Pee Pee Everywhere!Urine crystalization & adrenal?

[Deleted]

Sorry in advance for the novel. I'm kind of wigging out about ferret medical stuff right now, and I think the way I deal with that is by explaining a lot more than I prolly need to. Here goes...

Snickers, my usually well mannered (in the bathroom sense) little girl, has been leaving mini pee puddles all over the room that serves as the overly large ferret cage and doubles as a bedroom for us human folk. (yuck!)

I've been in the midst of trying to find a decent ferret vet way out on the Outer Cape in Massachusetts, so she's seen two vets recently for what is most likely a case of adrenal. She has a swollen vulva, some discharge that is apparently NOT an infection (tested for one-results neg), but (aside the new pee puddles?) no other adrenal symptoms. Here is the earlier post about that situation: holisticferret60.proboards.com/index.cgi?board=vetting&action=display&thread=994&page=1

When she started leaving me these puddles about a week ago, I thought it was probably linked, so I called both vets to try to get an appointment/recommendation. I wound up taking a urine sample (which I collected off the floor in one of those medicine does syringe things- felt pretty clever about that) to the closer of the two vets, Dr. Morgan. I actually like(d) Dr. Blake better, but I had to get to work and couldn't drive the extra 20 min that day.

So Dr. Morgan looked at the sample and saw no infection (yay!) but some slight crystallization in the urine (??). She didn't have much to say to me about it, except to confirm that it could be linked to possible adrenal and that it could be related to Snicker's diet. Snickers and Hiro are not raw feeders- they were in transition (up to ground meats including liver!) but had some human related setbacks (bad ferret mom!) and have not really progressed past one ground-raw meal in (some/most) evenings. Right now they primarily eat a mix of Evo Feline and/or Evo Ferret (whichever is available) Natural Balance Ultra Prem Feline (lower protein at the recommendation of a previous vet, who incidentally thought the other foods might cause kidney and bladder problems bc of overly high protein levels) and Wellness Core (which is a new food for them). Dr. Morgan has already expressed misgivings about raw foods, but her comments about diet in this conversation focused on ash content in the kibbles as a possible problem, and on fish being problematic.

She had no real treatment advice, except to possibly cut out the Wellness Core, and didn't really explain what was going on all that well, so I had her fax her results to Dr. Blake, who called me back today.

Dr. Blake has impressed me more than Dr. Morgan thus far, in that she seems far more interested in ferrets in general (when she met Snickers, she was happy to let her climb and crawl all over her, unlike Dr. Morgan, who touched her the bare minimum her job allowed) and has been much better at explaining what she thinks might be going on. She is younger, and has less experience, but knows more of the newer treatments for adrenal than Dr. Morgan, who pretty much knew about lupron and surgery and thats it. Dr. Blake was not familiar with des, but at least she'd heard of melatonin being used....

However there are some concerns with her too. Firstly, she keeps using the term Cushings interchangeably with adrenal. That should be a big red flag, no? Second, our conversation today had a few concerning parts.

First, the part that made good sense to me. She recommended an x-ray to see if Snickers has a bladder stone (which I intend to schedule for Friday, which is my next day off). Snickers is peeing all over the place, so I know she has no blockage, but I will be keeping an eye on her JUST IN CASE. Dr. Blake seems to think the urine crystallization is further evidence of adrenal, which Snickers is not currently being treated for since she only presented with the one symptom and both vets recommended that I wait and see if another symptom developed. I cannot afford the Tennessee panel- it would eat through 1/4 of my savings- which I will likely need for treatment, NOT testing. Without any testing I was not about to cut her open, and both vets thought that there could be other (seasonal, not too concerning) causes for the swollen vulva, despite the fact that she is fixed. Thus, if we treated medically, we would not know if it was coincidence or successful treatment if the symptom subsided. So we waited. And now Snickers is peein everywhere and probably not to comfy

If it turns out she has a bladder stone, than I think I will probably take her to a real ferret specialist in Boston to get it taken out (assuming it can wait the weekend) and do sugary for adrenal at the same time. Snickers is very young and thus a good surgical candidate (not to mention medical treatment for the rest of her life would be very challenging to pay for- I work as a cashier) so I was already considering surgery for adrenal, but especially if she already needs surgery anyhow- it seems like it would be best to do it all at once, right? That being said, I would trust neither vet here to do a ferret surgery unless it was something that needed to be done immediately on an emergency basis- in which case I guess I would have to.

