ULTRASONOGRAPHY OF ADRENAL GLANDS IN NORMAL FERRETS

The adrenal glands of 20 normal ferrets were imaged with ultrasound. Of the forty glands, only 4 (three right and one left) could not be clearly identified. Mean (±standard deviation) dimensions of the right (7.6 ± 1.8 mm length by 2.6 ± 0.4 mm width) and left (7.2 ± 1.8 mm length by 2.8 ± 0.5 mm width) glands were similar. Both adrenal glands were wider (p<0.05) sonographically in males than females. Measured length and width of the right gland positively correlated (p<0.05) with body weight. The glands had a hypoechoic outer zone and hyperechoic central region, were elongate to avoid in shape and located medial and, variably, at the level of the cranial pole of the ipsilateral kidney. This study demonstrates that normal adrenal glands can be imaged in ferrets.     

Ultrasonographic evaluation of the adrenal glands in six dogs with hypoadrenocorticism.

The purpose of this study was to determine the value of ultrasonographic characterization of the adrenal glands in dogs with hypoadrenocorticism. Measurements of adrenal glands were obtained in six dogs with hypoadrenocorticism. The adrenal glands on both sides were shorter (range: left adrenal gland length, 10.0 to 19.7 mm; right adrenal gland length, 9.5 to 18.8 mm) and thinner (range: left adrenal gland thickness, 2.2 to 3.0 mm; right adrenal gland thickness, 2.2 to 3.4 mm) than in normal dogs (range: left adrenal gland length, 13.2 to 26.3 mm; right adrenal gland length, 12.4 to 22.6 mm; left adrenal gland thickness, 3.0 to 5.2 mm; right adrenal gland thickness, 3.1 to 6.0 mm). Statistical analysis revealed a significant reduction in size of the left adrenal gland (p less than 0.05) in dogs with hypoadrenocorticism compared to the left adrenal gland in normal dogs. The results of this study show that atrophy of the adrenal glands in dogs with hypoadrenocorticism seems to lead to an ultrasonographic-measurable reduction in size of the adrenal glands.     

Ultrasonographic evaluation of the size of the adrenal glands of 24 diseased cats without endocrinopathies

The ultrasonographic measurements of the adrenal glands of 24 diseased cats without a clinically or laboratory identifiable endocrinopathy were evaluated retrospectively. The mean (sd) thickness of the left adrenal glands was 3.8 (0.8) mm and their mean length was 11.3 (2.8) mm; the thickness of the right glands was 4.5 (1.0) mm and their length was 9.8 (2.4) mm. The products of thickness and length were 43.9 (20.2) mm(2) for the left gland and 45.7 (19.7) mm(2) for the right gland. There were no significant correlations between the bodyweight, body surface area or body condition scores of the cats and the thickness, length or the product of thickness and length of either gland.     

ULTRASONOGRAPHIC PARAMETERS OF NORMAL CANINE ADRENAL GLANDS: COMPARISON TO NECROPSY FINDINGS

Ultrasonographic evaluation of the adrenal glands was performed in 14 fasted healthy adult dogs. Frequency of visualization was 100% for both the left and right adrenal glands. Moderate correlation was present between Ultrasonographic and gross measurements of thickness for both left (r_s= 0.727; p < .005) and right (r_s= 0.537; p < .05) adrenal glands. However, no correlation was found between Ultrasonographic and gross measurements for length or width of either adrenal gland. Differentiation of adrenal cortex and medulla was possible in 79% of left adrenal glands and 64% of right adrenal glands. The echogenicity of the adrenal glands was less than that of the renal cortex in all dogs. Factors which made evaluation of the adrenal glands more difficult included pyloric gas, intestinal gas, and deep-chested body conformation.     

