From: Lynn McIntosh [faiml@uswest.net] Sent: Wednesday, February 16, 2000 3:45 AM To: FAIMLanon; FAIML Cc: faiml@miamiferret.org Subject: FAIML #389; Feb. 16, 2000 Ferret Adrenal/Insulinoma Mailing List (FAIML) #389; Feb. 16, 2000 1. Sunshine Gang Is Losing Its Light (Long) 2. Gabby's Autopsy Post here's the complete post 3. Kato 4. Wally and Gadzook Update 5. Interferon as a possible adrenal treatment 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. Sunshine Gang Is Losing Its Light (Long) Date sent: Mon, 14 Feb 2000 14:44:55 -0600 (CST) From: "Buetow" Hi Everybody, I want to send out condolences to all who have lost one of their beloved angels recently. Sorry I haven't sent out individual messages. I thought I would be okay posting this at this point, but I find that I am wrong. AD went to the Rainbow Bridge last month. I wish I knew what happened. His liver enzymes were fluctuating recently and mostly above normal, but I wasn't given any indication that it was a big concern. Late on January 8 he basically collapsed--he pooped in his bed and couldn't really walk well. So I took him to an emergency vet (had to go quite a distance to get one who felt experienced with ferrets). They said he was extremely dehydrated (somehow I missed that, too--and he was eating AND drinking very well) and his blood test showed completely elevated liver enzymes (even more so than when he had surgery) and pretty bad anemia. On the advice of my brother, who is a vet but lives far away, I left him there getting IV fluids until Monday morning. Monday, January 10, I transferred him to his regular hospital. On the way, he had a black and tarry stool. And, of course, his regular vet was out for a couple weeks. In some ways, I wish I would have simply taken him home then, instead of leaving him there. Everybody said it was serious, but nobody bothered to say he was dying. He died at the hospital sometime during the night, probably January 11--alone. I wish I would have stayed with him during the day on Monday, or at least visited him again. I just shouldn't have left him there. After I brought him home on Tuesday, I got a message from my brother. He's studying pathology and wanted to look at AD's liver. So I had a closer vet remove it and send it to him. Basically, his pancreatic cancer (the beta cell tumors) had metastacized to the liver, damaged the liver and caused inflammation and liver cell death. He doesn't think even another surgery would have helped. With Pippy, I felt perhaps I should have tried at least one more thing. With AD, I wish I had taken him home and not hoped for a miracle. At least he could have died with his loved ones around him. I buried AD in his hammock and his favorite bed, with some of his favorite things, like cat lax, Ferretone, petroleum jelly, kibble, etc., and this time I buried him myself. So, once again, I find myself dedicating these to my *two* little angels: Goodbye [to you], my little one. You gave me love and helped me find the sun. And every time that I was down, you would always come around and get my feet back on the ground. --from "Seasons in the Sun" I will see you in the light of a thousand suns. I will hear you in the sound of the waves. I will know you when I come, as we all must come, Through the doors beyond the grave. --from "Sand and Water" If I could hold you one more time, Like in the days when you were mine. I'd look at you 'til I was blind. So you would stay. I'd say a prayer each time you'd smile. Cradle the moments like a child. I'd stop the world if only I Could hold you one more time. --from "One More Time" As for Buddy and Xan, I think Buddy is fading. Recently she had a very bad clawing at the mouth episode. We (the vet and I) are not sure what is going on. She hasn't lost her appetite and her stools are not black and tarry. At times I get the impression that she is not comfortable going to the bathroom. Right now she's on carafate and we've added proglycem to her regimen and are decreasing her pred dose. She's holding on, but having episodes of grinding her teeth (especially when I give her the meds, but also at other times) and also a lot of licking her lips (so to speak). During playtime, when I get the little cat bed out, she chews on the tags of the bed, as well. And sometimes when I pet her, she seems to jerk or twitch. When we were at the vet on Christmas Eve, he felt a mass in Xan's abdomen. We did x-rays and because of what they showed, ran a Tennessee panel. The TP came back almost normal, with the recommendation to try again in six months, if symptoms persist. Part of me would like the vet to do exploratory now, while she's feeling well. But if it's her right adrenal (left has already been removed), the vet won't remove it, because he doesn't think ferrets do well after bilateral adrenalectomies. I don't know if I want to argue with him. But I'm afraid it might be malignant cancer, like her last one was. In the meantime, she has lost