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Cancer is currently the most common cause of illness and death of the ferret. Approximately 70 – 90% of all ferrets will develop some kind of cancer in their lifetime. Older ferrets, especially, seem prone to cancers; and multiple cancers are common in ferrets over 5 years of age. Fortunately, with regular veterinary check ups, blood work and X – rays, early detection and treatment can be achieved. Many cases of cancer in ferrets that are not curable are at least controllable if caught early.

ADRENAL DISEASE/ ADENOMA OR ADENOCARCINOMA
Adrenocortical disease is a common endocrine disorder that affects one or both adrenal glands in middle-aged to older ferrets. The adrenal glands are a pair of organs that lie next to the kidneys and produce many important hormones including sex steroid hormones. In ferrets, enlargement of one or both of these glands will lead to an overproduction of mainly sex steroid hormones. Enlargement of the adrenal gland may either be due to an adenoma (benign tumor, i.e. it does not spread to other parts of the body), adenocarcinoma (malignant tumor, which may spread to other parts of the body), or adrenocortical hyperplasia (increased size). Most affected ferrets develop adrenal adenoma.

Ferrets may have one or both glands affected by cancer. This is a common cancer usually found in ferrets over 3.5 years of age. About 40% of ferrets in the US develop it, whilst it is not as prevalent amongst ferrets in the UK it is on the increase as more are being kept as pets in doors.

Symptoms: Signs may include: alopecia (hair loss) over all or part of the body (often starting on the lower back or along the back bone); poor coat quality (dry, brittle, thinning); loss of muscle and skin tone; itchy, flaky skin – sometimes with red patches or scaling; large deposits of abdominal fat; and a strong musk odor may be apparent. Spayed females may develop vulvular swelling as if they were in heat. Males may become more aggressive as if they were in rut.

Diagnosis:
Diagnosis is based on history and signs. Abdominal palpation is very difficult.
Although diagnosis may be suspected, it will only be fully diagnosed on a blood hormone analysis (comparing androsteredione, 17a hydroxyprogesterone and estradiol), this ferret adrenal endocrine blood panel will need to be sent to a specialist lab such as that the University of Tennessee, which will indicate which hormones, if any, are elevated. Concurrent disease, such as insulinoma, another common ferret disease, may also be discovered with the blood test. Ultrasound, by an experienced imager is very valuable to help assess which gland is affected before any major surgery is undertaken, and an XRay may be undertaken to assess the general health of the ferret.

NOTE - If adrenal disease is suspected and the ferret is female and under 3.5yrs, it is probably suffering from remnant ovarian tissue.
If a ferret is >3.5yrs, it is more likely to be adrenal disease.

Treatment: Surgery used to be the recommended treatment for most ferrets under 5 years of age, however only the left adrenal gland is easily operated on. In 2008 Deslorelin (Suprelorin), a slow-release Gn-RH implant, was licenced for use in the UK for dogs but has been used by vets for ferrets. This, when used on a ferret suffering from Adrenal disease, can cause the adrenal gland size ito reduce and physical appearance to improve (hair growth to resume, appetite and body condition to improve, and in the case of females the vulva swelling to dissappear within , weeks of the implant). If the gland is not carcinogenic then deslorelin will work very well, however if the gland is cancerous then surgery is the best option. The Deslorelin implant will need to be replaced every 18 months (4.7mg implant) or 3 years (9.4mg) , costs vary between vets. NOTE these replacement periods relate to use for treating adrenal not for neutering,

It is now recommended that where it is established only the left adrenal is affected, surgery is indertaken and a Deslorelin implant used in addition to help prevent adrenal in the right hand gland (which does tend to occur within 18 months of surgery). Where the right hand or both adrenal glands (bi-lateral) are affected then surgery is not considered beneficial (there is no point in doing surgery if any tissue is left behind and not only is the right hand gland difficult to access surgically it is also connected to the caudal vena cava, and ferrets do not fair well with both glands removed) so instead the implant is the best form of treatment currently available. If an adrenal adenocarcinoma is present treatment is essential as it can result in the cancer spreading to other parts of the body.

Prevention: While vets don't know for sure what exactly causes adrenal disease in ferrets, most theories point to two possible causes:

1- Spaying and neutering at a young age
Many large ferret breeders spay or neuter ferrets at the age of 5 or 6 weeks, which may cause the ferret's body to overcompensate for the lack of normal sex hormones. Adrenal disease has occurred in ferrets that are spayed or neutered after they have reached sexual maturity, but it is not nearly as common.