Ultrasonographic measurements of adrenal glands in cats with hyperthyroidism

Feline hyperthyroidism is potentially associated with exaggerated responsiveness of the adrenal gland cortex. The adrenal glands of 23 hyperthyroid cats were examined ultrasonographically and compared to the adrenal glands of 30 control cats. Ten hyperthyroid cats had received antithyroid drugs until 2 weeks before sonography, the other 13 were untreated. There was no difference in adrenal gland shape between healthy and hyperthyroid cats: bean-shaped, well-defined, hypoechoic structures surrounded by a hyperechoic halo in 43/60 (71.6%) healthy cats and 34/46 (73.9%) hyperthyroid cats; more ovoid in 13/60 (21.6%) healthy cats and 9/46 (19.6%) hyperthyroid cats while more elongated in 4/60 (6.7%) healthy cats, 3/46 (6.5%) hyperthyroid cats. Hyperechoic foci were present in 9/23 (39.1%) hyperthyroid cats and 2/30 (6.7%) healthy cats. The adrenal glands were significantly larger in hyperthyroid cats, although there was overlap in size range. The mean difference between hyperthyroid cats and healthy cats was 1.6 and 1.7 mm in left and right adrenal gland length, 0.8 and 0.9 mm in left and right cranial adrenal gland height, and 0.4 and 0.9 mm in left and right caudal adrenal gland height. There was no significant difference between the adrenal gland measurements in treated and untreated hyperthyroid cats. The adrenomegaly was most likely associated with the hypersecretion of the adrenal cortex documented in hyperthyroid cats. Hyperthyroidism should be an alternative to hyperadrenocorticism, hyperaldosteronism, and acromegaly in cats with bilateral moderate adrenomegaly.     

Accuracy of Ultrasonographic Measurements of Adrenal Glands in Dogs: Comparison with Necroscopic Findings

Ultrasonographic evaluation of the adrenal glands was performed in 85 dogs, followed by macroscopic and histopathological examination either post‐mortem or after adrenalectomy. This retrospective cross‐sectional study evaluated the difference between gross and ultrasonographic measurements to determine the diagnostic accuracy of ultrasonography in the evaluation of canine adrenal gland size. The differences were assessed for gland length, thickness at cranial, middle and caudal regions, and surface area. In our sample, ultrasound error accuracy ranged between 0% in measurement of the right adrenal gland surface area and 25.21% for left cranial pole thickness. The parameters with minor errors were caudal pole thickness (3.64% right side and 3.49% left side) and length (5.75% right side and 2.19% left side). The ultrasonographic measurements generally underestimated the actual size of the adrenal glands. No statistically significant differences were observed for measurement errors between normal and pathological adrenal glands. This study confirmed that the caudal pole of both glands is the best parameter for ultrasonographic evaluation of normal and pathological adrenal glands size in dog. Furthermore, the surface area could be considered as a dimensional parameter for better assessment of the complex shape and the global aspect of the adrenal glands, while standardize ultrasonographic projections are needed to measure the cranial pole of both adrenal glands.     

ULTRASONOGRAPHY OF HISTOLOGICALLY NORMAL PARATHYROID GLANDS AND THYROID LOBULES IN NORMOCALCEMIC DOGS

The purpose of this study is to characterize the sonographic appearance of canine parathyroid glands using high‐resolution ultrasonography. Ten cadaver dogs were studied after euthanasia for reasons not relating to the parathyroid. The cervical region was examined using a 13–5 MHz linear transducer in right and left recumbency. Ultrasonographic features of the parathyroid and thyroid glands were compared with the gross and histopathologic findings. Thirty‐five structures were identified sonographically as parathyroid glands but only 26 of 35 glands (74% positive predictive value) were proven to be normal parathyroid glands histopathologically. Of the nine false positives, five (14%) were proven to be lobular thyroid tissue. The remaining four (11%) structures were visible grossly or found histopathologically. There were no statistical differences between ultrasonographic and gross measurements of the parathyroid glands. The average size as seen sonographically was 3.3 × 2.2 × 1.7 mm and the average gross size was 3.7 × 2.6 × 1.6 mm (length, width, height). The average size of the thyroid lobules assessed sonographically was 2.3 × 1.6 × 0.8 mm (length, width, height). Normal parathyroid glands can be identified using high‐resolution ultrasonography. But some thyroid lobules will be misinterpreted as parathyroid glands; this will result in false positives when identifying parathyroid glands with ultrasonography.     

