>From:    Alicia K Drakiotes <[log in to unmask]>
>Subject: U Tenn adrenal test
>My understanding of the U Tenn panel test for adrenal disease is this.  The
>test is designed to evaluate several (2?) hormone levels.  Unfortunately it
>may be other hormones that are actually elevated (and not those the test
>was designed for).  This would cause a negative reading when in fact the
>ferret is asymptomatic.
 
Hi there Alicia.  I understand that six hormones are being tested for in the
complete panel now (last I checked that is!).  I had my two adrenal
(confirmed through surgery now) fuzzies tested for estrogen only (Percy was
also tested for testosterone levels, which were normal).  U Tenn will do
selected tests, and it cuts down on fees.  One of my vets (who had an
adamently adored adrenal fuzzy herself and has done lots of research) says
that the most commonly elevated hormone is estrogen, and this is also the
hormone responsible for hair loss.  Both of my adrenal fuzzies had extensive
fur loss and both had elevated estrogen levels.
 
I agree (and have read many places) that the Tenn U panel is inconclusive,
but wanted to go a little more into detail about when and how it might help.
 
Percy's (old) vet didn't recommend the U. Tenn panel, saying that normal
hormone levels for ferrets haven't been established.  Nor did he conclude,
through surgery, that Percy had adrenal abnormalities.  Nor did he treat
with Lysodren, saying it was too toxic.  Knowing what I know now about
adrenal fuzzies, I, myself, would have diagnosed Percy as adrenal, based on
symptomology (hair loss, itching, frequent urination and UT infections) and
histology (hyperplastic adrenal tissue was present but the vet said that any
four-year-old ferret might exhibit hyperplastic adrenal tissue but have
normal hormone output :(!!!!) )
 
Percy was scheduled to go to his new vet (very experienced with ferrets),
but a week before the appointment his urinary tract backed up and he became
completely blocked.  He died from complications due to an enlarged prostate
caused, ultimately, by his adrenal growth or tumor (surgery was tried to
clear the blockage but he didn't wake up).  We had already sent a blood
sample to the U. Tenn and I canceled the test, but Betsy Bailey, a really
great lady who runs the Endocrinology Lab there, ran tests for estradial and
testosterone at no cost.  Percy's estradial was quite elevated.
 
In Percy's case where symptoms were present, after inconclusive exploratory
surgery the Tennessee adrenal panel, or simply the estradial test, would
have confirmed he was adrenal, as I think it would in other adrenal fuzzies
who have had (sometimes multiple) inconclusive exploratory surgeries (i.e.
where the adrenals look normal).
 
Three of us that I know of, in Seattle, are also using the estradial test as
a base upon which to evaluate therapy.  All three fuzzies have hair loss,
and all three have high estradial test readings.  Two of us are giving our
fuzzies Lysodren (which kills adrenal tissue) and one is giving Lupron
(which either interrupts the pituatary/hypothalamus feedback loop or blocks
estradial receptors, theoretically).  The two who started earlier have
fuzzies with nearly full hair regrowth (my Wally looks grand and is a real
bopper, too!), and the third is getting good hair regrowth.  All three had
elevated estradial tests and all three will be retested to see that those
levels are down.
 
[Our two fuzzies on Lysodren, which is a chemotherapy drug) are also getting
prednisone as needed, and Wally gets carafate for an upset stomach.  Both
have had an episode of toxic reaction to the Lysodren, but both have come
through and are doing fine.  It's not an easy ride, but both are inoperable
adrenal fuzzies.  One has no adrenals, and the other, Wally, has a HUGE
adrenal tumor, right side, encapsulated in the vena cava).]
 
I have learned that adrenal fuzzies can grow a full coat of hair back and
still have a developing adrenal growth (my Wally lost hair in August, grew
it back fully for nine months, lost it again... and in exploratory surgery a
HUGE adrenal tumor, right-sided, fully encapsulated in the vena cava and
deemed inoperable at the time).  SO, IMPORTANTLY, estradial and/or other
hormone tests might help determine if ferrets who have experienced some
extensive hair loss (and/or other adrenal symptoms) and are regrowing hair --
including those with apparently spontaneous recovery and those who are on
new and/or alternative therapies -- still have progressing adrenal disease.
High hormone levels can cause other problems besides hair loss, and adrenal
tumors can spread to other organs (though non-malignant adrenal-encapulated
tumors are more common).
 
Based on my and other's personal experience, I will always get any of my
fuzzies exhibiting adrenal symptoms a baseline estradial test, at the very
least, from which to evaluate treatment.
 
Anyway, that's my .02 on the U Tenn Adrenal panel.  So, thanks for writing
Alicia, and prompting me to write!
 
For Clare Sebok and Nancy Homquist, who recently asked about adrenal
disease, feel free to e-mail me and I'll add you to our support and
informational group, the Adrenal Mailing List.  We are also discussing
insulinoma disease as well now, since it so often goes hand in hand with
adrenal problems.
 
Sorry it was so long, but for those still reading, Thanks for listening!!
 
Lynn Mc. and the Gang of Seven Fuzzies - even adrenal Wally!!!! (and, as
always, Squeekers and neural-tube siblings, Schroedee Boat, and Percy, in
leaping spirit...
[Posted in FML issue 2106]