Adrenal Surgery? Need Lower Cost

Question
Hi Jacquie,
I read your response to Kristina who's ferret, Baby, also has adrenal gland disease. My ferret, Gizmo, is 5 years old and had started losing his hair last year. He eats Eagle Pack Ferret food. Other that the hair loss, he is perfectly normal. I took him to the vet about 8 mo. ago to get checked, but they just said they didn't feel any tumors and to just wait and see what happens. Well, he kept losing fur, so I brought him in again and now they can feel the tumor. My vet said that the surgery would cost $700 and the Lupron Depot shots would be $50/month. These are both too expensive for me. The only other option that she suggested was 1 mL of oral melatonin every day. But, after some research, it seems that the melatonin implant would be a much better option but she didn't even suggest this. I called their office and asked about the implant, but they said the only vet around here (grand rapids, Mi) that might do it is MSU. In your respnose to Kristina, you said that you would be able to find vets in her area, do you know of any in my area that would be able to give this implant? Or maybe one that could do a cheaper surgery? I want to do everything I can for Gizmo, but I just spent $700 on my other ferret's surgery after she swallowed a piece of rubber and my animal budget is very low. Thank you very much for your help.

Answer
Hi Michelle:

I'm so sorry to hear that Gizmo is having problems. I'm sorry, but I have to laugh that your vet needed to "feel" the adrenal tumor before they would accept that as a diagnosis. A ferret's adrenal gland is approximately the size of the tip of a ballpoint pen! So, an enlarged adrenal gland would have to be HUGE before they would feel it!  So, not only does Gizmo have adrenal disease now, apparently it is very large, as it can even be palpated. I'm wondering if possibly your vet *may* not be very experienced when it comes to ferrets. Any vet who is very experienced in ferrets would know that adrenal disease is almost the ONLY reason a ferret loses his/her fur, and it's really not a good idea to let the tumor grow for a year before removal.

That being said - let's look for another vet in your area who might be able to do the surgery.  In my experience I have seen vets do adrenal surgery for anywhere from $250 to $1,000; sometimes the from the highest extreme to the lowest within the same city, so it's ALWAYS worth calling around and asking. Just be SURE you ask exactly the same question at each place so you are "comparing apples with apples" so to speak.  You will want to ask "How much would a BASIC, LEFT ADRENAL SURGERY WITH NO COMPLICATIONS COST?" and "DOES THAT COVER PRE SURGERY TESTS AND POST SURGERY PAIN MEDICATIONS AND FOLLOW-UP ALSO?"  Here's the list of vets so you can start making those calls:

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/

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)

You do need to keep in mind that the vet you choose *may* get Gizmo in surgery and find the tumor on the right adrenal, which would cost a little more OR he could have complications that could cost more - so NO vet can guarantee that any surgery will cost a specific amount of money, but they should be able to give you a ballpark figure of what it will cost IF everything goes perfectly; which will allow you to choose the least expensive vet.   

Being the LEAST EXPENSIVE vet, of course, is only ONE qualification. You will want to meet the vet and make sure you're confident in the vet's qualifications. Ask questions like "how many adrenal surgeries did you do last year?" or "how many adrenal surgeries have you done so far this year?" and "how many of those ferrets died either in surgery or within a week after surgery?"  Those are very important questions to ask so that you will have peace of mind the day Gizmo goes to surgery. NO surgery is a bargain if you have to worry yourself sick the day of surgery.

Even though lower doses of Lupron are available at lower prices, from all I've read and heard, I have not seen ANY indication that lower doses relieve symptoms such as fur loss and/or prostate swelling that causes difficulty urinating.  The difficulty urinating is the thing we're concerned with most in males who have adrenal disease, so you want to be SURE to keep an eye on him when he's in the litterbox. Does he stay in the box too long? Does he dribble a long line as he walks instead of a puddle?  It's a good idea to put down some newspapers instead of litterbox at least once a week so you can see exactly HOW his bladder is working. Is the urine tinged with blood (pink)? When my male ferret's prostate was the most swollen, he would get in and out of the litterbox frantically, trying to go pee, but frustrated that he could only dribble a drop or two. His sides would go in and out, but when I put paper towels underneath him, I soon discovered that nothing was coming out! So, do be sure to test him to be sure he is passing urine at least once a week if not more often. If he's had this for a year, he is very very likely to already be having prostate swelling and problems urinating. It takes AT LEAST A 1MG DEPOT DOSE OF LUPRON (3-mo DOSE) TO RELIEVE PROSTATE & FUR LOSS SYMPTOMS; 2MG DOSE IS EVEN MORE ECONOMICAL AND LASTS EIGHT MONTHS (mine was $140).

