>I have an unusual problem.  Doc (who is 8) is on low dose prednisone for
>insulinoma.  He's been on this for about a year.  About 6 months ago he
>developed, quite suddenly, a very pendulous abdomen.  It is so large that
>he frankly has trouble walking.  He's thin as a bone elsewhere (chest,
>legs, etc).
>
>My vet says this is a symptom of insulinoma and there isn't much we can
>do.  She has X-rayed him (no masses) twice over a 4 month period.  She also
>"tapped" his belly to look for fluid (ascities?) and found none.  So she
>says it is just extra weight put on by the pred.
 
Dear Linda:
 
This may be unusual in that it is not a problem at all.  Many ferrets as
they get older, tend to lose muscle mass and put fat on abdominal fat.  Not
outside the abdomen, as humans do, but inside the abdomen - in and around
the organs and in the mesentery.  It gives them a bit of a pear shape.  I
have seen it a lot in older adrenal ferrets, but it very well may be just
a sign of age.  It is sort of a vicious cycle - as they get larger, they
become more sedentary, and lose more muscle mass and become more immobile,
and lose more muscle mass, etc.
 
Although I'm not sure about the insulinoma part, I think that you vet has
taken the appropriate approach and that you probably don't have to get a
second opinion.  A good X-ray will show fluid in the abdomen even better
than an aspirate.  Fluid tends to obscure all of the abdominal organs -
the abdomen becomes a milky white with no detail.  Aspirates are good when
a lot of fluid is present, but not so good when used as a "fishing"
expedition.
 
Unfortunately, there is not a lot you can do here - dieting is usually not
an option in these older animals, especially when they have insulinoma.  Do
the best you can, lots of TLC, and occasionally keep checking those X-rays.
 
With kindest regards,
Bruce Williams, DVM
[Posted in FML issue 3306]