I haven't posted for awhile, as I've been working every spare minute on a
ferret video for veterinarians.  I think it's going to be pretty good!!
 
However, the reason I'm posting now is to comment on right adrenal
surgery.  The right adrenal is always attached to the vena cava, the
largest blood vessel in the body.  That's just the way ferret anatomy is.
It has presented a real challenge for vets to learn how to remove it.
 
Although freezing the gland is a very useful surgery, I don't use that
method because I believe that it can leave too much of the gland still
functional and allow the same symptoms to return within a year or two.
The procedure is usually referred to as a "subtotal adrenalectomy".  By
definition this means some of gland is left.
 
The method I use now is to clamp off the vena cava above and below the
gland, remove the gland and the piece of vena cava to which it's attached,
and then sew the vena cava back together.
 
This is a technically demanding surgery, but a very effective one.
In this way, I can be sure that the entire gland is removed.  I've
successfully used this method on about 100 ferrets.  In only two cases did
the ferret develop post-op bleeding from the vena cava that required a
second surgery to repair, and that was early on in the learning process.
 
In some cases, the gland is so big and wrapped around the vena cava that
the vena cava can't be salvaged.  In those cases, the decision must be
made whether to do a subtotal adrenalectomy or to remove a large piece of
the vena cava and simply ligate it.  I try to discuss this with the owners
prior to surgery.  As drastic as it sounds, the survival rate for vena
cava ligation is about 90%.
 
I hope this may answer some questions about right adrenalectomy.
 
Deborah Whiting Kemmerer DVM
[Posted in FML issue 3669]