Adrenal Disease Complex in Ferrets

Ferrets

Adrenal disease is one of the most common diseases of ferrets and can occur as early as 18 months old. In adrenal disease, the adrenal glands start to produce excessive sex hormones (both male and female sex hormones). These elevated sex hormones begin to cause problems for ferrets such as hair loss, itchy skin, pot -bellied appearance, loss of muscle tone, and lethargy. Some ferrets are intensely itchy.  Females often develop a swollen vulva.  Males may develop a swollen prostate gland causing difficulty urinating or causing him to have accidents outside the litter box. Female ferrets may develop and enlarged vulva. Some ferrets may show sexual behavior (mounting) or become aggressive. Some ferrets with adrenal disease can develop life-threatening drops in their red blood cells due changes in their bone marrow, and can be incurable if not caught in time. As the disease progresses the abdomen often becomes larger and ferrets become weak in their hind legs s the disease progresses the abdomen often becomes larger and ferrets become weak in their hind legs. If left untreated, adrenal gland disease is a life-shortening and life-threatening disease for ferrets. 

One or both of the adrenal glands may become hyperplastic(over-active) or develop tumors. The majority of ferrets have hyperplasia or benign tumors. Less frequently, adrenal gland cancer can occur. 

Ferret with a swollen vulva due to adrenal disease complex is shown here on the left. 

Diagnosing Adrenal Disease

The clinical signs of hair loss, enlarged vulva, difficulty urinating (males), thin skin, and abdominal enlargement support a presumptive diagnosis of adrenal disease.  Diagnostic blood tests including adrenal hormone analysis, complete blood count, and blood chemistries help diagnose adrenal disease and assess your ferret's overall health.  An abdominal ultrasound to measure adrenal gland size provides confirmation of the diagnosis of adrenal disease and allows for monitoring of response to treatment (glands getting smaller). Additional tests may be needed based on your ferret's physical examination.

Treatment Of Adrenal Disease

MEDICAL OPTIONS

Medical management of adrenal gland hyperplasia with Deslorelin implants currently is the best recommended treatment with the longest survival. 
 
Deslorelin: Deslorelin implants are currently the best way to treat adrenal gland disease caused by benign tumors or hyperplastic conditions in most ferrets. Studies have shown that desorelin implants are more effective at controlling adrenal disease than older surgical methods of removing the enlarged gland(s). Deslorelin implants do not require anesthesia and surgery and are therefore provide a much less expensive treatment for adrenal disease.  The implants control adrenal gland disease for 16-18 months on average. Most ferrets experience a complete resolution of abnormal signs and seem"back to normal" within 2 months. Ferrets can receive a 2nd implant when the first one stops working if they are still healthy. If you choose Deslorelin therapy for your ferret, a thorough examination and ultrasound exam to measure the adrenal glands is needed.
 
A progress exam and repeat ultrasound should be performed 1 month after implantation to assess response to treatment. If the tumor is getting smaller and there is good response to treatment, follow up exams and ultrasounds to measure adrenal gland size need to be repeated every 6 months. If no response to medical therapy occurs after 1 month, surgery should be considered.
 
Lupron: Lupron (leuprolide acetate) may be given as an injection once a month to control adrenal gland disease.    Some ferrets may do well with monthly Lupron alone, and some may do well with Lupron on a less frequent schedule.  Lupron is highly recommended as an immediate treatment to any male ferret with difficulty urinating and with any female ferret with a swollen vulva.  
 
A progress exam should be performed in 1 month to assess response to Lupron treatment. If there is good response to treatment, Lupron should be administered monthly. Progress exams and ultrasounds to assess response to treatment and to monitor for other health problems need to be performed every 3 months. If no response to medical therapy occurs after 1 month, surgery should be considered.
 
Ferretonin: There is an even better response to the above treatments when combined with an injection of Ferretonin (slow release melatonin) every 3-12 months.  Ferretonin helps fur regrown more quickly and seems to resolve many other issues in afflicted ferrets.

SURGERY

Approximately 5% of ferrets do not respond to medical management and need surgery. These ferrets often have very large tumors or cancerous ones.
 
Left adrenal glands are much more commonly involved than right adrenal glands. Surgery to remove the left adrenal gland is usually uncomplicated and is easily removed most of the time in a surgery called a left-sided adrenalectomy. The right adrenal gland is in a more difficult position because it lies very close to a major vein (the vena cava) that can cause extreme bleeding and even death if it ruptures during the surgery. Because of this removal of the right adrenal gland may require two separate surgeries for complete removal or the surgeon may do a single surgery and remove as much of the tumor as possible. Another option is for an ameroid constrictor band to be placed around the vena cava at one surgery and a second surgery in 42-45 days is performed that completely removes the right adrenal gland. 
 
You can see how close this tumor of the right adrenal gland is to the largest vein in the body in the photo on the left. 
 
We offer surgical options including left-sided adrenalectomies, right-sided adrenal debulking surgeries, the ameroid constrictor band right-sided full adrenalectomies, and bilateral adrenalectomies.

Why do ferrets get adrenal disease?

Adrenal gland disease is a genetic disorder that appears to be made worse by a combination of two things, neutering/spaying and exposure to varying hours of artificial light instead of natural seasonal changes in the light cycle.
 
The neuter and spay surgeries are done before ferrets ever get to pet stores.  Spays are done because serious health problems arise in unspayed ferrets that are not bred every year.  Neuters are done to make male ferrets less odiferous and reduce the risk of behavioral problems.
 
 
Ferrets are very sensitive to changes in the day length over the course of the year.  The lengthening of daylight in the spring, and shortening of daylight in the fall, sets the pattern for their reproductive cycle. Pet ferrets are usually kept indoors, and are exposed to lights at different times of the day and night, usually without any seasonal pattern.  Without the regular change in photoperiod over the course of a year, they do not have the right triggers for normal hormone production, and the adrenal glands can overproduce sex hormones. This typically happens at 3 years or older but has been seen in ferrets as young as 1.5 years. 

 

 

 

 

 

New drugs and treatment regimens are being explored across the country and we stay current with cutting edge information to offer you the best possible choices for your ferret's treatments.