From:
sukiec@optonline.net
Date: 2006-09-16 16:36:08 UTC
Subject: [ferrethealth] RE: Diabetic Ferret
To: ferrethealth@smartgroups.com
The tarry diarrhea indicates an ulcer. Get a prescription for the liquid prep of Carafate from your vet. Any pharmacy will have the med. Carafate will bandage the ulcer but needs to be given at a different time from other meds and not given with food. Because it is convenient to do so we usually separate Carafate by 30 minutes from food, and by an hour from other meds.
Temporary diabetes is not unusual after insulinoma surgery, but ferrets have gotten permanent diabetes as well.
If there is also an adrenal growth the ferret needs a Lupron Depot shot because that stops a mechanism which can lead to diabetes.
The chromium in Brewers Yeast has a mild effect to reduce blood glucose.
See enclosed vet posts for type of insulin.
Here are a few of the past vet posts on the topic:
BEGIN QUOTES
http://ferrethealth.org/archive/browse.php?msg=SG15992
Yes, what you are describing is diabetes.
As for treatment, PZI insulin is my recommendation
for insulin therapy. Ferrets in general require a high
amount of insulin (1 to 5 units, 2 times a day) initially,
but as the glucose level normalizes you may have to
reduce the insulin amount. Feeding a high protein food
such as baby food, Hill's a/d, Oxbow's Carnivore Care,
Natural Gold ferret food, or Totally Ferret baby version
will also help to control the glucose level. Chromium
can also be added to the food to help control the
glucose level. SQ fluids may be needed initially to
help control the dehydration.
Hope that helps,
Jerry Murray, DVM
http://ferrethealth.org/archive/SG15191
I don't feel the Purina DM is that different from the Wysong Archetypal 1 so
you might try that one over the one she is on. It is high protein low carb
which is pretty much what the Feline Rx diet is. This might help. Try to
increase her exercise to burn some fat, it may just take a whle to
accomplish. Humulin N is not my first choice but since right now she seems
regulated I wouldn't mess with changing just yet. I would use a longer
acting insulin or even the Feline PZI insulin is she dysregulates again.
Watch any treats or supplements that might interfere. Keep a close eye out
for other problems and be certain it is primary diabetes and that there
isn't an underlying cause. It may be a long shot but check a Tenn panel too
for adrenal since often when there is one hormonal based problem there are
many more. Sometimes correcting the primary problem (if there were adrenal
issues) would correct the diabetes too. Best of luck.
Dr. Sue
http://ferrethealth.org/archive/SG6649
Interesting question about the cause of your ferret's
diabetes and wether it is insulin dependent DM or
non-insulin dependent DM.
First how can adrenal gland disease cause diabetes?
1) If it is overproducing cortisol (~5% will) then the cortisol
can cause diabetes.
2) If it is overproducing progestogens (~55% will) then the
progestogen can cause diabetes.
3) If the ferret is obese then the excessive fat can cause
diabetes.
How to read the insulin concentration test?
1) In cats with non-insulin dependent DM, the insulin concentration
is usually low, so insulin concentration is not used.
2) The test has to be validated for the species being tested.
The human RIA test is not accurate in cats.
3) The only lab that I know of that offers a ferret insulin is the
University of Tenn., and it is only rarely used in insulinoma cases.
4) Unfortunately the suppressive effects of elevated glucose on beta
cell function (called glucose toxicity) will often cause low serum
insulin concentrations in animals with non-insulin dependent DM.
Since very little work has been done with ferret insulin and diabetes,
no one knows how to interpret the insulin test except to say ferrets
are likely to be close to cats (see 1, 2 and 4).
Hope that helps,
Jerry Murray, DVM
http://ferrethealth.org/archive/SG6592
You have asked some good questions about how
to treat your ferret with diabetes. I will try to answer
them.
1) What type of insulin to use? This is a very good question.
The short answer is PZI VET insulin from Idexx.
NPH is an intermediated-acting insulin, and it is the best
insulin for dogs. Ultralente insulin is a long acting insulin,
and it is the second choice for cats and ferrets. The PZI VET
insulin is a beef insulin product that is the first choice for cats
and ferrets. Interestingly there has been very little work done
with ferret insulin. Cat insulin is very close to cow insulin.
That is why PZI works well in cats. I have asked Dr James Fox
(the lab vet at MIT) about which insulin is closet to ferret insulin,
but that research just has not been done. However in my
experience the PZI VET insulin works best, so perhaps ferret
insulin is close to cat (and cow) insulin. I would recommend starting
at 1 Unit/ferret 2 times a day of the PZI VET insulin. PZI is a 40 unit
per ml (U-40) product, so you will need U-40 syringes.