My talk with Dr. Blake up to this point made good sense, but when I mentioned what Dr. Morgan had mentioned about diet, things took a turn for the worse.

Dr. Blake and I had barely talked about diet before this, and when she found out what kibble I have been feeding the ferrets she got really concerned. She said that I shouldn't be feeding the ferrets any cat food (she's right- but only in the sense that they really ought to be eating fresh whole prey and RMB, which is NOT what she meant) and that I ought to be feeding them a food formulated for ferrets. Like Marshalls. We didn't even touch upon the raw issue in the few minutes we spoke about diet.

She did seem really open to discussing diet further, which is a good sign, but this is not really the time that I want to be educating my vet on ferret nutrition and why it is that Marshalls ferret food is terrible stuff. I want a vet I can trust to know what she (or he) is doing and give Snickers the best possible care. I would really like that vet to be located closer than Boston (a two hour drive- and I have to borrow a car every time I go! I don't even own my own.) but I'm starting to think I may be s*** out of luck there.

I guess I don't have any specific question, more just looking for general advice: Has anyone else had an adrenal ferret with urine crystallization? Is this common? How freaked should I be about possible blockage in the next few days from a maybe non-existent bladder stone? My impression is that they are less common in girls? Also, advice on how to deal with the vet(s) is appreciated... I will be seeing Dr. Blake for that x-ray on Friday and talking to her about diet at that point. And of course adrenal treatment advice is always sought after- though I've done quite a bit of reading both here on Holistic ferret and elsewhere on the web- the more info I have the better, right?

If you got to the end of this really looong post than thanks so much for reading! Snickers and I both appreciate your time.

[miamiferret2]

I have heard of other persons having issues with wellness core causing urinary stones in their cats and dogs. Actually, if you Google wellness core and urinary/kidney or bladder stones, I'm sure you will find it.
I would cut the natural balance and wellness core out totally.
I have not heard of Adrenal disease causing urinary problems in females. It is a common problem with males bc of their prostate.
If the stone is removed, or if the vet can get a sample of crystals in the urine I would send them to out to test what type they are and what caused them to form so you can prevent them in the future. how does he know she has a stone? Little pee puddles can be urinary/ bladder stones but they can mean other things too.

But ferrets often have more than 1 thing going on medically. I don't think a stone in her bladder would cause an enlarged vulva? That is usually the case with Adrenal. I would get her either lupron or Melatonin and see if she responds. I am not too quick to get surgery done on my ferrets unless they absolutely need it. Most Adrenal tumors grow back. So, I wouldn't do surgery if she is not showing other signs of Adrenal disease. And if you do remove diseased Adrenal glands, I would suggest preventive deslorelin once per year for the rest of her life after surgery, bc like I said those tumors usually grow back.

[miamiferret2]

www.lafebervet.com/small-mammals/?p=108

[Deleted]

"I have heard of other persons having issues with wellness core causing urinary stones in their cats and dogs. Actually, if you Google wellness core and urinary/kidney or bladder stones, I'm sure you will find it"

I did and I did. Even so, Wellness Core makes up less than 1/4 of their diet, and it seems like a pretty big coincidence that it would only be once she had symptoms of adrenal that this should come up, right?

"If the stone is removed, or if the vet can get a sample of crystals in the urine I would send them to out to test what type they are"

I didn't even know they could do that! Do you know where they would send them? I could possibly try to bring in another sample when we go in for the x-ray on Friday....

"how does he know she has a stone? Little pee puddles can be urinary/ bladder stones but they can mean other things too."

Hence the x-ray- the vet doesn't know but wants to rule it out, just in case.

"I don't think a stone in her bladder would cause an enlarged vulva..."

