To Jan Fleury:
 
>They kept Willie a couple days and did some blood work and some ultrasound,
>and evaluated him for surgery (he has both insulinoma and adrenal tumor).
>We had considered the surgery a while back ... but had come to the
>conclusion not to put him through it...
 
I'm surprised that Angell didn't consider the possibility of cystic
prostatic disease in Wille, and I wouldn't hesitate to ask them about it.
In males with adrenal tumors, the elevated levels of estrogens can often
result in large keratin and pus-filled cysts in the prostate which cause the
urine flow to be impeded.  This condition will not respond to antibiotics,
only removal of the adrenal tumor.  (I guess I'm not too surprised - the
condition hasn't received a lot of publicity in the veterinary literature -
it's out there, but you have to look hard to find it), and the MA vets
haven't been treating them for that long.
 
If it's prostatic disease, and not a urinary tract infection (which I find
is far less common than the prostatic cysts- AND we already know Willie has
an adrenal tumor), then he'll exhibit the signs again, usually shortly after
the antibiotics are finished.  (I don't know why he won't show signs during
antibiotics, but for some reason, animals always show signs AFTER the
antibiotics are finished - odd fact of life).
 
>we'll be deciding maybe now to GO with the surgery, esp. since the
>ultrasound shows primarily his left adrenal (which apparently is the more
>'operable' site because it's not so close to the major vein (vena cava ...
 
Here's one for the FML VETS:
 
Did you know that you can ligate the posterior vena cava in ferrets with
large invasive right adrenals?  I didn't think it was possible, but I know
two vets that are doing it, and the ferrets actually have enough collateral
circulation to prosper post-sx..  Two cases and both did great!!!
 
So no more "inoperable" right adrenal tumors, OK?
 
Bruce Williams, DVM, DACVP              Chief Pathologist, AccuPath
Dept. of Veterinary Pathology               [log in to unmask]
Armed Forces Institute of Pathology
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[Posted in FML issue 1700]