From:
"Sukie Crandall"
Date: 2008-05-29 18:08:33 UTC
Subject: RE: Insulinoma and Diabetes
To: ferrethealth@yahoogroups.com
It sounds like your ferret has
adrenal disease
cardiomyopathy
and given the persistent high glucose even after removing the
Pred and Diazoxidethere is also insulin resistant diabetes
secondary to insulinoma.
Some ferrets with diabetes find that Lupron helps reduce it.
Here is some info with vet quotes from a recent post. Being
new you don't yet know about our separate archives but they
can be reached from the FHL homepage.
Another person recently had a ferret do this. It isn't terribly
unusual when insulinoma has gone on long enough (I think
the timing by be shorter when it hasn't been recognized early,
but check me on that.)
Anyway, here is what I found for that other person:
Some related past VET posts which are easily found in the FHL
archives (and there are more):
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 of
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
Notice that adrenal disease itself can on rare occassion
play into the development of diabetes:
http://ferrethealth.org/archive/SG6592
BEGIN QUOTE
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
END QUOTE
http://ferrethealth.org/archive/YPG1417
BEGIN QUOTE
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
level.
Hope that helps,
Jerry Murray, DVM
END QUOTE
--- In ferrethealth@yahoogroups.com, "artroxy_artemis" <artroxy_artemis@...> wrote:
>
> Hello, this is my first post but hopefully someone will be able to
> help me out. My ferret thats approximately 5 years old has been very
> sick and the vets are not quite sure what to do. Currently she is
> diagnosed (and verified) to have cardiomyopathy and adrenals. She's
> on digoxin and lupron for both and so far she has responded well.
> What we are concerned about is another symptom of hers.
>
> Before being diagnosed with adrenals & cardiomyopathy I brought her
> to the vet for collpasing onto the floor and not being able to walk.
> A BG test was done and she was low (approximately 3, this is canadian
> BGL test btw). She was then put on prednisone and diazoxide at the
> lowest dose. The following month her BGL was also indicated to be low
> so her prednisone dosage was increased. By this time she started to
> show lack of interest in food but most importantly she blew up to
> such a degree that she could barely walk. Also her skin was very
> flaky and her vulva swollen. During this time the adrenals and
> cardiomyopathy were diagnosed. Since February however her BGL is
> extremely high, 20+ where the maximum should be 15 (according to my
> vet). They slowly reduced her prednisone and diazoxide to no result
> and finally they removed both medications. Her BGL remained exactly
> the same whith no changes (20). Yesterday I took her in not only for
> her lupron but because she was beginning to show some symptoms of
> lethargy. They noted that she was dehydrated and gave her some
> fluids and sent me home with her. At night she completely collapsed,
> extremely lethargic, could barely walk, pale nose and gums, and she
> threw up a bit. Her feces (just a little) was a little on the yellow
> side. She showed absolutely no interest in food but she was drinking
> a ton of water (and peeing alot). I took her to the emergency where
> she was given fluids. She is still stable but very weak.
>
> I've tried to look up what this could possibly be or what course of
> action I should even take. Has anyone encountered such a situation
> or can think of something? Thank you so much and sorry for the long
> post.
>
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