While virtually wading through the mailbox (Elizabeth had saved >600
messages and the box had >700) I noticed a handful of email asking for
information regarding my opinions on adrenal treatments. Buddy had died
from adrenal tumors that ultimately spread throughout his body, Sandy is
currently fighting the problem, and Simon has just started showing symptoms.
When Buddy was ill, I wrote, called or otherwise badgered about 20 well
respected veterinarians, who all agreed with my assessment to allow nature
to take its course as the most humane treatment.
As far as I understand, there are four basic treatments for adrenal tumors:
1) Chemotherapy, 2) Surgical removal, 3) Steriod therapy, and 4) Do nothing
(which isn't actually a treatment). Some of these might be done in
conjunction with others, or some done after others have failed.
There is a cost to each treatment. Chemotherapy is short-term expensive,
and in the long run might cost more than surgery. Surgery, depending on the
location, can be very expensive ($500-$700 US). Steriods are much cheaper,
but they don't cure anything; the problem is still there, only hidden.
There are physical costs as well; surgery is quite traumatic and painful.
Chemotherapy can be quite uncomfortable as well, and even though the initial
discomfort levels are below that of surgery, the long term discomfort could
be greater. Steroids can cause many side-effects, the worst being
osteoporosis. No one seems to know how much discomfort is caused by doing
nothing, although quality of life is certainly affected.
The risks of each treatment can be high. No nothing, and the ferret will
ultimately die from the disease. Steroids will suppress the adrenal
activity, but the tumor is still there, and ultimately steriods will fail,
the disease will spread and the ferret will die. Chemotherapy may or may
not kill the tumor cells (more research is needed!!), but the long term
effects of treatment to the kidney and liver cells of the ferret are
unproven. Surgery has it own set of risks and could result in immediate
death, short term death from surgical complications, or diminished lifespan.
Admittedly, these complications occur in a small percentage of cases, but
they are still risks that should be considered.
The benefits of not doing anything are low trauma and pain to the ferret
compared to chemo/surgical discomforts. The ferret will be bald, and will
gradually lose much of its weight. Steroid treatment reduces the hair loss
to some extent, and slows the spread of the disease. Chemotherapy may work
and the ferret may return to normal appearance and behavior. Surgery has a
high success rate, and shaved hair will return after the next moult.
The question that always comes back to me is, how long will the ferret live
for each of these procedures? There is considerable disagreement on this,
partally because each ferret is an individual, and also because no one
really knows (as far as I can determine a comparative study has not been
published). The best I can tell is, do nothing and most ferrets die in
about 1 to 1.5 years. Use steroids and most ferrets die in about 1-2 years.
Use chemotherapy and most ferrets die in about 1-2 years. Do surgery and
most ferrets die in about 1-3 years.
Notice a pattern? Ferrets that are good surgical risks live a bit longer,
but I'll bet they were healthier and younger to begin with. Everything else
is about the same length of time before death, which may be a phenonemon not
of treatment, but of lifespan. Ferrets either get this disease early or
late, with the early onset (2-3 years) being more positively surgically
addressed. Late onset occurs about 4-5 years old. Add 1.5 years of
survival time and you get the low-end average of the typical lifespan of a
ferret, which is about 6-8 years.
Another thing to consider is *why* they are getting the disease. Lots of
hyperbole has been spread that MF ferrets get the disease more than others.
Maybe, maybe not. A scientific study has never been published as far as I
can tell. However, I'm beginning to think that what we are seeing is a
consequence of greater lifespans and possibly a "limiting disease." To begin
with, tumors, both benign and malignant, occur in greater frequencies in
older individuals, primarily because DNA damage accumulates over time. Some
species have a tendency towards certain types of tumors in specific parts of
the body, and such a thing may be going on in ferrets having tumors in the
adrenal glands. In other words, one reason we are seeing an increase in
adrenal disease is because ferrets are living long enough to develop it (New
Zealand feral ferrets only live 2-4 years; 5 is very old, majority die under
2 years). However, you *cannot* eliminate the environment from this
discussion, and the onset of tumor growth may be initiated or speeded up by
diet (specifically lack of natural fiber), ad libatum feeding,
photoperiodism, lack of exercise, unnatural chemistry (cigarette smoke,
solvent fumes, wood formalehyde, etc.), micronutrient undernutrition,
unknown viruses, overnutrition, and/or lack of physical handling, to name a
few of many environmental factors.
REQUEST: How about everyone on the FML who has had a ferret *die* from
adrenal disease, or who can accurately report someone else with the
experience, write in and say: "Toby (Private Breeder; Adopted from Shelter
at 3 years old; Silver Mitt; Male): onset of disease 5 years old, surgical
treatment followed by steroid therapy, death at 6.5 years of age." Send them
to me or post them and I will compile them and report the results. Now,
this *isn't* a scientific analysis because the FML is not a random list, so
you vets online send data as well. Shelter ferrets need to be identified as
such (all my adrenal babies came from shelters), because sick ferrets may be
abandoned at a higher rate than healthy ferrets and the lifespans may be
shorter due to less human interaction. The bigger the data base, the better
I can detect a skew and correct for biases. Be as accarate as you can and
label guesses (estimations) accordingly.
This may not be scientific, but at least we can have *something* to base our
decisions upon, and anything is better than nothing.
Bob C and 20 MO Sharkdogs
[Posted in FML issue 2151]
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