Harmony Animal Hospital's Blog

Authored by: Simon Starkey BVSc, PhD, D.ABVP(Avian)

The adrenal gland is responsible for many important functions. One key function is to produce adrenaline (epinephrine). Adrenaline helps the body respond to life-threatening situations and is the key driver of the fight or flight response. The glands also produce a critical hormone known as cortisol. Cortisol assists in regulating blood sugar and in metabolizing protein, fat and carbohydrates; it is also an immune regulator. Finally, the adrenal gland also produces relatively small amounts of reproductive hormones and their precursors.

What is Adrenal Disease?

When used to describe disease in ferrets, adrenal disease refers to hyperadrenocorticism. This big term simply means an overactive adrenal gland. An overactive adrenal gland usually produces too much cortisol in humans and dogs, and this condition is known as Cushing’s disease (or syndrome).

Ferrets get a Different Type of Adrenal Disease

The type of adrenal disease that ferrets get is different to that seen in people and dogs. In ferrets it is the reproductive hormones that are overproduced with overactive adrenal glands. The glands may be overactive due to hypertrophy (exaggerated growth), benign tumors or a malignant form of cancer. Without a surgical biopsy or gland removal and pathology, determining which of the three causes of adrenal disease a ferret has is difficult to impossible.

What are the Clinical Signs (Symptoms) of Adrenal Disease in Ferrets?

The increased amounts of circulating reproductive hormones lead to one or more of the following clinical signs in ferrets:

• Hair loss: This usually starts at the tail and often extends to involve the back, stomach and ultimately most of the pet’s body. Some ferrets initially lose fur only over the crown of their heads and look a bit like little Friar Tucks. These pets may go on to lose fur over their entire body as well.
• Itching: Approximately 30% of ferrets with adrenal disease will have itchy skin. They may have little scabs and scratches from itching so much. Some ferrets will also show a yellow discoloration of the skin accompanied by waxy-type exuded matter.
• Swelling of vulva: The majority (over 70%) of female ferrets with adrenal disease will have an enlarged vulva secondary to the increased reproductive hormones produced by overactive adrenal glands.
• Anemia: Female ferrets may develop anemia. Typically it takes a veterinarian to diagnose anemia, however you may suspect it if your ferret’s gums appear pale or if she is weaker than usual.
• Aggression: Aggression and increased sexual activity can be seen in some ferrets with adrenal disease. Typically, aggression is more common in males, but can be seen in female ferrets as well.
• Urinary problems: Because of increased testosterone levels, male ferrets can suffer from an enlarged prostate that can make urination difficult or impossible. This rapidly becomes a life-threatening situation and warrants emergency veterinary care.

How is Adrenal Disease Diagnosed?

While the symptoms of adrenal disease in ferrets are fairly characteristic, it is important to allow your veterinarian to perform additional diagnostic tests to help confirm the diagnosis and determine your pet’s overall health. In any middle aged or older ferret, whether there are signs of illness or not, your veterinarian will likely suggest a complete blood count (CBC) and chemistry panel. These tests don’t diagnose specific diseases; however, they give an overall picture of health by assessing liver and kidney health as well as monitoring for anemia and signs of infection. There are two tests available to specifically diagnose adrenal disease itself:

• Ferret adrenal panel:  Your veterinarian sends a blood sample to the laboratory for endocrine testing. Three common reproductive hormones are studied and if one or more are elevated, and then a diagnosis of adrenal disease can be made.
• Abdominal or adrenal ultrasound: This test is done by a skilled veterinarian, often a specialist in radiology.  The abdominal (stomach) ultrasound is more comprehensive than an adrenal ultrasound as all abdominal organs are evaluated (liver, kidney, spleen, bowel, bladder, and prostate) in addition to the adrenal glands. In an adrenal ultrasound only the adrenal glands are evaluated. The adrenal-only ultrasound will likely be slightly less expensive than a full abdominal ultrasound, but may or may not be an option depending upon your veterinarian’s policies.

How is Adrenal Disease Treated?

