Percy had her adrenal surgery Friday.  She's home and recovering
very well now.  Here's the details:
 
(Warning:  This is LONG!)
 
I took Percy in about 8:30 Friday morning.  I also took Bree in in case
Percy needed a transfusion (I had her fast as well).  Since I was staying
with a vet student who has worked with Dr. Kawasaki in the past we hung out
in the back while waiting for a chance to talk with him.  First I watched
them put a ferret to sleep to run blood work.  Boy, they aren't kidding
when they say a ferret has thick skin.  Dr. K actually bent a needle
trying to peirce the ferrets skin!  Then after watching him declaw a cat,
I finally got a chance to talk to him.  (The person I was with was
visiting, so it wasn't just like he was ignoring me)
 
A few days before we went down Percy's vulva had started to go down.  So,
by the time we got there, she was only slightly swollen.  Also, as I said
before she only has minimal hair loss.  So, Dr. K wasn't entirely
convinced that she had an adrenal tumor.  So, we discussed our options.
 
1.  Wait and see if the swelling comes back, then we'll do surgery - I
    didn't want to wait because I was afraid that if I did whatever was
    wrong could escalate to the point where it was inoperable.  Also, that's
    a pretty long trip, and pretty stressful for the ferrets so I wanted
    to take care of it while we were down there.
 
2.  Go ahead in and remove the left adrenal gland - I didn't want to have
    him remove a perfectly healthy adrenal gland.  What if it did turn
    out to be the right adrenal gland (it's usually the left, and you
    can't remove the right one anyway because there's someting wrapped
    around it.).  Also, he told me that 1/6 to 1/12 of his adrenal surgeries
    die within 2 days.  They appear to be recovering nicely, then they
    just die.  So, I didn't want to take any uneccessary risks.
 
3.  Do exploratory surgery - go in and look around to see if there's
    anything amiss.  If so, then fix it.  Exploratory surgery isn't
    all that risky.  He would look to see if there was any ovarian tissue
    or if the uterine stump was cystic, then go back and look at the
    adrenal glands.
 
4.  Do and ACTH Dexemethizone Supression test (Please forgive any
    spelling errors, I'm just guessing at these terms) - This involves
    anesthetising her twice to do blood work.  This test shows if there
    is an adrenal tumor.  But it has not been shown to be conclusive
    with ferrets.  (I think Dr. K is doing research with them to try and
    determine if they can be used on ferrets.)  I couldn't see any
    merit in this.  Either A)  It would show that there was a tumor and
    he would have to do surgery, or B) it would be inconclusive and
    he would have to do exploratory surgery anyway.  So I determined that
    this would just be putting undue stress on Percy.
 
So, I decided (after making a fool of myself and breaking out in tears)
that the best bet would be to do exploratory surgery, and ONLY remove
the adrenal gland if it appeared to be enlarged.
 
Then the person I was staying with and I went out to breakfast while
Dr. K did some of his other surgeries.  When we came back Percy was
already sedated so that they could run a glucose test and shave her.
She was just laying there shaking violently with her tongue hanging out.
It was very nerve wrenching to see her that way.  (Like I said before,
I had just watched him declaw a cat, so I'm not squeamish, except when it
comes to my own animals)  Then Dr. K and the person I was staying with
suited up for surgery (she assisted him, since she was there and
interested in seeing the surgery anyway), and I waited in an office
right outside of the operating room.
 
While I was waiting, about three people came by and said "You know you
can go in and watch if you want" which was answered by "No way, I wouldn't
mind seeing a surgery, but I just can't watch it being done on my Percy".
 
After a while he came out and told me that there was no ovarian tissue
and her uterine stump looked fine, but her left adrenal gland did
feel slightly enlarged.  He advised me that he recommended going ahead
and removing it, so I gave my consent.
 
So he went back in, did the deed, and finished the operation.
 
Ferrets generally have a hard time maintaining body temperature while
anesthetised.  So the surgery is done on a heating pad, and they are
kept wrapped in one afterwards until their temp. stabilizes.  So, she
came out of surgery wrapped in a heating pad, and placed with all the
cats who were also still under anesthetic and being observed until
they stabilized.  A ferret's temp. coming out of surgery is usually about
95 deg. (normal is about 106, I think).  When they checked Percy's it
was down to about 90!!  So, in my stressed out condition, I think that
this indicates that she's going to die.  But, I surprisingly managed
to control myself, and just asked "is that really bad?", and she
explained to me that it wasn't good, but it just meant they had to watch
her temp. more closely.  But with the heating pad she wasn't in any real
danger.
 
