Q: "One of my ferrets has had adrenal problems for about a year now.  The
vet removed the left one but couldn't get out the right one.  I have two
questions.  First, what is the adrenal....Second, my Howie broke his leg
jumping off the couch and I wondered if it was related...."
 
A: For two questions I get extra raisins. In 125 lines, I get money.
 
Technically, adrenal means "near the kidney," so it could be used to
describe a number of things.  In practice, adrenal usually refers to a gland
that is found on the head-end of the kidneys.  The adrenal gland is composed
of two parts, the internal medulla and the outer cortex.  These two parts
have different functions, and are actually anatomically distinct.  The
adrenal cortex produces three types of hormones; Glucocorticoids (which
increase blood glucose levels), Mineralcorticoids (which help regulate
electrolyte levels), and Androgens (which have a masculating effect and
increases muscle mass), while the adrenal medulla produces Adrenaline and
Noradrenaline.
 
Glucocorticoids (such as hydrocortisone, cortisone and cortisterone) cause
the liver to increase glycogen levels, they raise blood sugar levels, and
they also act as anti-inflamatory agents.  It is easy to understand why some
ferrets with adrenal tumors have a difficult time maintaining blood sugar,
while many others seem very energetic and increase their activity levels.
Most of the people who have responded to the adrenal survey indicated their
ferrets typcially display the later characteristic, which *could* indicate
the tumor increased glucocorticoid production.
 
Mineralcorticoids (such as aldosterone) are essential in regulating the salt
and water concentrations in the blood and extracellular tissues.  If they
are goofed up, you could either have electrolyte or fluid imbalances, which
affect everything from cardiac output, urinary volume, thirst, and
increased/decreased salt requirements.  Many ferrets with adrenal tumors
become very thirty, and have increase urinations.  They also develop
osteoporosis, which I'll talk about later.
 
Androgens (such as androsterone and testosterone) promote male
characteristics and are necessary for maintainence on muscle mass.  In most
females, their effects are masked by estrogens, but when the estrogens are
gone, they become more apparent.  This is why post-menopausal ladies grow
moustaches, and neutered ferrets with adrenal tumors can become quite
aggressive, and even start displaying sexual behaviors and traits.
 
Adrenaline (AKA epinephrine) and Noradrenaline are powerful hormones which
increase blood sugar levels, slow down the bowels, increase blood pressure
and heart and metabolic rates, and generally prepares the ferret for action.
Noradrenaline is similar to adrenaline, but is not as immediately powerful
nor as long lasting.  When you are startled by someone, the sudden buzz you
feel is a result of adrenaline being pumped into your body to prepare it for
flight or flight situations.  Ferrets with adrenal tumors often display
increased body heat and eat more, reflecting an increase in the metabolic
rate.  Some also have increased bloodpressure and heart rates.  Other
symptoms can include problems with maintaining proper sugar levels,
excitability, and nervousness.
 
Because the adrenal gland is composed of two parts, and because a tumor can
reside in both or either parts, the inital symptoms of adrenal disease can
vary, and many are not noticed at all until hair loss (due to elevated
coristeriods) occurs.  They can be slow to show, develop gradually, and,
depending on the area of the adrenal affected, may never show any severe
symptoms until it to too late to do much for the little guy.
 
Osteoporosis (abnormally light, decalcified bones) is common in ferrets
suffering from adrenal disease; in 8 ferret skeletons where the poor beastie
died from adrenal-related problems, I found osteoporosis to some degree in
all of them, yet never found osteoporosis in 12 other ferret skeletons where
the beastie died of non-adrenal problems.  My sweetie, Razz, died earlier
this year from a series of massive strokes, which came on suddenly and
unexpectantly.  Her bones displayed extreme osteoporosis, and a close
inspection of both the adrenal and pancreas showed small cancerous nodules.
When the skeleton was prepared, the left tibia had a large lumpy mass on it,
and the dried skeleton weighed 1/3 less than it should have.  Between the
necropsy and the skeleton, it was clear that Razz developed a cancer, which
spread to her internal organs and bones.  When it reached the adrenals, it
caused an increase in cortisteriod production, causing osteoporosis (the
cancer in the bones could have also caused the osteoporosis, and the two
together probably accounts for the severity that I found).  The stroke must
have been the result of a combination of increased adrenaline production
resulting in higher than normal blood pressure, coupled with water balance
problems, yet I never saw a symptom until it was too late and nothing could
be done.
 
The reason for the osteoporosis is because bone is the body's storehouse of
electroyltic salts.  When mineralcorticoid levels are thrown off, one of the
effects is that bone is disolved to replace blood salt levels, which are
being eliminated in the urine.  Over time, the bone gradually gets thinner
and thinner.  The ferret is always thirsty, has increased urination,
sometimes forms kidney stones, and loses bone mass.  The end result, over
time, is the bones get thinner and thinner.
 
As for the ferret in question, Talk some more with your vet.  I would have
anther blood series drawn to make sure the steroid levels are at normal
levels.  Ferret bones are much stronger than they need to be, and although
I've heard of fractured or dislocated joints, I think the actual incidence
of jumping-related fractures is rather small, especially from objects as low
as couches.  Perhaps the limb was trapped by something that caused it to
bend in the middle?  Osteoporosis is easily confirmed with an x-ray of the
affected areas, which might not be a bad idea if you suspect it.  I also
recommend you ask your vet about bone-meal and vitamin supplements, which
can be mixed with nutrical for ease of administration, and help to offset
the dissolution of bone for metabolic needs.  Please keep me informed of
your ferets progess and condition.
 
Bob C and 20 Boneheads
[Posted in FML issue 2168]