Broadly speaking there are two main ways to treat ferret adrenal disease: medical or surgical management. The decision as to which to use is made between the veterinarian and the pet owner by considering the following factors: The ferret’s age and sex, the disease and symptoms, presence of additional diseases, affected gland(s) (left, right or both), owner’s desire for cure versus control, risks of surgery, possible complications during and after surgery, and willingness to tolerate possible recurrence or disease of opposite gland if surgery is performed.

• Surgery: Generally speaking the prognosis for left-sided adrenal gland removal is good and the chances of medium to long-term cure are good. Right-sided disease is complicated by the close proximity of the right adrenal gland to the largest vein in the body (the vena cava) and the liver. As such, right-sided or bilateral (both sides) adrenal disease carries a larger risk of complications as well as a reduced likelihood of cure. If the right gland is affected, the surgeon may only be able to partially remove the gland. This may slow the progress of the disease, but is unlikely to cure.
• Medical management: There are several types of medical management available. The medication offered to you will likely vary with your veterinarian’s experience and comfort level with one or more of the available treatment options. Medical management will help reduce and potentially eliminate some of the potentially life-threatening secondary symptoms of adrenal disease (such as anemia or urinary blockage) but it is generally not believed to be effective in slowing or stopping tumor growth in those ferrets affected by adrenal gland cancer.

Lupron (leuprolide): Lupron has been a mainstay of medical management for several years. This medication is generally effective in controlling clinical signs when given to ferrets by injection once a month. Lupron helps to reduce the hormone-induced aspects of adrenal disease, such as fur loss, estrogen-induced anemia and prostate disease. Lupron is essentially a synthetic hormone, and over time the ferret’s body may recognize this substance as foreign and create antibodies against it, thereby reducing its effectiveness.

Deslorelin: This drug is similar to Lupron, although it is available in a longer-term implant (8-12 months).

Melatonin: The use of oral melatonin has been studied in ferrets and it has proven effective in treating the clinical signs and hormonal changes seen with this disease. One problem with its use, however, is the lack of regulation of melatonin manufacture in the U.S. As such it can be difficult to be certain that the ferret is gaining the benefit it should from this drug. As an alternative, a melatonin implant is available to veterinarians in the U.S. This product is being actively researched and initial reports are very promising as to this product’s ability to improve fur loss and the hormonal status of ferrets with adrenal disease.

Treating adrenal disease requires a commitment on the owner’s behalf and teamwork between the owner and their veterinarian.

“Max”, the schnauzer next door begins to wheeze, scratch and chew at himself at the first sign of Spring. “Kitty”, the sweet tabby across the street gets an upset tummy whenever she eats a particular food. And “Ginger”, your very own lovable mutt, scratches herself raw anytime she’s bitten by even one flea. She even keeps you up at night with the constant scratching and collar jingling!

There are countless diseases that can cause pets to scratch including mange, fungal infections, ringworm, some bacteria, and even shampoo residue left on the pet’s skin after bathing. But the poor, uncomfortable pets mentioned above suffer from an affliction called allergies.

An allergy is the body’s reaction to a substance it can’t tolerate well. When the body comes in contact with an allergen (allergy-causing substance), either through physical contact, through something eaten, or by inhaling the substance, it produces antibodies and is called an allergic reaction. Common contact allergens include house dust, pollen, feathers, flea saliva, wandering Jew plants, ragweed, staph bacteria, and grass.

In pets, the allergic reaction can cause various symptoms including vomiting, diarrhea, and other gastrointestinal problem; respiratory problems; a runny nose and runny eyes; or itchy skin. Allergic pets will often lick their paws, scratch or rub their faces, or have watery eyes. Repeatedly red, or infected ears can also be a result of an allergic reaction. The constant scratching can produce bacterial skin infections and hair loss.

Flea allergy is the most common allergic reaction. Signs include intense itching, red skin, and the appearance of small, hard, red bumps called papules. The most common sites are the base of the tail (a common area for fleas), along the spine, and on the pet’s inner thighs and abdomen.

