From:
"Pam Sessoms"
Date: 2006-11-10 18:08:29 UTC
Subject: Re: [ferrethealth] Insulin/Blood Glucose levels
To: ferrethealth@yahoogroups.com
Jeff,
1) What would 'normal' levels of insulin be, and does 196 indicate that the
> insulinoma may be far along in its progression?
The normal range is given as 0-20 in a couple of ferret web pages. The
range is attributed to Susan Brown (noted ferret vet), but there is no unit
of measurement given, so hopefully we're not comparing apples to oranges. I
can check some ferret vet books later today or tomorrow, when I'm home and
have access to my books, if you'd like.
Anyway, I do not think that you can really use this level to indicate a very
advanced case. From what I've read in the past, it sounds like the insulin
level can fluctuate a lot, and it is even often normal in ferrets with
insulinoma. You likely caught this one in a spike.
2) Is there any way of knowing or making an educated guess from the levels
> of 196 and 30 whether or not the 8.7 mm tumor would probably be the
> primary cause of the insulinoma, or whether there is also a good chance that
> he has many smaller tumors in the pancreas. I would be more inclined to
> choose surgery for him if I believed it was the tumor that was the primary
> culprit.
It would be better if a vet would comment here, but I believe that an 8.7 mm
insulinoma is a real whopper. These are usually pretty small; Bruce
Williams' Pathology of the Domestic Ferret (
http://www.afip.org/ferrets/ferret.path.html) says they are usually 1-2 mm.
So if that mass is an insulinoma, it is a really big one. They are
ordinarily so small that they do not show up well on ultrasound.
I've generally had good experience with insulinoma surgery, especially when
done early on in the disease. If the insulinoma is long-standing, in my
limited experience, the benefits of the surgery are typically
shorter-lasting than in the cases where surgery was done as soon as symptoms
appeared.
Now, it is entirely possible that there are more insulinoma tumors on this
guy's pancreas, beyond the big one the ultrasound found. I had one where we
went to surgery and found a big whopper like what you see, and we removed
that, plus a big chunk of the patient's pancreas with one or two smaller
masses present (partial pancreatectomy usually is better than just popping
the individual tumors out). We still had to leave in one smaller tumor
because it was in an area that was pretty much inoperable, given the chunk
we had to take out, and proximity to a big blood vessel.
Personally, I'd tend to go for surgery, at least to reduce the numer of the
insulinomas and to get a picture of what is going on, but I tend to be
pro-surgery with insulinoma. Also, the left adrenal could be addressed at
the same time.
3) A few days ago I started adding some brewers yeast powder to his 'gruel',
> as I had read in a couple of places that it is high in chromium and does a
> good job of regulating BG and insulin levels.
I don't use chromium for insulinoma, coming down more on the side that it is
more useful in diabetes for lowering blood sugar levels. However, I'm a big
fan of meat-based diet for insulinoma; mine get Bob C's chicken gravy with
no kibble added. It seems to help them a lot.
Keep up the great work on your guy. You are clearly really working hard to
do the best thing for him. He's a lucky ferret.
Best wishes,
-Pam S.