From: Lynn McIntosh [faiml@uswest.net] Sent: Thursday, October 28, 1999 10:39 PM To: FAIMLanon; FAIML Subject: FAIML #346; Oct. 28, 1999- complete version Ferret Adrenal/Insulinoma Mailing List (FAIML) #346; Oct. 28, 1999 Hi. I'm sorry to have sent out the first version of this list missing two important posts, #'s 3 and 8 here. Ever since I updated my software I've been having to send posts to myself first to check the formating. In this process I pulled up the unfinished version of FAIML and sent it out. My humble apologies to Amy, and to Becky and Steve. Please check out these posts as one is seeking answers to an important question, #3, and the other gives a sad update regarding the loss of the ferret in Australia. 1. Hair Loss 2. Cappuccino 3. question about pred poops 4. Reply to Robert:FAIML,10/26/99 (options for adrenal gland disease 5. Update on the girls and possible insulinoma with Bugsy 6. Update 7. Aussie ferret with insulinoma 8. Insulinoma ferret in Australia The FERRET ADRENAL/INSULINOMA MAILING LIST (FAIML) is a group that's come together to share support and information about adrenal and insulinoma diseases. FAIML comes out in digest format three to six times per week, depending on the number of posts sent, and their surgency. FAIML information is the opinion, only, of subscribers, mostly ferret caretakers. It is not medical advice, comes with no guarantee of accuracy, and is not meant to replace the examination and medical oversight of a qualified veterinarian. If your ferret is sick or exhibiting signs of illness take your fur kid to the most ferret-experienced vet you can find! A ferret- experienced vet is one of the most important services you can provide to your ferret. TO POST: Write POST at the end of your subject heading (the more specific you can be in your subject heading, the better) and send to . URGENT POSTS: If you feel the message is urgent please mark it POST URGENT and I'll send it out to subscribers as soon as I can, then include the message in the next list. CALIFORNIA RESIDENTS: Please write POST ANONYMOUS after your subject heading if you don't want your address or last name published. SUBSCRIBE/UNSUBSCRIBE: Just use the one address for posts, subscription questions, requests, cancellations, comments, etc. The list is run by hand so just send me an email. ADRENAL/INSULINOMA WEBSITE: FAIML ARCHIVES/PHOTOS: Past FAIMLs are being archived, with a search feature, on Michael Janke's adrenal/insulinoma web site: . Michael is also kindly posting pictures of FAIML subscribers and the ferrets at this site in the FAIML Album. Check out his site for more info. PAM GREENE's FERRET FAQs: I suggest people read (and reread) Pamela Greene's Disease FAQ's on Insulin and Adrenal diseases, as they offer a good background. I forward them to all new subscribers, and will gladly send them upon request. I also send the "Disease Package", a file that tells how to get all six of Pamela Greene's FAQs on ferret diseases. Pam also has excellent FAQ's about general ferret care as well, and a link to these may be found on the FERRET CENTRAL web site: . THE FERRET MAILING LIST (FML): The FML has 3,000+ ferret-loving subscribers and the topic is simply ferrets, ferrets, and more ferrets. Moderated by Mr. Bill Gruber, it's a great source of ferret entertainment and information. Visit FERRET CENTRAL on the web (see paragraph above) for more info on the FML. To subscribe to the FML, send email to its moderator, Bill Gruber, at and ask to be added. You can also try subscribing automatically by sending email to with the command SUBSCRIBE FERRET in the body of the email. 1. Hair Loss From: "Mary Rogers" Date sent: Wed, 27 Oct 1999 9:05:22 -0500 Daisy is showing signs of thinning hair from her rear to shoulders, not the tail, no swollen vulva either. Is this just a coat change or adrenal signs? When Rowdy had hair loss it started on his tail and progressed to his rear and overall thinning. I hope I'm just being paranoid! Thanks, Mary and The 12 Munchkins 2. Cappuccino From: "facemars12@home" Date sent: Wed, 27 Oct 1999 18:22:14 -0400 Hello, I have posted a few times before about my Ferret Cappuccino, He has had what it seems to be An Adrenal Tumor. My vet said it was an adrenal tumor since he wasnt resonding to the meds, by now he hads lost pretty much all his fur. he was on and said it was an allergy. So we started to give him raw turkey burgers. He was on that for a while and he was fine. Then since he wasnt getting anybetter we decided to put him and my other ferret Noone back on Regular ferret food. Since he was on it he has gotten better and his dry skin and sores have gone away, He has also grown his hair back. Has