From:
pjdutche
Date: 2002-05-07 18:56:00 UTC
Subject: Re: the value of some medical procedures on your sick
ferret
--- In Ferret-Health-list@y..., "cuteusbelleus" <cuteusbelleus@y...>
> i see the test valuable as a diagnostic tool, but ongoing every
> two weeks deal as some owners promote, i don't agree. The stress
> to some ferrets outweighs the benefit ( which i don't see, as
> prednisone can't be regulated as effectively as insulin is
> following a blood test, for example)
While it is definitely true that blood sugars need to be followed
extremely closely to give proper insulin doses to diabetics, I
personally think it is very important to also follow blood sugars for
insulinoma ferrets. I seem to have a special curse for having
ferrets with insulinoma: 100% of my current and former ferrets except
for two that are quite young now.
In the beginning, I did as most do: surgery followed by meds, with
vet re-checks as symptoms warranted. It worked OK for the most
part. Then my beloved Sonic had the rare complication of becoming
diabetic while on pred and diazoxide for her insulinoma; one day I
received a phone call that her blood sugar on her latest bloodwork
was over 500. One frustrating thing about diabetes in a formerly-
insulinomic ferret is that it *looks* a great deal like worsening
insulinoma signs. Weakness, lethargy, stumbling, etc. It is very
tempting to just say, "blood sugar seems low, increase the meds."
That would be very bad if the ferret has swung to the other end of
the blood sugar spectrum... I have corresponded with several others
who have had their ferrets go through this (some on only pred
and not also diazoxide), and tragically, they do not all survive. I
don't know if it is a rare complication to the meds or some
underlying pancreatic (or other) problem or a combination of factors,
but I do know I wish I had caught Sonic's diabetes earlier. She
lived, but it was a very difficult time.
Anyway, regulating Sonic's blood sugar after that was a challenge
(high then low then high then low, etc), and I learned to check it at
home. I am currently keeping track of blood sugars on four
insulinomic ferrets and correspond with my vet about medication
changes, etc, given what is found. I don't even have to quick nails
now; I am able to get enough blood for the Freestyle meter by using
the lancing device on a toe pad. With ferretone distraction, they do
not even flinch. It is definitely NOT stressful in the least, and
once the technique is down (took awhile to get a good success rate,
and there are little tricks to it), it only takes a minute or so from
start to finish. The payoff is the ability to easily test those
blood sugars when the fuzzies are looking low in addition to
flexible "scheduling" of fasting tests. Is it as accurate as a test
run on a big machine in a vet's office? Probably not, but it surely
gives me the trend data I am looking for.
My long-term insulinoma guy Mojo has recently come to a time where
suddenly he was really slipping very quickly; his old pred dose had
held for many, many months, and we suddenly need to more than double
it over the span of only 45 days or so to keep him in the low normal
range. We have added diazoxide and been able to drop the pred back a
bit and it seems to have stopped the downslide for now. Without
careful blood sugar monitoring, we'd be doing a lot of guessing.
Also, he now has some other problem causing lethargy. I have more
than once been convinced I'd get low blood sugar readings lately
because of how he looks only to be surprised to get numbers in the
90's.
Please don't get me wrong; I'm not saying that all insulinoma
ferrets need to be tested every x days or weeks on any rigid
schedule. But I do think that it is important to base medication
changes on real blood sugar values, and it is certainly quite normal
to need to increase doses of meds during the course of this disease.
Home testing is just a way for me, a layperson, to collect data that
my vet can use to make decisions about those meds. I still take my
ferrets in for exams and other tests often; home testing does not
take the place of a real exam by my wonderful vet. It is not right
for everybody, but it can work for some, especially perhaps those of
us with a particular interest in this stuff who also happen to be owned by multiple ferrets with insulinoma... My vet is actually the one who suggested I start testing at home. Certainly everyone owned by an insulinomic ferret must figure out what works best in their situation (schedule, vet's preference, ferret's personality, etc).
Best wishes to all,
-Pam S.