Due to the high incidence of this disease in ferrets, we thought it might be helpful to identify the symptoms of the disease and clarify a few misconceptions that often occur.

First, the term sometimes used, "Cushings Disease," is technically incorrect when it comes to ferrets. It does not appear that ferrets develop Cushings as it occurs in dogs. While both suffer significant hair loss, ferrets do not develop a similar degree of elevated serum cortisol. No one knows what causes the gland or glands to become abnormal, though speculation includes early neutering, diet, lighting conditions and inbreeding in U.S. raised ferrets.

Many people insist it’s caused by early neutering. That may or may not be the case. But, we had a 6 year old female, spayed at about 2 ½ years of age with symptoms of adrenal disease. She spent the first half of her life in natural lighting conditions. Like most illnesses, there is rarely a direct cause and effect.

For the ferret owner, however, whether it is the same illness as Cushings with different symptoms or a different disease with similar symptoms, the most important thing to remember is 1) it is usually NOT immediately life-threatening, and 2) it is usually operable with a high degree of success.

How do you know if your ferret has "adrenal gland tumors?" You can’t tell for sure visually. However, you should become very suspicious if you encounter any of the following symptoms:

Bi-lateral hair loss. Huh? Well, that means hair loss on both sides of the body. With adrenals, it USUALLY follows a distinctive pattern. What we see most often is hair loss that seems to begin at the base of the rump where the tail starts and works it’s way in both directions up the back and down the tail. It may start with just a quarter sized patch of missing hair. Very often, you change diet or even laundry detergent and the hair grows back. You and your vet think you licked whatever caused the hair loss.....but the next coat change cycle, less hair grows back and over the course of the next 6 to 18 months, your ferret’s hair begins to "thin out," especially across their sides or in the belly area. Left untreated, the ferret eventually becomes totally bald or just retains a bit of hair around it’s muzzle. NOTE:  Ferrets change coats twice a year - Spring and Fall.

We had another situation involving a 2 to 3 year old ferret that did NOT show ANY hair loss. In her case out vet felt something in the area of the adrenal glands (which are near the kidneys).  We decided on exploratory surgery and found an adrenal gland was grossly enlarged and had to be removed. She made out fine.

Reduced activity level. This can be a hard to notice. Generally, adrenal tumors show most frequently on ferrets in the 3 to 5 year old range. But, that’s not absolute. Occasionally, though rarely, we’ve seen a 2 to 3 year old ferrets develop adrenal disease as well. In older ferrets, general hair loss seems to be more often a by-product of old-age.

Keep in mind that age 3 to 5 is when you normally see a ferret’s naps increase in length. Just because your furry is sleeping more does not indicate there IS a problem - but you should become suspicious if you see reduced activity with one or more other symptoms.

Swelling of the vulva or vaginal discharges in female ferrets. There is a small chance that this is a symptom of residual ovarian tissue; tissue that was missed or regrows following spaying or an infection. But in an older, 4 to 6 year old ferret, I’d suspect adrenals before ovarian tissue. Either usually indicates exploratory surgery.

Straining to urinate in males. There appears to be increased incidence of partial or complete urinary tract blockages in males. We have seen at least half of the males who develop adrenal disease also show symptoms of blockage. An early symptom is "spotting," "dribbling," or "straining" to urinate. Your ferret may run from place to place only dribbling a few spots of urine. This usually indicates he’s unable to fully empty his bladder. In advanced cases the urethra becomes completely blocked with mucous and crystals. This is extremely dangerous! If your ferret stops urinating, it must be seen by a veterinarian IMMEDIATELY.

Thinning of the skin. Ferrets with adrenal disease show thinning and drying of their skin. which begins to look translucent in advanced stages. In advanced cases their skin becomes quite thin, dry and sensitive.

