From: Lynn McIntosh [faiml@uswest.net] Sent: Sunday, November 26, 2000 3:21 AM To: FAIMLanon; FAIML Cc: faiml@uswest.net Subject: FAIML #484; Nov. 26, 2000 Ferret Adrenal/Insulinoma Mailing List (FAIML) #484; Nov. 26, 2000 There are nine messages in today's list: Ligating the Vena Cava Vena Cava Ligation Ligating the Vena Cava Vena Cava Ligation Followup on Dr. Weiss' visit to New Mexico Central Texas Vets Central Texas Vets Copy of Artcile on Prostatuc Disease by Dr. Susan Brown Dr. Susan Brown's article FERRET ADRENAL/INSULINOMA MAILING LIST (FAIML) is list featuring support and information about adrenal and insulinoma diseases. It comes out in digest format three to six times per week, depending on the urgency and number of posts. It is the opinion, only, of subscribers, and is not intended as 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 exhibiting signs of illness please take him or her to the most ferret-experienced vet you can. A ferret-experienced vet is one of the most important services you can provide for 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 and FAIML ARCHIVES/PHOTOS: For more info, check out Michael Janke's adrenal/insulinoma web site: . Past FAIMLs are archived there, with a search feature, and there is a FAIML album featuring pictures of FAIML subscribers and their ferrets. FERRET CENTRAL WEBSITE and PAM GREENE's FERRET FAQs: Ferret Central Website is the grand intersection of ferret websites, at . You can also find the Ferret FAQs there, which include invaluable FAQs on insulinoma and adrenal diseases. I forward these two FAQs 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. 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. Date sent: Fri, 24 Nov 2000 13:14:27 EST From: AFERRETVET@cs.com Subject: Ligating the Vena Cava Hi Micheala, You are right ligating the caudal vena cava during the removal of the right adrenal gland is a last resort situation. The goal is to remove the right adrenal gland and to repair the vena cava when possible. Magnification (i.e., surgical loupes) really helps with this. If only a small amount of the vena cava (usually the lateral wall) is removed with the right adrenal gland then suturing the laceration is the best option. If you remove a large portion of the vena cava then an anastomosis of the vena cava is best (ie tying the 2 ends of the vessel back together). Magnification is needed for this kind of microvascular surgery. I did talk to one of the surgeons down at Texas A&M who had ligated the caudal vena cava. The ferret did survive. I also talked to an endocrinologist from California who also said ligating the vena cava is an option. So far I have only done 3 ligations of the vena cava. 2 of the 3 ferrets survived and are doing fine. The other one died a few days after the surgery. The surgeons at the University of Florida do not recommend ligating the vena cava. They recommend using magnification, vascular clamps, 6-0 to 10-0 suture material to repair or to anastomose the vena cava. Jerry Murray, DVM Date sent: Fri, 24 Nov 2000 12:35:33 -0500 From: "Michael F. Janke" Subject: Vena Cava Ligation Dr. Bruce Williams posted this to the FML this morning. It bears repeating here. "Caval ligation is a salvage procedure reserved for ferrets with large makignancies on the right adrenal gland whic have either invaded or severely compromised the posterior vena cava - the largest vein in the body. As the right adrenal sits directly on the cava, it is not uncommon that aggressive tumors on this side will either grow to a size where they block the flow through the cava, or directly invade the vena cava, comporimising and ultimately impleing blood return to the heart. Now, when this occurs, the body will attempt to establish collateral circulation through other vessels in the area to pick up the backup from the partially blocked vena cava. This phenomenon is the basis for vena caval ligation. If sufficient time has elapsed for collateral circulation to develop, then the cava can be ligated without harm to the ferret, allowing removal of the entire tumor. If not, and the cava is ligated, then you will see infarction of any number of organs in the body - most commonly the spleen and segments of the jejunum. While there has been no peer-reviewed literature on the technique, tothe best of my reckoning, having talked with many practitioners who are now performing it when necessary, the mortality rate is about 15% for this technique. This is why it is a salvage procedure - it is reserved only for cases in which there is no other way to remove the neoplasm, and you do take a risk when performing it. The key