Q: "My ferret has just been diagnossed with adrenal disease...she is 6 years old. Should I risk surgery?" A: Do you risk life? You have brought up a subject (perhaps a philosophical one) which represents perhaps one of the most difficult questions a ferret owner is forced to ask, "when is medical intervention appropriate and to what extent do I allow it to occur." These are difficult questions and virtually impossible for one person to decide for another; there are NO right or wrong answers. In many cases, you can do everything right and still lose. I cannot speak of an individual ferret's frame of mind regarding it's state of health, but I always assume a ferret would want the same things that I hold dear to myself; reasonable freedom, healthy environment, intellectual stimulation, freedom from fear, interesting and nutritional food, and responsible health care. In the case of the last category, I would assume appropriate health care would include medical and surgical intervention when required, in a manner which a) does not increase harm, and b) prolongs quality (and perhaps quantity) of life. These last two goals are more or less what vets pledge as they become animal doctors. While opportunism exists everywhere, I do believe most vets sincerely support those goals. Each and every time a surgical procedure is performed, from as minor as the extraction of a splinter of wood to as major as removing extensive cancerous growths, there exists the danger of a sudden and catastrophic medical problem, perhaps caused by a bad reaction to the anesthesia or shock or just unknown causes. The smaller animal, the more problematic the surgical intervention. Ferret vets are forced to contend with anatomical structures of an extremely tiny nature; if you have ever seen a chicken heart, then you have seen something perhaps double the size of a typical ferret heart. A kidney bean is roughly the size of a ferret kidney, their bladder is about the size of a garbonzo bean. While the largest blood vessels are about 1/4 inch in diameter, most are much smaller--some thinner than crochet thread. The point is, ferrets are roughly 1/50th to 1/150th of human size (1 lb ferret compared to a 150 lb human); I find it miraculous that some surgical procedures can be done at all, considering the size of the anatomical structures involved. I use binocular glasses to distinguish the difference between the tiny wrist bones in a ferret; I am in awe of people who can repair a structure smaller than the nail on their pinkie. The point here is that ANY surgical procedure is inherently risky and that risk is far greater in animals of small stature and fast metabolisms. So when does the risks of intervention outweigh the benefits? In my humble opinion, it is when the QUALITY of life cannot be improved and the QUANTITY of life cannot be extended. I ask myself (and my vet) two questions: will the procedure make my ferret feel better and will it make my ferret live longer? If I get a "yes" to either of the questions, I proceed. If I get a "no" to both, then I have to decide if the disease warrants euthanasia or if I can wait. Sometimes my decisions, based on the above criteria, have resulted in the sudden death of my ferret. Sometimes I feel immense guilt each time an old balding ferret staggers across the room. I wish I could make perfect decisions and always get it as right as hindsight, but I can only do my best, based on the best advice and knowledge I can muster. Sometimes I do everything right and still lose. Adrenal disease takes several years to sap a ferret's life away (although not considered to significantly shorten it), and it has some major impacts on the ferret. I can see a significant change in the density of a ferret's bones, especially in the lower back, hips and heads of the femur and humerus, which MAY be a reason why older adrenal ferrets seem to lurch or stagger when walking. I have noticed adrenal ferrets have a lot of hairballs. The disease negatively affects the ferret's behavior and disposition. The loss of hair might be mostly cosmetic, but the sensitivity to cold reduces quality of life. And the spread of the tumor to other organ systems, such as the liver or the pancreas, can and does cause pain. SO, even with the risks involved in the surgical intervention, when it comes to adrenal disease, I personally feel the possibility of positive benefit requires I ask my vet to attempt yet another miracle, provided I am convinced it will either improve or extend my ferret's life. Please, discuss your concerns with your vet. Work together to provide your ferret with responsible--and appropriate--health care. Bob C and 16 Mo' Philosophical Phurts [Posted in FML issue 3071]