some weight and her activity level varies. I'm sorry this post was so long. Chris and the Sunshine Gang With Pippy and AD always in my heart buetowc@sls.lib.il.us 2. Gabby's Autopsy Post here's the complete post From: "Lisa Little" Date sent: Tue, 15 Feb 2000 10:16:18 -0500 Here's the complete post my server kept kicking me offline last night. Thank you to everyone who wrote me notes. It helped alot and I am actually recovering from the loss of Gabby quicker then any of my others that have passed over the bridge. I just got back from the necropsy {autopsy} I found it to be a learning experience and am very happy I went and watched. One thing I know now is I waited too long, Gabby showed small signs of Adrenal problems the summer of 98 { slightly enlarged vulva and aggressiveness} but they were gone by that september when her yearly shots were done the symptoms were gone and I figured I was wrong.Gabby was my first ferret to ever have adrenal problems so the only thing I can urge people to do is DON"T WAIT. Now I know, and can use my knowledge not to let it happen again. Now the Necropsy.....if you don't want to know what one is like don't read this. She's had a bladder infection that was being treated with antibiotics. The infection was caused by the enlargement of the vulva which was caused by the adrenal tumors. She was having problems urinating because of this. Small amounts of pus were also found in the body cavity and in the left kidney. A green sack of pus the size of a marble was near her bladder this was the stump of her uterous. Other then a small amount of pus her left kidney was healthy and normal. the left adrnal, which is rather smaller then I thought it would be was healthy. No tumors on her pancreas. I actually gasped when he pushed back the skin covering her right adrenal and kidney. There was a mass there the size of two golf balls side by side. This was her Adrenal gland {which was huge} which was cemented to her kidney {also enlarged}, her liver was stuck to the top of this mass. Bisecting the kidney and comparing it to the healthy left kidney it was a sick red brown,pockets of absent flesh were apparent where she had had tumors break and bleed. Bisecting the Adrenal gland some of the flesh had actually begun to rot while she was alive. No question of why she died, although I did question how she lived so long still looking healthy with that huge thing inside her. There's no sense in beating myself up over my ignorance in not acting soon enough. I only hope this information can help others know what is going on on the inside. When the outside is having "seasonal" behavior. Lisa ~who is learning more everyday 3. Kato From: EquineAmy@aol.com Date sent: Mon, 14 Feb 2000 15:14:58 EST My oldest ferret had very similar symptoms, only she was also vomiting. Still had an appetite and all. Turns out she was poisened by advil. She was very very lucky to survive - even if this is not what Kato has, please get him to the vet NOW, not tomorrow. The only thing that saved winnies life is the fact that she fell asleep shortly after she ate the advil and slept for 8 hours. I was gone all day - my roomates were home when the "incident" took place, and were somewhat to blame for it as well - one of my roomates let winnie in the cabinet by accident and forgot she was in there and locked her in - there was nice sweet advil in there that winnie licked the coating off of. Then my roomate remembered that she locked winnie in there and let her out not htinking anything of it. I came home and said hi to them and they woke up and winnie started vomiting unbelievable amounts and when she came out of the cage she started to eat (I had the bowl outside cause I was refilling it at the moment) and she ate a lot, but was standing funny. So i touched her and she fell, then I really started to see how bad she was - limp and couldn't hold herself off and had no coordination. I was at the vet 15 minutes later - and the vet did a whole bunch of stuff which I can't recall at the moment, but saved winnie for the moment - then we had to wait for blood results the next morning. Luckily we were okay and winnie took a few days to get back to normal, but she is okay. My point is - time may be a major factor. GO TO THE VET ASAP!!! And good luck, Amy 4. Wally and Gadzook Update From: Lynn McIntosh Date sent: Tues, 15 Feb 2000 17:13:52 EST Hi. Gadzook had a bi-adrenalectomy, including a vena cava ligation due to the invasive tumor, last July and is healthily rotund again, and beautifully furry. He gets a quarter table of florinef (based on a blood test for sodium/potassium ratio) every three and two days. This old six-plus-year-old is a sight for sore eyes! He's our first and a beautiful roaning silver mit, with liquidy black eyes, and a blond tail. It's lovely to see him looking and acting so healthy. Wally is our second and a little over six. He had exploratory surgery a couple years ago and his right adrenal