While some people have been happy with using daily Lupron rather than the depot form others had the adrenal disease suddenly markedly worsen, and I DO mean markedly. How often that happens is not documented but the mechanism is well known and covered later in this post. How often that might happen and be confused with a different and usually more serious form of growth being present also is not known. Also in this post is why fur regrowth happens better with melatonin even though melatonin does not provide as good control as some other approaches, and is best used along with those meds since it uses a different mechanism. When the FHL was in its very early years both Mike Janke and I heard from a series of such people, some in private letters, and their letters were heartbreaking. At first he and I both figured those people were facing carcinoma or lymphoma located in an adrenal which took off, but some had necropsies with pathology done later. Mike then contacted one of the research pharmacologists who MOST STUDIED Lupron. Here is that person's expert info: http://www.miamiferret.org/24hr_lupron.htm As one of the people Mike put in charge of his site files at his death I think it should be okay for me to copy the whole article but I suspect that the others lack time to reply so I will just copy some portions: QUOTED MATERIAL from Mike Janke: ...I then contacted John Hines, who wrote, "Adrenal Disease and the Therapeutic Effect of Lupron." Since John studied the topic of Lupron usage, has a Ph.D. in Pharmacology and is a ferret lover, I felt I wouldn't find anyone more knowledgeable on the subject and definitely one with the credentials to offer an expert opinion. First a brief layman's description (mine) of how Lupron works so some of John's comments might make a little more sense. Lupron desensitizes the pituitary gland and causes it to stop producing two hormones, LH (luteinizing hormone) and FSH (follicle-stimulating hormone). These two hormones (the primary problem is LH) stimulate the adrenal glands into producing sex hormones which cause the adrenal disease symptoms we see. This is an extremely basic explanation. There are many more details in John's paper. My main question to John was, can 24 hour Lupron be effective in ferrets for adrenal disease treatment if used as a monthly dose? John's comments on the topic were as follows: "... 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." We had several discussions, particularly about the claim that the 24 hour Lupron works for a month or more because of "the way it attaches to the adrenal receptors" to which John responded: "I did notice in your earlier correspondence that the vet and pharmacist had described their Lupron as binding to 'adrenal receptors'. I can see how a drug that binds to the pituitary and impacts on the adrenals could be misconstrued as binding to the adrenals by the average person; however, if the pharmacist or vet actually said to her that "Lupron binds to adrenals", then that immediately is cause for concern as it demonstrates a fundamental ignorance about how the drug works." "[pharmacist's name omitted] doesn't understand how Lupron works. He seems to know what its ultimate effect is, just not the mechanism. That's a shame, because he should know better than anyone. Leuprolide binds to receptors on the pituitary. The word "attach" could be misleading -- to some people it might imply a permanent joining of the leuprolide to the GnRH receptor, which is not the case. Leuprolide tightly associates ("binds") with the GnRH receptor, but it is a reversible process. It can dissociate ("unbind") as well." ...The important message I want to get across is, ask questions, know what you are getting and what you are treating your ferret with. This applies to ANY treatment, not just one for adrenal disease. ...If 24 hour Lupron is something you want to try for whatever reason, this probably won't change your mind. Just be aware that you may see no results and in fact, may make matters worse. END QUOTES There is a parallel situation with deslorelin. There is a horse 24 hour type that should be avoided with ferrets and there have already been some people speaking of marked worsening after trying that med. Deslorelin is in the same class of meds as Lupron and has the same method of action so that just plain makes sense. If using deslorelin, please, take the quoted expert info above into account and remember that the Suprelorin Implant, being longer acting has excellent reasons to be favored. There is even less of a chance of the time without coverage, and the very temporary spiking than happens with Lupron specifically because it is longer acting. In the U.S. that med is sold directly to vets by Virbac U.S. Because these drug use a different mechanism than melatonin you safely CAN use melatonin along with it, with Ferretonin being the longer acting form of that. Fur regrowth is NOT a good indicator of how well any adrenal treatment approach is working; it has some correlation to partial control but often an adrenal growth can be increasing in size while fur regrows, whereas some who have control do not always regrow fur or may regrow sparse fur after as long as many months or even years (from personal experience that includes even successful and complete surgical removal of both adrenals, with Fludrocort or Precorten as well as Prednisolone or other similar steroid needed to avoid Addisons, with her having had many years of life afterward followed by necropsy and pathology to teach vets who were new to ferrets). Melatonin works very well -- very, very well -- to regrow fur because it also works directly on the skin and follicles themselves. Sadly, it does not control adrenal disease as well as meds in the same class as Suprelorin Implants and Lupron Depots, but it safely can and should be used in conjunction with them for increased control. On that topic of fur growing: http://jhc.sagepub.com/content/44/4/377.long http://www.ncbi.nlm.nih.gov/pubmed/8601697 http://www.biolreprod.org/content/53/6/1251.long http://www.ncbi.nlm.nih.gov/pubmed/7673877 Implant capsules do NOT need to be removed after used up. 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 7726]