It took about 30 minutes for Percy's temp. to stabilize.  Then we went
ahead and took her home.  She wasn't even awake yet, but since I was
staying with a knowledgeable person, I guess he saw fit to release her.
 
If you recall, I told you it was a 2 night hospital stay.  Well, it turns
out that when a ferret comes in with an adrenal tumor they USUALLY have
a pancreatic tumor as well.  Since Percy (luckily!) didn't have that,
she got to come right home without spending any time in the hospital.
 
So we went home and put Percy on a heating pad in her cage and waited for
her to come around.  It took about an hour before she started to wake
up, and then it was just an occasional twitch.  In about another hour
she would sort of lurch her head  and then be so tired she would fall
right back to sleep.  Then finally, she was able to lurch her head over
and drape it over her water dish (which only had a few drops in it, since
she could fall asleep and drown in it), but then she didn't have enough
strength to hold her head in position to get a drink, and would just
fall back to sleep with her head over the edge.  So, I helped her to hold
her head in position, and dribbled water into the dish, and she was able
to get a drink.  After drinking for about 20 seconds (which seemed like
quite a long time in her condition, she fell back to sleep and I helped
her get more comfortable.  Then in about 20 minutes we repeated the whole
thing.  Then the next time, I also gave her some NutriCal, which she
ate quite a bit of (again considering her condition.  It really wasn't
all that much).  I guess she then felt satisfied, and fell asleep for
a few hours.  When she woke up she tried to get in the litterbox, but
didn't make it before falling asleep exhausted.  The next time, I helped
her get in, but the effort was still too much and she fell asleep before
she could go.  The next time, I helped her in, helped her get in position,
and helped her to stand up, but I guess she didn't feel comfortable going
with me holding her, so she gave up and went back to sleep.  Finally the
next time I guess she was desperate enough that the was willing to go with
me holding her in position.  She seemed very releaved and went back to
sleep for a few more hours.  So I'm really glad that I was able to
be there for her while she was waking up.  I think I made her much more
comfortable than she would have been in the hospital.
 
It wasn't until the next morning that she seemed to be really awake, and
to be able to stand up.  She still seemed very disoriented and clumsy.
But she did come out of the cage for a minute or two before tiring out and
wanting to go back to sleep.
 
Today (Monday) she's pretty much back to her normal self, except that she
sleeps a lot more and doesn't make any really daring moves (like jumping
down from furniture).
 
Her incision is a little over 3 inches long, which seems HUGE on a 1 1/2 lb.
ferret.  It goes from right below her breast bone to about 1 1/2 inches
above her vulva.  It's much longer on a female since they need to look
around from down around the uterine stump to way up above the kidneys
where the adrenal glands are located.  Also, to get to the adrenal gland
(located near the back) they pretty much have to take all the organs
out, then put them back in when they are done.
 
Fortunately her surgery went by without a hitch except for the temp. thing
at the end.  She didn't need a transfusion, so Bree fasted and spend the
day in the hospital for nothing.  And now she's past the critical 2 day
period associated with adrenal surgery, so it looks like she's out of
the woods barring any very unlikely complications such as infection.
 
Something you may want to note if you ever have a ferret who needs
abdominal surgery.  Percy has an ectopic (sp?) spleen, which is just
a little piece of spleen tissue seperate from the main spleen with it's
own vein going to it.  Apparently this is rather common in ferrets, and
it is nothing to worry about.  So, if your vet does surgery and sees this,
tell him that it's not unusual in ferrets, and he doesn't need to remove
it.
 
Sorry this was so long, but I figured this is such a common problem with
ferrets that many of you might appreciate the details.
 
- Nancy
 
Nancy Hartman                     CIS graduate student
[log in to unmask]                  U. of Delaware
        President and founder, Delaware Valley Ferret Club
                      Owner of Percy & Bree
 
[Posted in FML issue 0255]