this happened to anyone. Can you give me any help to what might be happening? Is he ok? Thank for listening. Julie, Noone, and Cappuccino 3. question about pred poops From: "Steve McMall" Date sent: Thu, 28 Oct 1999 05:23:27 -0500 Hello, it has been some time since I have posted, although I try to keep up with the list just to stay informed. Scamper, after having gone through adrenal surgery just last December, now has several lesions or tumors on her pancreas and possible insulinoma. She has been on pediapred for a week. I noticed right after I started the pred that her poops were dark, shiny and soft.......looks a bit like a melted toostie roll. For those of you who have had to administer pred before, does this sound usual? It occured to me yesterday that perhaps it is because the pred is making her ulcers worse (she grinds her teeth a lot, esp. when eating or drinking) and that it was truly old blood that I was seeing rather than a side effect. I also heard her groan/whimper during one bowel movement. We are giving Scamper pepcid a/c mixed with ferretone now (since Tuesday) and it does seem to help a little with the ulcer pain. I had asked about carafate, but Dr. K said that it is only a temporary patch while the food goes past. Anyway, has anyone else noticed the odd, dark stools since using pediapred? Becky and Steve 4. Reply to Robert: FAIML,10/26/99 (options for adrenal gland disease) From: AFERRETVET@cs.com Date sent: Thu, 28 Oct 1999 15:42:14 EDT Hi Robert, Re: Options to treat adrenal gland disease: Your post on 10/21 asked for options to treat adrenal gland disease. Treatment is generally divided into 2 big categories: Surgical and/or Medical. You mentioned that Daisy has already had 2 adrenal gland surgeries. Apparently she has had her left gland removed and part of the right gland removed. Thus the only surgery left would be to do a complete right adrenalectomy. This can be done with temporary occlusion of the caudal vena cava with vascular clamps and microsurgical dissection with magnifying loupes. The problem with leaving part of the right gland in her is it will grow back (usually within 1 year). and it may spread to her liver. Medical treatment: Medical treatment is aimed at controlling the hormone levels that are being over secreted by the adrenal gland(s) in order to control the clinical signs (ie. hair loss, swollen vulva,swollen prostate, weight loss, sexual behavior, itchy skin,etc.).Medical treatment used to consist of the use of Lysodren (mitotane). Lysodren mainly destroys the cortisol producing cells of the adrenal glands;however, in ferrets cortisol is not the problem. Remember it is the sex steroids (estrogen,17-hydroxy- progesterone, and testosterone) and the androgens (DHEA, and Andro) that are being oversecreted. This is why Lysodren does not work well in ferrets. Furthermore lowering cortisol levels can cause serious hypoglycemia (low blood sugar) problems if the ferret also has an insulinoma. The new treatment for ferret adrenal gland disease is Lupron depot (leuprolide acetate). Lupron is a long-acting GnRH analog that stops the stimulation to the adrenal glands. This decreases the sex steroid and androgen production by the adrenal glands. This results in reduction in the size of the prostate or vulva,and hair growth. Lupron is an injectable product. Most vets use the once a month version. The monthly injection is given at a dose of 100 mcg/kg into the muscle of the back leg. I increase it to 200mcg/kg if it is a carcinoma or if the ferret does not respond after 2 injections. See the May/June 1999 issue of Ferrets for more info on the monthly version of Lupron. Dr. Weiss is using the once every 4 months version of Lupron depot. He recommends given 2-3 mg/kg every 4-6 months IM. See the May/June issue of Modern Ferret (the one with pretty,Playboy playmate Tiffany Taylor on the cover) for more info on the 4 month version. His dosage of 2mg/kg every 4 months is 5 times higher than the 100mcg(0.1mg)/kg once a month when compared on a monthly basis. Either way Lupron is an expensive human product. The monthly version cost almost $500 a bottle and the 4 month version is almost $2,000 a bottle. That is the actual cost of the product! Remember in human cancer treatment, cost is not a factor, but cost is a major factor in veterinary medicine.That is why I use the monthly version at the 100mcg/kg dose. Yes there are two other GnRH analogs: Zoladex and Synarel. Zoladex(goserelin acetate) is also a long-acting GnRH analog. It comes in a monthly version and a 3 month version. The main problem wit Zoladex is it comes packaged already in a syringe, so it would be very hard to divide into sterile dosages