From: "Sukie Crandall"
Date: 2008-05-23 03:06:11 UTC
Subject: RE: Insulinoma and Diabetes
The timing is probably a coincidence.
Some related past VET posts which are easily found in the FHL
archives (and there are more):
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 of
insulin-unresponsive diabetes (Type 2), and it seen not
infrequently in ferrets on long-term prednisone for insulinoma
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
The reason that the timing is probably a coincidence is
because Lupron has been known to sometimes reduce
blood glucose levels in ferrets.
Notice that adrenal disease itself can on rare occassion
play into the development of diabetes:
(Final portion of post below)
You have asked some good questions about how
to treat your ferret with diabetes. I will try to answer
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
There is only a small chance that Lupron might
effect the glucose level in an insulinoma ferret.
In a small percentage of adrenal ferrets (5-8%)
the adrenal(s) overproduce cortisol along with the
sex hormones and androgens. If you reduce the cortisol
level this could lower the glucose level in an insulinoma
ferret. This can happen after surgery to remove the
adrenal gland too. Again this is a rare situation and not
a major problem. If the glucose decreases then increase
the amount of Pediapred to compensate for the lower cortisol
Hope that helps,
Jerry Murray, DVM
Sukie (not a vet)
Recommended ferret health links:
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