From:
"alliemegan"
Date: 2009-05-06 06:29:33 UTC
Subject: [ferrethealth] Insulinomic ferret not responding to pred
To: ferrethealth@yahoogroups.com
My 4 year old male ferret Merry had been diagnose with insulinoma during an adrenalectomy about 10 months ago. Part of his pancreas with a visible nodule was remove and he had been on prednisone ever since. He's on a raw diet and we're testing his blood glucose at home regularly (with a human glucometer calibrated to our vet's). Most days his BG is hovering around 3.0 mmol/L (55mg/dL) Unfortunately his disease was progressing and we had to increase his pred dosage to 1.3mg/kg BID.
2 weeks ago Merry had his first hypoglycemic crash. We're getting him up for breakfast and he looked a bit groggy. 5 minutes later he was speedbumping on the living room floor. We managed to get some breakfast into him but he slowly became unresponsive over 15 min. We rushed him to the vet and they gave him IV dextrose. He came around in no time flat. We're instructed to bump up his pred to 2 mg/ kg BID and monitor his BG.
For 4 days, his BG was up in the 4.5 mmol/L(80mg/dL) range, which was amazing. However, on the 5th day, he'd developed a stumble when he walks, but when we checked his BG it was still in the 4mmol/L range. We brought him to the vet and we're all stumped. Merry's stumbles went on for another day when we started noticing that the new bottle of pred we just started him on, which is compounded in ferretone, wasn't looking quite right. There was big congealed clump on the bottom. When we check him BG that day, it was down to 2.4mmol/L. Our suspicion is that the pred had congealed and crashed out of the suspension. There's no telling how much pred was actually got into Merry's belly in the 2.5 days that he was on the new bottle, which could explain his stumbling. We went back to the pharmacy and got a new prescription compounded. We continued with the 2mg/ kg dosage and the next day, Merry was running down the hallway, NO STUMBLING! That confirmed our suspicion that the pred concen
tration was off.
What really concerns us is that it's been 4 days since we started Merry on the new, "good" pred, his BG did not come back up to the 4 mmol/L level. In fact, it was back down to <3 mmol/L, despite the higher 2mg/kg dosage. He's still bright and active but there's an incident when we couldn't wake him up from his sleep for a good minute, which had never happened before in the 3 years he'd been with us. We'd also found a pile of vomit/ regurgitation in his cage this evening, which is really alarming. Even though he's still bright and active, we're going to bring him to the vet tomorrow. My questions are:-
1. Is it true that once an insulinomic ferret has a hypoglycemic episode, he's more prone to them in the future?
2. Can the few days of low pred intake cause permanent damage in Merry such that his BG is not coming back up despite the appropriate dosage was resumed?
3.Since Merry is already on such high dose of pred, the next stage will be diazoxide to get his BG under control. Does any one have experience with it? Does it taste horrible to a ferret? But more importantly, does it work?
Thanks very much for your help. Sorry about the long post.
Allie and Merry
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