Message Number: YG4113 | New FHL Archives Search
From: Karen Purcell, DVM
Date: 2001-05-29 19:54:00 UTC
Subject: Re: something besides insulinoma??


You wrote:
> I am looking for opinions on the following:
> Approx 4yr old non marshall spayed female presenting with some
> classic signs of insulinoma: glazed eyes, weakness in hind end,
> glucose of 23 after 6hr fast. ( Wouldn't that low a glucose be almost
> comatose? She was alert and active at the time of testing.)

Not if it gradually decreased, they adapt. (Amazing, aren't they?)
I've seen this several times.

> Diagnosis was, of course, insulinoma. Treatment begun with Pred.
> Seemed to respond well enough. 3 weeks after pred started, she
> rejected her food (did not change it, she just wouldn't eat it
> anymore) tried softening, warming, etc - still refused. Did get her
> to eat A/D mixed with Simulac and Ferretone thru a syringe for 2 days
> at 4 hour intervals. She started to eat the same on her own the 3rd
> day, and gradually went back to TF. Fine for 3 weeks, then refused
> her TF again. SAme ritual with the A/D, etc. Now eating just a/d
> with Ferretone with a great appetite. Still turning up her nose to
> anything else. I'm still hiding her Pred in the mix.
> Her stools a very loose, sometimes mucousy,and very foul smelling.
> They are light brown in color (about the same as the a/d before it's
> eaten) nothing dark or tarry, and no bright blood, either.
> She is gaining a little weight, and is more active than I have ever
> seen her - but I just got her in February, with no medical history,
> what so ever. Someone had just dropped her at a local "petting zoo",
> for lack of a better term - they actually do wonderful work there
> with unwanted exotics.
> We have a vet visit scheduled for next week for a repeat glucose, and
> a CBC. Nothing I have read seems to fit quite right, so I am kindly
> asking for opinions of what we may be facing. There has been no
> undo stress, restriction from food or water, no exposure to ECE, no
> forgien body gumming things up, no "junk food"... ( I realize that
> the simulac would cause runny stools, but that is no longer in the
> mix, and hasn't been for several days now - and she doesn't get but a
> drop or 2 of ferretone with her a/d) and even a day of no ferretone
> doesn't make a difference.
> Any thoughts, ideas, constructive critisms are more than welcome!!

I find that many of my insulinoma patients become finicky. I try
to increase the protein intake, decreasing any sugars/carbos. I also
try sucralfate before meals - there seems to be a minor stomach
sensitivity that responds to the sucralfate, without needing to do
the whole gastric ulcer therapy.
Hope this helps,
-Dr. Karen

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