2 - Extended photoperiods
Most ferrets have been forced to adapt to their owner's lifestyle and are exposed to at least four or five hours of artificial light in the evening in addition to the natural light during the day. This limits the time they spend in darkness, which decreases melatonin production. Too little melatonin results in overstimulation of the adrenal glands. Ferrets should have no less than 12 hours of complete darkness throughout a 24 hour period.

When a ferret develops adrenal disease, it is most likely the combination of a variety of factors. In addition to environmental factors, some ferrets are probably genetically predisposed to developing adrenal gland cancer.

In the UK some vets are now recommending the use of deslorelin implants (aka adrenal impants) instead of surgically neutering, or at least along with neuturing (at any age) to reduce the chance of adrenal disease. The 9.4mg Suprelorin is the only licensed version in the UK for ferrets, and has been only licenced for the chemical neutering of hobs (to date no licence has been issued in the UK for the chemical neutering of jills or treatment of adrenal in either sex using Suprelorin, it is down to the vets to decide if they choose to recommend an unlicensed product for this purpose). For chemical neutering of hobs the manufactuerer, Virbac, advises with the 9.4mg that any mating that occurs more than 16 months after the administration of the product may result in pregnancy, and that the reduction of testerone can take at least 5 weeks from administering the implant. The need for subsequent implantations should be based on the increase in testis size and/or increase in plasma testosterone concentrations and return to sexual activity.

No advice is provided regarding the use of this with jills, although in practice vets may use it to bring jills out of season (takes app 3 weeks, during which time the jills vulva may swell further, and she may become even more sexually driven), and to chemically neuter jills which may last for one or two seasons with the 4.7mg dose, its too early to tell what is the case with the 9.4mg.

What is clear is that OWNERS RELYING ON THE IMPLANT FOR FERRET NEUTERING MUST KEEP ON TOP OF REIMPLANTING AND MONITOR CHANGES IN THEIR FERRETS BEHAVIOUR OVER THE SEASON, otherwise unwanted litters or jills may occur with mixed groups. More information on the 9.4mg implant >

INSULINOMA
Insulinoma is a cancer of the beta cells of the pancreas. It is fairly common in ferrets over 3 years of age and approximately 40 – 50% of all ferrets get it (these are statistics from the USA). This cancer causes the beta cells to produce abnormally high levels of insulin, which drives the sugar out of the blood stream and into the body too quickly. This causes a serious drop in the blood sugar level and affects the brain, which needs a constant supply of sugar.

Symptoms: These may vary with the severity of the case. Early signs are easily overlooked and may include mild trances (staring into space for a few seconds) or the ferret sleeping more or harder to wake up. Staggering while walking; drooling; pawing at the mouth; and mild seizures usually come next. This may be followed by vocalizations (the ferret can make sounds varying from a noise like a hiccup to screeches and screams. These are generally involuntary and do not mean that the ferret is in any pain), severe seizures, coma and death.

Diagnosis: The most accurate test to confirm Insulinoma is a "FASTING" blood glucose levels test. The normal range for a ferret is 80-120 mg/dl, with anything under 70 (by lab test) strongly indicating the possible presence of one or more tumors.

Treatment: Depending on the severity of the case and the age of the animal, different treatments may be suggested by your vet.

Surgery - Some vets prefer to approach the disease aggressively by surgically removing most of the tumors. One problem with this is that there are no guarantees that more tumors won’t grow or that your vet will get all the tumors out (the average insulinoma tumor is smaller than a pin head) or there are too many of them to remove without damaging the pancreas.

Medication - Another choice is medical therapy with Prednisone (tablets) or Prednisolone (liquid) for the rest of its life. Prednisone helps the body make blood sugar. Usually the dose of prednisone must be gradually increased as the disease progresses. Eventually prednisone alone is not enough to control signs of hypoglycemia, and a second drug, diazoxide (Proglycem®, Schering), may be added. The prednisone acts to change the way the ferret’s body uses sugar. This greatly reduces the high and low sugar levels responsible for the symptoms caused by the tumor. Diazoxide helps to block the effect the insulin has on body tissues. For a time, prednisone and diazoxide controls the signs of hypoglycemia, but eventually they are no longer sufficient. Some animals can survive over three years on medical therapy. Giving the ferret high protein treats and making sure that the ferret eats regularly throughout the day is beneficial. The disadvantage of medical therapy is that it does not necessarily stop the growth of the cancer. Insulinomas have also been known to spread to other tissues and organs, such as the spleen, liver and even the lungs.