is that these animals will die shortly without it, so you are gambling that by removing the adrenal tumor and cava en bloc, you can save this animal's life. There are many variables surrounding this procedure, and the ones that are most likely to determine the success of the operation is the amount of time the tumor has been there and the percent blockage of the vena cava. Surgical mortality will likely revolve around tumors that have frown to fast to allow collateral circulation to become viable, or those in which there is incomplete blockage of the vena cava (which will result in lesser collateral circulation development). Some vets have only rare mortality, far lower than the average, and some have 50% or more. For a surgeon, the most important ability is to be able to read the tumor to see if caval ligation has a chance of working in a particular ferret or not. If you ligate the vena cava in a normal healthy ferret, you will assuredly get infarction and death. However, with adrenal tumors that have slowly occluded the vena cava over time, the body may well have compensated and the vessel can be safely ligated. I think that it is important, however, that owners be told that this is a salvage procedure with a 15% rate of mortality up front. This is a last ditch operation, but you never want to go in, find an adrenal tumor, and close the animal back up. With kindest regards, Bruce Williams, dVM" For the ferrets, Mike * Michael F. Janke, mjanke@miamiferret.org * South Florida Ferret Help Line, 305-752-7040 * * Website: http://www.miamiferret.org * Adrenal/Insulinoma web site: http://www.miamiferret.org/fhc Date sent: Fri, 24 Nov 2000 10:53:40 -0800 From: "E. Rain" Subject: Ligating the Vena Cava Michaela asked about vena cava ligations. It's been too long for me to remember all the details, but our Lemke had his vena cava ligated about 1.5 years ago during a surgery on the right adrenal. He was very weak immediately after surgery, but recovered quickly & adrenally speaking has been fine since then (we do estradial tests every 6 months or so, and he had an ultrasound last January) Of course he has since developed cardiomyopathy, but hey that's a different issue. I think the biggest factors in his case were having an excellent vet doing the surgery and Lemke's incredible will to live no matter what life throws at him. i don't know if this is the kind of info you were looking for, but I hope it helps Eden ______________________________________________________ WARNING: Dates on the calendar are closer than they appear! Eden Rain raghead@liripipe.com Date sent: Sat, 25 Nov 2000 22:03:17 -0800 From: "Lynn McIntosh" Subject: Vena Cava Ligation Hi. I wanted to mention something that my vet has found helpful in vena cava ligation, and also a comment about one of my fur kids who has been through this and is doing wonderfully. My vet, if she thinks she may need to ligate the vena cava, gently squeezes it shut for a short time and watches the reactions of the organs and respiration. She has stated this simple technique, which she heard of from Dr. Weiss, has been a real key help in determining if the ferret is a candidate for successful ligation. Our very first ferret, Gadzook, was a candidate for ligation due to an invasive right adrenal tumor, as Dr. Williams so well described in his post of Nov. 23 to the FML. Gadzook had both adrenals removed and the vena cava ligated. He has done wonderfully, being both fully furred and having lots of energy. He had this procedure done when he was a little over six (July before last). He does need to have a minimal dose of florinef, a quarter tablet, every other second and third days (we watched him closely after surgery and began this a couple days out). Blood tests have confirmed that his potassium and sodium are in balance. I personally am a firm believer in surgery as the best option for adrenal disease, when a ferret is a candidate, and the only option that offers a cure, though the disease still has a high rate of occurence due to the regenerative nature of adrenal tissue. Gadzee, unfortunately, recently began a low dose of pediapred for insulinoma, so surgery for this is probably in the offing. I'm grateful that he hasn't shown signs of adrenal, though, as he was one with prostate problems. Lynn and five sweet fur slinkies Date sent: Fri, 24 Nov 2000 22:32:24 -0800 From: "M.Jo" Subject: Followup on Dr. Weiss' visit to New Mexico We were the ones who traveled about 400 miles (from southeastern Arizona) to have Dr. Weiss and Dr. Michael Treitler operate on our Bilbo in Santa Fe. I just wanted to update you on how well he has done so