was deemed inoperable - so oozy our vet couldn't even get a biopsy, and racket-ball sized. He went on Lysodren, then Lupron and Lysodren, and soonafter we added pediapred (up to 1.5 2x/day prior to surgery) and Proglycem (.1 2x/day of the commercial stuff) for insulinoma. He was getting gartantuan, the Lupron wasn't working well (at a low dose but we didn't really want to up it as he was on so many drugs), and, the last straw, he started vocalizing when going to the bathroom and just randomly. Dr. Weiss advised halving the pediapred and doubling the florinef (while taking weekly blood glucose checks) to try to get some weight off (eight ounces at least). Halving the pedipred so he wouldn't be so at risk for infection. If we could do this we could try for surgery he, and our vet in Seattle, WA, agreed. We got the doses adjusted but no weight off. Thats when the vocalizing started. We took him in for an ultrasound and his heart and everything looked fine, just the huge right tumor. So, we all sucked in our breaths and tried surgery. Wally went through with flying colors! He was our best surgery boy, yet. A guy so fat and enweakened in the back end he could scarcely walk! Now he's growing hair everywhere and has even been seen to gallop a little. The removed right tumor was ping-pong sized, 2/3 the size it was when the first exploratory was done. The lysodren had shrunk the tumor down and it had pulled away from the vena cava enough to allow excision without a ligation. His little eyes look so much happier these days. That was soon after the millenium. Also during that surgery he had a large insulinoma removed (though nearly undoubtedly the islet cell tumors are throughout his pancreas) and he recently had one seizure while we were adjusting his pred dose post-surgery. He's on .3 mls pediapred 2x/day now, far below the doses of pediapred, plus the Proglycem, pre-surgery. He's doing quite well :) So, miracles do happen. Just for the record, Gadzook had been on Lupron, as had Wally. We knew Wally's tumor had shrunk (from the Lysodren) before Lupron commenced. Gadzook's kept growing. Another ferret, Petey, a sweet guy we lost to cardio, had been on Lupron and an ultrasound for his heart revealed a large left adrenal tumor. All three were on 100 mcg/month, a low dose, but symptoms had mostly abated. I was one of the first to jump on the Lupron bandwagon and I still sing its praises when surgery isn't an option. But whereever possible, I say do that surgery. We're lucky. I searched high and low to find our ferret surgeon; a skilled, experienced ferret vet (in adrenal surgery) is, in my opinion, really key to successful outcomes. I want a vet who is going to take out both, if needed, and do a vena cava ligation, if needed. Many won't or aren't comfortable doing this. Wally's left was left in, but our vet examined it very carefully before deciding to do this (and being as his was a touchy situation she didn't want to risk more than was needed; we can get it later if need be). She examined Gadzook's left carefully too, and, though it was small it was a bit lumpy, so she took it out and pathology revealed it to be diseased (adenoma). She also checks all the organs during surgery and runs her fingers along the underside of the pancreas to feel for pinpricks that might indicate early insulinoma (she felt these on Wally and he showed symptoms a few months later). Yes, it's fun to report the good, but lord knows I've been through the bad with these guys, too, and my heart and prayers go out to those who are on the hard side right now. These are my two best cases to date and I was so ready for them after hard deaths from adrenal (1), cardio (2), birth defects (4), and lymphoma (1).... Fuzzy hugs. Lynn 5. Interferon as a possible adrenal treatment From: "Shelley Knudsen" Date sent: Sun, 13 Feb 2000 22:05:48 -0600 Hello, I just wanted to share something with all of you that I have been experimenting with. I originally wan't going to post anything until I was sure, but since I am in the process of closing down my shelter, and will likely not get any more ferrets in, I won't have any ferrets to try it on, so I thought I would pass it on so that if anyone is interested, who may have no other options left, you might want to try it. Several months ago, one of my ferrets came down with a bone tumor in his head. It took us a while to figure out what the problem was, and by the time we did, it was too late to do anything about it. However, one of the treatments we tried on him was Interferon. While it did nothing for the bone tumor in his head, it did eliminate a great deal of his pain, and make him much more energetic, almost like his old self, until the very end. But, while Jasper was on the Interferon, I aso had a little girl adrenal in the shelter, that had had a right sided tumor debulked (not removed) by a vet that was not ferret experienced, and she was losing all of her hair. So, just to see if the