Q: "My ferret has just been diagnossed with adrenal disease...she is 6
    years old.  Should I risk surgery?"
 
A: Do you risk life?
 
You have brought up a subject (perhaps a philosophical one) which
represents perhaps one of the most difficult questions a ferret owner
is forced to ask, "when is medical intervention appropriate and to what
extent do I allow it to occur." These are difficult questions and virtually
impossible for one person to decide for another; there are NO right or
wrong answers.  In many cases, you can do everything right and still lose.
 
I cannot speak of an individual ferret's frame of mind regarding it's state
of health, but I always assume a ferret would want the same things that I
hold dear to myself; reasonable freedom, healthy environment, intellectual
stimulation, freedom from fear, interesting and nutritional food, and
responsible health care.  In the case of the last category, I would assume
appropriate health care would include medical and surgical intervention
when required, in a manner which a) does not increase harm, and b) prolongs
quality (and perhaps quantity) of life.  These last two goals are more or
less what vets pledge as they become animal doctors.  While opportunism
exists everywhere, I do believe most vets sincerely support those goals.
 
Each and every time a surgical procedure is performed, from as minor as
the extraction of a splinter of wood to as major as removing extensive
cancerous growths, there exists the danger of a sudden and catastrophic
medical problem, perhaps caused by a bad reaction to the anesthesia or
shock or just unknown causes.  The smaller animal, the more problematic the
surgical intervention.  Ferret vets are forced to contend with anatomical
structures of an extremely tiny nature; if you have ever seen a chicken
heart, then you have seen something perhaps double the size of a typical
ferret heart.  A kidney bean is roughly the size of a ferret kidney, their
bladder is about the size of a garbonzo bean.  While the largest blood
vessels are about 1/4 inch in diameter, most are much smaller--some thinner
than crochet thread.  The point is, ferrets are roughly 1/50th to 1/150th
of human size (1 lb ferret compared to a 150 lb human); I find it
miraculous that some surgical procedures can be done at all, considering
the size of the anatomical structures involved.  I use binocular glasses
to distinguish the difference between the tiny wrist bones in a ferret; I
am in awe of people who can repair a structure smaller than the nail on
their pinkie.
 
The point here is that ANY surgical procedure is inherently risky and that
risk is far greater in animals of small stature and fast metabolisms.  So
when does the risks of intervention outweigh the benefits?  In my humble
opinion, it is when the QUALITY of life cannot be improved and the QUANTITY
of life cannot be extended.  I ask myself (and my vet) two questions: will
the procedure make my ferret feel better and will it make my ferret live
longer?  If I get a "yes" to either of the questions, I proceed.  If I get
a "no" to both, then I have to decide if the disease warrants euthanasia or
if I can wait.  Sometimes my decisions, based on the above criteria, have
resulted in the sudden death of my ferret.  Sometimes I feel immense guilt
each time an old balding ferret staggers across the room.  I wish I could
make perfect decisions and always get it as right as hindsight, but I can
only do my best, based on the best advice and knowledge I can muster.
Sometimes I do everything right and still lose.
 
Adrenal disease takes several years to sap a ferret's life away (although
not considered to significantly shorten it), and it has some major
impacts on the ferret.  I can see a significant change in the density of a
ferret's bones, especially in the lower back, hips and heads of the femur
and humerus, which MAY be a reason why older adrenal ferrets seem to lurch
or stagger when walking.  I have noticed adrenal ferrets have a lot of
hairballs.  The disease negatively affects the ferret's behavior and
disposition.  The loss of hair might be mostly cosmetic, but the
sensitivity to cold reduces quality of life.  And the spread of the tumor
to other organ systems, such as the liver or the pancreas, can and does
cause pain.  SO, even with the risks involved in the surgical intervention,
when it comes to adrenal disease, I personally feel the possibility of
positive benefit requires I ask my vet to attempt yet another miracle,
provided I am convinced it will either improve or extend my ferret's life.
 
Please, discuss your concerns with your vet.  Work together to provide your
ferret with responsible--and appropriate--health care.
 
Bob C and 16 Mo' Philosophical Phurts
[Posted in FML issue 3071]