Adrenal disease affects the adrenal glands in a ferret, which are located adjacent to the kidneys and produce hormones.  Disease can occur in either or both of the glands and can be hyperplasia (overactivity) or caused by benign or malignant cancerous tumors. 

How many ferrets will develop adrenal disease?

Ah, the $64,000 question.  We don't know of any actual source from a study for any sort of hard number.  Our shelter population can't tell us much, since we see critters for a short time in their life, often receive ferrets in middle to older age and even receive some because they are already affected by adrenal disease.  We recommend you plan for your ferret to have surgery at some point in life, which might be for adrenal disease, a blockage, etc.  While not all ferrets have surgery by any means, if you're doing what you can to be responsible, stick $500 in an account for your ferret - or build up to that amount for each ferret you have.  Then you'll be able to handle 3 of your ferrets of 7 developing adrenal disease in the same year!  :)

What is the outcome...is adrenal disease painful or fatal?

Left untreated, adrenal disease can become very advanced and end up as a wasting disease that, while it doesn't seem to be painful, will eventually cause death.  Of course if cancer is the root cause of the trouble critter can have real trouble! 

What are the symptoms?

Hair loss is the most common and noticeable symptom of this disease - no matter the form. "Rat tail" (hair loss on tail with or without associated blackheads) is often associated with the disease but keep in mind this condition can also be seasonal (alopecia) and unrelated.  If hair loss progresses up the tail onto the belly, adrenal disease might be the culprit.  Other hair loss patterns might include base of tail up onto the back, between toes or on up the foot, between shoulders, top of head or the bottom of the neck.  Hair loss can also present in the form of overall and generalized thinning, which is often more difficult to observe when it happens gradually. 

Above photo:  Beatrice shows off classic adrenal symptoms.  Swolen vulva, skinny appearance, major hair loss, droopy belly.  Yet this pretty lady "felt fine" and had a happy life!  Click the photo for a larger version.

Are there tests to determine if adrenal disease is present?

Yes, but even all the possible testing won't always pick up on the disease.  A regular blood workup usually won't tell the vet anything definitive.   Ultrasound or xray can pick up some of the larger tumors, but typically the tumors are awfully small and won't be detected (an adrenal gland is about the size of a pea).   In fact, if the gland gets large enough to be seen on an ultrasound, your vet might already be able to feel it by palpating the abdomen.  There is a more specific blood panel offered by the University of Tennessee.  This panel is not 100% accurate by any means and can be rather expensive.  Because we are familiar with the many presentations of adrenal disease, we don't run the U of T panel and diagnose using symptoms.  An experienced vet should see your ferret if you suspect adrenal disease.  The presentations can be both varied and rather subtle at times; only a vet who has seen many of the different presentations can help you make a firm diagnosis in many cases.

Above photo:  sexual agression.  We call sexually agressive males "Mad Rapists," but in fact they aren't able to much else but hang on and complain about their hormones!  Click the photo for a larger version.

Are there any treatments?                       

YES!!!  Surgery is the best option, but if your critter is too old or infirm there is are drug therapies to help with the symptoms.  Lupron is used to deal with hormone levels and does work, but it's very expensive.  Melatonin is an affordable alternative and we're using it here at the shelter.  The medical management the Lupron and Melatonin offer are not "cures" and will do nothing to cancer, should it be present.  It's also impossible to tell from symptoms what kind of adrenal disease your ferret has.  So surgical remedy should always be considered; never think your ferret will be "cured" with Lupron or Melatonin, or that it they are acceptable alternatives simply because of cost or bother.  

Traditional adrenal surgery involves simple removal of the affected gland(s).  Often this type of surgery did in fact remove the problem tissue and the critter would have no further trouble.  However, traditional surgery has historically been far less effective if the right side gland was affected.  In ferrets, the right side adrenal is often located very near the vena cava, the main abdominal artery.  In fact, the gland may actually attach itself!  Surgeons must be very careful not to cut into the vena cava while dealing with the adrenal gland, which is often quite a challenge.  Because of this difficulty, traditional surgery would often be able to remove the left gland entirely, but only remove a portion of the right gland - which might leave the disease process enough tissue to continue to progress!

