Date: 2001-04-10 20:12:00 UTC
Subject: When to do surgery for insulinoma
My ferret Mackenzie is just turned 7 and was diagnosed with
insulinoma a couple of weeks ago with a fasting blood sugar of 46.
She is otherwise a healthy girl and my vet considers her a good
candidate for surgery. However, he wanted to try to get her blood
sugar stabilized first. He has only operated on a couple of
hypoglycemic ferrets whose blood sugar he couldn't get under
control. We started her on pediapred .4cc (about 1 mg/kg) twice
daily. I didn't notice any difference in her, and was not surprised
when one week later, her blood sugar (fasting) was unchanged at 47.
So we increased to .8 cc ( About 2 mg/kg) twice daily. It's been
about 4 days and I still notice no change, so I have empirically
increased to 1 cc/day today. Her next appointment is in 3 days for a
blood sugar check. I am assuming his next step will be proglycem.
From what I have read so far, it doesn't seem like increasing the
prednisone much more will be of benefit.
I was wondering if anyone has any opinions on whether it is
worthwhile to continue trying to get her blood sugar under control
medically, or if it is better to do surgery as soon as possible.
Given how resistant she is to the prednisone, is there a good chance
she will be relatively resistant to the proglycem? That stuff is so
expensive (not that I wouldn't pay for it to help my ferret), but I
really don't want to be wasting my time or money.
Also, Mackenzie's symptoms are anorexia, teeth grinding, and a slight
clumsiness in the hind legs. She is and has been on carafate for the
last 4 weeks, so we are not thinking ulcers anymore. And my vet
thinks she is doing remarkably well for a blood sugar in the 40's. I
have received many helpful responses to my question on what to feed
her--thanks everyone!--and right now she is doing great on a mixture
of chicken baby food with a bit of Hills A/D and some ferretone. She
eats it off my fingers without a fuss and has even gained 1/2 lb. So
as of now, there isn't really any clinical urgency to change
management. I just want to know if I should push to do surgery
sooner rather than later when she might be sicker.
Kristy and Mackenzie