Hyperadrenocorticism associated with adrenocortical tumor or nodular hyperplasia of the adrenal gland in ferrets: 50 cases (1987-1991)

Karen L. Rosenthal From the Departments of Medicine (Rosenthal, Quesenberry, Hillyer, Peterson) and Pathology (Moroff), The Animal Medical Center, New York, NY 10021; Rutherford Animal Hospital, Rutherford, NJ 07070 (Beeber); and College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37916 (Lothrop).

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Mark E. Peterson From the Departments of Medicine (Rosenthal, Quesenberry, Hillyer, Peterson) and Pathology (Moroff), The Animal Medical Center, New York, NY 10021; Rutherford Animal Hospital, Rutherford, NJ 07070 (Beeber); and College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37916 (Lothrop).

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Katherine E. Quesenberry From the Departments of Medicine (Rosenthal, Quesenberry, Hillyer, Peterson) and Pathology (Moroff), The Animal Medical Center, New York, NY 10021; Rutherford Animal Hospital, Rutherford, NJ 07070 (Beeber); and College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37916 (Lothrop).

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Elizabeth V. Hillyer From the Departments of Medicine (Rosenthal, Quesenberry, Hillyer, Peterson) and Pathology (Moroff), The Animal Medical Center, New York, NY 10021; Rutherford Animal Hospital, Rutherford, NJ 07070 (Beeber); and College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37916 (Lothrop).

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Neal L. Beeber From the Departments of Medicine (Rosenthal, Quesenberry, Hillyer, Peterson) and Pathology (Moroff), The Animal Medical Center, New York, NY 10021; Rutherford Animal Hospital, Rutherford, NJ 07070 (Beeber); and College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37916 (Lothrop).

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Scott D. Moroff From the Departments of Medicine (Rosenthal, Quesenberry, Hillyer, Peterson) and Pathology (Moroff), The Animal Medical Center, New York, NY 10021; Rutherford Animal Hospital, Rutherford, NJ 07070 (Beeber); and College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37916 (Lothrop).

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Clinton D. Lothrop Jr. From the Departments of Medicine (Rosenthal, Quesenberry, Hillyer, Peterson) and Pathology (Moroff), The Animal Medical Center, New York, NY 10021; Rutherford Animal Hospital, Rutherford, NJ 07070 (Beeber); and College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37916 (Lothrop).

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Summary

Adrenocortical adenoma, nodular hyperplasia, or carcinoma was diagnosed in 50 ferrets. Thirty-five (70%) ferrets were female and 15 (30%) were male. The mean age at which clinical signs were first noticed was 3.4 years (range, 1 to 7 years). Clinical signs included large vulva (n = 31; 89% of females), alopecia (n = 43; 86%), pruritus (n = 20; 40%), and increased consumption of water and increased urine output (n = 4; 8%). A mass was palpated at the cranial pole of the kidney during physical examination of 17 (34%) ferrets. Ultrasonography, performed on 39 of 50 ferrets, revealed a unilateral adrenal gland mass in 19 (49%). Four ferrets were anemic, and 2 ferrets were thrombocytopenic. Baseline plasma concentrations of cortisol and corticosterone were within or below the reference range in all 17 ferrets tested, whereas baseline plasma estradiol concentrations were high in 4 of the 11 ferrets (36%) tested. After adrenocorticotropic hormone (acth) administration, only 1 ferret had a slightly exaggerated response on the basis of plasma cortisol concentrations, and all 17 had normal responses on the basis of plasma corticosterone concentrations. There was little or no increase in plasma estradiol concentrations after acth administration. Of the 50 ferrets, 39 were treated by adrenalectomy. Unilateral adrenalectomy was performed in 34 ferrets in which 1 adrenal gland was large, whereas subtotal bilateral adrenalectomy was performed in 5 ferrets with bilateral adrenal disease. Five ferrets died in the immediate postoperative period, and follow-up information was available for the remaining 34, 1 to 34 months after surgery. A decrease in vulvar size was generally noticed by 2 days after surgery, and complete hair regrowth was noticed by 2 months.

Because clinical signs resolved after adrenalectomy, it was likely that the adrenocortical tumors and nodular hyperplasias of the adrenal gland were hyperfunctional. However, these ferrets did not have excessively high circulating concentrations of cortisol. At present, we recommended that diagnosis of adrenocortical disease in ferrets be made on the basis of characteristic clinical signs, results of abdominal ultrasonography, and finding large adrenal glands during surgery. Results of acth stimulation tests, with determination of plasma cortisol or corticosterone concentrations, were of no value in the diagnosis.

Summary

Adrenocortical adenoma, nodular hyperplasia, or carcinoma was diagnosed in 50 ferrets. Thirty-five (70%) ferrets were female and 15 (30%) were male. The mean age at which clinical signs were first noticed was 3.4 years (range, 1 to 7 years). Clinical signs included large vulva (n = 31; 89% of females), alopecia (n = 43; 86%), pruritus (n = 20; 40%), and increased consumption of water and increased urine output (n = 4; 8%). A mass was palpated at the cranial pole of the kidney during physical examination of 17 (34%) ferrets. Ultrasonography, performed on 39 of 50 ferrets, revealed a unilateral adrenal gland mass in 19 (49%). Four ferrets were anemic, and 2 ferrets were thrombocytopenic. Baseline plasma concentrations of cortisol and corticosterone were within or below the reference range in all 17 ferrets tested, whereas baseline plasma estradiol concentrations were high in 4 of the 11 ferrets (36%) tested. After adrenocorticotropic hormone (acth) administration, only 1 ferret had a slightly exaggerated response on the basis of plasma cortisol concentrations, and all 17 had normal responses on the basis of plasma corticosterone concentrations. There was little or no increase in plasma estradiol concentrations after acth administration. Of the 50 ferrets, 39 were treated by adrenalectomy. Unilateral adrenalectomy was performed in 34 ferrets in which 1 adrenal gland was large, whereas subtotal bilateral adrenalectomy was performed in 5 ferrets with bilateral adrenal disease. Five ferrets died in the immediate postoperative period, and follow-up information was available for the remaining 34, 1 to 34 months after surgery. A decrease in vulvar size was generally noticed by 2 days after surgery, and complete hair regrowth was noticed by 2 months.

Because clinical signs resolved after adrenalectomy, it was likely that the adrenocortical tumors and nodular hyperplasias of the adrenal gland were hyperfunctional. However, these ferrets did not have excessively high circulating concentrations of cortisol. At present, we recommended that diagnosis of adrenocortical disease in ferrets be made on the basis of characteristic clinical signs, results of abdominal ultrasonography, and finding large adrenal glands during surgery. Results of acth stimulation tests, with determination of plasma cortisol or corticosterone concentrations, were of no value in the diagnosis.

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