small enough for ferrets. This is also an expensive human product. The monthly version is almost $400 a syringe, and the 3 month version is almost $1,200 a syringe. Synarel (nafarelin acetate) is a nasal solution that would have to given nasally twice a day. Needless to say it would be extremely hard to divide this into small enough dosages for ferrets and then give it twice a day nasally. As you can now see Lupron is the best option of the GnRH agonists. Another product that should stop the stimulation to the adrenal glands is Melatonin. Melatonin is a natural hormone that is secreted by the pineal gland. Melatonin is involved in activating (in the spring) and terminating (in the fall) the ferret hypothalamic-pituitary-gonadal axis in response to the seasonal changes in the photoperiod (amount of daylight). Melatonin inhibits GnRH release,decreases LH and FSH, and ultimately decreases the sex hormone concentrations. Most of the work with Melatonin (in Ferrets) was done with intact jills to bring them into heat or to take them out of heat. The questions about Melatonin are the amount to give, time to administer the tablet, and the long term effects on the adrenal hormones. A suggestive dose is 1mg/kg given around 8-9 hours after sunrise. Melatonin tablets are cheap and available without a prescription at GNC,Wal-Mart, etc. As far as other herbal treatments go, I can not recommend them until there are some valid studies in either lab animals or humans to prove they are both safe and effective. In the meantime, lets keep the Chinese herbal/folk medicine away from our ferrets. So if you want a lower cost option go with the monthly version of Lupron. If that is still too expensive then try Melatonin tablets. Also change the photoperiod to resemble winter (ie. 9 hours of light with 15 hours of darkness per day). FYI some ferret vets in the Houston area: 1) Dr Antinoff at the Gulf Coast Avain and Exotics Referral Center. 2) Dr Soifer at the Bellaire Blvd. Animal Clinic and 3) Drs. Jensen and Johnson at Texas A&M -College of Veterinary Medicine. Jerry Murray, DVM Animal Clinic of Farmers Branch Dallas,Texas P.S. I know that adrenal gland disease is frustrating. My male (Barney) has it too. I removed his left adrenal gland last week and started him on Lupron monthly to protect his right adrenal gland this week! . 5. Update on the girls and possible insulinoma with Bugsy From: "Michaela Maurice" Date sent: Wed, 27 Oct 1999 00:25:18 -0000 Hi everyone, Had a great radiologist today and some luck on our side; She had absolutely no trouble seeing the adrenal glands on the ultrasound. Unfortunately, both girls look like they are bilaterals. All four glands measured 1 cm wide and all but Mighty Mouse's right one were very 3D/round. It is 'better' that Mighty Mouse's was more flat but still it is enlarged. Neither have any impingement on the vena cava which is good. The only other findings were a 1 cm cysts on Mighty Mouse between her stomach and liver and a small amount of fluid in her abdomen. We are doing echocardiographies next week just to be rule out any type of heart disease. Unfortunately, I found out today that Bugsy, my 'first born' and my lil 'mama's boy' has a blood glucose of 60. This is devastating for me. I am going to retest as there was a mix-up with charts that I had to straighten out today and if it's not Bugsy, it's Mighty Mouse..one or the other, it's not good news. These guys have been such a constant part of my every day life. I just can't remember a time they weren't with me. I can't fathom the idea of losing any of them, especially in the wake of Spikey's recent death. I am so glad I found this forum though. It has meant alot to me to be able to share this with everyone and to ask questions of a vet, such as Dr. Karen Purcell, experienced with ferrets. I just found out from her that she has a book. hmm....it was my bday this last weekend and no one asked me yet what I wanted..maybe I can put in a late request with one of the folks hehe :). Well, must get some sleep. Just wanted to keep everyone updated and say thanks for all your support. Let you know when the surgery is scheduled. I'll say a prayer for all your little fuzzies and not-so-fuzzy fuzzies tonight. Take care, Michaela Maurice College of Veterinary Medicine Ohio State University Class of 2002 6. Update From: FHbytheSea@aol.com Date sent: Wed, 27 Oct 1999 17:36:19 EDT Hi Everyone! I know its been a while since my last posting, so I figured I'd better put together an update on the crew: As some of you know, this year has been particularly hard on us, with all the surgeries seeming to come in groups as the shelter kids get turned in....Here goes: Ben - 6 