From:
Bruce Williams, DVM
Date: 2001-03-18 22:04:00 UTC
Subject: Re: Another High? Glucose question
--- In Ferret-Health-list@y..., "Debi Christy" <ferrets1st@f...>
wrote:
> I go away for a few days & you guys come up with all sorts of
thought
> provoking things....
>
> On the high glucose topic:
>
> I've got an 8-year old late-neutered, distemper survivor male,
> Pippen, that turned up a glucose level of 487. By the seemingly
> obvious symptoms, stumbling & nausea, we first thought insulinoma
but
> he was also more active than usual rather than lethargic so we did
a
> glucometer test at home, which was later confirmed by the vet with
a
> CBC & urine test to be diabetic.
>
> This ferret has never had insulinoma (or adrenal) symptoms, so we
> were somewhat surprised. We started him on insulin and over a
period
> of weeks his glucose levels came down to 100-110 where it stablized
> for a couple of weeks, then suddenly (in a 3-4 day period) dropped
to
> 45. We discontinued insulin and gave Pediapred to bring glucose
back
> up. He is now fairly stable in a range of 124 to 134 without
insulin
> to keep it down or pred to keep it up.
>
> The first question: Was this just an incidental pancreas
inflammation
> that may or may not return rather than actual diabetis?
>
> Second: Given this history, at what high glucose level should we
> worry about resuming insulin, or is it likely that it will happen
> again?
Dear Christy:
This one is not making much sense to me - spontaneous diabetes
doesn't usually come and go, unless it is drug-induced or the result
of temporary insulin lack following insulinoma surgery.
Pancreatic inflammation doesn't result in diabetes - diabetes is
ither the lack of production of insulin by the islet cells of the
pancreas, or end-organ resistance to insulin. In interesting cases
such as this, an insulin test would be interesting to see if insulin
was being produced or not.
Given this unusual history, it is very difficult to say if and when
diabetes will occur. I consider a consistent 180+ to be evidence of
glucose derangement, and suggestive of diabetes. 180 is a good
level, as it is the level when glucose can first be picked up in the
urine - 180 exceeds the kidney's ability to reclaim the glucose.
180 is probably too low to try to play with insulin - there is too
much chance to induce hypoglycemia at this level - but it will give
you an idea to start watching closely for continued elevation of
glucose. AS the glucose passes about 250 - then you should start
looking at insulin again.
With kindest regards,
Bruce H. Williams, DVM, DACVP
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