From:
Sheila Sykes
Date: 2001-03-07 17:11:59 UTC
Subject: RE: prednisone-diazoxide questions
From: "Sheila Sykes-Gatz" <sheilasykes@h...>
To: mjanke@m...
CC: ferret-health-list@yahoogroups.com Save Address
Hello Mike,
Thank you so much for your very quick response. Your
information is very
helpful and we will present it to our vet so he can
begin medicating with
Lupron for adrenal disease. We would be very grateful
if you could help us
with some questions about prednisone and diazoxide. We
are in a rather
desperate situation for help.
Surgery to remove insulinoma tumors on our now 7 year
old male ferret was not
performed due to the late stage of diagnosis. Instead
we medicated with
Prednisone one time per day (since April 2000). We
might have reached the
maximum benefit that Prednisone can offer at
approximately 3.12mg/day (he
weighs approx. 1 1/2kg). In February we found it
necessary to increase the
dose from 2.5mg/day to 3.12mg/day within a 10 day
period. This is the
largest increase given in such a short period of time.
When does Prednisone
(at what dosage) become ineffective or/and harmful? We
have conflicting
reports of how much to offer before it becomes
ineffective. Do you have any
further suggestions for the administration of
Prednisone (e.g. offering
Prednisone twice daily instead of once & how much)?
We tried a trial small diazoxide dosage of 3.13mg
(Proglycem 25-powder from
a capsule) in Feb. (in the a.m. & in addition to
Prednisone) and his
insulinoma symptoms grew severely worse throughout the
day and into the
early evening. In addition he acted like he would
vomit & had very soft
stool. Overnight he bounced back. Our vet suggested
that we not use the
diazoxide and increase the Prednisone, although its
losing its effect.
What dosage of diazoxide should be offered per day (we
have conflicting
suggestions)? We were aware of diazoxides side
affects, although they
seemed to intensify his insulinoma problems (and maybe
his adrenal problems
too). Does our ferret have to go through these bad
side-effects created by
diazoxide (which seem to make his symptoms dangerously
worse) and how
intense of side-effects before the drug will work
positively for him? Could
diazoxide react negatively with his adrenal disease or
future Lupron
medications? Until advised otherwise, we will medicate
only with
Prednisone.
Thank you again,
Sheila
sheilasykes@h...
--- Mike Janke <mjanke@m...> wrote:
> Adrenal disease is routinely diagnosed
> symptomatically, though some
> people opt to have an "adrenal panel" run by the
> University of
> Tennessee in questionable cases. Ultrasound and
> x-rays are rarely
> helpful. In my experience, if it "looks like a duck,
> quacks like a
> duck and walks like a duck..."
>
> It does sound as if your ferret has adrenal disease.
> If you're
> interested in having this adrenal panel testing
> done, you can find a
> couple links with information on where to send the
> sample and how to
> send it to the U. of Tenn. on my website at
> http://www.miamiferret.org/fhc. I don't know if it's
> something that
> could be done from Germany unless sent in an
> expeditious manner.
>
> Serum cortisol levels are rarely elevated in ferrets
> with adrenal
> disease and Cushings is something I've never heard
> of occuring in
> ferrets. One of the vets here may wish to comment
> on this, but I'd
> have to say that it's rare enough that it doesn't
> even need to be
> considered.
>
> I know of no adverse reactions if Lupron is given in
> combination with
> prednisone. I have one ferret that has been
> receiving both of these
> drugs for a year or more now and there has been
> absolutely no
> problem. I also know of no side effects of Lupron
> usage. One vet
> reported reddening around the injection site for a
> few days, but that
> rapidly cleared and this is the only reaction I've
> heard of. Lupron
> usage is relatively recent, so we don't know what
> the long term
> effects are.
>
> Keep in mind that Lupron is not a cure. It simply
> works to eliminate
> the symptoms while the adrenal tumor most likely
> still grows. Surgery
> is still the best option, if the ferret is a good
> surgical candidate.
>
> As for Lupron dosage... I believe Dr. Weiss
> recommends 500mcg of the
> one month depot or 2000mcg of the four-month depot.
> I have had
> excellent results with as little as 150mcg of the
> one month depot in
> a 1.3kg ferret.
>
> Mike
>
>
>
>
>
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