Modern surgery is done using cryo technology, which uses liquid nitrogen to freeze the tissue - just like having a mole removed from your arm!  The freezing kills the tissue: gland, tumor, surrounding tissue cancer might have spread to, etc.  Because no cutting is needed, the surgeon can insert the tip of the cryo gun to touch that hard to access right side adrenal and ZAP!  freeze that sucker and (hopefully) stop the disease right in it's tracks.  To us, this is a dramatic improvement in the treatment of adrenal disease.  The equipment is also rather affordable, so we encourage you to speak to your vet and encourage him/her to begin providing the cryo surgery. 

Surgery?  What can I expect?                        

The first thing you need to do when your ferret develops adrenal problems is make sure you have a competent and well experienced vet.  Unfortunately the cost of surgery can range from $250.00 to $1500.00, depending on which part of the country you live in.  But within your area, the price of surgery can range just as dramatically!  Here in the Detroit area, only one vet is providing the cryo surgery, which will cost about $600.  If you visit another vet in the Detroit area who quotes you $1,200.00, you should really ask yourself what that price is paying for!  A seriously high quote may suggest the vet is inexperienced or simply doesn't want to do the procedure.  So it is important to shop around to find the best care!

Some ferrets go right on with life the very night they've had surgery as if nothing had happened that day, but you should plan for critter to at least have a couple of "down" days.   Although your vet may advise you to withhold food the night before surgery and the evening of, please remember these are traditional dog/cat guidelines and are not appropriate for ferrets!  We get so outraged when the staff of the vet clinic tells people to withhold food.  We remove food four hours before surgery ONLY and definitely make sure critter eats something that evening.  You should be prepared to force feed your critter, as a critter who's had surgery might not feel like eating kibble (some will eat on their own - just be prepared).  The mush need be nothing more complicated than moistened, mashed up kibble, but you could also add some Nutrical.  For more information on force feeding a ferret, please visit the "My critter won't eat" page from our Health home page. 

Keep your critter warm and quiet the evening of surgery.  If you have a large, multi level cage, either remove critter from it or remove the ramps.  No climbing, running, jumping or otherwise possible blowing those stitches for a few days.  If critter has any bleeding, is excessively cold or is vomiting, consult your vet right away.  Complications are possible, so do plan to keep an eye on critter for 2-3 days.  Now, once you've been force feeding your critter warm, mushy food, you may find that - although they feel just fine - they will be finicky about going back to regular old hard kibble.  Use all the powers of persuasion you have (tee hee)!  Trickery, chicanery, all are acceptable.  Little ferrotone on piece of kibble...whatever works.  It can take a couple of weeks, so don't lose hope!  Sophie was just terrible.  She so enjoyed being babied she absolutely was NOT going to go back to being a regular old get-your-food-from-the-general-dish-silly weezil.  Took some major work to get her extricated from Mom...but eventually she returned to her friends.  What you just can't do is stop feeding critter if he/she won't eat on her own.  It can be frustrating, but remember critter had major surgery.   You know what a baby you would be if you had your whole abdomen explored!   Patience and love is the key to getting critter through the whole experience.

Over the years we've taken in nearly 50 critters for surgery.  How did the critters fare?  There is really no standard or short answer.  Now, remember that our shelter population is different.  We often don't know how old a critter is or how long he has had adrenal disease already before we meet him.  Add in the stress of losing a home and perhaps even some former neglect or abuse...and our critters aren't the best sample from which to draw any conclusions.  In our experience and opinion, an otherwise healthy ferret (we screen all adrenal ferrets for insulinoma and if we find it, critter is no longer a candidate for surgery) under age 6 who lives a happy life in a great home is a candidate for surgery.  But as the information about Melatonin continues to come out, our shelter is starting to lean more and more on this alternative treatment.  Keep in mind we're considering the masses for our shelter.  :)  For more information on Melatonin, click here for the best site collection of information.  You'll find much info that you can share and discuss with your vet!