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Adrenal Gland Disease in Ferrets

By: Dr. Heidi Hoefer

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Diagnostic tests

  • There is no simple, single test to confirm adrenal disease and most cases are diagnosed based on symptoms alone. Diagnostic testing is important, however, to evaluate overall health of the ferret, to check for concurrent diseases, and to see if the adrenal condition has led to other complications like anemia.

  • Abdominal ultrasound (sonogram) is a relatively simple and safe test to evaluate the size of the adrenal glands and test for prostate enlargement in the males. The image provided by the sonogram allows measurement of the adrenal glands to determine which gland is affected. The normal adrenal gland in the ferret is about the size and shape of a lentil bean. Radiographs (X-ray's) are not as helpful because they cannot give detail on such small structures. The sonogram also allows evaluation of all the other abdominal organs which lets us know if there are other complications. Of particular importance is the prostate gland in the male ferret.

  • Complete blood count (CBC) and platelet count are essential to evaluate the activity of the bone marrow. The hormones produced by the tumor can suppress the production of blood cells from the bone marrow. This results in low red blood cells (anemia) and low platelet counts. Because platelets are essential for clotting in the body, ferrets with low counts develop bruises easily and are at a much higher risk of uncontrolled hemorrhaging. This is especially a concern if the ferret is to undergo surgical removal of the adrenal tumor. These individuals may require a blood transfusion before or after surgery. This test is very important, especially if the ferret has had symptoms for some time. Fortunately, not all ferrets with adrenal disease suffer from bone marrow problems.

  • Most veterinarians will also run a plasma chemistry panel to assess overall health of the ferret. This is especially recommended if the ferret will undergo surgery.

  • Plasma hormone testing can be performed on early cases but once the ferret is showing the typical symptoms, this test is usually not necessary to make the diagnosis.

    Therapy

    Because this condition is a hormone-producing tumor, the only real treatment is removal of the tumor or "adrenalectomy". In most cases, only one adrenal gland is abnormal. Both can be affected, however, so it is important that each gland is examined carefully during surgery. The right adrenal gland is adhered to the vena cava, the largest vein in the abdomen. Right adrenal tumors can actually wrap around this vein or grow into it making surgical removal very tricky on this side. An accomplished surgeon is recommended for this procedure. The left adrenal gland is easier to approach and remove. Cryosurgery (freezing the gland) is a new experimental technique that may hold future promise for destroying the abnormal gland. It still requires a surgical approach to isolate the adrenal gland before the freezing probe is applied to the tumor.

    There are medical therapies being used for treating adrenal disease. The principle behind medical therapy is to block the actions of the adrenal hormones without actually affecting the tumor. While this type of therapy may reverse the symptoms of adrenal disease, it is still not fully understood how it affects the tumor and should be considered experimental at this point. Medical therapy might be recommended for ferrets unable to withstand surgery because of age or other medical problems (heart disease, e.g.).

  • Surgical removal of the affected adrenal gland(s) is the only real treatment for this condition. Once the tumor is removed, the ferret should be considered "cured".

  • In some cases of bilateral adrenalectomy (removal of both adrenals) hormone supplements have to be given to make up for the total lack of adrenal function. Prednisone (Pediapred®) replaces the cortisol made by the adrenal gland and florinef helps with electrolyte maintenance. In most cases, these drugs are not needed at all or just for short periods following the surgery.

  • Medical therapy to counteract the side-effects of the adrenal hormones are being used by some veterinarians. The most widely used of these drugs is leuprolide (Lupron®). This drug blocks some of the symptoms of the disease like hair loss or urinating difficulty, but does not arrest the growth of the adrenal tumor. Lupron is an injection that has to be given every 1 to 4 months, depending on the formulation and is considered somewhat expensive. So while it initially looks like a "quick fix", the drug ultimately becomes more expensive than surgery, sometimes stops working, and the adrenal tumor is still present. Lupron may still be a viable treatment option in some situations. Discuss these options carefully with your veterinarian.

  • Emergency therapy sometimes must be given to ferrets with urinary tract obstruction. Relieving the urinary obstruction ("unblocking") a ferret can be very difficult, due to the small size of the urethra. A small sterile tube is passed into the urethra, past the prostate, and into the bladder where the urine is then removed. Urinary catheterization is a temporary procedure necessary to save the ferret's life. But as long as the adrenal gland tumor is active, the prostate will remain large and put pressure on the urethra and block the flow of urine.

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