2) What diet should I use? The "ideal diet" for diabetic ferrest
would have a high protein content 50-60%, high fat 30-40%, with
a very low carbohydrate content only 1-5%, vitamins/minerals/etc.
Thus Gerber's baby food, Hill's a/d, and the new Pretty Bird ferret
food should be used as a supplement or as the main diet. Also treats
need to be low carbohydrate such as cooked meats, cooked eggs,
canned tuna/chicken/salmon, baby food, a/d. The new Hill's canned
m/d or Purina canned DM may also be good options.
3) What about chromium? Chromium or brewer's yeast has insulin
like activity and can help lower the glucose level. A suggested dose
of chromium is 20-200 mcg/ day, divided and mixed in with the food.
4) What about Lupron? If your ferret is showing signs of adrenal
gland disease then I would recommend Lupron (or surgery when
you get the glucose regulated). A small percent (~5%) of ferrets
with adrenal gland disease will overproduce cortisol. Cortisol will
elevate the glucose level and may cause diabetes.
Hope that helps,
Jerry Murray, DVM
http://ferrethealth.org/archive/SG2385
Yes, your ferret has diabetes (blood glucose 611) and the ketones
in the urine means he has diabetic ketoacidosis. This can be a serious
and even a fatal problem. The "why does he have diabetes" is a great
question. According to Dr Jack Oliver (U of Tenn) ~8% of ferrets with
adrenal gland disease will have elevated cortisol levels, so that could
cause insulin resistance if his cortisol is elevated. However his lower
than normal insulin level suggest he is having problems making insulin.
Did he have an insulinoma before, or was he on pred before, or did he
have surgery on his pancreas before? We still do not know for sure
what is causing these somewhat rare cases of diabetes. I recently
had a chance to talk to an human internal specialist from the Mayo
Clinic in Minnesota about this very topic. She gave me a long list
of possibilities. Hopefully one of these days we will know more
about what is causing this problem. Lets hope a vet school starts
studying this to do all of the special testing required.
As for what to do now, it is time to start him on insulin, fluids (NACL),
antibiotics, and a high protein diet. I would suggest PZI insulin at 1 unit
per kg (2 Units for your big boy) twice a day, a high protein diet (no sugary
food or treats), SQ or IV fluids to correct dehydration, and a broad spectrum
antibiotic (Baytril, Clavamox drops). Chromium can also be added to
his diet.
Good Luck and Happy Thanksgiving,
Jerry Murray, DVM
END QUOTES
Home glucose testing:
http://www.unc.edu/~pjdutche/bloodsugar/
The following are some posts I mentioned to someone else facing diabetes in a ferret in the recent past:
Misc and general explanations:
http://ferrethealth.org/archive/browse.php?msg=YG10124
http://ferrethealth.org/archive/browse.php?msg=SG6649
http://ferrethealth.org/archive/browse.php?msg=SG14903
http://ferrethealth.org/archive/browse.php?msg=YG6778
http://ferrethealth.org/archive/browse.php?msg=YG1420
Meds (or meds and food):
http://ferrethealth.org/archive/browse.php?msg=SG15191
http://ferrethealth.org/archive/browse.php?msg=SG13506
http://ferrethealth.org/archive/browse.php?msg=SG9003
http://ferrethealth.org/archive/browse.php?msg=SG7264
http://ferrethealth.org/archive/browse.php?msg=SG6592
http://ferrethealth.org/archive/browse.php?msg=SG2385
http://ferrethealth.org/archive/browse.php?msg=SG1258
Food:
http://ferrethealth.org/archive/browse.php?msg=SG15480
http://ferrethealth.org/archive/browse.php?msg=SG15460
http://ferrethealth.org/archive/browse.php?msg=YG4476
There are more in the archives to help you. The archives are very easy to use so just play with them. Pam's instructions are very clear, and you do not need to fill in every box. For part of this search I only put in
diabetes
as being in the content and nothing else. You can fill in anywhere from one to three of the boxes; it is up to you. Some other things worth searching on:
insulin
Lupron and diabetes
insulinoma and diabetes
chromium
ketones
"diabetic ketoacidosis"
DKA
and so on with other words you will pick up from the posts mentioned already. The reason I mention Lupron to read about is because on a rare basis to an adrenal growth can trigger diabetes (for mechanism see some of the posts mentioned above).
-- Sukie (not a vet, and not speaking for any of the below in my private posts)
Recommended health resources to help ferrets and the people who love them:
Ferret Health List
http://www.smartgroups.com/groups/ferrethealth
FHL Archives
http://ferrethealth.org/archive/
AFIP Ferret Pathology
http://www.afip.org/ferrets/index.html
Miamiferrets
http://www.miamiferret.org/fhc/
International Ferret Congress Critical References
http://www.ferretcongress.org
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