As Dr. Bruce Williams once pointed out a necropsy without pathology is
very often wrong, often because one simply can not get accurate info
from the gross examination the vast majority of the time. That post
was either on the FHL or the FML in the past.

Ah! Here is one of his mentions:

http://ferrethealth.org/archive/YG11561
QUOTE
As a pathologist now with 12 years experience in ferrets, I know that
if you took my scope away, and required me to diagnose simply on gross
examinatin - I would come up empty at least half the time - and it's my
area of specialty! I would submit that the gross post from the average
clinician without pathology training or ferret experience would yield
far less....
END QUOTE

I doubt that many vets have taken much in the way of pathology courses
beyond the everyday stuff expected to be done in-house.

On gross examination alone (without pathology by a ferret knowledgeable
pathologist) it really would not be readily apparent if an adrenal
growth suddenly got much worse from the problem being a malignancy like
a carcinoma OR sudden more rapid growth of the tumor from a med being
used that is not sufficient. Most shelters simply can not afford to
have pathology done on a dead ferret and sometimes not even after
surgery so they just would not know.

At least if the daily form is given more rarely the downside for
ferrets would happen much less often.

From
http://www.miamiferret.org/24hr_lupron.htm
QUOTE
"... if the Lupron is of the type that all enters the bloodstream in
24 hrs., (24 hr. Lupron) what you get is a few hours of high pituitary
activity followed by only several HOURS of inactivity (desensitized).
Then the 24 hr. Lupron is gone shortly thereafter, and the pituitary
RE-sensitizes and LH release to the natural GnRH resumes probably in a
day or so. If the ferret is only getting the 24hr. shot once a month,
it's useless. In fact, the use of the 24 hr. Lupron probably makes the
adrenal disease worse because you don't get much therapeutic effect,
but you are still getting that initial high pituitary activity when the
Lupron is first administered. This initial burst of pituitary activity
is of little consequence when it is followed by cessation of pituitary
activity. But, with the 24 hr. Lupron, you get only the initial burst
of pituitary high activity -- followed by normal pituitary activity.
It's like adding a splash of gasoline to a fire."
END QUOTE

Many shelters and other ferret people also use melatonin, which is
very affordable and also treats adrenal growths (though not as well as
Suprelorin Implants or Lupron Depots) and melatonin regrows fur better
than anything. Fur regrowth (or not) can be very accurately used to
assess how well any adrenal treatment is doing. It is a very poor
indicator.

When it can be afforded, melatonin can and should be used in
conjunction with Suprelorin implants (long lived implants of deslorelin
sold by Virbac) or Lupron depot for a cumulative effect that better
treats the adrenal disease. Even back when it had to be imported we
personally found that the Suprelorin was cheaper over the space of time
than Lupron depot and more effective for two of our ferrets who had
adrenal carcinomas. The shelters who can not afford $150 (or reduced
cost from some vets for shelters) for up to a year of treatment might
find that just using melatonin may be at least as good and very
possible better (as well as cheaper) than also using the daily form of
either Lupron or deslorelin, though obviously the Suprelorin implant if
it can be financed would make sense.

Suprelorin implants currently cost us about $150 each and last about
a year in most ferrets with adrenal growths, though not for ones with
really bad growths like lymphoma at the adrenal(s) or carcinoma there,
and I doubt they have been checked with the very rare growths like
teratomas of the adrenal. They also last about a year for possible
adrenal disease prophylaxis which is what we are currently using them
for.

A number of shelters are also using melatonin, either in implant form
with Ferretonin or oral melatonin so its effect also has to be
considered.

In about 32 years with ferrets we have had three with definite adrenal
carcinoma, a couple of others who maybe had adrenal carcinoma, and one
with lymphoma at the right adrenal. About a third of our ferrets over
those decades have wound up with adrenal growths. Because our typical
number of ferrets at one time was 6 (though recently we have gone down
to 3 for reasons related to finance, age, and the needs of older human
family members) you can tell that we have had other ferrets who had the
most common adrenal growth: benign neoplasia.

There are excellent reasons to treat ferrets with any type of adrenal
growth:
1. Without treatment three life-threatening things are possible: fatal
anemia, urinary blockage, and having the growth change to a malignant
one
2. Ill ferrets are more likely to develop ulcers and those also can be
life-threatening
3. Ferrets with adrenal growths lose muscle mass, itch, are generally
uncomfortable, are extra vulnerable to urogenital infections and cysts,
and generally have a reduced level of quality of life
4. The treatments that reduce the LH too high output which triggers
adrenal growths to form also reduce FSH output. Too much FSH output
has been associated in a range of mammals with bone loss.

Again, without pathology done by a ferret knowledgeable veterinary
pathologist, people typically can NOT know for sure if an adrenal
growth that took off badly might have been from that "splash of
gasoline to a fire" described above by one expert (who is among those
who best understand the mechanisms used by that medication) or from a
malignant growth, so either possible cause may be innocently assumed
to be the other. (That is why I gave an idea of how rarely we have
encountered actual adrenal malignancies instead of benign neoplasia
because if the rate the shelters figure they are encountering is much
different than the rates known in places where pathology was done then
that might just mark a difference between locations, OR it might
pinpoint that there is a different cause for some of the individuals
worsening, which in this case might be that "splash of gasoline to a
fire".)

Sukie (not a vet) Ferrets make the world a game.

Recommended ferret health links:
http://pets.groups.yahoo.com/group/ferrethealth/
http://ferrethealth.org/archive/
http://www.miamiferret.org/
http://www.ferrethealth.msu.edu/
http://www.ferretcongress.org/
http://www.trifl.org/index.shtml
http://homepage.mac.com/sukie/sukiesferretlinks.html
all ferret topics:
http://listserv.ferretmailinglist.org/archives/ferret-search.html

"All hail the procrastinators for they shall rule the world tomorrow."
(2010, Steve Crandall)

A nation is as free as the least within it.

[Posted in FML 7727]