From: Lynn McIntosh [faiml@uswest.net] Sent: Sunday, December 31, 2000 10:23 PM To: FAIMLanon; FAIML Subject: FAIML #494; Dec. 31, 2000 Ferret Adrenal/Insulinoma Mailing List (FAIML) #494; Dec. 31, 2000 HAPPY NEW YEAR! For any of you with sick fur kids, my hope is they will have some healing and relief in the upcoming year. And that goes for their caretakers, too, who suffer alongside emotionally. This is kind of a neat New Year's FAIML, in that it is the first FAIML to include three vets' posts in one issue, Drs. Karen Purcell, Jerry Murray, and Bruce Williams (who also has invaluable insight as a longtime ferret-experienced pathologist). We are blessed that they take the time to share this forum with us. So... thank you to all the vets on this list, both those who share their expertise and those who read. And thanks to you all for coming together and sharing your experience and hope with others. Can you believe it's already 2001?! Happy New Year!! Lynn and an aging Gang of Five (three adrenal; two of them insulinomic) There are seven messages in today's list: Dustie - Surgery Bilateral Adrenal Update on Zackari Heart, adrenal and prostate problems Reply: FAIML #493; Dec. 30, 2000 medication for enlarged prostate Reply: FAIML #493; Dec. 30, 2000 FERRET ADRENAL/INSULINOMA MAILING LIST (FAIML) is a 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 find. 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 and send to . Remember: the more specific you can be in your subject heading the greater the chance someone will be able to find your important info when searching the archives. 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 get it; then I'll 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 Michael is kindly posting pictures of FAIML subscribers and their ferrets in a FAIML Album. 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 new subscribers the "Disease Package", a file that tells how to get all six of Pamela Greene's FAQs on ferret diseases. Pam has also compiled 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. Plus, it comes out daily. I encourage people to cross post on the FML and FAIML to get the most possible exposure and feedback. Visit FERRET CENTRAL website (you can find its address in the 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: Sun, 31 Dec 2000 16:48:18 -0600 From: "Lynne Wooldridge" Subject: Dustie - Surgery Dustie, my ten year old adrenal/insulinoma boy, has this very large tumor on his tail (benign). A large part of it broke off when he was at the vet for his lupron injection. She did a culture and sent the sample to a lab. It has a lot of bacteria in it--a lot!! He is on clavamox right now and he perked up after just a few doses of it. He takes baytril routinely for his urinary tract difficulties but the bacteria was resistant to baytril. My vet feels that the tumor has to be removed or that a life-threatening infection could result. Dustie has several problems in addition to his age. He has scarring in his lungs---perhaps due to allergies. At times he has fluid on his lungs. We recently cancelled surgery for the tumor removal because of fears that his lungs were too bad. Now it is rescheduled because of the bacteria. My vet thinks that this will be a ten minute procedure. Do you think that this is safe to try? I am feeling that I am running out of good options at this point. My vet is not dying to do the surgery either, but we both have fears of an overwhelming infection. Any vets out there or folks that have had experience with this situation? Ideas appreciated. Best wishes to all for a happy and prosperous New Year. Lynne and Dustie in Austin, Texas Date sent: Sat, 30 Dec 2000 13:01:50 EST From: Anonymous Subject: Bilateral Adrenal Hello everyone, I have a question about meds after bilateral adrenal surgery. My Sam, 2yrs old, had both adrenals removed in July 2000. At that time he weighted 1490 grams. He has lost quite a bit of weight since then. When he was sent home our vet had him on .4 ml of Pred and .6 Amoxi for 14 day. After the 14 days, he took .2 ml of Pred for another 10 days and then we started weaning him off the Pred. Our vet said to watch him but he didn't say what to watch for. The surgery has not slowed Sammy down one bit. He is VERY active and does not appear to be ill. He eats 2 cubes of Bob Church's Gravy a day (or more if he can steal from his siblings) plus his regular ferret food and anything else he can hang a fang on. I guess what is bothering me, is his thinness. With the weight lost, I am wondering if there is a blood test or other test to determine if Sam should be on Hormone replacement? I seem to remember someone mentioning blood levels of something, to determine whether Therapy was needed. Our vet suggested putting him on .8 ml of Pred (twice a day) and 1/4 tablet of Florinef Acetate once a day. I am really hesitant to put him on this much Pred without knowing for sure if he really needs the therapy. Does anyone know of a blood test? Thank you everyone, Dianna S. Date sent: Sat, 30 Dec 2000 13:34:45 -0500 From: "keclark" Subject: Update on Zackari Happy New Year to all on our mailing list from Zackari & Kathy! Our heart felt sympathy goes to Lucie & Sarah for the lose of Mandrake & Action Jackson. All others that have lost babies this year. My heart goes out to you. I know how deeply these little guys touch our lives.   