This post is in response to Julie's post on yesterday's FML; To clarify some things I said earlier. I stated in my last post that for the most part, adrenal surgeries are the equivalent of exploratories. I said this because of the fact that ultrasounds, in the most skilled of hands, only show enlarged adrenals 50% of the time and that the Tennessee panel is not near 100% effective in diagnosing adrenal disease. I have read alot of literature and been speaking with ferret vets who do hundreds of such surgeries a year as well as shelter workers who have alot of experience in this area, and the overwhelming consensus is that the most reliable indicators of adrenal disease are clinical signs and symptoms, the severity of which do not correlate to the severity of the lesion/disease. Negative results on ultrasound and the adrenal panel do NOT rule out adrenal disease. Many vets will go in despite negative results and find (and confirm with histopath) adrenal disease present in the animal. You also stated that you would not want to go into a six year old ferret without 100% positive proof of why you were going in. There are two issues here. One is that there is an increased risk with surgery after age 6. I would also be very hesitant to do surgery at that age. However, my girls are not yet five. The other issue is that rarely in medicine do we have definitive proof beforehand. An unfortunate but true statement. Most, if not nearly all, of medicine is the balancing of probabilities. In terms of my ferrets, they have had significant clinical signs for over a year and while I was not 'against' doing other tests, I did not feel it necessary to make a diagnosis or decide on appropriate treatment. The truth is the vets I saw DID NOT disagree that the girls have adrenal disease. They simply preferred to leave the disease to progress and saw no inherent problem in doing so. This was my frustration. Understanding why it was they felt this way DESPITE everything I had read and heard from those with the most experience with this disease (those who are considered by this list, the FML, to be the "experts" in the field). The other issue you brought up - about questioning the competency of a vet. Firstly, the way I stated one question.. I followed it by saying that I was not truly expecting an answer. That it was more an expression of frustration and a feeling of a lack of control. I regret that that may not have been clear. Aside from that, I am not sure what you are upset with in terms of my questioning a vet's competency. I have been a consumer of the health industry for 33 years now and I will soon be a provider. I don't see anything wrong with questioning care being provided. In the past, much medical care was dispensed in a paternalistic manner and some cultures still feel that any doctor who asks the patients what s/he would like to do is a quack. For most of us, however, being in control of decision-making is a part of the autonomy we value in this society. I, sadly have too much experience in human medicine to know that while you must at some point, give over your trust to the professionals, you must never do so blindly. You say that if I question the vets, I should go elsewhere and get my pets 'out'. Perhaps you had not seen my previous emails. This *was* elsewhere. I have been to a total of four vets and they are all the recommended vets in the area. This was again part of my frustration: Finding a vet who treats ferrets and is current on literature. The last issue you mention was about *not* bringing 'outside' information to vets and *not* looking to the mailing list for answers. I have looked *specifically* to this and the FAIML for answers and have found more than I could possibly have hoped for. I consider this forum to be one of the most educational and effective resources I have at my disposal. As for bringing new information to vets, I would challenge your disapproval for a number of reasons. One is a problem I brought up that others have emailed me about: that there is a *real* problem in getting new information about ferret medicine out to vets who are treating ferrets. It is an area of ongoing research in human medicine and an area I have developed an interest in. Most of what vets learn comes AFTER graduation. It is difficult to keep current on one or two species never mind if you treat all sorts of 'pocket pets'. Many vets know that most breeders know more about their particular animals than the vets themselves. That doesn't mean that the breeders are qualified to treat the pets. Being a vet is not simply what you know, it's how you incorporate and apply new material. In human medicine, many patients with serious illnesses know more about them than most doctos and are often the ones bringing the experts cutting edge pieces of literature (I have personal experience in clinical research-experimental research-in patients doing this). IMHO, any health professional worth his/her salt will not take offense to someone who respectfully brings them new information and such a professional will respectfully evaluate the material and weigh the pros and cons in relation to the case at hand. It also presents an extraordinary opportunity to educate clients. Education can go further than most lab tests, surgeries, etc. Your challenge for me to "take responsibility for my ferrets' does hit a sensitive spot. I want nothing but the best for my babies and I have spent much of my "free" time doing just that: taking responsibility. I may be a vet student but I go through many of the same emotions all of you do when it comes to being a guardian and 'mother' to my fuzzies. I just hope my personal experiences allow me to be respectful and sensitive when clients come to me in the future with their own similar or (dissimilar) worries and stresses. I hope I have clarified what I think may simply have been a regretable misunderstanding. If I haven't addressed your comments appropriately feel free to email me, personally if you wish. BTW, see my other post for great news about finding someone to do the surgeries :). Michaela Maurice College of Veterinary Medicine Ohio State University Class of 2002 [Posted in FML issue 2842]