From:
"Debra K Turcott-Johnson"
Date: 2007-02-08 04:48:00 UTC
Subject: [ferrethealth] Re: low glucose/novasource2.0
To: ferrethealth@yahoogroups.com
HI Dr Murray and others who are helping me
The post I sent out about low glucose/novasource 2.0 was to make SURE I
was not missing any new info about the subject. I will be seeing this
specialist tomorrow and want to be sure of what I know (based on already
having one ferret with an insulinoma who died Aug 06. He was on pred
and then diazoxide). I was very exhausted and disgusted when I wrote
that post it was obviously not worded very well. Guess what I was
trying to say was here are two ferret specialists- both of them missed
something that I would think would be common knowledge for them- I
kind of was thinking "who can I trust now?" Perhaps I have too high
exepections of "specialists"?
Luke is getting YOUR treatment protocol that you and I posted about a
few times about perhaps a couple weeks ago (posts 942,946,984). The
specialist (specialist 1) (he is not who I am seeing tomorrow) wanted
to use just Casodex and drop Lupron (for treatment of enlarged prostate
secondary to adrenal disease). After our posts I went seeking the truth
about these drugs. I went to the websites of Lupron, Casodex and
Propecia and proved the facts to myself. Then I decided to get a
little bold- I was desperate - I "pitched" your protocol to the primary
care vet in a voice mail. After he made a few phone calls he said that
it was a "go" for him!. So it is 500 mcg Lupron (monthly depot), 1mg
Proscar/Propecia and a antibiotic. Melationin is still on the table but
he does reserve it for cases that are not advanced as Lukes. I suppose
if I insisted he would give an implant or I could get the pills and
attempt to take care of this myself. Before I do something on my own I
would like to tell you all the meds he is on and then you could tell me
if giving him the melationin myself would be advisable.
Saw Specialist 2 (novasource doc) on 1/31 after an all night session
with Luke- possible blockage- ran under warm water- gave massage- got
dribbles then bigger dribbles but no puddle. Specialist 2 found Luke
had a Prepuce Constriction . So with a couple snips (or slices) Luke
had a much easier time urinating. Within 24 hours he urinated and
defecated with no vocalziaon- a very welcome improvement. He also found
a possible mass on the spleen and a Prostatic Infection prescribed
-Ciprofloxacin 0.5 cc by mouth every 12 hours for ten days
2/1 we had an appointment scheduled for Luke to (Z)SU's (Z=the name of
my state) College of Vet Med's small animal teaching hospital. The
primary vet got a referral for an ultrasound as apparently they have the
only probe that can do very detailed images of a ferret. Here are the
inital findings from ZSU:
Splenic Mass - 2.7 x 1.1 cm. "Ultrasound Aspirate. Cytology- free from
both atypical/cancerous cells and any signs of infection, thus the orgin
of the mass is unknown at this time"
Right Adrenal Gland- 1.2 x 0.8 cm "had multiple hyperechoic (can't
read handwriting on this )- she noted this word meant "brighter"
material that did not have shadows and could have been suture or
scarring from the surgery in 2005 ". (I will add that in 2005 the left
was removed and the right was debulked- histopatholgy from tissues on
right- Adrenal Carcinoma)
Paraurethral mass- 2.4 x 1.1 cm Ultrasound Aspirate "is to the right of
the urethra- mixed echogenicity (sp?). Cytology-free of
atypical/cancerous cells - did have some white cells but it did not have
any prostatic tissues in it. Possible that this could still be a cyst as
it was fairly acellular
Offical Report will be done sometime next week will fax to primary vet.
____________
2/1 have voice mails from Specialist 1 (the no Lupron vet). He said the
blood tests that he had sent out of house are in (almost 2 weeks after
the blood draw- he stated test results would be back in 24-48 hours).
These tests show Luke has Insulinoma.
I had these tests faxed to the primary care vet- he said these are very
sensitive tests- he rarely has a call to do this type of test-Luke has
not been showing any clinical symptoms but the tests make it very clear
he has Insulinoma. Primary Vet calls compounding pharmacy to make up
some Predisone -dose is 1ml by mouth twice daily. Luke had his first
500 mcg Lupron (monthly version) injection on 2/2 (had to be ordered).
He is on Propecia/Proscar (at the dose that was given to me in a post
from you- all of this is a first for the primary vet- he said he had
never given that high of a Lupron injection before).
I am surprised Luke is still having aggression (seems like it is not
just sexual). He continues to scratch himself very regularly no real
decrease then from before the injection. He usually took 2 to 4 days
after any Lupron injection to see the results. The Lupron would kick in
and we would have "Luke" back for awhile. If the symptoms he is having
do not improve shortly does this mean we have hit our maximum Lupron
dose and the gland has taken over? Which would be to say we have
exhausted our medical options? I do not know if he is a candidate for
surgery, factoring in that he is 7 years old and now Insulinomic. ZSU
states in its report that if we wish to pursue surgery for the right
adrenal or splenic mass to feel free to call them. I would have many
things to consider - I really did not think I would consent to opening
him up again. I would consent to prostate work if it was needed BUT it
is screwed up from the adrenal - the gland perhaps has gone wild and if
can't medically control it - does it make sense to cut him and work on
the prostate? In general probably not.
I am sorry to say that I am starting to gather information as it is made
available- I must have concrete evidence that if I have to help him to
the bridge that I am justified in taking his life (unless something
crazy happens then of course there would be no delay).
This last episode with Luke began 1/5 and has intensified since 1/15
now we are in Feb- I am starting get worn down. I need to know what I
should be looking for or at while I am in the decision making process.
So Dr Murray and others here, what are your thoughts for this situation?
Sorry for the length of this post.
Thanks
Deb
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