Ferret - Weak hind legs & less urination

Question
Cindy,

I've owned 9 ferrets over the past 15 years. I currently
have a male fuzzy who's almost 4 years old. I drive over-
the-road and he's been traveling with us for a while. About
a month and a half ago, I started noticing he was a bit
unstable on his feet but thought it was because he was
walking in a moving truck.

I let him stay home with my son last month and when I
stopped by the house, I found he was still walking funny
even on solid ground. That's when I knew something was
wrong, so I took with me in the truck again so I could
observe him better.

This weekend, we've been on breakdown so we've been in a
hotel since Thursday night. This has given me more time to
watch his behaviors.

Originally in my research online, I thought maybe he had
Insulinomas, due to the hind leg weakness. I've had a ferret
with Adrenal disease but her hind quarters balded & let me
know quickly. This one is showing NO signs of hair loss. But
since we've been at the hotel with no litter box available
(and thankfully with a fuzzy who prefers to use the bathroom
floor), I've found that he also isn't urinating much.

He's showing no signs of pain, is playful, is drinking and
eating as usual. His bowels seem to be normal as well and
he's not straining at all. There's just a lack of urine, his
hind legs are weak...oh, and he has been rubbing his face
against the carpet a lot since we've been here (we thought
it was because they have carpet on the wall in place of
woodwork but I see it may be a symptom of adrenal disease,
even with the lack of hair loss).

I called my vet but they refuse to offer any ideas since he
hasn't been in during the past 6 months.

Any ideas on how long I have to get him to the vet with the
urinary issues? We're working on getting him back home ASAP
but it takes a week or more sometimes. If he needs surgery I
want my vet at home to do it so my son can care for him at
home...I think it would be miserable for him to try to heal
on a moving semi-truck).

Any ideas are appreciated.

Debi

Answer
Hello Debi,

I agree that it sounds like your ferret may be suffering from adrenal disease.  Most, but not all cases show signs of hair loss.  It may be that your ferret is one of those that do not.  

An enlarged prostrate is a common symptom of adrenal in male ferrets.  It makes urination difficult.  Straining to urinate can also be caused by urinary stones that block the flow.  This is far less common.  regardless of the cause, if your ferret blocks completely and cannot urinate, the situation is dire.  He would need medical attention ASAP or he would die very quickly.  

Hind limb weakness is usually a nonspecific sign in a sick ferret.  It is less commonly attributed to things like paralysis, a buildup of toxins in the blood or spinal tumors.  In most cases, it is just generalized weakness from another cause.  The ferret simply lacks the energy to move much.

I have included a list of ferret-friendly veterinarians around the nation (and internationally.. I assume you are in the USA but cannot be certain).  It would be a good idea to have him checked out ASAP and talk about your options.  Also consider the nearest school of Veterinary Medicine.  They have state of the art facilities are most are very familiar with adrenal disease in ferrets.  


VETS CANADA:   
* http://www.ferretrescue.ca/start.php
* http://tinylink.com/?TlVyYKa6e0
* http://www.ferrets.org/Veterinarian_Listings.htm   (British Columbia)
* http://www.ferretcentral.org/for-others/db-vets.html

VETS USA:
* http://www.quincyweb.net/quincy/vet.html
* http://ferrethealth.org/vets/
* http://www.ferret-universe.com/vets/vetlist.asp
* http://www.ferretsanctuary.com/vets.shtml
* http://www.ferretcentral.org/for-others/db-vets.html
* http://ferrethealth.org/vets/

VETS  UK & IRELAND:  
* http://homepage.ntlworld.com/ferreter/vetlist.htm

VET INFO/ LIST OF FERRET GROUPS/ CONTACTS IN UK, ITALY, NEW ZEALAND, AUSTRALIA, NETHERLANDS, GERMANY & DENMARK:       
* http://www.ferretcentral.org/for-others/db-overseas.html (scroll down page to find the one you are looking for)

For the nearest school of veterinary medicine, the following link includes all 28 within the USA and internationally.  It is NOT in order by state but rather by college name.  It may be easiest to locate the nearest facility though google.  

http://www.aavmc.org/students_admissions/vet_schools.htm

Other Information about adrenal disease:

Adrenal disease is caused by tumorous growths or hyperplasia on one or both adrenal glands, which lie above each kidney.  It causes an overabundance of hormone production, such as estrogen which is the major reason for the hair loss, swollen vulva and aggressive behavior.  Testosterone is also produced, which can lead to increased aggression in males. No one is certain what triggers adrenal disease, but some speculate that it is the overabundance of artificial light, early spay/neutering, diet, or genetics.   

