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                                                                                                                                                                                                              Common Cancers in Ferrets

                                                                                                                                                                                                              Cancer is very common in ferrets.  We do not know exactly why this is, but genetics likely plays a big role in each case.  By the time most ferrets are 4-5 years old, they commonly have one if not multiple types of cancer.  There are classic signs of each type of cancer in ferrets, and most types of cancers can be treated and give the ferret a good quality of life.

                                                                                                                                                                                                              Adrenal Disease

                                                                                                                                                                                                              There are two adrenal glands in the body, sitting just in front of the left and right kidneys in the abdomen.  They are responsible for producing several different hormones, including the sex hormones estrogen and testosterone.  Adrenal disease in ferrets can be either benign or malignant, but all forms of cancer in the adrenal gland increase the production of the sex hormones as well as causing the adrenal glands to enlarge.  In addition to the problems that the overproduction of sex hormones causes, the adrenal glands themselves can get so big that they put pressure on the surrounding blood vessels, causing poor circulation and eventually death.

                                                                                                                                                                                                              Signs of adrenal disease
                                                                                                                                                                                                              There are several strong indicators that your ferret may have adrenal disease.  These include:
                                                                                                                                                                                                              • Hair loss - the hair loss in adrenal ferrets typically starts on top of the toes and on the tip of the tail, and travels upward and can eventually affect the entire body.  The skin usually looks normal, but the hair is thin and patchy.
                                                                                                                                                                                                              • Itchiness - over 30% of ferrets with adrenal disease are itchy.  This may be the only symptom your ferret has.  If there is not an obvious cause (fleas, lice, etc.) then adrenal disease is likely the culprit.
                                                                                                                                                                                                              • Swollen vulva - over 70% of female ferrets will have a swollen vulva.  Since almost all ferrets are spayed young, a swollen vulva is a diagnostic sign of adrenal disease.
                                                                                                                                                                                                              • Trouble urinating/abdominal pain - male ferrets typically get prostate swelling or prostate infections secondary to adrenal disease.  This results in the prostate squeezing off the urethra as it exits the bladder so the ferret will not be able to urinate.  This is an emergency situation and requires hospitalization.
                                                                                                                                                                                                              • Behavior changes - some ferrets will get more aggressive, become nippy or change their normal behaviors in response to circulating sex hormones.
                                                                                                                                                                                                              Diagnosing adrenal disease
                                                                                                                                                                                                              Usually clinical signs alone are enough to diagnose adrenal disease in ferrets and typically respond to treatment quickly.  There is a hormone panel that can be submitted to test for adrenal disease, but it is usually not necessary to do so.  Routine bloodwork can be suggestive of adrenal disease as most ferrets are anemic.  Abdominal ultrasound is used to identify enlarged adrenal glands.  It is important to know if your ferret has a right or left adrenal tumor if pursuing surgery, because surgery may not be a treatment option for right adrenal tumors once they are advanced.  This is because the right adrenal gland sits next to a very large vein, and late in the course of the disease this vein usually becomes enclosed within the tumor and surgery can no longer be performed.

                                                                                                                                                                                                              Treatment
                                                                                                                                                                                                              There are both medical and surgical treatments for adrenal disease.  The choice between medical or surgical treatment is based upon how advanced the disease is, the age and overall health of the ferret, and the wishes of the owners.  Medical treatment usually gives a good quality of life for several years, but the ferrets will need to be on medication consistently throughout that time.  Surgery can be curative, but there is always a chance of recurrence in the other adrenal gland and the risks and costs of surgery can be high. 

                                                                                                                                                                                                              For medical treatment of adrenal disease, we have two choices currently available.  These include Lupron injections and Melatonin implants.  Lupron is a monthly injection given to ferrets.  Melatonin is an implant that is placed underneath the skin (similar to a microchip) every three months.  Both work through different pathways to suppress the release of sex hormones and prevent the enlargement of the adrenal glands.

                                                                                                                                                                                                              For ferrets where the clinical signs of adrenal disease have been long-standing, where long-term treatment is not an option, if their quality of life is poor or medication is no longer working, humane euthanasia is the best alternative to suffering.  Though this is a hard decision, sometimes it is the best thing for the pet if we cannot fix the underlying problem.

                                                                                                                                                                                                              Insulinoma

                                                                                                                                                                                                              This type of cancer affects the cells in the pancreas that produce insulin.  The cells grow abnormally, secreting too much insulin into the bloodstream.  Insulin is responsible for taking glucose (the sugar we use for energy that is digested from our meals) out of the bloodstream and into the cells for energy.  When too much insulin is produced, the blood sugar drops to dangerous levels, resulting in the clinical signs we see in insulinoma patients.

