Message Number: FHL11108 | New FHL Archives Search
From: "Jeff"
Date: 2010-03-15 17:22:39 UTC
Subject: Re: [ferrethealth] Ferret with past adrenal and pancreatic surgery now low BG - what course now?
To: <ferrethealth@yahoogroups.com>

The blood glucose level of 46 should, in itself, be enough to reach a diagnosis of insulinoma. Of course, some other things can cause a low BG level, such as not eating or some other compromising illnesses, like IBD or lymphoma. Fur balls can also lower BG levels, but probably not to the lower level that you are seeing. But given the prevalence of insulinoma, and that his age makes him a prime candidate, then this is the most likely cause.

According to the Tufts online medical course on ferrets (see link below), ultrasound is not a recommended way of diagnosing insulinoma. Here is a quote from their online course:

BEGIN QUOTE:
Ultrasonography has been used to screen for pancreatic nodules but it is not an ideal tool since many of these cases do not produce nodules at all, or the nodules cannot be recognized with ultrasound. In one study only about 22% of confirmed cases were positive using an ultrasound exams.

END QUOTE

link to full document: http://ocw.tufts.edu/Content/60/Lecturenotes/807949

You can spend much less money by testing the insulin levels in his blood, if you want confirmation beyond the basic blood glucose level. You can also 'confirm' insulinoma by starting him on prednisolone and seeing if it improves his behavior and increases his BG level. Start with a lower dosage and adjust upward as needed based on his behavior and on regular checks of his BG levels when fasting 3-4 hours.

You don't have to make a decision on surgery yet. See if prednisolone helps, and how much it helps, and then see how his over all health is in a few months.

There was a study done (see abstract below) that determined that the treatment option for insulinoma that produced the longest survival times was surgery to remove any visual nodules AND part of the pancreas.

Abstract:

BEGIN QUOTE

Insulinoma in the ferret: clinical findings and treatment comparison
of 66 cases

CA Weiss, BH Williams, and MV Scott

The clinical signs and surgical findings were reported for 66 ferrets
with insulinomas confirmed histologically. All of the ferrets were
treated with one of three modalities, and disease-free intervals and
survival times were gathered to determine the most effective treatment.
The three treatment groups included 10 ferrets treated medically, 27
ferrets treated with pancreatic nodulectomy, and 29 ferrets treated
with pancreatic nodulectomy combined with a partial pancreatectomy. The
mean disease-free intervals for each group were 22, 234, and 365 days,
respectively. The mean survival times for each group were 186, 456, and
668 days, respectively. Based upon the data, recommendations were made
for treating insulinoma in the ferret.

END QUOTE

Hope this info is helpful to you.


Jeff
In Memory of Trinny, Neo, Pip, Mr. Parker, and Possum the Million Dollar Ferret
Caring for Morphy, Baby Girl, Luna, Dozer, Sabrina, Minnie Mouse, and Pop



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