In ferrets with hyperadrenocorticism, does use of deslorelin acetate implants compared to adrenalectomy result in a superior prognosis?

Megan Ballman

doi:10.18849/ve.v6i4.459

Abstract

PICO question In ferrets with hyperadrenocorticism, does use of deslorelin acetate implants compared to adrenalectomy result in a superior prognosis?  Clinical bottom line Category of research question Treatment The number and type of study designs reviewed One study was reviewed, a retrospective cohort study that directly compared the outcomes of these treatments Strength of evidence Weak Outcomes reported The study found that in ferrets with hyperadrenocorticism, use of deslorelin acetate implants resulted in a longer average time to recurrence of clinical signs and a lower mortality rate than adrenalectomy. However, the strength of evidence for this study is weak and it has several design limitations Conclusion In view of the evidence, both deslorelin acetate implants and adrenalectomy are valid treatments for a ferret with hyperadrenocorticism, but it cannot be concluded based on the current literature that deslorelin acetate implants result in a superior prognosis  How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care. 

Highlights

Adrenalectomy surgery was defined as complete removal of the left gland alone and/or subtotal removal of the right gland
Ferrets were not included if they received surgery and medical therapy simultaneously, or if they were euthanised soon after surgery for problems not related to adrenocortical disease (ACD) or ACD surgery
The study by Lennox & Wagner (2012) found that post-treatment, the medical group had superior outcomes, including numerically a longer time to recurrence of clinical signs than the surgical group (16.5 months vs 13.6 months). This is similar to a study in which 30 ferrets with HAC were given 4.7 mg deslorelin acetate implants and the average time to return of clinical signs was reported as 17.6 months (Wagner et al, 2009)

Summary

KNOWLEDGE SUMMARY

PICO question In ferrets with hyperadrenocorticism, does use of deslorelin acetate implants compared to adrenalectomy result in a superior prognosis?. The strength of evidence for this study is weak and it has several design limitations Conclusion In view of the evidence, both deslorelin acetate implants and adrenalectomy are valid treatments for a ferret with hyperadrenocorticism, but it cannot be concluded based on the current literature that deslorelin acetate implants result in a superior prognosis. How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. The strength of evidence for this PICO is very low and further studies are required before any recommendations can be made

Summary of the evidence

Search Strategy

Findings

Intellectual Property Rights