From:
dr_bruce_williams
Date: 2001-12-25 22:19:00 UTC
Subject: Re: requesting info from vets/ferret owners for my vet
--- In Ferret-Health-list@y..., "moxie4192" <moxieent@t...> wrote:
> Hi, I'm doing some research for my vet who will be performing
> insulinoma surgery on my 3 year old Chance in January. He has done
a
> ton of adrenals but has limited experience with pancreas surgery.
> He would like to know what to do if no nodules are visible, should
he
> close and try again at a later date? He mentioned he experienced a
> problem with leakage (I believe he used this term) after removing
> nodules and infection set in afterwards. Any suggestions on how to
> avoid infection? How long should a ferret fast prior to surgery
and
> is there a waiting period after surgery? I think I recall
something
> on this list about that but couldn't locate it. Any tips I can
pass
> along to my vet will be appreciated. He has read the
Weiss/Williams
> article. Also, what is the initial dose of pred after insulinoma
is
> diagnosed? I'm only giving Chance .1 once a day. His blood
glucose
> was 52 last time we tested. He seems to be doing o.k.
Dear Moxie:
My general recommendation is that if no nodules are visible, then a
partial pancreatectomy should be performed - that will take care of
the problem in 50% of the cases, and the post-surgical disease free
interval is longer than nodulectomy.
Infection is generally not a problem - your vet may be concerned
about inflammation and post-surgical peritonitis, but this is really
not a major concern if technique is good and excision is precise
(usually these nodules just shell out very nicely.)
Fasting should be 3-4 hours, tops, and dextrose can be given at
surgery in very hypoglycemic animals.
The appropriate dose of prednisone is the one that keeps the blood
glucose at a level that no clinical impairment is noted. (Note that
I did not say blood glucose is in the normal range, as this can be
difficult to acheive. 0.1 ml is pretty low, and a BG of 52 can be
worrisome - I might double it and see where that takes the glucose.
If you can get the glucose over 60, then that would be appropriate.
With kindest regards,
Bruce Williams, dVM