Learn from mistakes, wherever they come from. I apologize for being scarce on a weekend, but we lost one of our own this evening, following adrenal surgery yesterday (and a relatively famous one, who was pictured on the cover of the JAVMA last April 15th in a watercolor I painted as a lark) Not a happy story, but one that might be of interest to everyone else out there. For the last two months or so, Cosmo was becoming progressively more lethargic. His hair loss had dramatically increased, he had assumed the pot-bellied, pear shape appearance that is occasionally seen in adrenal cases, and over the last week or so had become very lethargic. Yesterday I took him over to Charlie Weiss' for surgery. Preoperative bloodwork showed everything looked pretty good, except for a marked decrease in platelets (45,000/cm instead of the normal 150,000+) Knowing that ferret don't spontaneously bleed until 10,000, and that his condition was deteriorating relatively quickly, we opted to proceed with surgery, following a transfusion. Post- transfusion, the platelet count was 338,000. Surgery was uneventful, with removal of a right adrenal malignancy and a nodule off the pancreas (he had never shown signs of insulinoma.) Recovery was uneventful and he went home with me about 90 minutes after surgery. He did fine last night, and was sternal and relatively alert. This AM, he was non-responsive, hypothermic (97 degrees) in significant pain, and had bruising surrounding the incision site. He spent the balance of the day in ICU with fluid, steroids, and torbutrol for pain. This afternoon he was not progressing, and died peacefully following a third shot of torbugesic. The necropsy resulted in an interesting, but not altogether unexpected finding (given his post-operative signs). The elevated platelet count was not in error, but these platelets were likely not functional. Slow bleeding was seen at every area of surgical dissection, and subcutaneously at venipuncture sites. In effect, he died of hemorrhage brought on by deficient platelet function. His own were too few to stem the damage of surgery, and the transfused ones were non-functional, it would appear. I need to review with Charlie how the transfused blood was collected, and work backward to see if there was a step in the collection that might have resulted in the platelet's lack of activation in Cosmo's circulation. The moral of this particular tale is that while conventional wisdom is that ferrets may be successfully operated on with platelet counts less than 50,000 - there will be some mortality. Had his condition been better, perhaps we might have been able to delay surgery, but as he was already slipping away, we took a calculated risk, and lost. Watch those platelets. With kindest regards, Bruce Williams [Posted in FML issue 3494]