Ultrasonographic evaluation of the adrenal glands in healthy dogs: repeatability, reproducibility, observer-dependent variability, and the effect of bodyweight, age and sex

Adrenal length and width were determined from two-dimensional ultrasound longitudinal images. In study 1, 540 measurements of adrenal glands were attempted from five healthy beagle dogs by three different observers with different levels of expertise in ultrasonography, to determine the variability of adrenal gland measurements. Of these, 484 measurements were included in the statistical analysis, since 16 measurements of the left adrenal gland and 40 for the right could not be visualised by the observer. In study 2, a single measurement of both adrenal glands was taken from each of 146 dogs by the most trained observer from study 1, and the effects of different health status (healthy dogs v dogs with non-adrenal diseases), bodyweight, age and sex were assessed. A total of 267 measurements were included in the statistical analysis. The lowest intra- and inter-day coefficient of variation values were observed for the left adrenal gland and by the most trained observer. The health status had no statistically significant effect on adrenal gland length or width, whereas age had a significant effect only for the left adrenal gland (the greater the age, the greater the width or length) and sex had a significant effect only for the right adrenal gland (the width was larger in males and the length larger in females). The bodyweight had a significant effect for the length of both adrenal glands (the greater the bodyweight, the greater the length), but not the width. The differences between sd and coefficient of variation values for the width of the left adrenal gland were not statistically significant between the three observers, whereas they were statistically significant for the right adrenal gland.     

Effects of mitotane therapy in dogs with pituitary dependent Cushing syndrome on the adrenal gland size--an ultrasonographic study]

The effect of mitotane therapy on adrenal gland size was evaluated in 13 dogs with pituitary dependent hyperadrenocorticism. Ultrasonographic measurements were obtained before and during mitotane therapy. During therapy both adrenal glands were shorter and thinner (median during therapy: left adrenal gland 19.4 mm long, 5.4 mm thick, right adrenal gland 18.1 mm long, 6.1 mm thick) than before mitotane therapy (median before therapy: left adrenal gland 23.6 mm long, 8.3 mm thick, right adrenal gland 21.6 mm long, 8.1 mm thick). Statistical evaluation showed a significant reduction in size. But ultrasonographic measurement of adrenal gland size is not useful in the evaluation of adrenal reserve during mitotane therapy. Inadequate adrenal reserve was not identified and adrenal size measurement by ultrasonography was not helpful to differentiate adequate and inadequate control of adrenal cortisol secretion during mitotane therapy.     

Ultrasonographic Adrenal Gland Measurements in Healthy Yorkshire Terriers and Labrador Retrievers

An upper threshold of 7.4 mm for maximal adrenal gland diameter is commonly used to detect pituitary‐dependent hyperadrenocorticism ultrasonographically in dogs. There is a substantial overlap between adrenal gland diameter of healthy dogs and of those with pituitary‐dependent hyperadrenocorticism. The aim of this study is to determine the measurements of both adrenal glands, in particular, of the height at the caudal glandular pole in a longitudinal plane, in the Labrador retriever and Yorkshire terrier, two breeds widely represented in the population suspected of hyperadrenocorticism. Seventeen Labrador retrievers and 24 Yorkshire terriers considered healthy were included in the study. Adrenal gland measurements were taken on static images and comprised in measurements of the length in a longitudinal plane (L), of the height at the cranial (CrHLG) and caudal pole (CdHLG) in a longitudinal plane and in a transverse plane (CrHTR and CdHTR, respectively), and of the width at the cranial and caudal poles in a transverse plane (CrWTR and CdWTR, respectively). This study established new upper thresholds for the left and right height at the caudal pole measured in a longitudinal plane: 7.9 mm (left) and 9.5 mm (right) for the Labrador retrievers and 5.4 mm (left) and 6.7 mm (right) for the Yorkshire terriers. All the measurements were significantly different between the two breeds. There was a significant relationship between CdHTR and CdHLG, and the age of the dogs for both breeds.     

Long-term outcome of domestic ferrets treated surgically for hyperadrenocorticism: 130 cases (1995-2004)

OBJECTIVE: To determine the long-term survival rate and factors that affect survival time of domestic ferrets treated surgically for hyperadrenocorticism. STUDY DESIGN: Retrospective case series. ANIMALS: 130 ferrets with hyperadrenocorticism that were treated surgically. PROCEDURES: Medical records of ferrets surgically treated for hyperadrenocorticism were reviewed. Data recorded included signalment, duration of clinical signs prior to hospital admission, CBC values, serum biochemical analysis results, anesthetic time, surgical time, concurrent diseases, adrenal gland affected (right, left, or both [bilateral]), histopathologic diagnosis, surgical procedure, caudal vena caval involvement (yes or no), postoperative melena (yes or no), days in hospital after surgery, and whether clinical signs of hyperadrenocorticism developed after surgery. RESULTS: 130 ferrets were entered in the study (11 of 130 ferrets were admitted and underwent surgery twice). The 1- and 2-year survival rates were 98% and 88%, respectively. A 50% survival rate was never reached. Combined partial adrenal gland resection with cryosurgery had a significantly negative effect on survival time. No other risk factors were identified. Survival time was not significantly affected by either histopathologic diagnosis or specific affected adrenal gland (right, left, or bilateral). CONCLUSIONS AND CLINICAL RELEVANCE: Ferrets with adrenal gland masses that were treated surgically had a good prognosis. Survival time of ferrets with hyperadrenocorticism undergoing surgery was not affected by the histologic characteristic of the tumor, the adrenal glands affected (right, left, or bilateral), or complete versus partial adrenal gland resection. Debulking was a sufficient surgical technique to allow a favorable long-term outcome when complete excision was not possible.     

