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From:
Sukie Crandall <[log in to unmask]>
Date:
Wed, 3 Sep 2008 12:19:35 -0400
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Okay, I worded part of that eye post badly. By second I meant acute
glaucoma. Infection or chemical damage are among other possible answers
to the eye problem seen which also can cause enough pain to result in
loss of appetite. Eye problems always need immediate vet appointments,
I am afraid. They can go too wrong too fast otherwise, and not just
for sight. The links will help find a specialist.

Adrenal disease, insulinoma (w some added info beyond earlier pers
com): The monk-like bald head top effect is not that often seen but
very classically from adrenal disease as the cause when it does occur.
Usually, if there is bilateral fur loss forward of the tail adrenal
disease is the first thing to consider if fleas are not readily
apparent. I have even heard of one or two ferrets whose fur loss
wasn't bilateral but that is more unusual.

Some vets are beginning to prefer Lupron, but it is not a strong trend.
We'll see over time if that changes as more data is acquired. Those who
seem to be having better results with Lupron seem to all (or most?) be
in the North (usually pretty extreme North) and it has been suggested
by some vets from elsewhere that the more sunlight then the less
effective the Lupron vs. surgery. (Just one of the reasons that many
vets who are not very North hope the U.S. will soon permit the right
deslorelin implant.) Actually, one of the northern Lupron researchers,
Dr. Cathy Johnson-Delaney, has been getting vets in some other areas
try Lupron to see if it is anywhere near as as effective for them as it
is for her, which is the right thing to do -- getting actual data and
trying to be careful about methodology and other possible factors.

Lupron can shrink hyperplasia (tissue overgrowth which can really
undermine quality of life and can set the stage for some life-
threatening complications) which is the most common type of adrenal
growth but it has to be given tightly on schedule to do so, and some
ferrets require a larger than normal dose. Meanwhile, for the malignant
forms of adrenal disease it still appears to be a poor second choice
after surgery, with variable effects.

Usually, but not always, it is best to combine using a melatonin
implant at the same time as using Lupron.

If there is early insulinoma then catching it now has a chance of
ending that disease for your ferret. When caught early with surgery we
have had ferrets who never had insulinoma return. That is
supported by a past study, as is the choice of surgical procedure:
>J Am Anim Hosp Assoc. 1998 Nov-Dec;34(6):471-5.
>Insulinoma in the ferret: clinical findings and treatment comparison
>of 66 cases.
>Weiss CA, Williams BH, Scott MV.

includes
>The mean disease-free intervals for each group were 22, 234, and 365
>days, respectively. The mean survival times for each group were 186,
>456, and 668 days, respectively.

Those groups (in order) were: medically, pancreatic nodulectomy,
and pancreatic nodulectomy combined with a partial pancreatectomy
Read also:
http://www.afip.org/consultation/vetpath/ferrets/PDF/insulinoma.pdf

http://ferrethealth.org/archive/YG10123
>It is no secret - at least on this list, that I far prefer to do
>surgery early on, and reserve medical treatment for non-surgical
>candidates.
>
>It is inevitable that these ferrets will become refractory to the
>prednsione over time, and then surgery will be required. However, at
>that point they may have become non-surgical candidates.
>
>Surgery gives a 60% chance of cure if done early, and this number
>decreases over time. The remaining 40% will develop additional
>tumors within the next 10 moths, but that's the equivalent of a 10
>year interval for a human.
>
>With kindest regards,
>
>Bruce Williams, DVM

Might as well do both at the same time if your vet is used to operating
on ferrets, is a good surgeon, and if your ferret does not have any
medical reasons like heart disease which would complicate matters.
After a "certain age" (usually 5 or 6, always 7 or older, partly
depending on critter's health) we always have hearts imaged before
considering surgery. Be SURE to have a CBC and Chemistry Panel
beforehand. If that testing finds some values too off then there might
be a malignancy which has *already* spread and in that case it is
usually best to go with meds instead of surgery. We've been there once
with an adrenal growth (lymphoma) and twice with a pancreatic growth
(one lymphoma, one carcinoma).

It sounds like you and your vet have thought long and hard about this
problem and that is the right thing to do, of course.

[Posted in FML 6083]


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