year old male - you may remember he is the ferret that had the adrenal problem causing his prostate to swell and block his ureter, and has his urethra rerouted. Ben is doing great! He has fully regained his coat (his surgery was in July) and is a happy fella again! We have to wipe him down a couple times a day with baby wipes (his prostate is still cystic and he sometimes dribbles pee on his back legs) and he has gotten his second Lupron shot in the hopes of reducing the size to normal. He dooks, plays and gives kisses - and is extremely well-natured. He hasn't met a ferret or person he didn't like! Emily - 6 year old female - after her bilateral surgery, she has gotten back her coat as well. Miss Em is not like Ben - she does not like to share her people.....such a stubborn little miss....backs down even the most aggressive ferrets with just one hiss. Plugger - 6 year old male - just had surgery this month. Had the typical 'male pattern' of hairloss - and he was bilateral. Vet even saved his adrenal gland for me...about the size of a navy bean. Plugger is already sprouting hair and we hope that he will fluff out for the winter. Garret - 4 year old male - had insulinoma surgery after when released by his owner, we noticed a lot of lethargy. The vet removed more than 1/2 of his pancreas, but unfortunately, the neoplasms are spread throughout the organ. Garret is back on prednisone, but is responding well. His last BG was 80. He thinks his medicine is a treat - I suspend the pred in ferretone - he hears me coming and is usually at the cage door, licking his lips! Suzy - 8 year old female - she was a left only - and my only death from surgery. She did excellently during surgery and died suddenly in the recovery area. The vet thinks that she may have had a reaction to the painkiller that he gives to them after surgery. Trella - 7 year old female - bilateral adrenal; actually caused stress in her cagemate by being separated - we had to bring Trella home to Tigger sooner than the vet liked because he was pining. She hasn't started getting her hair back yet, but its only been a couple of weeks. She did have a problem adjusting to her lack of adrenals and we had to medicate her for a couple of days, but shes doing great now - very active and alert. Maxine - 5 year old female - left only - she was my stinky girl! She completely recovered after her surgery, getting back both guard hairs and underfur. Doing great in her new home! Pele - 6 year old female - left only - couldn't do her adrenal surgery because of the complicated surgery that she was having for intestinal cancer. She had suddenly stopped eating, a barium xray revealed some type of blockage, and the removal of the tumor and surrounding tissue was pretty dicey. She was under for a couple of hours already when they discovered her enlarged adrenal gland and made the decision not to leave her under any longer and leave it in place. She has had her first lupron shot, 3 weeks post operatively and we will see what happens. We will most likely not do another surgery on her, based on the prognosis (not good). Matt - 7 year old male - waiting for adrenal surgery - He's our last case, and we are scheduling surgery for November. We are carefully monitoring him for problems urinating - thats why Plugger went in first - his symptoms were more severe. Matt is a happy-go-lucky kind of fella, cages with Ben and will lick any exposed skin. Hes a very loving ferret. Add to these a couple of hairball surgeries (Tigger, Emily, Piper the day she was turned in!), removing mast cell tumors (Plugger, Maxine, Emily, Emilia), a couple of intubations (Emily, Maxine, Rogue) Squamous cell cancer (Katie), Nerve sheath tumor (Rascal) and various checkups and treatments, and you get an idea of how busy it has been! Lisa, Head Ferret The Ferret Haven "By-the-Sea" URL: http: www.kozykingdom.com/ferrethaven Want to help The Ferret Haven By-the-Sea? Register at iGive.com by cutting and pasting this link: http://www.iGive.com/html/ssi.cfm?CID=1236&MID=854 7. Aussie ferret with insulinoma From: "Michael F. Janke" Date sent: Wed, 27 Oct 1999 21:23:51 -0400 Personally, I don't think I'd be rushing into surgery if the vets there are not totally familiar with a partial pancreatectomy. According to Dr. Weiss' research, a partial pancreatectomy seems to have the longest term reversal of symptoms. Sadly, it doesn't seem to be a cure in any case that I've heard of. Some ferrets do well just treated with diet and medication. My Beasley was diagnosed over a year and 7 months ago and is doing just fine with regular, high-protein meals and Prednisone. He's has a pretty good quality of life and I'm not the least bit sorry I