From:
Kymberlie Barone
Date: 2001-03-11 22:36:00 UTC
Subject: Prednisone Use (long post)
This message was a reply to dbrn2@a... regarding Prednisone but is also a
more in-depth commentary on my feelings about the drug.
I, too, am not a vet though my vet has told me on several occasions I know
more about ferret medicine and treatments than many vets. I have been
running a ferret shelter since 1993, have owned ferrets since 1988, and have
learned a great deal over the years. In the past three years, I have rarely
needed to take a ferret to our vet anymore, as I can often diagnose and
treat here without the cost of veterinary visits. I use my vet for surgery,
blood tests, and for diagnosis when symptoms aren't the normal ones that
I've seen dozens of times before.
I have had at least three dozen cases of adrenal disease come through here,
easily that many insulinoma cases, as well as countless numbers of other
ailments. By all of this I do not mean to say I know anything for a fact and
I am not a vet as I stated. But experience has taught me a lot and I would
like to share.
I know that prednisone usage in the ferret community has been debated. The
reason for it is that many people have been comparing the effects of pred to
those that happen on people. Ferrets are not people and unlike people, they
tolerate prednisone wonderfully. The side effects that people experience do
not seem to happen to ferrets. The only problem that I know of for ferrets
on prednisone is that it apparently wears away the lining of the stomach and
gi tract, particularly if administered without food. However, the
deterioration is at such a slow rate that it should never cause harm to
ferrets, again, particularly if care is taken to give pred along with food
or to a ferret that is eating regularly. Pred is actually a blessing to me
because it causes the ferret's appetite to increase, thus increase their
food intake.
Prednisone is a miracle drug to me. We get so, so many ferrets into the
shelter that are insulinomic, have been ill for some time, but were never
diagnosed or treated. The number of elders that we take in is sickening. We
do everything that we can for them and never stop trying. I do my own
glucose testing here at the shelter, so an older ferret is routinely tested
upon coming to the shelter, and if found to be insulinomic, is started on
prednisone immediately. I always begin with .5 cc once a day, no matter what
the glucose level. Ferrets should respond within 24-48 hours after receiving
the first dose of pred. What I am looking for in these ferrets is an
increase of activity, appetite, and the alleviation of symptoms such as
hind-leg weakness, staring off into space, etc. If I don't see marked
improvement, I will up the dose to .5 cc 2x a day. I try not to go too high
on dosage too quickly because I max them at 1 cc 2x a day, won't give more
than that. I keep the dosage low so that when they eventually begin
exhibiting signs again, I can still increase the dosage and get more time
from the ferret. I did this with my ferret Koto, who began showing signs of
insulinoma at age 6, and she just passed away at age 9 1/2. I did not do
surgery on her until she was 8 1/2, and had maxed out on pred and proglycem
was making her wish she were dead (she hated the stuff).
I digress. Using my method of routine pred usage at the shelter has been
wonderful. I rarely ever have a ferret seize (maybe twice in two years). The
quality of life of these ferrets goes up amazingly when put on pred.
Scrawny, weak, unhappy ferrets become pudgy, bouncy, darling animals. I have
one girl here, Bonnie, who has been on pred for well over a year, .5 cc once
a day. I weaned her off of it (that's another story why, it was
experimental) and it was the worst thing I could have done. She began a
downhill spiral, stopped eating, I was going to lose her. I immediately put
her back on the prednisone (she was off of it for a few weeks) and the
change literally put tears in my eyes. Once again, she is eating like a
horse, and this ferret, at age 6, is more active than the youngest ferrets
here.
A while back, I spoke to my vet about using prednisone as a preventative to
shelter shock. So many older ferrets here come in and suffer
life-threatening cases of shelter shock - they can't handle the stress of
being pulled from their home and the changes in routines and the new smells
and sounds and people. Very often they end up needing to be hand-fed, given
sub q fluids, and we still were losing too many of these cases. My theory
was that because pred is a steroid, and because it increases appetite, why
not use it in low doses as a preventative to shelter shock. My vet gave her
blessing to try it and it worked. I give ferrets one day when they come in -
if they are eating healthily and show no signs of problems, I won't do it,
but if they do, I give them .5 cc once a day and then evaluate each ferret
case by case as to if/when to wean them off of pred. The ferret needs to
have a glucose test done prior to beginning this treatment, though, so you
know of any changes if/when you take them off of the pred.