Symptoms:

Whether the tumors are malignant or benign, the most common symptoms of adrenal disease include hair loss usually beginning at the end of their tail (though it can appear anywhere on your ferret) moving up towards their shoulders in a symmetrical fashion, muscle loss and/or a potbelly appearance, lethargy, an orange skin color and weight loss which can be dramatic. It is quite common for a ferret to loose all their fur, except for a few areas and their face. Females often develop an enlarged vulva (50%), and males experience an enlarged prostate often causing them to strain while urinating. Male ferrets can also return to intact male behavior including aggressiveness due to the increased levels of testosterone. There can also be a thinning of the pelt or brittle skin.  

Diagnosis:

Ultrasound is a great way to rule out adrenal disease without jumping directly to surgery, but if the tumor is too small ultrasound may not be diagnostic.  There is a blood test available, but the accuracy is about 50%.  Radiographs are unhelpful in the diagnosis.

The problem can occur on either the right or left adrenal gland (or both). In the overwhelming number of cases the problem is in the left gland only (80%). Eventually, both glands are commonly involved.

The left gland is much easier to work with because it is in a fat pad above the left kidney. The right gland is much more difficult to approach because it is under a lobe of the liver and is attached to the posterior vena cava, the main vein that returns blood from the back end of the body to the heart. In most surgeries we remove the diseased left gland, leaving the right gland alone. If the problem is in both glands we remove part of the right gland in addition to all of the left. Complete removal of both glands can cause serious complications. Sometimes removal of only one of the glands can cause a problem if the remaining gland can not make up for the loss.

Treatment:

Adrenal disease is 100% fatal IF untreated.  The best method is surgery to remove the affected gland(s).  In a young ferret, this will likely be the best option.  In older ferrets, or those that cannot go through surgery, there are medications (Lysodren, Lupron, melotion injections, etc) that can help slow the progression of the disease and promote fur growth.  Medication will NOT stop the condition, but it will allow a longer more comfortable life.  Adrenal disease is VERY painful and if left untreated the ferret will die a terrible death.  If surgery is not an option, the ferret will require Lupron and/or melatonin injections for the remainder of its life.  

Complications with surgery:

Unfortunately, it is quite common after the removal of a gland to have the other gland become affected, and to a lesser degree to have them both affected at the same time. If both are affected together, the recommended protocol is to remove the gland that's worst first and then remove the other one 1-2 months later to avoid Addison's crash.

When both glands are removed, the ferrets body stops producing the needed hormones at once, which can send the ferret into shock, Addison's Disease and possibly death. It is very possible that some ectopic tissue remains from surgery, producing enough natural hormones on their own without drug intervention. The only way to know for sure is through frequent Chem Panels to monitor the levels. Your ferret will most likely need to be given Florinef (pill) daily for life or an injection of Percortin monthly for life. Blood tests are vital at the beginning to establish the correct drug dosage, and should continue quarterly thereafter to ensure all is well. A majority of the vets prefer the Florinef for the easier flexibility in dose changes and less visits for you to the office.

When both glands are removed, it is very common to immediately administer the Florinef or Percortin to avoid Addison's shock due to the immediate loss of needed hormones not being produced. Constant and continual monitoring by blood tests are vital to the health, survival and well-being of your ferret.

Prognosis:

Most ferrets that have this surgery regain hair growth and do well for years. Even though most adrenal tumors are benign, recurrence can occur. a tumor can reappear in the adrenal gland that remains after surgery, and symptoms can recur.  Injection therapy (Lupron) instead of surgery will only mask the symptoms and not stop the progression of the disease.  

I hope this answer helps.  I like to be through and include as much information as possible.  If you have any other questions do not hesitate to ask.

-Cindy P.

//Edit: During class we were also speaking of renal insufficiency, and it reminded me of your fuzzy's problem.   The lack of urine production or a decreased amount can be caused by acute renal failure.  Since he is eating normally, it makes me less likely to believe it is a kidney problem.  I believe it is likely adrenal (more common in ferrets), but it is a good idea to have some bloodwork done to make sure his kidneys are functioning normally.  I just wanted to update you with some other thoughts and let you know I'm thinking about him!