>Need some of everyone's expert medical advice.  My oldest (Winnie) has
>previously had Insulinoma surgery and did fine for about two years after
>that.She is now about 6 years old and for the last couple of months, she
>has been showing obvious signs and symptoms of not only a re-occurence
>of Insulinoma but also hair loss on her tail, which is probably Adrenal
>Cancer.
 
Whoops!  Common misconception - hair loss on the tail MAY be adrenal
disease, but may also be a totally unrelated process, either seasonal or
stress-related.  Only if the hair loss extends up over the rump, abomen,
flanks, etc., should the subject of adrenal disease be broached.
 
Also, not all cases of adrenal disease are malignant, so the use of the
term "cancer" implies a poor prognosis which is generally not the case.
Many cases of adrenal disease are simple hyperplasia of the adrenal gland,
or benign tumor; the minority are malignant.
 
>(Regarding Prednisone) This seems rediculous and I would like to possibly
>add the additive myself but after speaking with my Vet out here, we are
>not sure that is such a good idea; as it may change the effectiveness of
>the Prednisone as well as if the additive has any kind of sugar in it, it
>will defeat the purpose of the Prednisone.
 
Certainly the flavoring agent will not inactivate the prednisone.  It is
difficult to tell what sweetener is in any particular flavoring, as all
have different ingredients.  Saccharin, sucrose, sorbitol, aspartame, and
fructose are commonly used in flavoring agents.  It is unlikely that sugar
will counteract the action of the prednisone, as the point of the pred is
to raise the blood sugar level, and a small amount of sugar can only raise
it a bit more (if it does anything at all.) Pediapred is already flavored
as cherry, and my experience, however, has shown that it is difficult to
counteract this flavor by adding another flavor.  You may want to try
grinding up an equivalent amount of a pednisone tablet into a bit of baby
food - my ferrets rarely taste the prednsion "around" the baby food.
 
>I'm not totally conviced about putting her through another surgery and my
>Vet wants to do a $300.00 ultrasound on her little belly and surgery will
>be about another $800.00 bucks!
 
While I can't comment on whether anouth surgery is warranted here, as I
don't know too much about the case, the previous surgery, youyr ferret's
age and general health, and the disease free interval, I will comment on
the need for ultrasound.  Although I know lots of vets out there are using
ultrasound as part of a surgical workup for adrenal disease, I continue to
fail to see the logic of it.  Functional adrenal lesions can be too smal to
be picked up by ultrasound, so a negative ultrasound in a ferret with signs
of adrenal disease does not preculde the need for adominal exploratory
surgery, it just adds to the overall bill.  If the diagnosis of adrenal
disease is in question - the Tennessee blood panel is cheaper and far more
diagnostic.
 
Plus, if you are considering insulinoma surgery, and you are going to be in
there anyhow, why do the ultrasound when direct observation of the adrenal
glands is far more diagnostic?
 
With kindest regards,
Bruce Williams, DVM
[Posted in FML issue 3191]