Sorry, that's not what I meant- I meant that could BOTH be caused by the adrenal? Or both the crystals and the enlarged vulva, since stones are unconfirmed?

"I am not too quick to get surgery done on my ferrets unless they absolutely need it. Most Adrenal tumors grow back."

Most? The statistics I've heard are closer to half- and usually you get a few years before recurrence, at which point couldn't you treat medically? I've actually been wondering about this issue, so I would love any references you could provide.

However, I'm only leaning to a surgical treatment if they have to operate anyhow for a bladder stone. If that's not the case, than all options are on the table.

[miamiferret2]

I honestly can't say with certainty whether Adrenal disease can cause urinary stones in female ferrets. In male ferrets, an inability to empty the bladder bc of enlarged prostate (caused by Adrenal disease) can cause bladder/ urinary stones/ crystals in the urine. This is because the ferret is not able to empty his bladder. So, the urine sits in the bladder longer and as a result, crystals / stones develop.
female ferrets don't have prostate. So, if she has stones, I would think it would likely be diet related.
BTW I forgot to ask you how much ash is in the kibble that you feed? I have treated Adrenal disease with medicine for several years. I would say that my ferret Lemmy became Adrenal at around age 2.5 and he lived over 8 years.

As for stones/crystals yes they can tell you what kind they are. Usually they are struvite crystals. I get kidney stones and my doctor sent them to a lab then he told me what not to eat (medical advice which I never followed )

[Sherry]

Since she already has a swollen vulva, I'd get her started on lupron at least asap. So that is one problem dealt with. For the crystals, I've not had any experience, so can't help there at all.
Here's a list of ferret vets(may be outdated) www.ferret-universe.com/vets/vetlist.asp
Your vet should be able to contact anyone here to get proper dosage for the lupron.

[Heather]

This little one needs a dose of lupron asap. The swollen vulva says adrenal, that is a firm given. I've never heard of a female ferret suffering from urinary problems with adrenal (not saying it doesn't happen but) so you've got a secondary issue too. Now one thing that no one has mentioned is some issue with the bladder itself. Now bladder stones is indeed an issue but you need an xray to be done asap. You need to rule out some things. Bladder stones is indeed one, but a bladder tumour is another, an xray should be able to tell you what you're looking at. The xray should also be able to tell you if the adrenal gland has got issues (this one is often not clear, ultra sound is better for this). The urine was it properly concentrated? clear? Has she had blood work done? So, she's eating kibble, that's a good setup for crystals. I'm hearing more and more kibble fed ferrets who are having issues with this. I'm not surprised as ferrets are similar to cats. As long as kibbles are continued to be fed we're going to see an even greater increase of it, same as cats. Actually, for the same reason as cats.
I would not be overly concerned with the reference of cushings crossed over adrenal. For vets who treat cats and dogs this is their reference. My vet does it all the time, it doesn't bother me any more.
ciao

[miamiferret2]

I did not even think of bladder issues. I have dealt with ferret bladder cancer. My vet suspected cancer can spread from the Adrenal tumors into the bladder liver kidneys. my ferrets bladder looked like a foggy grey mass on the x-ray the walls were not well defined. get an xray, blood tests check kidney function. I would also suggest lupron or deslorelin if your vet can get it. Also Melatonin. If you can't get the Melatonin implant, you can give 1 mg every 12 hours. The implant is more effective though.

[Deleted]

I feel like I can chime in on this topic (I usually stay back on the medical issues) since Jack just went through a severe case of bladder stones back in October.

Hillary, anytime urine is concentrated it has the potential to crystallize (and then form stones). Some ferrets have a propensity to crystallize even more. Without an xray you wont be able to determine if stones are present or not. The good part is that Snickers is getting urine OUT which means she is not blocked and you don't have a full blown emergency (you still have to get this taken care of ASAP). Has your vet done a urine pH? Depending on the pH of the urine, certain compounds crystallize... high acidity and you get one type of crystal, high alkalinity and you get another. The crystals can point to one (or a combination of) three things... 1.) Snickers had a urinary tract infection that progressed to the bladder (have you seen any blood in any urine, even a slight pink color - blood would also point to stones in the bladder, ouch!). Infection increases the acidity of urine. 2.) Diet! (this is very common). Peas are a common ingredient in the "Holistic" cat foods and is a very common trigger to bladder problems. I still really believe that this was a major contributing factor to Jack's stones (well in conjunction with #3) because he was eating Halo Cat food (I didn't know any better then) and Halo is loaded with pea protein. 3.) some ferrets have a genetic predisposition for producing excess cysteine. This is rare and can be ruled out once the stones (if they are present) are removed and sent away for composition analysis - either they will be cysteine or they will be calcium or struvite (magnesium based).