Interferon might do anything, I gave it to her for two weeks, until Jasper died, at which time I stopped giving it to her too. A month later, all of her hair grew back. That was 6 months ago, and she is still happy and healthy, with no adrenal symptoms. Now this could have been a complete coincidence, but my curiosity was piqued. I had no more adrenal ferrets come into the shelter after that, but a shelter helper of mine had a ferret that she had adopted from me years previously, who had already had 2 adrenal surgeries, and for whom Ovaban was not doing anything. He was completely bald, very underweight, and according to her, only moved around for about 5 minutes at a time, to eat and poop, and then he went back to sleep. Basically, he was going downhill fast. I asked her if she would be willing to try the Interferon, and she said yes. So, I got a bottle from my vet for her, and she gave him 1cc twice daily. This was around Christmas time. I called her a week ago to see how he was doing. His hair is growing back, he has gained his weight back, and he is just about back to normal activity, as in before the adrenal tumor. Now this could also be a coincidence, as she just moved into a new apartment at the beginning of December, and all of her ferrets have 24/7 runtime now, whereas before it was just a few hours a day. Interferon, from what I have been able to find about it, is a substance that is naturally secreted by our bodies to boost the immune system to fight viruses and tumors. Alpha Interferon fights viruses, and Beta Interferon fights tumors. The Interferon that is available at the vet's is made by isolating Interferon from a cat, and basically ampliflying it to large amounts that are usable. Now, the reasons why it shouldn't work are: Interferon is species specific, and the Interferon available from a vet is cat Interferon. The Interferon at the vet's is alpha Interferon, but alpha fights viruses, beta fights tumors. The Interferon is oral, and I don't know just how acid stable it is. But, I do know, when I started giving it to Jasper, the change was very noticeable, if not in his bone tumor, in everything else. But again, the two ferrets that had adrenal tumors could have both been coincidences. But, I thought, if someone had a ferret that had already exhausted all of his options, surgically and medically, maybe they would like to try the Interferon. The downside is that it is expensive (my vet charged me $75, and they usually give me a really good rate), and it takes about a month to see any noticeable results. Plus, I don't have any idea (assuming it was working) if it just takes care of the symptoms, or if it actually shrinks the tumor. I don't yet have the resources to experiment with anything like that. But, wouldn't it be great if it did work? The upside, is, there are no side effects, whether it works or not. So, if anyone on this list does decide to try it, I would love to know, if you get any results, or, if you don't get any results. Dooks and kisses to your fuzzies, Shelley Knudsen Pre-Veterinary Student UNK ferrets@tcgcs.com http://www.tcgcs.com/~ferrets 402-463-0190 402-461-6541 fax: 253-981-1054 MODERATOR'S NOTE: Thanks for the info, Shelley. It's important to share new ideas on the list, especially in a field, ferret medicine, where things change rapidly and often aren't yet researched or published. I only know of one ferret that was on interferon and she got sicker and sicker, and ended up needing florinef. I kept worrying about her and checked out a website on interferon for treatment of hepatitis in humans. The descriptions of side effects really worried me, bigtime (though the Lupron website has lists of side effects, too). I guess what caught my eye with the interferon was people's testimonies of how they really had to screw up their courage to try the drug due to 1) nasty, common side effects, and 2) the fact that the results were really spotty in terms of efficacy, in combination with the side effects. Of course, one can't really extrapolate from humans to ferrets (consider the side effects of pred in humans versus pred in ferrets, at least from outward appearance in ferrets). This isn't any more scientific than hoping it might work for adrenal disease because it appears to have helped two ferrets, though. So perhaps we could hear from vets on this one? Dr. Karen or Dr. Murray? Or perhaps Michael could check, or ask Beth Camorow to check, with Dr. Weiss. I don't mean to be a wet blanket. Just that there are about three drugs that Dr. Weiss has put through clinical trials and did research first to check that there was some basis for them working. But you did say, Shelley, that this might be something to try for ferrets whose options were exhausted. Still and all, I'd recommend checking it out very carefully, including checking with other experienced ferret vets, first. Other opinions? Vets? Lynn ----------------------- End of FAIML #389 -------------------------