didn't have surgery done on him. Are you sure about that blood glucose reading? I'm no vet, but I don't think a reading of ONE is something a ferret could have without being in a coma or near death, if even then. You might want to contact Dr. Weiss and order his new video. It's meant for vets and shows adrenal surgery, partial pancreatectomy surgery, diagnosis/symptoms, pre/post op treament, etc., etc. This would be ideal for vets that have no experience with these things. You can contact Dr. Weiss at ferretdoc@ex-pressnet.com. For the ferrets, Mike * Michael F. Janke, mjanke@miamiferret.org * Secretary, South Florida Ferret Club & Rescue * A 501(c)3 not-for-profit corporation * * Shelter web site: http://www.miamiferret.org * Adrenal/Insulinoma web site: http://www.miamiferret.org/fhc > 1. Subject: Help Before Thursday!!!! > From: "Amy Flemming" > Date sent: Tue, 26 Oct 1999 21:52:45 +0800 > > Hi! > > Just moving to Australia from the US, I was contacted by a woman > here regarding Insulinoma. She thought her ferret had insulinoma > and had a hard time getting information form vets in this area and > turned to me for help. (It is thought that ferrets do not develope > insulinoma here and there has only been one reported case in Sydney) > I have had one ferret suffer from Insulinoma. Unfortunatly I > paniced when she went into grand mal seizure and the rushed the > ferret to an emergancy vet that administered valium and killed her > (she was dead with in 20 minutes and the necropsy stated an > overdose). So I do not have that much practial experience. She has > had 2 blood tests (I believe that last was a fasting) and both have > pointed to positive - she goes in for exploritory on Thursday (our > Thursday is your Wednesday - we are about 12 hours or so ahead). > The first test showed her glucose level at slightly under 1. I do > not know what the second test showed. > > Here is the story: > > Ferret - spayed female - non-descented. Late alter. Estimated to > be around 4 or 5. The ferret, for a few months now, has been acting > spacy, having seizures, hind end weakness, and sleeping a lot. Her > weight is great, coat condition is beautiful (going into summer > here) and she, otherwise, seems normal. She will only eat beef - > they have tried all meats as well as kibble, baby food, etc. The > people adopted her from the ferret society here as the ferret was > involved in a car accident and was unclaimed. They have had her for > a year and has been showing these signs for the past few months. Not > knowing what to do during the seizures, they applied honey to her > gums and that seened to pull her out of the seizures. That is no > longer working. The vet she is seeing (that will be treating her) > has her currently on Pred which has gotten her to be more active and > semi-control her seizures. I am working on getting his name as well > as other information. All I know at the moment is that he worked > quite a bit on ferrets in the UK. > > What they need to know: > > How do they approach this? Do a partial pancriatic removal? Remove > only the neoplasms? What type of meds does she need to be on? How > long? What would the estimated life be of the ferret - after > surgery or if no surgery (only meds)? What should the ferret be > eating to maintaine her blood sugar level? Remeber there is NO > Nutri-Cal or Nutri-Stat here - only a lower quality product like > Ferret-Vite, called Nutri-Pet. What can the owner expect out of the > surgery? Should they also check the adrenal glands? > > Any and all help would be wonderful. > > The womans name is Susan Belcher and can be reached at > rosevean@hotmail.com. If i may request that I be cc'ed on as much as > possible, I would appriciate it. I am writing an article on the > incident and would need as much info onm this case as I can get > ahold of - Sue has asked me for my assistance and agreed I can > forward her information. > > Ta! (Thanks!) > > Amy Flemming > Flemming Farms > Perth, Western Australia 8. Insulinoma ferret in Australia From: "Amy Flemming" Date sent: Thu, 28 Oct 1999 16:09:38 +0800 Just a line to thank those that helped little Dookie and her owner Sue with information on insulinoma. Her surgary was Thursday morning and was successful. Unfortunatly, a few hours after surgery, Dookie's heart stopped and she slipped on over to the rainbow bridge. If you would like to drop Dookie's family (the Belchers) an e-mail on their loss (Dookie was their first ferret) they can be reached at rosevean@hotmail.com Again, thanks for everybody's help and support. Amy Flemming Flemming Farms Perth, Western Australia -------------------------- End of FAIML #346 ----------------------------