From:
Sukie Crandall
Date: 2005-10-01 21:18:00 UTC
Subject: insulinoma
To: hferretmom4@wmconnect.com, rezgrrl@netzero.com, ferrethealth@smartgroups.com
Message-id: <E79D2250-604F-4C28-9A2F-49F0A6644D14@optonline.net>
Clover and Tracy, some ferrets may just need their doses or timing
adjusted.
We have had ferrets who have received their Pred as often as every 8
hours because the action of Pred is for about 9 hours. Usually twice
a day works well, though.
First of all is make sure if the ferret is getting Prednisone or
Prednisolone? There is a liver step where the body turns Prednisone
into Prednisolone, so if her liver isn't very effective changing to
prednisolone may work. We've seen ferrets for whom Prednisone may as
well have been water but Prednisolone worked.
Some have used injectable Pred with good results.
Some have used Dex, but if a ferret does well on Pred that is usually
the better steroid for blood glucose maintenance.
Secondly, as insulinoma advances the dosing needs adjusting -- and
this may happen more often, also as it advances the exhausting and
limiting effects of strong play, of illness, or of not eating will be
larger so expect some bad bouts that change after eating and rest, too.
It pays to monitor the blood sugar regularly.
When the vet thinks it is time a trial of Diazoxide can be tried
along with the Pred. This med does not work for all. We have never
had any who could be maintained on only Diazoxide but we have had
some who responded so very well that their Pred could be reduced, but
others have shown almost no effect. Since it is an expensive med it
pays to buy it from a compounding pharmacist who normally stocks it
(Look in the Reference Shelf in the FHL Files here on the website.)
and to try a small trial amount.
Some opt to try surgery when insulinoma advances with a partial
pancreatomy for extra time, some prefer surgery early on, and some
don't operate. We have had very few cases of insulinoma here and
have opted for early surgery, because something like half can wind up
cured if that is early enough and done well enough, but know that it
is hard op in terms of finding and popping out all of the growths
since they are often like dispersed tiny sand grains within the
pancreas. As you see the recurrence rate is high after surgery, but
if you look at papers such as those by Weiss and Williams early
surgery usually increases the time of survival even when it doesn't
stop the illness. Some people, like Mike, have had exceptional luck
with meds and very careful monitoring.
When the meds no longer suffice try having dietary sugars available
at all times while continuing the meds. Some ferrets who seem at the
end of their ropes can get extra days to months of quality time this
way.
I am sure that others will chime in with more info.