Shelly,
 
        (A copy of this reply is being forwarded to the FML for informational
purposes.)
        The problem that you are seeing with Vanilla's hair falling out is not
related to the puppy entering your house, but most likely is a manifestation of
adrenal disease in the ferret.  In a lot of older ferrets, there are lesions in
the adrenal gland which secrete excessive estrogen, and this results in hair
loss in both sexes, and in females, even spayed ones, you often see a swelling
of the vulva and perhaps a small discharge.
 
        Don't worry, this is not an emergency.  It is also something that your
vet probably can't pick up on a blood test.  Please read the following article
that I posted on the FML several months ago.  If you have any questions, please
feel free to email me or call me at the numbers listed below.
 
The following article may be reprinted by anyone desiring to
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publication.  This material may not be altered or changed in any way.
Under Title 17 of the U.S. Code, Section 105, copyright protection is
not available for any work of the United States Government.
 
 
                       Adrenal Disease in the Ferret
 
 
     "My ferret is losing its hair."
 
     While hair loss in the ferret can occur from many causes, I would like to
concentrate on what is the most common and what is becoming the most commonly
talked about reason for serious hair loss -- proliferative lesions of the ferret
adrenal gland.
 
     Ferrets with adrenal lesions - including areas of hyperplasia as well as
both benign and malignant neoplasms of the adrenal cortex - typically all show
the same clinical signs regardless of which type of growth is present. These
signs are fairly diagnostic, and in the majority of cases, are so characteristic
that no other diagnostic tests are required before therapy is instituted.
 
     The signs of adrenal disease in the ferret are well documented (Fox et al.,
1987, Lawrence et al. 1993, Rosenthal et al., 1993, Lipman et al, 1993) although
the cause of these signs is still somewhat unclear.  Adrenal lesions may be seen
in animals ranging from one to seven
years of age, with the average being around 3.5 years. In one study (Rosenthal,
1993), 70% of affected ferrets were female.  Hair loss, or alopecia, is by far
the most common clinical sign in affected ferrets.  Hair loss often begins at
the tail, and progresses forward over the trunk, flanks, and abdomen, until hair
is only present on the neck, head, and the extremities.  Additionally, in spayed
females, the vulva will often become swollen to theextent that the owner may
erroneously believe that the animal is estrus.  A watery mucus discharge from
the vulva may also be seen in this animal.  (Vulvar swelling in a spayed
female on its own is sufficient cause to warrant abdominal exploratory surgery).
 Other clinical signs that may be seen in ferrets with adrenal lesions include
increased scratching,excessive drinking and urination, anemia, weight loss, and
in longstanding cases, difficulty in using the hind legs.
 
     The cause of the hair loss and vulvar swelling is not currently known.  In
other species with hyperadrenocorticism,  high circulating levels of adrenal
corticosteroids cause the hair follicles to atrophy and the skin itself to
become thin, resulting in hair loss.  But since we know that these ferrets do
not have these high levels of cortisone, this explanation
does not suffice for what we see clinically.  A plausible theory has been
advanced by specialists at the Animal Medical Center in New York City.
(Rosenthal, 1993).  Citing the fact that 36% of affected ferrets have high blood
levels of estrogen, the believe that early neutering (most ferrets in the U.S.
are neutered before six weeks of age) cause a population of cells in the adrenal
gland which have retained the ability to secrete gonadal hormones to grow, in
essence "filling the void".  High levels of estrogen are well known to
also cause hair follicle atrophy, and would also cause vulvar swelling in
females, as is seen in estrus.  In fact, Dr. Rosenthal has demonstrated that
serum estrogen levels are indeed higher in ferrets with adrenal disease.
 
     The treatment for adrenal disease in ferrets primarily involves removal of
the affected adrenal gland.  In most cases, adrenalectomy is performed based
solely on clinical signs.  Routine pre-surgical bloodwork should be performed in
all animals over 4 years of age, as would be done for any other type of surgical
procedure.  Special diagnostic tests which are used in other species to diagnose
adrenal disease are rarely of use in the ferret. Specific testing for estrogen
levels in the ferrets is not commonly available, even at diagnostic labs, and in
most cases is not necessary to confirm the diagnosis.
 