Inhalant allergy (called atopy) is the second most common allergic skin disease, mostly in dogs. At first, the condition is seasonal, but may become almost constant as the dog ages.

Sensitivity to foods, rawhide chews, medications, and other ingested items, can occur. Food allergies are often diagnosed by blood testing, and by feeding an affected pet a hypoallergenic diet for several months. To complicate the allergy picture, a pet may have multiple allergy problems. So a pet with food allergies, for example, may also have atopy or flea allergy.

Diagnostic tests often done to accurately determine the cause of allergies. Intradermal skin testing for contact dermatitis and atopy, and blood testing for most allergies, are two methods used for diagnosis. Treatment may consist of trials of various antihistamines, as well as nutraceuticals (nutritional medications that assist the body’s natural defenses), steroids, or hyposensitization therapy, which is a series of injections to reduce the sensitivity to allergens. Antibiotics are often indicated when the constant scratching has caused a bacterial infection.

While there are no cures, pets can lead much happier, stress free lives when the allergens are identified, avoided and the symptoms eased through different treatments. Early detection can help prevent more serious problems from developing.

It’s heartbreaking to see our old dogs acting, well, old. You figure there’s nothing that can be done for a dog showing signs that resemble senility. This is just part of the aging process, right? Maybe not.

A remarkable medication, called Anipryl, was approved by the USDA in December of 1998 to treat age-related behavior changes (although it has been on veterinary shelves to treat canine Cushing’s disease, a hormonal imbalance). It may prove to be a lifesaver for countless senior dogs and could significantly improve the quality of their declining years and the pleasure you take in your dog. By enhancing dogs’ functioning, Anipryl can prevent or reduce many of the symptoms of old age that can disrupt a household.

Once a dog loses its housetraining, stops interacting with the family, begins to grow restless at night or to become lost even in its own home, many owners will decide that it’s time to put their beloved friend down. Those that don’t must face their dog’s progressive debility and the disruption and pain it can bring to the household. What they may not realize, however, is that sometimes these behaviors in old dogs that may look like senility or even Alzheimer’s in humans are now believed by many veterinarians to be part of an aging-associated brain disorder.

Some of these changes that are usually interpreted as the typical aging process could be due to potentially treatable medical conditions, such as tumors and infections, which are more common in older dogs; call your veterinarian for an appointment anytime your dog’s behavior changes suddenly.

A major source of behavior change in the aging dog, however, is very possibly the result of changes in the brain. This leads to the loss of cognitive abilities like thinking, memory, communication and problem solving. In some aspects it resembles Alzheimer’s disease in humans. This generalized medical condition has been designated Cognitive Dysfunction Syndrome or CDS for older dogs exhibiting this group of problematic, age-related behaviors.

Anipryl (the trade name for L-deprenyl or selegiline) may help CDS. In the absence of any physical cause such as cancer, infection, or organ failure, CDS is present when a dog shows one or more of the following five signs. See if your dog has any of these symptoms.

• Disorientation or confusion:
  Your dog may wander aimlessly, stare out into space, or stand with his head in a corner; your dog may appear lost or confused in the house or yard;
• Decreased or altered responsiveness to family member:
  Your dog may fail to respond to your attention, and stop seeking out attention;
  he may be less enthusiastic in his greeting;
• Disturbances of the sleep-wake cycle:
  Your dog may bark, whine or pace at night; he may persistently bark abnormally any time of the day; he may be sleeping more, or awake more at night;
• Decreased activity level:
  Your dog may show less general interest in his usual activities;
• Deterioration in housetraining:
  A normally housetrained dog is suddenly having “accidents”; your dog may signal less to go outside and may urinate or defecate indoors soon after being outside.

Given the possible benefits for CDS, Anipryl may well be worth trying when your dog is declining in ways that lead you to contemplate putting him or her down. If the normal course of aging and its difficulties are not disruptive for your household, you may not wish to consider medication. It’s a judgement call. But it’s nice to know that there’s help for your older pet and some of the often devastating signs of aging are not something we are forced to live with and accept anymore.