A while back, someone wrote to me asking questions about Lupron. Through this exchange, I learned that a pharmacy and vet in the Midwest is promoting 24 hour Lupron with the claim that it is effective for one month. I was surprised to hear this and didn't believe this claim to be true, but since I'm not a vet or pharmacist, I thought it best that I do some research before disputing this claim.

I tried to get a better explanation from the vet and pharmacist prescribing this Lupron, to no avail. In their defense, I did not speak to them directly but through a second party. The only thing I knew was the claim that the 24 hour Lupron worked long term because of, "the way it attaches to the adrenal receptors." I was looking for a little more detailed explanation how this works for a period longer than 24 hours but was never offered any more than that.

I wrote to several vets I know and the response I got was that 24 hour Lupron works for 24 hours, period. That was appreciated but their response did not include any detailed explanation as to why it could not work as claimed.

I then contacted John Hines, who wrote, "Adrenal Disease and the Therapeutic Effect of Lupron." Since John studied the topic of Lupron usage, has a Ph.D. in Pharmacology and is a ferret lover, I felt I wouldn't find anyone more knowledgeable on the subject and definitely one with the credentials to offer an expert opinion.

First a brief layman's description (mine) of how Lupron works so some of John's comments might make a little more sense. Lupron desensitizes the pituitary gland and causes it to stop producing two hormones, LH (luteinizing hormone) and FSH (follicle-stimulating hormone). These two hormones (the primary problem is LH) stimulate the adrenal glands into producing sex hormones which cause the adrenal disease symptoms we see. This is an extremely basic explanation. There are many more details in John's paper.

My main question to John was, can 24 hour Lupron be effective in ferrets for adrenal disease treatment if used as a monthly dose? John's comments on the topic were as follows:

 "... if the Lupron is of the type that all enters the bloodstream in 24 hrs., (24 hr. Lupron) what you get is a few hours of high pituitary activity followed by only several HOURS of inactivity (desensitized). Then the 24 hr. Lupron is gone shortly thereafter, and the pituitary RE-sensitizes and LH release to the natural GnRH resumes probably in a day or so. If the ferret is only getting the 24hr. shot once a month, it's useless. In fact, the use of the 24 hr. Lupron probably makes the adrenal disease worse because you don't get much therapeutic effect, but you are still getting that initial high pituitary activity when the Lupron is first administered. This initial burst of pituitary activity is of little consequence when it is followed by cessation of pituitary activity. But, with the 24 hr. Lupron, you get only the initial burst of pituitary high activity -- followed by normal pituitary activity. It's like adding a splash of gasoline to a fire."

We had several discussions, particularly about the claim that the 24 hour Lupron works for a month or more because of "the way it attaches to the adrenal receptors" to which John responded:

 "I did notice in your earlier correspondence that the vet and pharmacist had described their Lupron as binding to 'adrenal receptors'. I can see how a drug that binds to the pituitary and impacts on the adrenals could be misconstrued as binding to the adrenals by the average person; however, if the pharmacist or vet actually said to her that "Lupron binds to adrenals", then that immediately is cause for concern as it demonstrates a fundamental ignorance about how the drug works."

"[pharmacist's name omitted] doesn't understand how Lupron works. He seems to know what its ultimate effect is, just not the mechanism. That's a shame, because he should know better than anyone. Leuprolide binds to receptors on the pituitary. The word "attach" could be misleading -- to some people it might imply a permanent joining of the leuprolide to the GnRH receptor, which is not the case. Leuprolide tightly associates ("binds") with the GnRH receptor, but it is a reversible process. It can dissociate ("unbind") as well."

I know that the vet offering 24 hour Lupron does a lot of good for ferrets and I understand the intent is to offer an affordable alternative for treatment of this all too common disease. Does 24 hour Lupron work in some cases? Several people have claimed that it does. What worries me, besides the fact that this type of Lupron may not work, is that after hearing John's explanation, realizing that there is also the chance it could make the condition worse.

The important message I want to get across is, ask questions, know what you are getting and what you are treating your ferret with. This applies to ANY treatment, not just one for adrenal disease. In this case, I was told by the person that contacted me that she was not told that what she was getting was 24 hour Lupron, only that it would work for a month or so. I am fairly certain that if the vet had been asked directly, "Is this 24 hour Lupron?" or "What formulation of Lupron is this?" the vet would have been honest and upfront. Vets (even human doctors) often don't give us all the information unless we specifically ask for it. So don't be afraid to ask. The type of Lupron that is a genuine, time-release formulation is called Lupron Depot.  This comes in three formulations: 1-month, 3-month and 4-month.

If 24 hour Lupron is something you want to try for whatever reason, this probably won't change your mind. Just be aware that you may see no results and in fact, may make matters worse.