From:
Caitlyn Martin
Date: 2004-07-15 16:33:13 UTC
Subject: Re: [ferrethealth] Insulinoma: Surgery vs. Medication (Long Post)
To: ferrethealth@smartgroups.com
Message-ID: <30472956.1089911110827.JavaMail.nobody@magnesium.smartgroups.com>
Hi, Leslie, and everyone else,
It sounds like your little one may have a few issues
going on at once.
In regard to the two renal cysts: are they one per
kidney or both in one kidney? Renal cysts, according
to our vet, usually don't cause any symptoms or
problems and usually don't have to be treated.
There are rare exceptions including what our Pertwee
had: polycystic disease, which is multiple cysts
(like lots of them) in the kidneys. It usually
happens in younger ferrets and is usually bilateral
(as in both kidneys). In those cases it's fatal. If
it's just in one kidney, which is *very* rare, your
vet can do a nephrectomy and remove the affected
kidney. This was done for Pertwee at age two and he
had three and a half good years after that. It
doesn't sound like polycystic disease, BTW, but I just
wanted you to be aware of what could be developing.
In all probability the renal cysts are not a problem.
In regard to the enlarged lymph nodes, that could by
lymphoma or that could just be fat deposits. Our vet
also told us that some ferrets have enlarged lymph
nodes without having lymphoma and they just go on
living with them. Lymphoma is truly bad news.
Anything else may be nothing to worry about. Your vet
may be able to aspirate the lymph nodes (with a
needle) rather than doing surgery and a full biopsy.
A pathologist should then be able to determine if your
ferret has lymphoma or not.
In regard to insulinoma, I don't understand why your
vet would say that if meds were given now surgery
later would not be an option. Our vet ALWAYS treats
insulinoma by giving pediapred. If a small dosage
keeps the blood glucose normal he keeps the ferret on
meds. When that no longer works he does surgery. In
three of our four ferrets who have/had insulinoma
small or moderate doses or pediapred either didn't
work on, in one case, caused severe diarrhea. In
those three cases our vet opted for surgery.
How long can your ferret live on, healthy and happy,
after surgery? That really depends on what's wrong,
and we don't know what's wrong yet. Lymphoma is a
death sentence, though your ferret may live a while
longer (maybe even a year or more) with medication to
relieve symptoms. If he has lymphoma there is no way
I'd put him through surgery. If not, well... things
look better.
Insulinoma surgery can give relief for anywhere from a
few months to a few years. Our Ker Avon lived more
than two years after his insulinoma surgery (lymphoma
got him in the end) and he never needed medication or
had symptoms again. Our Podo had surgery two years
ago and is doing fine on a moderate dosage of
pediapred. He was NOT fine before surgery. FWIW, Podo
is nine and a half. Kodo got the least out of
insulinoma surgery, only about four months symptom
free. We were able to maintain him on pediapred for
over a year after that. He died of lymphoma at the
age of nine and a half.
I think your vet does need to do more diagnostic work
to find out what is going on. I'd ask about a needle
aspirate of the enlarged lymph node(s) as a first
step. If it's not lymphoma and your ferret is a good
surgical candidate you may want to consider exporatory
surgery knowing there is a good chance it could be
insulinoma, but I'd certainly ask why meds first rules
out surgery later.
The usual disclaimer applies: I am not a vet, but
I've faced decisions like yours way too many times.
All the best,
Caity and the super six