Leuprolide acetate treatment of adrenocortical disease in ferrets

OBJECTIVE: To determine the effects of leuprolide acetate, a long-acting gonadotropin-releasing hormone analog, in ferrets with adrenocortical diseases. DESIGN: Case series. ANIMALS: 20 ferrets with adrenocortical disease diagnosed on the basis of clinical signs and plasma sex hormone concentrations. PROCEDURE: Ferrets were treated with leuprolide (100 microg, IM, once), and plasma hormone concentrations were measured before and 3 to 6 weeks after treatment. RESULTS: Leuprolide treatment resulted in significant reductions in plasma estradiol, 17 alpha-hydroxyprogesterone, androstenedione, and dehydroepiandrosterone concentrations and eliminated or reduced clinical signs associated with adrenocortical disease. Decreases in vulvar swelling, pruritus, and undesirable sexual behaviors and aggression were evident 14 days after treatment; hair regrowth was evident by 4 weeks after treatment. The response to treatment was transitory, and clinical signs recurred in all ferrets. Mean +/- SEM time to recurrence was 3.7 +/- 0.4 months (range, 1.5 to 8 months). CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that leuprolide can be safely used to temporarily eliminate clinical signs and reduce sex hormone concentrations in ferrets with adrenocortical diseases. However, the safety of long-term leuprolide use in ferrets has not been investigated, and the long-term effects of leuprolide in ferrets with nodular adrenal gland hyperplasia or adrenal gland tumors are unknown.     

Histo-anatomical studies on the accessory reproductive glands of the Anatolian souslik (Spermophilus xanthoprymnus) (Mammalia: Sciuridae)

In this study, the histo-anatomy of the accessory reproductive glands of the Anatolian souslik (Spermophilus xanthoprymnus) is investigated, using 102 males of the vouchers which were captured from central Anatolia and eastern Mediterranean regions. Averages of measurements taken from each part of the accessory reproductive glands were as follows: length of vesicular gland [right: 3.96 (+/-0.48) mm; left: 3.70 (+/-0.55) mm]; prostate gland [length: 2.55 (+/-0.38) mm; width: 2.63 (+/-0.45) mm]; length of bulbourethral gland [right: 2.32 (+/-0.33) mm; left: 2.37 (+/-0.39) mm], and the length of the pars pelvina of the urethra was 12.31 (+/-0.76) mm. Histological sections showed that vesicular gland was composed of typically branched tubulo-alveolar glands. As the fibrous connective tissue that was found among alveoles in the prostate was dense and relatively common, only few tubulo-alveolar glands occurred. The bulbourethral gland (Cowper's gland) was a tubulo-alveolar gland with a large and serrated lumen and septa between the alveoles consisted of dense fibro-muscular fibres.     

Ultrasonographic measurement of the adrenal gland-to-abdominal aortic ratio as a valuable method of estimating normal adrenal size in rabbits

A wide range has been reported for the ultrasonographic measurements of the normal adrenal gland in rabbits. Therefore, having sufficient information about the normal measurements of the adrenal gland and their relationship with indicators such as weight, sex and the diameter of the internal abdominal aorta will be of great help in diagnosing diseases of the adrenal gland. In the present study, 21 healthy adult intact rabbits were selected. The abdominal cavity of the animals was examined using ultrasound; adrenal gland parameters such as length, width, height, circumference and area on the right and left sides were measured in both sagittal and transverse planes. Additionally, the diameter of the abdominal aorta in the sagittal plane was imaged. After statistical analysis, the parameters of the adrenal glands on the right and left showed a positive significant correlation with the weight and the diameter of the abdominal aorta, although no significant correlation was found between these parameters and sex. The ratio of adrenal gland parameters to abdominal aortic diameter was calculated and the statistical analysis of the values showed that, except for the ratio of left adrenal area to aortic diameter, the other ratio of adrenal gland parameters to abdominal aortic diameter was not significantly related to weight. Therefore, these ratios can be used as suitable indicators for assessing the change in size of the adrenal gland of rabbits of different sizes. Knowing the relationship between normal adrenal measurements and the indices such as weight, sex and diameter of the abdominal aorta can help clinicians and researchers evaluate the changes in the size of the adrenal gland.     

