What is Adrenal Disease?

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 (over activity) or caused by benign or malignant cancerous tumors. It's important to remember that when you see symptoms such as a mostly bald ferret or a ferret with a bald patch somewhere, that's adrenal disease and it's still adrenal disease if/when your ferret grows in new fur at the previously bald location.  Visible symptoms will come and go as the seasons change.  Your ferret will still get signals to grow or lose weight and fur for summer or winter, and sometimes when adrenal disease is present these signals get pretty mixed up.  But in any case, once again it's very important to understand that once the disease is afoot there is no cure, only treatment for symptoms.  And if you use treatment to alleviate the symptoms, don't think your ferret has been cured!

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.  But over the many years of working with hundreds and hundreds of our own Shelter ferrets and the ferrets of our friends, we've come to the conclusion that if a ferret lives long enough, he or she is bound to develop adrenal disease at some point.  Our good friend, a veterinary pathologist, tells us that in every ferret she has occasion to do a necropsy on that is older than a year will certainly have at least the beginnings of the disease on board!  So it's best for all ferret owners to become familiar with the disease and even to expect that it will strike most, if not all, of their ferret business at some point.

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.  Adrenal disease can also transition to cancer, and of course cancer can then do whatever it wants.  There's no way to tell without a biopsy of one or both adrenal glands whether cancer is afoot, and in any case the treatment options are the same.  Important note for boys with adrenal disease:  boys can suffer from a problem the girls can't.  Their prostatic tissue can swell with the increased production of testosterone caused by teh adrenal disease to the point that the urethera is totally compressed and the ferret can't urinate.  If your ferret becomes totally blocked, that usually means it's the end of his story. However, we have seen some good results with the latest available treatment, the Suprelorin, or as it's called, "des."  The des seems to work quickly, so if your ferret is straining we feel it's worth a shot to get a des implant on board.  However, if your ferret is totally blocked it might well be too late.  All the more reason to use medication to treat early in the disease process and monitor your ferret daily, especially watching the boys for trouble urinating!

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 is the likely 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. 

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! 

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 shriveled 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 diagnosis in many cases.

Above photo:  sexual agression.  Jack is shown pestering Marvin in the photo.  Notice that although Jack is exhibiting classic adrenal-related sexual aggression, he has no visible hair loss!  Marvin also had adrenal disease and his hair loss is not visible either.  Jack had a small bald patch on the top of his head and Marvin had loss over his shoulder blades, and the photo doesn't capture the hairloss on either boy.  In other words, even very furry critters can have adrenal disease on board!  We call sexually agressive males "Mad Rapists," with loving humor, but in fact they aren't able to much else but hang on and complain about their hormones!  Notice not only the large amount of scruff in Jack's mouth, but also the position of his lower body (hey, he was fixed as an infant - he has no idea hahaha) and also his front arms wrapped around the object of his affections.  And this behavior isn't to be confused with normal playing behavior or dominance; Jack would assume this position for many minutes at a time until his friend would finally have enough, then he'd go searching for his next victim and keep it up all day!  :)

Are there any treatments?                       

YES!!!  Today there are a variety of medications and even surgery to deal with adrenal disease.  Back in the early days of the Shelter we used to take in all our adrenal ferrets for surgery.  But we grew weary with the results and once affordable medications came out we stopped doing surgeries altogether...around 2006.  We had probably 60 critters in for surgery in the first six years of our Shelter, then during the next six we just used the medications.  Based on our critters and their experiences, we don't feel surgery does any better than the medication treatment.  Additionally, for those who already have cancer surgery can be anywhere from troublesome to downright dangerous. You see, no matter the method employed during surgery (traditional or through the use of cryo freezing), the surgeon can never remove 100% of both adrenal glands and thus cannot cure the disease through surgery.  So that's why we're no longer going to discuss surgery as a choice we would recommend. 

Now it's important to note that any of the available medications are used to alleviate and symptoms and hopefully slow the progression of the disease, none should be considered a cure.  Remember the information from the beginning of this article:  if you administer one of the medications and your ferret grows new fur, gains weight and starts bouncing around all happy again, do not believe that your ferret has been cured by the medication!  The medications are helpers, NOT CURES.

Ferretoninę (melatonin):  a naturally occurring substance in the bodies of ferrets and humans!  And you may already be familiar if you take melatonin as a natural sleep aid.  Some years ago someone in the know noticed that melatonin can be administered to combat the symptoms of adrenal disease, and indeed, it can help!  Melatonin can be given orally each day or through our preferred method of a time-release implant, given every four months just under the skin.  Most ferrets will have a good response to the first implant, a decent response to the second, then by the third most have started to show symptoms again.  So the disease marches forth even on melatonin treatment. But we know it does no harm - we've given it to even our most decrepit critters with no ill effects - so we always keep treating even if symptoms return.  Your vet can order melatonin treatment from www.melatek.net.  Melatonin is the most affordable of all the treatments, but not by much.

Lupron:  a synthetic, it's used in humans to chemically castrate men or put women into chemical menopause.  We're not going to include information on lupron because it's expensive, doesn't work any better than melatonin and the next medication treatment, the Suprelorin, works much better and is now readily available.

Suprelorinę (deslorelin acetate):  this is the medication we're currently transitioning all of our ferrets to.  To date it's the most effective treatment (superior treatment for boys with prostate trouble), is cost effective and only needs to be given once every year to two years for most ferrets (some will require additional treatments). Although the research that has been done is very limited, all signs point to the positive with the des treatment over the others.  The implant costs more than the melatonin because it's not given as often; considered over the course of a year or more the des is as nearly as affordable as the melatonin. Your vet can order "des" from http://www.virbacferretsusa.com/about-suprelorinf-implant.

Summary

We strongly recommend treating all ferrets with adrenal disease with the newest medication treatment, the Suprelorin or "des" implants as they are called.  Additionally, many vets are now using des implants given annually, starting when ferrets are young, as a "vaccine" if you will to hopefully ward off this disease.  While a formal study has not been done to show if ferrets who receive des implants early and often will avoid adrenal disease, the reasoning behind the theory is pretty sound in our judgment.  We can't afford to "vaccinate" all of our Shelter ferrets but we do think it's important for ferret owners to consider doing so.  If a few hundred young ferrets were implanted annually with des, in a short few years we'll have an answer as to whether or not it will work as a preventative measure.  So talk with your vet about treatment for your ferrets with adrenal disease, as well as possibly using the des implants as a preventative measure!

 

Duffy Bandito Yoda Damien

Adrenal disease at the end.  All of these photos (from left to right:  Duffy, Bandito, Yoda & Damien) were taken just a few days before the critters passed away.  L to R:  Duffy is sporting a big tumor in her belly, Bandito kept eating like a piggie up until the day he died, Yoda told us he was miserable and it was time to go, and poor Damien arrived in terrible shape and it was downhill from there.  But fear not, MANY critters can live long, happy lives even with this disease!
 

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