The level of response seems to vary a lot with the types and sizes of
growths.

Mornie had a huge carcinoma on the right which was inoperable due to
her involved Vena Cava when she first showed any symptoms. She got 8
months on the deslorelin but the tumor was so large and so badly
situated that when discovered we were told that she could go at any
time so we look at it as an extra 8 months in her case. At first the
size of the tumor was steady. The rapid regrowth happened in the last
2 months of her being on the implant so any of us had known that there
would later be new advice that the very ill ones get second implants at
6 months we would have done that. She was almost 7 and passed shortly
before the new implants arrived.

Hilbert had complete control of his adrenal disease till the day he
died of his unrelated kidney problems, which was also at about 8 months
after implant. The extra happy surprise is that it also helped reduce
his insulinoma problems (for which he had already had two surgeries but
part of it was in an inoperable area). His adrenal disease was mild but
his insulinoma was a great hazard for him so that was a very big plus.
He was a few months from 8 (which would have been in three days).

Hubble turned out to have multiple hidden terminal health problems
going on at the same time (unrelated), one of which was discovered on
ultrasound (failing kidneys) and two strong possibilities (lymphoma and
advanced hypertrophic cardiomyopthy) later when his health suddenly
crashed so suddenly that they could not be confirmed without necropsy
but in his case the necropsy would not teach anything so we skipped it.
He had an implant put in as a preventative. What killed him were simply
time bombs he already had but hid. (We had expected an intestinal
disease because of diarrhea but his intestines were fine on ultrasound.

Telemna is in for a bilateral adrenalectomy today. Her implant at first
controlled it and symptoms decreased but that was not for a long time.
(Apologies for not having the time to look it up but we have some big
medical things going on both with a cousin of mine and with Telemna
today.) Of three ferret adrenal disease experts consulted 2 said to try
the implant first since right adrenal surgery can be tricky even with
as excellent a surgeon as we have. One of those said to use it but then
do surgery if serious symptoms returned.

When the symptoms increased we set a surgery date, but since our
preferred surgeon for a right adrenalectomy had to be away for a week
there was a bit of wait.

During the wait for Telemna we noticed an interesting thing. Her
symptoms that returned are enlarged vulva and slightly swollen breasts.
First the sizes worsened after the initial huge improvement, then they
decreased, but then they worsened another time in the last two days.
So in order over a few months: Bad, large improvement, worsening, some
improvement, some worsening. This leaves us wondering why the short
blip of improvement happened. Might it be the behavior of the tumor
itself? I know that in humans endocrinological organs like the ovaries
can vary in output but ovaries are more cyclical in nature while I
think that adrenals are on more of a diurnal clock in humans though in
ferrets they also have a seasonal clock so I don't know if that would
be likely.

One thing that DID change: Steve was away during the improvement phase
and we have a small place so there is no choice but for the ferrets to
be in the same room as his large computer and he uses a pretty bright
light which tends toward the blues when we uses his computer. What can
I say; our eyes are worsening. When he was away I only used the amber
light in that room because I had no need to use any other light.
Certainly, the more melatonin the body produces the more controlled
adrenal disease is, and melatonin production decreases with increased
light exposure. We had not had time for the melatonin implant before
she worsened and honestly, her sizes are large enough that the implant
would help some but I doubt the swellings would completely go away.

If not the light (though I think it is that), I am left wondering --
and notice that this is nothing more than hypothesizing so be careful
to not take it as if it were fact -- IF there MAY be factors which
might alter how much medication an implant can release and thought of
several possible factors -- i.e. guesses -- before I thought of that
light (which is nothing compared to the huge one for video conferences
which he has that is like the sun being in the room but is far brighter
than any light I use). Anyway, are there any studies out there on
physiological, positional, and behavioral (such as activity level)
factors which MIGHT influence the degree of medication release of
subcutaneous implants? There probably is but I have not had the time
to check yet. Do any of them actually have any effect? In her case I
really strongly suspect that light was involved in not a good way. We
are changing that light.

One of the huge pluses we encountered with the implants is that they
made every one of the ferrets more active with more joyful acting play,
so that alone has been worth it.

Oh, update before sending: I just got a call from the vet and Telemna
will not be having surgery. Her heart is about 6 vertebral bodies in
size, so surgery would be too risky. She will instead be having an echo
cardiogram and a ultrasound on a day when the ultrasound person is
there. It appears that she is starting cardiomyopathy. This means that
every single ferret we have had who is a classical silver mitt: FULL
and evenly margined mitts and bib has to date developed dilated
cardiomyopthy. Telemna no longer looks like a classic silver mitt due
to roaning but that is what her genetics are. (We also had one with
partial mitts and bib who developed hypertrophic cardiomyopathy.) Now,
the sample is not large: 4 ferrets over many years from 2 different
farms, but each and every one of the ferrets we have had over the years
with full and evenly margined bibs and full mitts has developed dilated
cardiomyopathy. Can you say "Very possible genetic signature"? At least
knowing early with this means more careful monitoring and medicating.
We've gotten as long as a year and a half with dilated cardiomyopathy
that was not discovered as early.

There is a surgical vet in southern NJ who has multiple types of very
specialized equipment and 24 hours in hospital monitoring by people
who know ferrets, so if Telemna's very large right adrenal (which is
probably carcinoma) is unresponsive to the melatonin implant (which
will be put in today) that might be a possibility for her.

Hard day. We are also waiting to hear if a dearly loved extended human
family member's removed tumor is a return of a malignancy through
metastasis.

Anyway, the upshot is that we would do the Suprelorin implants again.
They worked for some, they provide an option with extra time for some
who otherwise would not have that such as Mornie and maybe Telemna, and
they improved the quality of life for all. It's obviously not time to
declare the need for the scalpel in the hands of an accomplished ferret
surgeon to be be gone, though. DO remember that the melatonin implant
can be used at the same time, and since that helps with adrenal disease
in a different way using both can give a one-two punch. The implants
are NOT a cure; they are a treatment which can slow or stall the
adrenal disease depending on the type and size of each neoplasum.

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 6911]