If you should notice your ferret having an insulinoma seizure, you can help stabilize him by first administering something sweet to him, such as baker's glucose (available in most supermarkets) honey, tinned peach syrup or Karo syrup. (NOTE: As a general rule- ferrets with insulinoma should NOT be given sugary treats. This has been found to create a yo-yo effect with the blood sugars elevating rapidly and then dropping quickly again.) As soon as your ferret is steadier, give him some duck soup, oxbow carnivore care or some of his regular food to balance out the sugar intake. Call your vet and get your ferret into his/ her office ASAP.  Consider keeping a log that records episodes of hypoglycemia. This will help your vet to best evaluate the efficacy of your ferret’s medication(s).

More information: 2nd chance article by Ron Hines DVM PhD, Ferret magazine article by Bruce H Williams DVM

IMPORTANT: Never put food or liquid into the mouth of an unconscious animal. If the animal is seizuring or is unconscious, rub some baker's glucose, honey or syrup on his inner lips and gums. (Use a cotton bud, if possible, to administer t to avoid the ferret biting you if it starts to seizure again.) When the ferret starts to come around, then you can proceed as described above.

Prevention: Vets do not currently know what causes insulinomas to appear. Diet and heredity are suspects and some vets believe that it may be caused by a virus. Until more is known about the cause of this disease, no preventative measures can be established.

LYMPHOSARCOMA / LYMPHOMA
This is a cancer of the lymphatic system, which is a part of the body’s immune system. It is usually found in older ferrets, but is being seen in younger ferrets now, too. Due to the younger ferret’s body being geared for growth, juvenile lymphosarcoma is often fatal because the disease spreads quickly in the freshly growing cells. In older ferrets it usually develops more slowly and may tend to go unnoticed until it presents itself as swollen glands, an enlarged spleen, rapid or steady weight loss, difficulty breathing, poor appetite or chronic diarrhea. A ferret with lymphosarcoma may have one or more of these symptoms, but these symptoms by themselves are not totally indicative of the disease. Other diseases, such as the flu, may present themselves in the same manner. A complete blood count (CBC) and a lymph node or bone marrow biopsy are usually recommended to confirm the diagnosis., An X-ray or EKG may be helpful in finding cancer in the chest. Research is being done to determine the cause of this cancer. Many vets and researchers suspect that it may be viral in origin, but if it is, it is not thought to be highly contagious as many ferrets have been raised together without the disease spreading. A hereditary susceptibility is also being investigated. More information >

Symptoms: Most ferret owners notice the swelling of the lymph glands along the ferret’s neck, under the arms or behind the back legs. These areas may become so swollen that the ferret looks like it has marbles under the skin.

Treatment: Currently there is no cure, but progress of the disease can be slowed through different treatments available from your vets, the success of the treatment will vary from ferret to ferret and is of course subject to how advanced the disease is in the ferret and how fast it is spreading.  

Steroid treatment is a common form of therapy as it is minimally invasive, less expensive and for many patients improves quality of life. Prednisone (tablets) or Prednisolone (liquid) are commonly used (Prednisolone if hepatic involvement is suspected). Dexamethasone may also be prescribed.

Chemotherapy has been successful in treating many cases of lymphosarcoma, based on cat and dog treatments. Age, advancement of the disease, and other health problems factor into the criteria of whether a ferret would be a good candidate for chemotherapy (this is long term treatment with many visits to the vets (often weekly for bloods and IV administration of meds under sedation or through surgical implementation of a venous port) and changes in the drugs as the disease progresses, so will be expensive).

Tufts Protocol, a newer approach to lymphoma treatment aiming to maintain the good qualities of the previous therapies while minimising downsides. This protocol eliminates the use of IV meds but regular bloodcounts are still necessary, and some of the drugs are myelosuppressive (inhibits blood cell production).

Homeopathic vitamin therapy is also being tried by some veterinarians.

These treatments will only help extend the life of the ferret, it may work for weeks, months or in some cases years. If the disease is advanced and the animal is suffering, euthanasia is generally recommended.

More information: http://ferretcongress.org/sym2008/PittsPDF/chemo4g.pdf  

Prevention: Currently none. If a hereditary susceptibility is found, then ferrets with this predisposition should be kept away from ferrets known to have the disease already. If a virus is isolated, then work can begin on making a vaccine to protect ferrets from catching this disease. More information >

SKIN TUMORS
Some ferrets seem to be more prone to skin tumors than others. The most common are sebaceous gland adenomas and mast cell tumors.

Symptoms: Sebaceous gland adenomas and mast cell tumors generally present themselves as raised lumps under or on the surface of the skin. Some may look like warts or raised scabs on the skin.

Treatment: While most skin tumors are benign, removal is recommended, especially if the tumors are irritated, bleeding, or rough in texture.

Prevention: None.
More information about Ferret Skin Tumors, Cysts, Lumps & Abscesses >

If you have any questions about this information, please contact your vet.