How Old is Too Old for Adrenal Surgery?

Question
Hi Jacquie,
My best friend and the apple of my eye (my ferret) is worrying me. I think she might be showing symptoms of Adrenal disease but there are people (experienced ferret owners and others alike) that are telling me not to worry, that at her age (she's 5) that losing hair and such can be normal. here's what's happening though, my ferret is losing her hair, her vulva is swollen, she's drinking much much more than she used to be and her energy level is just.. well, gone? When she hears me coming up the stairs she's anxious to be out of her cage and when i let her out she walks around slowly and she'll play for a bit but after just a few minutes she sits and just plops her head down (which is very odd for her, she's usually this cuddly ball of energy that can keep on going and going). Maybe I'm over worrying but this change in her behavior is sudden to me as I've only seen she's been like this the past few days. I've made an appointment with the local vet but I know their primary experience is w/dogs, cats. I dont know of any vets in my local area that specialize in ferret care so I'm hoping they can find whats wrong. She's my first ferret and I don't have prior experience in knowing what to look out for. Another thing is if she does have any tumor/tumors I would more than gladly opt for surgery so she can have more years left to her life and not suffer. But the problem is that I see the costs vary and can be pricey and it might be a month or two before I can afford the surgery for her, so my question is how do ferrets have after being diagnosed?? I want to have her get better as fast as possible and I don't want her to suffer. She's the dearest to me and it breaks my heart to see her suffer so any advice will be very very greatly appreciated!

Answer
Hi Rachael:

I'm glad you wrote. I think ANY "sudden onset" symptom is absolutely worth checking out immediately with your vet. Adrenal tumors don't usually happen 'suddenly', but it's possible you just now are noticing the symptoms. There are other things she could have that could be causing some of her symptoms (whether she has adrenal or does not have adrenal). If your vet is not very experienced with ferrets, he/she may offer to do a Tennessee Panel (blood test) on your ferret to determine for sure if that's what is wrong with your little one. Nine out of ten experienced ferret vets will tell you to save your money to use towards the surgery; this test is really not as reliable as the symptoms you are describing. The results of the test are only about 50% accurate, so I wouldn't go for that one; but I WOULD go to a more experienced ferret vet and I WOULD go for an adrenal surgery at age 5 with a ferret who is otherwise in good health.

First you do want to establish good health tho. The sudden drinking of a lot of water *may* indicate some kidney problems (maybe not; I'm just saying that it should be checked out BEFORE you plunk down money for an adrenal surgery then find out she only had six months to live at best anyway).

Any vet can do a "full blood panel" for you initially and tell you if there are any abnormalities. If your ferret's blood work is all good, that means her organs are all functioning well and there's nothing to indicate she wouldn't have another couple years with you. If that's the case, my next move would be to locate an experienced ferret vet in the closest larger city and make an appointment for an exam with possible surgery following (same day if possible; next day if not, since you will be coming from out of town). Make arrangements to stay in a motel closest to the vet hospital as possible as soon as you know for sure when your appointment is and explain to them that you may be staying only one night, or several nights if she has surgery (you will want to stay close for post-surgery checks for 3 days I would think). Your hometown vet should be able to take over after that (or sooner if necessary - you *could* go home next day if you had to; it's just much more reassuring to be right there if there is a problem).

As far as how soon to take her to surgery? Well, let me relate my own personal experience with you and maybe that will help. My own personal ferret, age 5, suddenly started losing fur last December. It started so fast and seemed to just pop out of the blue! Like your ferret, his energy suddenly faded and my heart just broke. I immediately took him to my experienced ferret vet, bypassed the Tennessee Panel, had a full blood panel to be sure all systems were "go", then scheduled surgery as soon as possible...thinking I was doing the right thing.

My vet was in surgery for the longest time! I was pacing the floor waiting for her to come out and tell me everything was okay. I could even see the tops of her and her assistant's heads as they worked over the lighted table in the surgery room in the back of the building. Time seemed to drag on forever! When she finally came out, she said "Good news and bad news - which do you want first?" and I steeled myself for the worst.  She said the good news is that he is doing just fine and is stable post-surgically.  Bad news?  The adrenal gland had not been adequately swollen so that she could find it!  She removed what she believed was the left adrenal gland and sent it to pathology, but said she was never so unsure of having removed the offending gland in all her years of practice! Had I waited a month or two, the gland no doubtedly would have had time to swell up a bit more and no doubt would have been easier to identify. As she told me, a 'healthy' adrenal gland is about the size of the head of a pin!  A 'sick' adrenal gland can get as large as the size of a grape (which is huge in comparison, but still pretty small when you're looking around inside all those things God puts inside a ferret!).