far. He had a right adrenal operated on in May at which time it was found to be malignant. Being the right, and not being able to completely remove it, we knew his time was probably limited, although he didn't act like there was anything wrong. We had heard of Dr. Weiss' success with cryosurgery and had wished he was on our side of the country, but didn't see much hope. However, when you all got this going, I talked to my vet, then called Dr. Treitler and everything just worked out where we could make it up there, even with the storms the day before. When they operated on Bilbo, Dr. Treitler came out about 30 minutes after they started and said they had done the left adrenal, which was a surprise to me but they found it had also grown in the past 5-1/2 months. So they took care of it! Then they worked on the right adrenal and afterwards Dr. Weiss came out and told us all he had done and hopefully it was completely taken care of. Of course, time will tell, as he said, sometimes a little may be missed. But he felt very good about this surgery. They gave us a surgical glove with heated water to keep him warm as we had an 8 hour drive (course we had warm blankies and etc.), but within 5 min. of leaving, he got to playing with the surgical glove and I could just hear him say, "hey mom, this is a neat toy!.......ahhhhh mom.... it sprung a leak! It's getting wet in here!" So we had to stop, remove his "hot water bottle", and give him dry bedding. And then he played and tried to get out of his carrier all the way home except when we stopped to eat, that's when he took a nap. He was eating by the time we got to Socorro. I kept him confined for a couple days, much to his dismay, but he's since had his stitches removed and Tues. he goes in for blood work to see how his Na/K levels are. Then we will see if he needs to be on meds. But as far as how he's doing, you'd never know anything was wrong, except the shaved belly, but he is growing fur back, specially along the incision. Anyway, I've talked to my vet and our shelter president about contacting Dr. Weiss and trying to get him to come out to Arizona. They are very receptive to this, but you know how this time of year is. Hopefully this will eventually happen. Anyway, we want to thank you, Linda, for your part in getting Dr. Weiss' visit set up, along with Paula's part in this, and Sonya for encouraging me to bring Bilbo up there. I do feel like we've given Bilbo a lot more time to share with us. mjo (rich) and the zoo, Lady Star, Topanga, Ragine, Bilbo, Frodo, Frito, Pepper, Caesar, and the dogs Garth and Darwin (R.I.P. Nipper, Lightning, EZ, Cleo, Phantom, and Duke) Date sent: Fri, 24 Nov 2000 12:49:01 EST From: AFERRETVET@cs.com Subject: Central Texas vets Hello San Antonio ferret owner. You might want to check with Dr Leo Gates at the Universal City Animal Hospital (in Universal City), or Dr Harry Miller at the Westgate Pet and Bird Clinic in Austin. Jerry Murray, DVM Date sent: Fri, 24 Nov 2000 14:08:47 EST From: Ferrets1st@aol.com Subject: Central Texas Vets There are databases all over the net for ferret contacts, vets, shelters. In your case, you should contact SAFERICK@AOL.COM and ask how to contact Dr. Gates who is their vet, and one of the best. If you don't get a response (Rick is pretty busy) let me know and I'll look up Dr. Gates' number for you. Trish Director, Ferrets First Rescue & Shelter Serving TX & NM Date sent: Fri, 24 Nov 2000 12:54:46 EST From: WhyNotFert@aol.com Subject: Copy of Artcile on Prostatuc Disease by Dr. Susan Brown In a message dated 11/24/00 9:31:31 AM Pacific Standard Time, faiml@uswest.net writes: > Thanks, > Michaela Maurice > College of Veterinary Medicine > Ohio State University > Class of 2002 > > ps. I'm going to get the article by Susan Brown on Male Ferrets and > Prostatic Disease (particularly as it relates to adrenal disease) scanned > into my computer this weekend. So far, two people have expressed > interest in this article. If anyone else is interested, just let me know. Be > > happy to pass it along. > I'd be very interested in a copy! Carla Smith <>< WhyNot? Ferrets http://www.whynotferrets.com ICQ: 29478475 member, Rio Grande Domestic Ferret Club, El Paso, TX "Every pet deserves to be loved, and to have someone cry over them when they're gone." Date sent: Sat, 25 Nov 2000 20:11:33 -0500 From: "Gayle Ritzert" Subject: Dr. Susan Brown's article Michaela, I would like a copy of the article by Susan Brown on Male Ferrets and Prostatic Disease. My daughter is a pre-vet student at MSU and has also applied to OSU. Gayle ---------------------- End of FAIML #484------------------------