one of ours both
Suprelorin and Ferretonin implants. She is the second of two ferrets,
one of whom passed last year, whose first appearance of adrenal
symptoms turned out to be a huge R carcinoma. The first ferret could
not safely have surgical removal; the tumor was too involved with her
Vena Cava. The current ferret turned out in presurgical testing to be
in early dilative cardiomyopathy. Ultrasound makes it look like the
tumor is not yet involving her Cava, but her heart condition makes
the surgery much tricker so we are opting for the medical approach.
Carcinoma of an adrenal can be slowed with the medications but not
stopped. There is a surgeon in our area who has special services for
animals who are at high surgical risk and our vets like his work very
greatly, but we are feeling gun shy. Right now we are not emotionally
ready to risk her in surgery when the meds might slow her adrenal
disease for about as long as her heart disease may last. (BTW, with her
getting dilative cardiomyopathy that makes every ferret we have had
who has had clean and complete white mitts and bib getting dilative
cardiomyopathy in ages 5 to 7, despite coming from multiple breeders
over a space of decades, so something to test a bit more for with
those markings.)
The body becomes refractive toward oral melatonin the easiest. That
means that the value of giving it goes away in most (not all) ferrets
the easiest. It also means that when going with provided melatonin
the implant is a better choice. Again, oral melatonin is better than
nothing but never assume that regrowing fur indicates much since it
does that through two pathways, and one of those pathways means nothing
in relation to adrenal disease. Avoid that fallacy!
Two other things to consider:
Surgery is the best option for a number of adrenal ferrets, but
combined meds for others, and some may do as well with either approach.
It is wonderful to have options.
Second:
Don't diagnose adrenal disease yourselves. Suspect it but don't
diagnose it; use a ferret vet. Seriously, there have been too many
people who are not vets who "diagnose" adrenal disease in their ferrets
and then "treat" at home. Sometimes their diagnosis is right but -- and
this is a big "but" -- sometimes the ferrets actually have something
else going on like tail acne, or a rapid shed, allergies, fleas,
ring"worm", mites, malnutrition, or something else. Heck, we had one
long ago with hypertrophic cardiomyopathy and no adrenal disease
(confirmed by necropsy and pathology after death) who lost fur because
of peripheral circulation impairment!
It is important for people who read posts on lists to take into account
whether the ferret mentioned had a real or accurate diagnosis in the
first place -- or perhaps didn't -- and the risk of an erroneous
"diagnosis" is much higher with the do-it-yourselfers who did not go to
veterinary school. Sorry, but medicine is a field which needs a LOT of
background and then concerted, organized study with experts. It can not
be duplicated by random reading in spare time, despite popular desire
and myth. (and that is one reason I use the sig line that I use, so
that people always remember that grain of salt)
With adrenal disease that can not be sufficiently treated (such as a
large carcinoma involving the Vena Cava), or which is not sufficiently
treated because of lack of funds (unavoidable) or lack of veterinary
care (sometimes avoidable and sometimes not) there is an increased risk
of life threatening complications developing. Then additional meds or
even prostatic surgery (cyst drainage) may be needed, so prostatic
disease and anemia are also subjects to look into:
http://ferrethealth.org/archive/FHL11305
http://ferrethealth.org/archive/SG13972
Remember in some of those posts that Suprelorin implant was not as
available before as now so sometimes not mentioned for that reason
in past posts. It is in the same class of meds as Lupron depot.
Possible prevention or delay of onset often uses the same meds:
http://ferrethealth.org/archive/FHL9686
Here are some basics but I did not have time to find you many expert
resources so use the archives yourselves.
http://ferrethealth.org/archive/FHL9453
I will copy this to the FHL where it might help some others, also.
Sukie (not a vet)
Recommended ferret health links:
http://pets.groups.yahoo.com/group/ferrethealth/
http://ferrethealth.org/archive/
http://www.afip.org/ferrets/index.html
http://www.miamiferret.org/
http://www.ferrethealth.msu.edu/
http://www.ferretcongress.org/
http://www.trifl.org/index.shtml
http://homepage.mac.com/sukie/sukiesferretlinks.html
all ferret topics:
http://listserv.ferretmailinglist.org/archives/ferret-search.html
"All hail the procrastinators for they shall rule the world tomorrow."
(2010, Steve Crandall)
[Posted in FML 6985]
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