Unfortunately, Jack's stones came back as cysteine stones so a complete overhaul of diet was called for. I proposed a raw diet prior to the stones and my vet was a little on the fence so I stuck with her advice and switched him to the Evo Ferret (why vets think because it says ferret on the bag means it is better is baffling still). After nearly losing him (he showed zero signs of crisis until he was completely blocked - once blocked, they crash hard and FAST) my vet made several phone calls to colleagues across the country and the consensus was ferrets fed whole mice don't get stones. Of course, I don't believe the mice have anything to do with this, I think any raw diet would be just as efficient. The goal is to keep urine as dilute as possible and RAW diets do just that! and now we check in on his bladder every six months via xray (every 2 for the first 6) to make sure he is stone free.

You need to...
1.) get that xray done to rule out (or confirm) stones. Any vet can do this, you don't need to go to a specialist yet
2.) If there are stones, there are some drugs that can help dissolve them so long as they don't cause a blockage first.
3.) like Heather said, start treating the adrenal
4.)Re-dedicate yourself to switching to raw. ALL of your little ones will benefit, not just snickers

[miamiferret2]

I bought those urine PH test strips. they are about 12.00 at onlynaturalpet.com

this is a good article from dr. murray:

www.smallanimalchannel.com/media/ferrets/ferret-health/bladder-stones.aspx.pdf

[Deleted]

Snickers had her ex-ray on Friday, and it came back clean for stones. She is going in for her first Lupron shot this coming Friday (the office did not have enough to give her one when she went in last, or we would have just gone ahead with it then). Dr. Blake has mentioned Melatonin as a possibility, and we will talk more about that and about diet issues when I take Snickers back in.

It sounds to me like if the crystallization is a diet issue, than that's another point toward raw. But my vet is not raw friendly. Not sure what to do with the conflicting advice. Obviously I will not be feeding Snickers Marshalls, and it sounds like we need to phase out the Wellness Core. But I'm already feeding Evo- so short of a full raw transition, what else is there? I hesitate to attempt to transition her while there is so much else going on, especially if the vet is really against it.

[Deleted]

Oh yeah, and I forgot to mention- neither of the vets have even heard of deslorelin. Is it preferable to lupron? Why? If so, is it available in the US?

[miamiferret2]

Awesome! No stones!! Deslorelin must be ordered by your vet from Peptech in Australia. It is an implant. There is a thread around here with the email address for peptech sales. They will walk your vet through on how to order it. Lupron is monthly. I would not do Melatonin implant alone. do Melatonin with either monthly lupron or deslorelin.
I don't bother to speak to vets about food. Although one of my vets told me he feeds raw to his own dogs. I am glad she doesn't have stones.

[Deleted]

I've found the only vets that don't bat an eye about even feeding commercial raw are the ones who also specialize in reptiles (and also own them-or ferrets). Who's going to tell a snake owner to feed kibble? Sounds like it is trouble to find a knowledgeable vet up in Mass. which is a shame.

[Deleted]

@ Hillary - as far as diet is concerned, you need to do your own research and ultimately decide what is right for YOU (your vet is not the ultimate decision maker in this). Most of us on here are raw feeders, so we will tell you all the benefits of raw and how vets don't learn enough about pet nutrition. But if you go to another forum, they wont be pro-raw and they will tell you the benefits of their chosen diets. Ultimately whatever you choose, you still need to somehow keep snickers' urine dilute. You can try buying her a pet fountain and see if making drinking more fun encourages her to drink a lot more.