NORMAL CANINE PEDIATRIC GASTROINTESTINAL ULTRASONOGRAPHY

The normal sonographic appearance of the adult canine gastrointestinal tract has been described. Interpretation of abdominal ultrasonographic findings in puppies is difficult due to the lack of information on normal ultrasonographic findings. The gastrointestinal tract, jejunal lymph node size and the presence and appearance of abdominal fluid were investigated in 23 normal, 7–12-week-old Beagle puppies. The duodenal wall thickness was greater than in other parts of the gastrointestinal tract (mean 3.8 ± standard deviation [SD] 5 mm, range 3.2–4.8 mm). The mean stomach wall thickness was 2.7 ± SD 0.4 mm (range 2.2–3.7 mm), the mean jejunal wall thickness was 2.5 ± SD 0.5 mm (range 1.2–3.4 mm), and the mean colonic wall thickness was 1.3 ± SD 0.3 mm (range 0.7–2.0 mm). In addition, mean duodenal and jejunal mucosal layer thicknesses measured 2.7 ± SD 0.5 mm (range 2.0–3.8 mm) and 1.5 ± SD 0.4 mm (range 0.6–2.5 mm), respectively. Homogenous, hypoechoic jejunal lymph nodes were easily found and the mean thickness was 7.1 ± SD 2.2 mm (range 1.5–12.5 mm). A mild amount of anechoic free peritoneal fluid was present in all puppies.     

CHANGES IN ULTRASONOGRAPHIC APPEARANCE OF ADRENAL GLANDS IN DOGS WITH PITUITARY-DEPENDENT HYPERADRENOCORTICISM TREATED WITH TRILOSTANE

Trilostane, a 3beta-hydroxysteroid dehydrogenase inhibitor, has been used successfully over the last few years for the treatment of canine pituitary-dependent hyperadrenocorticism. In a prospective study of 19 dogs with pituitary-dependent hyperadrenocorticism, the adrenal glands were measured before and at least 6 months after initiation of trilostane therapy. Right adrenal gland length and caudal pole thickness and left adrenal gland caudal pole thickness increased significantly (p < or = 0.05); there was no significant change in left adrenal gland length. Enlargement of adrenal glands during trilostane therapy may occur as a result of suppression of the negative feedback mechanism affecting cortisol production.     

MAGNETIC RESONANCE IMAGING OF THE PRESUMED NORMAL CANINE ADRENAL GLANDS

Forty-three dogs without evidence of endocrine disease that underwent spinal or abdominal magnetic resonance imaging (MRI) for clinical reasons were studied. Because the procedures were not optimized for inclusion of the adrenal glands, they were not always visible in all planes. Eighty-five of the 86 adrenal glands were seen and only the left gland in a 6-month-old Irish wolfhound could not be found. The right adrenal gland lay cranial to the left in all of the animals in which both glands were seen. The best landmarks for localization of the glands were vascular; both adrenal glands were always cranial to the ipsilateral renal vessels and in the region of the celiac and cranial mesenteric arteries. Various measurements were made on all the available scan planes. In some dogs the whole adrenal gland was difficult to visualize clearly, and this hindered the measuring process, especially when the right adrenal gland was in close contact with the caudal vena cava. The adrenal glands were mainly linear in shape but also had a variable degree of modification of their poles, especially the cranial pole of the right adrenal gland, which tended to be consistently wider and to present different shapes (rounded, arrowhead, inverted P, hook-shaped, triangular, or dome-shaped). Two main patterns of signal intensity were seen on fast spin echo (FSE) sequences (T2-weighted, T1-weighted, and T1-weighted after administration of a paramagnetic contrast medium): homogeneous and hypointense to surroundings or a corticomedullary type pattern with a hyperintense central area surrounded by a hypointense rim of tissue. The outline of the left adrenal gland was always very clear. The clarity of outline of the right adrenal gland was more variable, especially if it was in contact with the liver or the caudal vena cava. It was felt that the amount of retroperitoneal fat was not as important as stated in the human literature for visualization of the adrenal glands and that with an appropriate selection of scan planes and pulse sequences good assessment of the adrenal glands can be performed with MRI in canine patients.     

