From:
Bruce Williams, DVM
Date: 2001-04-20 19:40:00 UTC
Subject: Re: Follow up Mackenzie's insulinoma surgery
--- In Ferret-Health-list@y..., macdoodle99@y... wrote:
> Hi, I thought I would just post a quick note to follow up on my
> ferret Mackenzie's insulinoma surgery. The path came back as
> metastatic islet cell carcinoma. Someone recently posted about
their
> ferret also having this and apparently it is rare, but here is
> another one. In this case, actually the "pancreatic mass" turned
out
> to be hyperplasia--so not the original tumor. But the liver lesion
> and the mass on the intestines was the metastatic carcinoma.
> Regardless of whether the original tumor was removed or not, the
> prognosis I believe is the same since my vet could not excise the
two
> metastatic lesions, but debulked them.
>
> Mackenzie had a normal exam and lab work including glucose about 4
> weeks prior to symptoms. 4 weeks after symptoms started she
> underwent surgery and had the three tumors and lots of other bad
> stuff. This definitely is a very aggressive carcinoma.
>
> She continues to grind her teeth. Which I now feel is unrelated to
> hypoglycemia as her blood sugars have remained in the 100's
(although
> falling). I believe it is abdominal pain. Which would mean that
she
> may never have even been symptomatic from her blood sugars in the
> 4o's. Her only symptoms really were anorexia and teeth grinding,
> which persist despite normal blood sugars.
>
Once again, I'm going o be a cynic about the pathologic diagnosis.
You say that the pancreatic lesion was not an islet cell neoplasm,
but hyperplasia, and that MacKenzie has no evidence of
hyperglycemia.
Your description of the widespread tumors does indicate a malignancy,
which may be an adenocarcinoma of some other origin.
This may seem like a small issue, but when we try to get prognostic
information on various neoplasms, such as the extremely rare
metastatic islet cell tumor, we need to be extremely sure that the
diagnosis is valid.
> And now that leaves me just trying to figure out how miserable is
> she? And when do I end her suffering? Aside from the teeth
grinding
> and weakness just after surgery, she is eating and is so healthy
> appearing. Unlike my other pets who were old and fragile and
clearly
> declining when I euthanized them, Mackenzie is a picture of good
> health. It is so difficult and heart breaking.
>
Have you treated her for a gastric ulcer - this is not uncommon after
surgery and can easily explain the teeth grinding....
With kindest regards,
Bruce H. Williams, DVM, DACVP
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