I just wanted to update everyone on Zackari, 7 year old MF, had his second adrenal last year Dec. 12th. Doc Prezant know we didn't get it all. We are so lucky to have him still. At the end of August he was showing some symptoms again. We had a ultrasound done and there were no sign of tumors anywhere. Just some fluid in his abdominal wall, so tiny they couldn't extract it. Also a medium sized prostate. So with his team of three vets we decided to do the monthly Lupron shots and Prednisone. His system just didn't do well with the Prednisone, he wouldn't eat, sohe only took that for three days. He's the only ferret in the world that wouldn't eat A/D. So it's a good thing he started eating better after taking him off the Prednisone. He just had his third Lupronshot Dec. 22nd. He is feeling great and playing more every day. His hair is growing back after his ultrasound and his thinning hair on his feet and tail is growing back. So the quality of life is good for Zackari. That was my goal to make his little fuzzy life a quality one. We only have him so I take time to play with him every day. He loves to play kill the rubber mouse in the plastic bag. So we feel very lucky to still have him with us for Christmas this year. Santa left him a new squeaky toy in his stocking for being a good boy.  Just a note to all about signs of adrenal trouble. You don't always get the hair loss. Watch the little guys for any abnormal behavior. Zackari the first time, started marking his territory. Like, he would pee infront of the front door. This was not normal for our little guy that had very good potty manors. Off to thevet we went. First off, the doc thought he had a bladder infection. But the Tenn. Panel showed positive. So that's when he had his first surgery4 1/2 years ago, just taking the left adrenal. The second timewe saw the hair lose. By the time we got to Dr. Prezant for the surgery, because we were in the middle of moving. Dr. Prezant and done his first surgery and moved to Stuart, FL from Vermont. We then were moving to Tampa, FL so I wanted him to do the second on also. Zackari had lostmost of the hair on his back and feet. Also was having trouble urinating. We didn't think he would make it. So good luck to all and keep a eagle eye on your fuzzy babies. Well, keep you posted on the Z. Sorry this is so long but it's at least good news. Kathy, Jim & Zackari Date sent: Sun, 31 Dec 2000 00:01:50 EST From: AFERRETVET@cs.com Subject: Heart, adrenal and prostate problems Hi Lorraine, You asked if there were medical options to help control adrenal gland disease and an enlarged prostate for your ferret with a heart problem. The answer is YES. [Based on your description of a 9 year old ferret with congestive heart failure, I would not recommend surgery for him.] Medically I would suggest starting him on Lupron depot. This comes in a 1 month, 3 months, and a 4 months version. I am not sure which version your vet will have up there (your e-mail address indicates your in Canada). My recommend dose is 100-500 mcg/kg/month IM. Since it is his right adrenal gland and he is having prostrate problems, I would start at the higher end of the dose ( 300-500mcg/ kg/month). As for Lysodren, I do not recommend using this drug in ferrets! There are 2 other medicines that can be used for enlarged prostates, and I would actually use one of these WITH the Lupron depot. The 2 drugs are finasteride (Propecia and Proscar by Merck) and bicalutamide (Casodex by Zeneca). I am not sure if they will have the same brand names up there or not. Finasteride comes in a 1 mg tablet called Propecia and in a 5 mg tablet called Proscar. It is an enzyme inhibitor that prevents testosterone from being metabolized into DHT in the prostate, liver, and skin. As a result the prostate becomes smaller, urinary flow increases, and hair regrows. A recommended dose is 0.1mg/kg up to 5mg/kg once a day. In your case I would probably start at 1 mg per day for the first 30 days. Most compounding pharmacies can make it into a flavored liquid. Bicalutamide is an androgen antagonist that blocks the androgen receptors on the prostate. This causes the prostate to become smaller and urine flow to increase. It comes in a 50 mg tablet, and it is used at a dose of 5 mg/kg once a day. Again a compounding pharmacy can make it into a flavored liquid. Also for his heart condition, you might want ask your