      In most cases, one gland is noticeably larger than the other and is
removed.   For unknown reasons, the left adrenal gland accounts for the majority
of lesions (64%), with the right adrenal gland accounting for 26%, and 8% of
ferrets having disease in both adrenals. Removal of one adrenal gland is
generally well tolerated in ferrets and in most of these cases, if disease is
confined to that gland, clinical signs will cease (i.e., the hair will grow
back and the swollen vulva will diminish to its previous size).  In animals with
bilateral disease, removal of one gland and part of another has been done, but
carries a more significant risk of post-operative complications.  Ferrets
require at least a portion of one adrenal gland to live.
 
     The surgery itself is not excessively difficult.  Removal of the left
adrenal is fairly easy and has a low risk of complication.  Due to the position
of the right adrenal  near several large blood vessels, it is a more difficult
surgery and requires considerably more expertise on the part of the surgeon. As
always, if your veterinarian has little expertise in performing this surgery, it
is wise to ask for a referral to a more experienced surgeon. In cases in which
surgical excision of the offending adrenal gland is not an option, medical
treatment with certain drugs that kill off a large portion of the cells of the
adrenal cortex may be tried.  Unfortunately, this medication is not specific for
estrogen-secreting cells, and affect all of the other cortical cells as well.
For this reason, this form of treatment should be reserved only for those
animals who are poor surgical candidates.
 
     Unfortunately, not all adrenal surgeries end happily.   Postoperative
mortality averages from 10% (Tom Kawasaki, personal communication) to 12.5%
(Rosenthal, 1993). The cause of the post-surgical mortality is not known; most
theories center on the inability
of the other, unaffected adrenal gland to produce enough cortisol on short
notice, i.e., the hyperfunctioning gland has caused it to atrophy.
 
     On a personal note - while some owners believe that hair loss is only
cosmetic and would "rather not put their pet through the stress of an
operation", let me categorically state that the changes seen in ferrets with
adrenal disease are cumulative and progressive. Animals with adrenal lesions do
not just lose their hair - they also lose muscle mass, and have little energy
While the lesions themselves are rarely life-threatening  (in over one-hundred
twenty cases, I have only seen two cases of tumor metastasis), their clinical
manifestations are debilitating and greatly decrease the quality of a ferret's
life.  (When I noticed the signs of adrenal disease in one of my ferrets who was
six at the time - I had the surgery done immediately.  The hair has grown back,
the vulva has reattained its normal size, and she is more fit than ever.)
 
     Adrenal disease in the ferret is common, and if detected by a watchful
owner or a knowing practitioner, can be easily treated.
 
      Get those hairless ferrets checked, and have a festive ferret-filled
holiday season.
 
 
1.  Fox J.G, et. al.  Hyperadrenocorticism in a ferret.  JAVMA, 191: 343, 1987.
 
2.  Lawrence, H.J. et al.  Unilateral adrenalectomy as a treatment for
adrenocortical tumors in ferrets:  Five cases (1990-1992).  JAVMA 203: 267-270,
1993.
 
3.  Lipman, N.S. et al.  Estradiol-17B-secreting adrenocortical tumor in a
ferret.  JAVMA 203(11): 1552-1554, 1 Dec 1993.
 
4.  Rosenthal, K.L. et al.  Hyperadrenocorticism associated with adrenocortical
tumor or nodular hyperplasia of the adrenal gland in ferrets:  50 cases
(1987-1991).  JAVMA 203: 271-275, 1993.
 
       Bruce Williams, DVM                 Department of Veterinary Pathology
       [log in to unmask]         Armed Forces Institute of Pathology
       (202) 576-2453/2454                 Washington, D.C.  20306-6000
 
[Posted in FML issue 0797]