                                                                                                                                                                                                              Signs of insulinoma in ferrets
                                                                                                                                                                                                              The clinical signs we see in ferrets with insulinoma all relate to low blood sugar levels.  These include:
                                                                                                                                                                                                              • Stumbling, weakness in the rear legs
                                                                                                                                                                                                              • Lethargy
                                                                                                                                                                                                              • Staring off into space
                                                                                                                                                                                                              • Excessive drooling
                                                                                                                                                                                                              • Grinding teeth
                                                                                                                                                                                                              • Unresponsive, coma
                                                                                                                                                                                                              • Seizures or twitching
                                                                                                                                                                                                              If you see any of these signs in your ferret, he or she needs to be seen by a veterinarian immediately.  If your ferret is seizing or unresponsive, take some Karo syrup, corn syrup or honey and run some on the gums.  This will help to raise blood sugar levels for a brief period of time while you immediately take your ferret to the veterinarian.

                                                                                                                                                                                                              Diagnosing insulinoma is usually straightforward.  Normal blood glucose levels stay around 80-100 mg/dL.  Insulinoma ferrets have blood sugars ranging from 70 mg/dL to too low to read on our meters (less than 25 mg/dL).  If we test the blood glucose and your ferret has a low reading it is usually an insulinoma.  There are a few other diseases (sudden, severe diarrhea, malabsorptive intestinal disorders, some viral diseases) that can cause severe low blood glucose readings as well, but these are less common.

                                                                                                                                                                                                              Treatment for insulinomas
                                                                                                                                                                                                              The primary medical treatment is corticosteroids.  Steroids inhibit the production of insulin and therefore allow the blood glucose levels to remain within normal limits.  Steroids are given by mouth twice a day for the rest of your ferret's life.  Surgery is an option in ferrets, especially if medical therapy is not working.  Surgery is not a cure for the insulinoma, but ferrets that undergo surgery usually remain symptom-free for longer periods of time (about 6-9 months) and have longer life-spans than those treated with medicine alone.

                                                                                                                                                                                                              There are always times when your ferret may have low blood sugar despite treatment.  This usually happens with concurrent disease processes (dental disease, diarrhea, vomiting, anything that causes inappetance) so we recommend keeping some ferret carnivore care (a prescription recovery diet) on hand.  This is a powdered diet that can be mixed with water and given by syringe even if your ferret is not eating hard food on his/her own.  Please remember that all ferrets should have food available to them at all times so they can regulate their intake when blood sugars begin to fall.  This becomes even more important if your ferret has an insulinoma. 

                                                                                                                                                                                                              Insulinomas will progress and medical and/or surgical therapy will ultimately fail despite our best efforts.  At some point, humane euthanasia will be necessary, but we can try to give your ferret the best quality of life that we can until that point.

                                                                                                                                                                                                              Lymphoma

                                                                                                                                                                                                              The most common intestinal cancer in ferrets is lymphoma.  This is an abnormal growth of lymph cells, and usually affects older ferrets (5 years and up) but can be seen in ferrets as young as 2 years of age.  The most common signs are:
                                                                                                                                                                                                              • Vomiting
                                                                                                                                                                                                              • Diarrhea that is not responsive to treatment
                                                                                                                                                                                                              • Weight loss despite a good appetite
                                                                                                                                                                                                              • Physical exam findings - thick, ropey intestines or swollen lymph nodes in the neck, legs or abdomen
                                                                                                                                                                                                              Diagnosis of lymphoma is made by performing basic bloodwork (often times this is normal but can suggest elevations in lymph white blood cells or secondary problems from the cancer), and abdominal ultrasound is useful for trying to identify enlarged lymph nodes within the abdomen.  The only way to truly diagnose lymphoma in the intestinal tract, though, is with a biopsy.  Surgery to explore the abdomen will result in a diagnosis but also is a way to look at the other organs and identify any other problems that could be mistaken for lymphoma (foreign bodies, inflammatory bowel disease). 

                                                                                                                                                                                                              Treatment for lymphoma is usually unrewarding.  If a small part of the intestinal tract is affected, removing it may help alleviate symptoms for a short period of time, but they usually return.  Chemotherapy is available but is typically unsuccessful in treating intestinal lymphoma and is costly.  Corticosteroids are the primary treatment at this time.  They will help your ferret feel better, and clinical signs will resolve for a limited time.  Symptoms usually return within 3-6 months and euthanasia is recommended once medical therapy fails. 

                                                                                                                                                                                                              Mast Cell Tumors

                                                                                                                                                                                                              These are skin masses that appear as red, swollen nodules in the skin.  They may have a bit of black crusted debris covering the top of the nodule.  These masses are usually very itchy because they secrete substances associated with allergic responses.  Unlike in other animals (where these are aggressive cancers that spread quickly and need to be removed immediately), mast cells in ferrets are almost always benign and do not spread.  We usually try to treat these tumors with anti-inflammatory medication or topical creams, since most will regress with this therapy and this tumor does not readily spread to other tissues.  If it becomes a problem, though, removal is done under general anesthesia. 
                                                                                                                                                                                                               
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