vet about using digoxin along with the lasix and enacard. I hope this helps your little guy out, and I hope you both have a healthy and Happy New Year. Jerry Murray, DVM Dallas, Texas. Date sent: Sat, 30 Dec 2000 21:35:16 -0500 From: "Bruce Williams, DVM" Subject: Reply: FAIML #493; Dec. 30, 2000 Dear Lorraine: >Hi I was wondering if anyone could offer their advice on one of my >ferrets. He is nine years old and has a bad heart condition. He has >been on furosimide and enapril for two years now and during a recent >ultrasound I was told he had a huge cyst in his prostate, an abdomen >full of fluid and a right adrenal tumor. The vet drained 600 ml of fluid >out of his abdomen, but now he only urinates a little bit and every few >days the vet has to apply pressure to his bladder to get the urine out. >She says his bladder is extremely stretched. The cirtical care hospital >vet was going to operate on him but they took another ultrasound and >said his heart problem was too bad and he also had liver damage and >it was too risky and nothing could be done. I read on the internet that >Lupron and Lysodren helped ferrets with adrenal tumors and prostate >problems and I was just wondering if anyone knew if either would >help with his problem or is his bladder too damaged by now. Are >ferrets on heart medication able to take this. He is eating and drinking >well and still shows an interest in things around him although he does >have hindend weakness. You are truly between a rock and a hard place. Normally, I would recommend immediate surgery, and a temporary course of Lupron and Casodex (another drug that works on prostatic disease by inhibiting further effects of estrogen) until the estrogen levels decrease, but it looks as if surgery is not an option. Your ferret cannot continue for long in this fashion, so I would suggest the Lupron and Casodex combined to begin ASAP. Your vet can get the dosage and ordering information for these drugs off Charlie Weiss's site (www.ferretdoctor.com) - I worked with him on a clinical trial of these drugs. To my knowledge there is no contraindication for ferrets with heart disease, although that has not been specifically investigated. To my mind, you really don't have much of a choice here. Good luck in a difficult situation, Bruce Williams, dVM Date sent: Sat, 30 Dec 2000 21:56:02 +0000 From: "Karen Purcell, DVM" Subject: medication for enlarged prostate Lorraine, You wrote: (excerpt included in message above) Your vet may also want to try Flutamide. It is used in men with prostatic hyperplasia to shrink the prostate and ease urination. I've had a pretty good response rate in ferrets. The dose is 10 mg/kg q 12-24 hrs PO, and most compounding pharmacies can make it up for you. Warning - it is very expensive!! Dale, > question is whether or not he still eats his kibble or is living > only on the > hand feedings. I have not seen him eat any kibble in > months but I am >not in his room 24 hours a day. Does anyone know > if fuzzies stop >eating by themselves when they are hand fed? I find it depends on the ferret - my Magic eats a jar of baby food daily, but he still loves his kibble! Laura, >SNIP> Someone mentioned a medication that can shrink/ease the >prostate problems while waiting for surgery. Anyone know what it >is? See the flutamide comment above! Hope everyone has Happy Holidays this year, -Dr. Karen DISCLAIMER: This e-mail is provided for general informational purposes only. It is in no way intended as a replacement for a consultation with a qualified licensed veterinarian. If you are concerned about your pet's health, you should seek the advice of your regular veterinarian as soon as possible. Date sent: Sat, 30 Dec 2000 21:42:05 -0500 From: "Bruce Williams, DVM" Subject: Reply: FAIML #493; Dec. 30, 2000 Dear Dale: >Does anyone know if fuzzies stop >eating by themselves when they are hand fed? Well, I don't really want to generalize, but in my experience, yes. It can be very difficult in some cases to wean hand-fed ferrets back onto kibble, and I don't recommend doing it cold turkey. Ferrets like the attention of hand feedings, and if he is really packing it away, I would surmise that he is eating little on his own. My recommendation - start gringin a little bit of his kibble very fine with a coffee grinder, and add increasing amounts to his A/D baby food mixture to get him back to liking the taste of the kibble. Over time, and I'm talkinmg weeks to a few months, you may be able to graduate to hand-feeding kibble, and then maybe he'll surprise you and go back to the kibble full time. However, keep up with his blood sugar, for as you mentioned, your switch to hand-feeding has resulted in decreasing his meds. I would hate to see a return to kibble mean a return to pred and proglycem. With kindest regards, Bruce Williams, dVM ---------------------- End of FAIML #494 ------------------------