From:
dr_bruce_williams
Date: 2002-03-11 19:11:00 UTC
Subject: Re: insulinoma metastasis?
--- In Ferret-Health-list@y..., "- Z -" <regina_z@h...> wrote:
> Hello all,
>
> On Friday, Amelia (7.5 y.o., insulinoma for the last year and five
months)
> had an echocardiogram to check out a heart murmur. The good news
was that
> although one of the left ventricular walls was slightly thickened,
the rest
> of the heart is compensating and no medications are recommended at
this
> time. The bad news was:
>
> --cranial thoracic mass which is already large enough to be putting
pressure
> on one of her lungs.
>
> --enlarged lymph nodes
>
> --elevated liver enzymes and bilirubins (sorry I don't have exact
enzymes
> and numbers, probably the usual two enzymes)
>
> --confirmation of what I suspected, her remaining adrenal is acting
up
>
> --dehydration
>
> There was also a weight gain of about half a pound, which I don't
think is
> good because her previously swollen belly isn't any bigger and her
enlarged
> spleen has remained about the same. My vet felt that we could not
> accurately aspirate Amelia's lymph nodes due to the fat surrounding
them,
> and that to do a biopsy for the thoracic mass would be a risky
procedure for
> Amelia. Her blood glucose was in the
> 30s, but the sample had been sitting for a few hours so her true
level was
> probably a bit higher than that (last couple of visits have been in
the
> 50s).
>
> I've been reading through the archives and various ferret health
websites
> out there, and to me it sounds like Amelia's insulinoma could have
> metastasized. Does this sound likely to those with far more
knowledge than
> I have, based on the limited information I've given? If so, what
can I
> expect to see now?
>
Dear Regina:
Well, she definitely has an insulinoma, but it hasn't metastasized -
in ferrets, they don't do that (contrary to what you see in the
literature.) Looked for them, tested some suspect ones - never seen
one. Not to say that it couldn't ever happen - I just wouldn't ever
offer it as a diagnosis.
Next, the mass in the thorax. Most likely cause in an older ferret
with a histroy of obesity would simply be an accumulation of fat in
the mediastinum - this would show up more from top to bottom view
(what we call a VD) than from the side.
The only elevated liver enzyme that I am really concerned about is
the bilirubin - but I need the actual value to comment.
Heart enlarged, adrenal acting up - she IS a 7.5 year old ferret.
With kindest regards,
Bruce Williams, dVM