So, my point here is that not only have I never had problems using
prednisone, it has given YEARS of extra life to several ferrets in my care,
and is now helping to save the lives of ferrets coming into the shelter that
aren't even insulinomic.
One disclaimer - prednisone usage should not routinely be used as a
replacement for surgery. If you have an insulinomic ferret that is in good
health and can withstand surgery, do it. Surgery will not cure a ferret of
insulinoma, but can give 1-2 years of symptom-free life, and once the
symptoms return, you can then use prednisone to treat the ferret for another
year or two (I have had ferrets gain this much extra time from diagnosis to
death, and usually the ferret dies from a host of problems related to old
age, not just insulinoma).
Specifically speaking to dbrn2@a..., however - it sounds to me as though
your ferret had other problems than adrenal disease and insulinoma. Adrenal
disease generally doesn't kill ferrets unless it is cancerous or if you are
speaking of a male ferret whose prostate enlarges, causing him to not be
able to urinate. You said that your ferret was seizing at the end, and that
would definitely be due to insulinoma. I still think that there were other
problems going on, as well. You mentioned that Charlie was under stress from
moving and a change in climate - this alone can kill a ferret. This can (and
often does) trigger insulinoma to kick in full-blown because their little
systems get out of whack. I have no idea what the first vet was telling you
by saying that your ferret had leukemia and I am not familiar with pred
being a treatment for leukemia. You said that you took Charlie off of
prednisone after three doses - I would suggest that you did not give the
drug enough time to work. I can completely understand why you attributed the
problems to the pred since he was not getting better, but worse, right after
starting him on it, but I think that they were unrelated. You should always
give prednisone with food, you didn't mention if you were told to do that,
but without it, your ferret may have been feeling nauseus and generally not
well, and that's the change in behavior that you were seeing. You mentioned
a slow chronic gi bleed - prednisone, as I mentioned above, will eat the
lining of the stomach and gi tract, so again, in the absence of food being
given with pred, this could have aggravated the condition. However, this
would not kill your ferret. Many ferret owners use carafate in conjunction
with prednisone, especially at first, to help coat the stomach and gi tract
to prevent ferrets from having trouble. If Charlie had ulcers, prednisone
without food or carafate would have also caused some internal bleeding -
again, not life-threatening. I don't know anything about this kind of
adrenal disease your vet was mentioning, I will leave it up to the vets on
this list to comment to whether your ferret truly died of it. From what you
mentioned, if the ferret were one in my shelter, I would say that the death
was caused by insulinoma, which was triggered by stress, and though you did
not mention food intake, I think that Charlie was probably not getting
enough to eat and he suffered seizures and death of a result.
I hope that I am not sounding uncaring toward your situation - I completely
sympathize and I am so sorry that this happened to you with your first
ferret. I lost my first ferret to insulinoma before I even had ever heard of
the disease. I didn't notice the symptoms of it until it was too late, he
was rushed to the vet, given fluids and prednisone among other things, and
was scheduled for surgery the next morning. He died overnight, we didn't get
to him in time. I truly am sorry for your loss. I only felt the need to post
this because I do not want you with your future ferrets to shy away from
prednisone should they be diagnosed with insulinoma. It really, truly is a
wonderful drug for ferrets.
A general comment to everyone - please, please have your ferret's blood
glucose level tested annually at the age of four and five, and every six
months thereafter. Insulinoma used to be a death sentence to me, and it no
longer is anymore, thanks to wonderful surgeons and prednisone. But time is
of the essence, don't wait until you see signs of insulinoma before
testing - it can be too late. If you treat the ferret before the onset of
symptoms, you truly can get many years of good life out of your insulinomic
ferret.
I welcome other thoughts and opinions!
Kymberlie Barone
Director, Pennsylvania Ferret Rescue Association of Montgomery and Chester
Counties
http://www.ferretrescue.com