Hey all!
Quickie note to add to Jeffrey's question (I think that was his name) and
Amy Seyler's note about her bilateral adrenal fert.
 
Yep, left-sided tumors are more common (75-80%, I think), which is lucky
since right-sided adrenal surgery is much more difficult because the right
adrenal gland lies right on top of the inferior vena cava (IVC), which is
the huge main vein draining the whole body below the shoulders.  The tumor
can in some cases grow right up against and sometimes start to surround the
big vein, so it obviously can be very hard to dissect out the tumor without
penetrating the vein, which would cause major bleeding which would be
extremely difficult to control.  If upon surgery only the right gland is
found to be affected, you just have to hope that the surgeon has the
patience, skill, and hopefully experience to remove such a mass.  My own
vet/boss is great at this.  She uses special magnifying goggles and special
tiny instruments in order to slowly tease the tumor off the vein, and hasn't
had a problem yet.  From what I understand, a lot of vets who are used to
dogs and cats alone don't have this expertise, tho I know there are some out
there.  Anyway, if the case is such that both glands are affected, as has
been the case in 2 of my ferrets, our option is to completely remove the
left gland and to remove 1/2 - 2/3 of the right.
 
This is called "debulking" the tumor, meaning you take as much as you can to
slow down the progression of the tumor while still allowing the body to use
the remaining part of the gland.  The remaining part of the right gland can
take over the production of all the needed hormones.  It obviously isn't a
cure, but can buy a lot of time.  My first (wonderful) ferret went through
this and lived 2 more wonderful years before succumbing to a very quick
death (more likely an aggressive pancreatic cancer than recurrance of the
adrenal).  The other ferret died from completely unrelated reasons (systemic
mast cell cancer).  My doc rarely uses Lysodren because it's very toxic in
other animals and apparently there isn't any known definite dosage in
ferrets (tho if people have more info on this I'm open to opinion).  Plus
we've (she's) gotten very good results from the bilateral surgery leaving a
partial right adrenal.  Her opinion (and I agree) is that since she's
willing and able to do the right adrenal surgery, she'll only use Lysodren
in a case where a ferret has had a bilateral adrenalectomy (sparing a bit of
right) and then it becomes obvious that the adrenal tumor has recurred in
the remaining part of the right adrenal.  In almost all cases we find that
the fret has something else going on (insulinoma, whatever).
 
Whew- after re-reading this I know that it sounds like a lot of
psycho-babble.  Please- if anyone has any questions, email me.
 
NUTSHELL- Removal of 1 1/2 adrenal glands (leaving part of the right
adrenal) is a very acceptable mode of treatment, and can spare the need for
using sometimes harmful medical treatment.
 
Thanks for listening!    Jamie
[Posted in FML issue 2083]