Behavioral changes in either sex. Males may become more assertive with other ferrets, including pushing and butting, excessive grooming, neck-biting, "picking" fights with ferrets they previously got along well with. In females, we’ve seen "nesting" behavior including excessive grooming of whomever will sit still for it - human or ferret or attempting to drag or keep other ferrets within their "nest.". The behavior in and of itself is not dangerous, but seeing a marked change in behavior is a warning that something is amiss that needs to be checked by your veterinarian.

First, the "bad news."

There is currently no reliable way to identify adrenal tumors except by exploratory surgery. There are one or two tests out there, but nothing that definitively identifies it. And, as often as not, the vet still has to perform an exploratory surgery to confirm the diagnosis. Since the only possible "cure" is to remove all or a part of the gland, it’s sometimes far easier just to skip right to surgery particularly if several of the above symptoms are involved. Before undertaking surgery, however, your vet may want to take a radiograph (x-ray) or ultrasound to identify any other concurrent illness that could complicate surgery. However, in and of themselves, adrenal gland tumors cannot be diagnosed by x-ray. Ultrasounds can help, but are rarely definitive. Dr. Rosenthal in Hillyer & Quesenberry’s "Ferret, Rabbits, and Rodents - Clinical Medicine and Surgery" [1997} states "Surgical removal is the preferred treatment in ferrets, as it is for dogs with adrenocortical tumors. Medical management with the drugs currently available is usually unsuccessful and may be accompanied by dangerous side effects."

Now for the good news!

Ferrets, if not debilitated from other illnesses, are very tolerant of adrenal surgery. They usually recover and heal quickly provided there are no other concurrent medical conditions to complicate recovery.

The surgery is NOT EASY for your vet! The glands are very tiny and the gland on the right side of the ferret’s body (that is, the ferret's right) is tricky to remove as it’s snuggled right against the aorta, the major artery to the heart. The vet should always check both glands and may find either one or the other that is enlarged, discolored or otherwise appears abnormal. There seems to be an about equal chance for the "offending" gland to be on the right or the left. Usually just one gland is involved, but if both are, the vet may choose to remove the "worst" one and leave or, at most, only remove part of the second. I have heard of cases where BOTH glands were removed, but that is generally NOT recommended.

Being that diagnosis is often made visually during exploratory surgery, you may find cases, where the vet cannot make a definitive judgment as to which gland to remove. Don’t be disappointed if nothing is removed! You don’t want your vet to take a guess and learn 3 months later the wrong gland was removed. Your vet may have to close and try again 3 to 6 months later. Discuss this possibility in advance of surgery, so you are both clear on what he/she should do. Unless there are pressing reasons, postponement is usually the preferred option. (Pressing reasons may include: urinary blockage in males; a swollen vulva/discharge in females).

We also had a ferret where the offending gland could not be safely removed. It was intricately wrapped in blood vessels. In her case the risk of cutting critical blood vessels was too great. Our vet decided to close without removing the gland. She slowly became completely bald! She remained her same devilish self, though funny-looking, for almost two more years with her adrenal tumors. In her case, she never developed more than a slight enlargement of her vulva.

Immediately following surgery your vet may give administer a shot of azium or prednisone or, put your ferret on a brief regimen of corticosteroid replacement therapy to ease any shock to their system.

The bottom line is that adrenal gland tumors are rarely a death sentence. If you are observant for the early and developing symptoms, you will usually have time to deal with it. The tumors generally develop slowly and it can be many months before it becomes a life-threatening issue. It may never progress beyond hair loss and some minor behavioral changes. I’ve seen worse "problems" than a bald ferret! I can assure you – they don’t seem to mind one bit.

There may be times when surgery is not appropriate for one reason or another. Your ferret may be too old to risk the trauma of the surgery; or, if the ferret is under treatment for insulinoma, your vet may recommend against surgery as it is difficult to monitor and regulate blood sugar levels with both diseases present. You and your vet may decide that it is not appropriate to put your pet through the surgery. The important thing is to be aware of the options and watch for developing symptoms. In the case of a female with a swollen vulva, there is the increased risk of recurring infections and anemia. In males, there is the risk of the development of prostrate cysts and urinary tract blockages.