From:
Sukie Crandall
Date: 2007-04-27 16:27:06 UTC
Subject: Re: [ferrethealth] Low Glucose/Insulinoma
To: ferrethealth@yahoogroups.com
Before trying any of these things see the final note in the message.
it is IMPORTANT!
First off, it is not terribly unusual for vets to choose to go
beyond the the maximum usually noted for Prednisolone when there is
no other choice as long as the ferret does not have a medical reason
to not do that.
Second, if the vet has earlier texts then the maximum put in some of
those was lower than the same authors mention nowadays.
Third, Prednisolone has an action of about 9 hours so it is not
unusual to go to giving that med three times a day, every 8 hours for
optimal coverage as insulinoma advances.
Fourth, if the liver is at all compromised (even if you don't know
it) then Prednisolone can work better than Prednisone. That is
because the liver normally converts Prednisone into Prednisolone
before the body can use it, so you skip a challenged liver not being
up to the conversion job.
Fifth, some vets try injected steroids instead of oral when
insulinoma is really advanced. (We have not done that ourselves, but
others here have mentioned it.)
Sixth, some vets try alternative steroids.
Seventh, when all else fails instead of sudden sugar additions try
providing food and sugar that are constantly available to that
individual. We have gotten as long as an additional 3 months for one
with that trick, but for most the added time is shorter. We also had
one who actually had lymphoma in the pancreas instead of insulinoma
who needed it throughout her final 9 months, but another with
carcinoma in her pancreas instead of insulinoma never needed it as I
recall. What we do in that situation which seems to work best os to
take two forks and take apart some Nutrical in water, then let it sit
to give time for the film to rise because ferrets seem to dislike
that so we remove it. Then that bowl is left available. It gives a
sugar lift to off set the increased insulin.
Finally: *****AND THIS IS IMPORTANT *****
TEST THE BLOOD SUGAR!
Why? Because in some there can be a sudden shift to diabetes, not
always just post-surgically, and the symptoms are the same.
http://ferrethealth.org/archive/SG5628
BEGIN QUOTE
Actually, although it sounds contradictory, it does happen.
Here's how it occurs: The insulinoma occurs first, liberating high
levels of insulin. We combat it with prednisone, which raises the
blood glucose in spite of the high insulin levels. AFter months of
high insulin levels, the body gradually downregulates the insulin
receptors on the cells, which are being overstimulated. As the cells
become non-insulin responsive, the animal develops diabetes. Its a
form on insulin-unresponsive diabetes (Type 2), and it seen not
infrequently in ferrets on long-term prednisone for insulinoma control.
The blood doesn't alternate between high and low - the pattern you
see in these ferret is that it is low for a long time, then all of a
sudden it goes in to the 250-350 range or higher.
Another reason to consider surgical treatment in younger ferrets as
soon as the disease is diagnosed.
With kindest regards,
Bruce Williams, DVM
END QUOTE
Sukie (not a vet)
Current FHL address:
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Recommended ferret health links:
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http://ferrethealth.org/archive/
http://www.afip.org/ferrets/index.html
http://www.miamiferret.org/fhc/
http://www.ferretcongress.org/
http://www.trifl.org/index.shtml
http://homepage.mac.com/sukie/sukiesferretlinks.html
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