So......from my own experience, I would say "take a deep breath. Get the blood panel done. Contact a ferret club or ferret shelter in a nearby city if at all possible (trust me, shelter moms know the best and cheapest vets) and start asking around about possible vets. Save every penny you can. Cost CAN range between $250 to $1,000 or more, so ASK - and be sure you ask the same question each place so they all give you the answer to the same question "What is your BASE PRICE for a LEFT SIDE ADRENAL SURGERY for a ferret, no complications?"  Your ferret may not have a no-complication left side adrenal surgery, but at least you were able to compare apples with apples when comparing vet costs.

The problem with waiting IS that the tumor CAN enlarge, CAN metastasize to other organs such as the right adrenal, even to the liver or spleen. For this reason, you DON'T want to wait too long. How long is too long?  If I could tell you that, my friend, I would have known that answer myself. I DO understand the sense of urgency - my own was one of utter panic. When one of my babies is sick I can barely think of anything else. But don't let your friends upset you more by telling you that age 5 is too old to get the surgery either. I hear of a LOT of ferrets who are 6, 7, 8, 9 years old - one a few weeks ago was 12 years old!! When well-loved, I think these guys can be pretty tough about hanging on.

Something else your vet here *may* be able to do (IF he's a really good sonographer) is to do an ultrasound to see if he can find the tumor with his ultrasound. For that test (about $100), they will shave the ferret's belly, put some gel on it and just gently and slowly run a rod around on it. If you can talk the vet into letting you in the room, the ferret will stay much calmer and you will get to see the screen and the results as they show up (or don't) on the monitor. I was able to do that when my little female who had cardiomyopathy had an ultrasound test last year. It was the first time the sonographer had done a ferret and he said he'd not hesitate to do another, especially if the mom was there to hold the ferret; she was very very cooperative and a good little girl (even tho the news was very very bad).

So, hopefully that gives you some ideas as to where to go from here. I will give you the list of vets and also of shelters and hopefully you can get some contacts that can lead you to the *right* place. From my experience, I don't think waiting a month or two would be a bad thing...but I'm sure every case is different and as sure as I say that, probably six other people could say otherwise. I can only share my experience with you.  I do encourage you to keep asking -  everyone you respect, every place you think someone knows about ferrets - ASK!  In the meantime, just love on that little girl all you can (I'm sure you already do) and don't fall into the 'she's 5 years old'....because for all the good, bad and otherwise information I had with my little guy last December, he is laying right here, two feet from me as I type this, peacefully snoozing, waiting for mommy to turn out the light and go to bed. I thoroughly expect to have another year or two with him.  I did choose to give him Lupron injections every six months just to be *sure* he's covered. I don't like the idea of Lupron "only" as treatment unless surgery is really absolutely NOT an option due to old age (7 or more years old or poor health that could not tolerate surgery in a younger ferret).

I will give you a bunch of links so you can do some reading and make some decisions for yourself.The best thing you can do is get all the information you can get and see how it fits into YOUR life, your finances, your ferret's blood test results (even IF they are bad, don't forget Lupron!), there is always something; we just have to stay informed. So, here are a bunch of links for you:

ADRENAL DISEASE: * http://www.ferretcentral.org/faq/med/adrenal.html

LUPRON:   * http://www.miamiferret.org/fhc/

SHELTERS/RESCUES - UK (ENGLAND)
* http://www.everythingferret.com/ferret_shelters.htm
* http://homepage.ntlworld.com/ferreter/ferretrescues.htm
* http://www.ferretfacts.com/ferret-shelter-directory-international-ferret-shelter...

SHELTERS/RESCUES - U.S.
* http://www.ferret.org/links/shelters.shtm
* http://www.everythingferret.com/ferret_shelters.htm
* http://groups.msn.com/Ferret/yourwebpage5.msnw
* http://www.ferretcentral.org/for-others/db-products.html
* http://www.ferretfacts.com/ferret-shelter-directory-us-ferret-shelters.html

=================VETS============

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
* http://pets.groups.yahoo.com/group/sask_ferrets/

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/

I sure do understand the feelings you are going through with all this - please know that my thoughts and prayers are with you and I hope you will update me as time progresses and you get the blood panel results, and hopefully ultimately find a vet and have successful surgery. I will be happy to help in any way I can. Just know you aren't alone, okay? I hope my little bit of experience has helped in some way.

Sincerely,

Jacquie Rodgers