From:
"Sue Liszewski"
Date: 2004-01-11 08:41:28 UTC
Subject: RE: [ferrethealth] Diabetic ferret
To: ferrethealth@smartgroups.com
Message-ID: <Law12-F1168FSA4AleL00003060@hotmail.com>
It is really hard to say how low to go when you don't have the clinical
signs of hypoglycemia to monitor (I mean since he remains lethargic, etc).
Based on what you have mentioned it is the tumor on the pancreas that is
wreaking havoc on his blood glucose levels. The goal is to get the blood
sugar to normal without the dramatic swings from very high to very low. I
think that since he is just starting on insulin I would watch closely and if
you are dropping this low this quickly then the insulin dose may be to high.
Since I don't know what type of insulin he is on or how often they plan on
having you give it its progression is difficult to asscess. If we go with
standard twice daily insulin admin then 6 hours should be the peak low and
he should start coming back up. If he starts to climb up after this level
that would be better if he is still dropping I would become more concerned.
I think with a tumor there it can play havoc and either cause it to be high
or low. I also would be very conservative on insulin with his appetite
being poor. I think he is painful from the pancreatic mass. These types of
tumors are extremely painful and enzymes leak from the pancreas into
surrounding tissues which is very painful. Some of the glucose elevations
could also be stress related.
Treatment for now, give subQ fluids at least twice daily, use an H2 blocker
(tagamet, pepcid, omprezole, etc.) 1 hour after the carafate, but more
importantly you need some pain medication for him. I don't know that a
nonsteroidal is a good choice if you belive he may also have an ulcer. If
it is not they you need a narcotic analgesic. I think pain control is very
important. I think getting him stabilized and to surgery might be your best
idea, since you will never get a handle on his Blood Glucose until this is
done.
Best of luck to you and I hope this helps some.
Dr. Sue
>From: dooknook@comcast.net
>Reply-To: ferrethealth@smartgroups.com
>To: ferrethealth@smartgroups.com
>Subject: [ferrethealth] Diabetic ferret
>Date: Sun, 11 Jan 2004 05:32:25 +0000 (GMT)
>
>Ranger is a 7 year old ferret that came into my care today, for 6 months.
>He had a BG of 600 on 1/6. Unfortunately, Ranger's vet has been out of
>town and was been seen by someone that doesn't normally treat ferrets. Due
>to miscommunication, etc., Ranger was only started on insulin this
>afternoon.
>
>He also has a mass on his pancreas, confirmed by ultrasound two days ago,
>history of insulinoma, on pred for more than a year then stopped last
>summer when his bg went up to 246. Apparently he hasn't been seen by a vet
>untill now. He was scheduled for exploratory surgery on Tues. but that's
>been cancelled for now.
>
>Just prior to his first unit of insulin, Ranger's bg was 600, as high as
>the meter will go.
>
>Readings so far this afternoon/evening:
>2:40 600
>4:40 399
>6:45 144
>9:30 106
>
>No ketones.
>
>Ranger has been lethargic, dehydrated, nauseated, grinding his teeth and
>not eating except for duck soup I've given him a couple of times, didn't
>urinate for a few hours which was totally different than when he was going
>frequently per his mom. She said he had been eating well, drinking a lot
>of water. I've given him 30cc's of fluids at 4 and again at 9pm. Gave him
>0.5cc's of carafate about two hours ago.
>
>I'd appreciate any advice on how to continue his treatment until his vet is
>back in town. Please. :) How much lower should I let his bg go without
>treating him for hypoglycemia? I think I know the answer but I don't want
>to take any chances.
>
>Also, what are some of the areas I can use to get a drop of blood other
>than clipping a nail?
>
>Dr. Murray, thank you. You too, Pam and Angela.
>
>Jackie
>
>
>
>
>
>
>
>--
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>
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