RETROSPECTIVE REVIEW OF THE ULTRASONOGRAPHIC FEATURES OF ADRENAL LESIONS IN 21 FERRETS

Clinical signs and follow-up information were recorded. Histopathologic diagnoses were obtained for 25 adrenal glands in 21 ferrets. Adrenal lesions included ten adenocarcinomas, nine adenomas, one hyperplasia and one cortical cyst. Four adrenal glands (all right-sided) were diagnosed as unspecified adrenal tumors but lacked a definite histopathologic diagnosis (adenoma vs. adenocarcinoma) due to incomplete surgical resection and consequent small sample sizes. Bilateral adrenal lesions were identified in 4 ferrets (19%). Adrenal shape, size, echogenicity, laterality, and the presence of vascular invasion were evaluated with ultrasound. Size and shape were variable and not specific to lesion type. Both benign and malignant adrenal tumors (adenomas, adenocarcinomas) appeared most often as masses with increased thickness and a normal length (11/23), less frequently as larger masses with increased thickness and length (4/23) or as nodules focally deforming the normal adrenal shape (6/23). The only cortical cyst appeared as a nodule. Three adrenal glands had a normal size and shape and were diagnosed as adenomas (2) or hyperplasia (1). Therefore treatment may be warranted based solely on clinical signs if adrenal glands are ultrasonographically normal. Vascular invasion was not identified ultrasonographically. However, focal absence of periglandular fat resulting in contact of 8 adrenal glands with either caudal vena cava (6), aorta (1) or liver (1) identified ultrasonographically, correlated with incomplete surgical resectability (6/8) and histopathologic diagnoses of carcinoma (4/8) or unspecified tumors (4/8). Therefore, a focal absence of periglandular fat between the adrenal gland and the large vessels or liver, deviation or compression of the large vessels by the adrenal lesion may indicate malignancy. Adrenal tumors (benign and malignant) were often associated with a prominent uterus, uterine stump or prostate with or without prostatic cysts.     

Surgical treatment and long-term outcome of ferrets with bilateral adrenal tumors or adrenal hyperplasia: 56 cases (1994-1997).

OBJECTIVE: To determine signalment, clinical signs, concurrent diseases, response to surgical treatment, and long-term outcome of ferrets with bilateral adrenal tumors or adrenal hyperplasia. DESIGN: Retrospective study. ANIMALS: 56 ferrets with bilateral adrenal tumors or adrenal hyperplasia confirmed histologically following subtotal bilateral adrenalectomy. PROCEDURE: Medical records of all ferrets with bilateral adrenal tumors or hyperplasia examined between 1994 and 1997 were reviewed. Ferrets underwent a subtotal bilateral adrenalectomy or a unilateral adrenalectomy initially, followed by a unilateral subtotal adrenalectomy when tumors or hyperplasia later developed on the contralateral adrenal gland. A long-term follow-up of a minimum of 18 months after final adrenal gland surgery was obtained by examination of medical records and follow-up telephone conversations. RESULTS: Clinical signs of hyperadrenocorticism included bilaterally symmetric alopecia, return to male sexual behavior in castrated male ferrets, or swollen vulva in spayed female ferrets. Surgical treatment of bilateral adrenal disease by subtotal bilateral adrenalectomy (or unilateral adrenalectomy followed by contralateral unilateral subtotal adrenalectomy) was effective with a mortality rate of < 2%. Only 3 (5%) ferrets required glucocorticoid or mineralocorticoid replacement following subtotal bilateral adrenalectomy. Recurrence after bilateral adrenalectomy was 15% with a mean long-term follow-up period of 30 months. CONCLUSIONS AND CLINICAL RELEVANCE: Bilaterally symmetric alopecia, return to male sexual behavior in castrated male ferrets, or swollen vulva in spayed female ferrets are indicative of adrenal tumors or adrenal hyperplasia in ferrets. Surgical treatment of bilateral adrenal disease by subtotal bilateral adrenalectomy is effective, with a low rate of complications and postoperative recurrence rate.