My own experience with melatonin implants was that they were incredibly expensive - at least at my vet's office...more than melatonin actually in the long run. The melatonin implant was $75, the vet appointment to give the injection was $45; a monthly injection of lupron was $54, and a six-month depot injection (which is said to last EIGHT MONTHS) was only $140. Maybe you could do a 6-MONTH 2MG LUPRON DEPOT (which can last up to 8 months), then plan to do surgery when the Lupron wears off?  At least a Lupron shot would give you some TIME to look for a less expensive vet and to consider your options. Prices I'm sure will vary - so don't assume they will be the same as at my vet....I just gave you my prices so you have something to compare to. I just paid over $1,000 in tests for a ferret to finally be diagnosed (not typical symptoms) adrenal, another almost $1,000 for surgery, and sure enough, after surgery his symptoms did NOT subside, so he is now undergoing Lupron depot shots - the 6-month depot shot for $140. That injection is 2MG and is said to be effective for up to eight months in tests on ferrets. I hope by the time that one wears off that his body will have gotten the message that the tumor has been removed. Only one gland was removed; my vet couldn't even see the right adrenal gland (even the adrenal glad that was removed was teeny tiny, although considered enlarged, certainly could not be palpated).

I do understand how the costs can add up quickly with these little guys!  Every ferret owner at one time or another gets backed into a corner like this.  I always recommend that owners have a MINIMUM of $1,000 on hand FOR EACH FERRET in a separate savings account that gets money added to it on a regular basis as the ferret grows older. As you (and I) have learned the hard way, it can be gone so very quickly with just a simple problem; multiple problems, a difficult diagnosis, or complications quickly multiply the cost. I will post the lists of ferret vets that other ferret parents have compiled over the years and hope that helps you find a vet in your area that may cost less than the one you've been seeing.  You may also find that it's even cheaper to travel to a nearby city (even stay in a motel for a couple nights!) to have the surgery and still come out ahead, so don't hesitate to call vets in nearby cities, especially if they are larger cities where there would be more competition. You just never know - the next phone call may be *the* one that costs half of the prices you've been quoted up till then, so just don't give up.

Some (most) vets also mark up the price of any injections they give. They purchase it for say $50, then sell it to you for $65 and charge another $15 to give the injection. IF you can get a vet to write a prescription for you, you can order the Lupron directly, have it shipped to your home and (IF you're comfortable with it) you can even give the injection. However, Lupron injections MUST BE GIVEN IN A LARGE MUSCLE, so there IS a trick to it. Since it is so expensive, most people opt to have their vets give the injection. Still, you could order the medication and have it shipped to your home. You can get it by calling:  Professional Arts Pharmacy, 1-800-832-9285. You will need a major credit card to pay and they will also include the shipping cost. Call them for current prices and details if you wish to place an order. This is the pharmacy I'm using for my ferret and they are AWESOME - I recommend them without hesitation. They ship immediately and even tho they are in Maryland and I'm in Arizona, it gets here in TWO DAYS! That's outstanding service!! They ship needles, everything necessary for the injection.  Just be sure to discuss this with your vet, especially if you are going to be administering the injection.  That's the lowest cost way to give him Lupron treatment if you do choose to go that route.

REMOVAL OF THE ADRENAL GLAND IS THE *ONLY* DEFINITE CURE for adrenal tumors. Lupron only masks the symptoms. Melatonin *may* reverse the symptoms of adrenal disease EXCEPT in cases of carcinoma. You can read some really good, informative facts on melatonin use in adrenal disease in ferrets here:

http://www.miamiferret.org/fhc/melatonin.htm

Of course only you can determine what treatment you can afford. Probably the best you can do right now is something to buy a little more time until you can get the surgery for Gizmo. In the interim, you can spend some time making sure you have the best vet at the very lowest cost possible. There is great strength in having ALL the facts and being able to make a well-informed choice; to consider ALL options and to not be rushed into making an overnight decision. It's just too bad that your vet didn't let you know a year ago that the adrenal gland was so very tiny and that Gizmo would undoubtedly reach a point where surgery would become the only option to save his life. The longer he waits to have surgery, the more his body has a chance to develop a carcinoma (cancer) and spread to other organs in his body; and IF that happens, there is nothing you can do except wait until he is uncomfortable, then help him to the Rainbow Bridge. I am confident that we can get all the information together and help you make a better choice in plenty time to save Gizmo's life. I can tell that you do love him dearly...so whatever you do, DON'T GIVE UP on him.  I will help in any way I can, so don't hesitate to write if you think of any other information I can help with.

Sincerely,

Jacquie Rodgers