Hi Dawn!
 
>He called me at work that day to tell me that my ferret has an adrenal
>tumor.  It is on the right side, not the left, so its inoperable.
 
Some right adrenals, if severely involved with the vena cava (a big vein on
the right side) are inoperable.  Did your vet say why your fuzzy's tumor is
inoperable?  I agree that surgery is the best option as cure for adrenal
growths (the only potential "cure" right now), but read on about our Wally's
inoperable tumor, which one of our vets says is not uncommon.  By the way,
our vet's fur kid's right adrenal was inoperable -- they couldn't even touch
it, and our vet hired a very advanced surgeon and technology.  He was put on
Lysodren, with my vets modified protocol, and did very well.  When he did
die, of insulinoma, a detailed necropsy by a respected ferret-experienced
pathologist showed death was due to advanced insulinoma, but that the
adrenal growth had shrunken up (and would still have been inoperable) around
the vena cava.  A slightly enlarged heart, not out of the norm for this age
of fuzzy, was found, but no evidence was found of damage from the Lysodren.
 
About Lysodren, it doesn't work for all fuzzies, and seems to work best for
fuzzies whose adrenal growths haven't reached the adenocarcinoma stage, but
are in the hyperplastic or adenoma stages.  Did your vet send tissues in for
histology?  I hope so.  With Wally, his tumor was so large and engaged with
the vena cava our experienced vet didn't dare even biopsy it (it oozed blood
dangerously at the slightest touch), but did get a needle biopsy which at
least identified it as an adrenal tumor -- she'd never seen anything like it
and didn't want to assume; I was surer than she, but then I don't have a vet
degree and am not responsible for the diagnosis, so I CAN jump to
conclusions ;) The tumor was big too, tubular and between golf-and
racket-ball sized, poor Wally...
 
Lysodren seems to be working well for our Wally, but we use a slightly
different protocol than the standard one which I believe was developed by
Dr. Susan Brown.  We've never given it more than four days in a row, whereas
some vets start with five, seven, even ten days on, then back off the dose.
Our vet feels this doesn't give the fuzzy time to clear the toxicity of the
drug from it's body and flush away the killed adrenal tissue.  Wally's tumor
has shrunken (he's quit sleeping in odd positions to accommodate the large
presence in his body, and a vet could barely feel it last time she checked),
his hair has fully regrown to a normal coat in every aspect, he has a good
appetite and is very playful.  We still shudder when we give him this
chemotherapy drug, but were up against a wall without few options.  He gets
it two times per week, Monday and Tuesday right now.  Initially we had to
watch him for signs of toxicity (he was on a higher dose) and feed turkey
soup and give prednisone (only gave about three times) if he became weak
and/or nauseated.  If we saw any signs of weakness or anorexia we stopped
Lysodren for the entire week immediately.
 
By the way, I spoke with Dr. Kawasaki the other day, who said he has now
done more than 2,000 adrenal surgeries on ferrets!  According to his info,
the term right adrenalectomy is a bit misleading.  He says he never gets
every single bit of the right adrenal, and it is the little bit that is
left, in the case of bi-adrenalectomies, that enables the fuzzy to go on to
live a healthy chemical-free life.  He treats with prednisone following a
bi-adrenalectomy, then starts cutting back the dose until, I believe it was
four to six weeks (he talks fast and is very busy!) the fuzzy is weaned off.
Another prominent fuzzy vet has said he only uses prednisone following a
bi-adrenalectomy if there are symptoms present.  It sounds to me that any
"right adrenalectomy" is really a "de-bulking".
 
Michael Janke wrote:
>Our shelter's vet removes right adrenals with little problem unless it has
>grown into the vena cava.  Maybe it's time to look around for another vet?
 
I agree that surgery is the best option as cure for adrenal growths!  The
only cure available now, in fact.  My friend's fuzzy, who is older than
Wally, with more advanced and/or serious adrenal disease (he has prostate
enlargement, which Dr. Weiss, in his recent paper, has theorized may be more
common to fuzzies in the adenocarcinoma stage of adrenal disease) is doing
very badly on Lysodren :(, though it's helped the urinary problem.  The
fuzzy also had borderline low blood sugar prior to Lysodren therapy, so the
Lysodren has made that worse, and he must be fed every four or so hours to
avoid bad seizures, though he sometimes has them anyway.  Hopefully
something can be done, as the fur kid is very sweet and seems to really love
me, as I love him.
 
One other thing.  My two vets don't advise vena cava ligations.  The data
I've seen (skimpy but from an experienced ferret vet) shows about a 33%
mortality rate within 30 days.  Our vets don't feel the surgery is conducive
to long-term health either.  I'm very, very glad for those fuzzies who have
had this done and survived but, only my opinion, I would try chemical
therapy before vena cava ligation, and only select ligation as a last resort
(such as when the vena cava is nicked during surgery and must be ligated; or
if the fuzzy has very bad adrenal symptoms such as a swollen prostate which
could lead to a fatal urinary tract blockage, and Lysodren can't be used or
doesn't work).  Of course, especially in adrenal disease, each situation is
unique!
 
Hey, for those who read this long tome, thanks!  Sorry it was so long (it'll
probably bounce back at me then I get to "take the time" to write shorter).
 
Lynn Mc., an adrenal fur-kid mom
[Posted in FML issue 2264]