I just realized I haven't sent everyone an update about what's going on
with Sonic in a long time.  She's my sweet blind 7 year old who became
diabetic while on pred and diazoxide for insulinoma.  We stopped the
diazoxide and weaned her off the pred and her blood sugar came down on its
own, so we never started insulin.  She developed a bladder infection from
all the sugar in her urine from the diabetes, so we treated that.  Dr.
Williams has been WONDERFUL about commenting on all of her developments...
Here is the latest.
 
Even after we treated the bladder infection, she still had a high urine pH
and struvite crystals.  It's odd because she was only eating chicken baby
food and Bob's chicken gravy, and those should lead to acidic urine.  So we
put her on a low dose of methionine to acidify her urine, and it worked,
but it also gave her pretty bad diarrhea.  The urine pH went back up when
we stopped the methionine, so then we tried powdered cranberries, and
that's worked great.  The stuff has no added sugar and she actually seems
to like the flavor it adds to her various foods (gravy, baby food, Totally
Ferret mush as her tastes dictate).  Urine pH is staying nice and low, and
so far I can't detect any bad side effects from the cranberry supplement.
 
It's probably been around a month of her having no appetite and me giving
her carafate before each handfeeding, but she's starting to come around
there too.  We put her on weekly B-vitamin complex shots and also Reglan
(mixed into her food, she reacted very violently to being given it orally
via syringe) to help her appetite, and those seem to have turned her
around.  We're holding cyproheptadine (sp) in reserve in case we need
another boost down the road... Now I don't have to force any food down her,
she'll eat several times a day willingly from my fingers.  AND last night
for the first time, she picked up kibble with some actual interest.  She
only carried it across the room, but I was *very* excited; previously if
she even sniffed it in passing, she'd smack her lips, retch, and walk away
all in a huff.
 
Our remaining stumbling block is her lack of desire for water.  She just
won't drink enough on her own and so usually needs SQ fluids every day.
She'll try to drink from a bowl, but she smacks her lips and makes "ewww
gross" faces and gives up... Dripping ferretone on it doesn't help, and
serving it warm or from a glass or from the cup of my hand doesn't either.
Ditto bottled water or chicken broth.  She will lick water droplets from my
feet after I shower :-) but that's it.  I am very hopeful that her natural
thirst will come back as her appetite improves, but until then, the fluids
have gotten a bunch easier and she doesn't mind it much anymore.
 
She also *hates hates hates* carafate (both liquid and tabs in water) and
foams and cries when I give it to her, and then she walks around clawing
her mouth occasionally for a few minutes afterwards.  But I'm afraid to
stop it...
 
Her sweet personality is back.  She had gotten very suspicious for awhile,
when it seemed like everytime I touched her it was to do something
unpleasant (like feed or medicate her).  Blood sugar?  Reasonably normal
for now (80-100).  I think the insulinoma will regain control eventually,
and in fact, a week or two ago she had some head-bobbing and blood glucose
was 72, but she snapped back from that the next day and has been strong
and active since.
 
So.... all in all, it's been a hard road, but things are looking up.  I
think a lesson to be learned here is to ALWAYS monitor insulinoma patients
carefully, especially if they're on both pred and diazoxide (proglycem).
I was following Sonic pretty closely, I thought, but she turned into a
diabetic over a two-week period - that's how long it was between her last
normal blood test and the one that showed the problem.  She had been stable
on her dose of meds for awhile, and she was on quite moderate doses.  An
unusual scenario, but one that can happen.
 
Thanks for everyone's help, and my best thoughts for those with sick or
departed beloved ferrets,
 
-Pam S.
[Posted in FML issue 3301]