Dr. Williams and FMLers who might learn from this,
 
Dr. Williams, you responded to my inquirey re: the weaning of pred from
Fang, due to his BG reading of 200.  He had been on 1 ml.twice a day due
to his terminal condition (liver tumor).  You asked me what type of cancer
it was, and if he was showing any signs of insulinoma at this time.  His
BG reading was down to 45 two months ago with his seemingly returning
insulinoma.  No other signs, even when he had it last winter.
 
When the vet opened him up this time, he said his pancreas didn't look that
bad,but he didn't mess with anything too much (inspect carefully)...There
were little speckles of insulinoma in several places in his body, and his
spleen was slightly enlarged.  He said as soon as he saw the condition of
the liver, he knew there wasn't much hope.  He had removed a little piece
of the liver last Feb.  during his pancreatectomy and right adrenal
cryosurgery, because it didn't look good to him then, either.  The lab
report came back at that time with: (whatever the term for nutmeg liver
is), but not cancerous.  They diagnosed it being due to lack of caloric
absorption (something like that; I can't find the report) as a result of
the insulinomic condition.  (this is the best of my recollection).
 
The tumor he found now was quite large (and soft), and sort of intertwined
in and around the liver.  He thought it was from the insulinoma, but did
not mess with it any more than he had to.  (you had said that it is not
common for liver tumors to be insulinomic related?) Knowing it was more
important to me to have him live throught the surgery, he treated it
delicately, and sewed him back up.  I have to say here, that he is a great
ferret vet...remember I told you he has attended Weiss's lectures and calls
him when needed...other vets refer ferrets to him from other cities, he has
a great track record,etc.  But as I said before, he is not God, and maybe
you would have done a more thorough investigation of the tumor itself.  I
wish I knew what kind it was, but my vet basically said it was aggressive,
and was gently honest with me that there wasn't anything that could be done
surgically.
 
It is important to say that blood was sent to the local (huge) hospital due
to the fact that they could run a complete test quickly ; his BG was 120
at that time.  I had him on 1/2 ml.  of pred twice a day the week prior to
surgery, and it had elevated it only to 50.  Someone on this list suggested
the diseased liver can cause fluctuation of the BG...is this true?  (I
don't know much about the liver).  I had written to you telling you he was
still quite lethargic ten days following surgery, and you said to go ahead
and increase the pred, as Troy Lynn had suggested.  (vet agreed).  Fang
then became more active when awake.  (still sleeping most of the time, but
getting around well when awake).
 
Then the weakness in the hind legs began when holding himself up to
urinate; the only time we noticed weakiness in the hind legs at all.  He
has two big bags of fat in the groin area, that actually look like big
testicals when you look at him from the rear.  They sort of hang under his
tail.  This is why I thought he would be more comfortable if he lost some
of that pred fat if possible.  Then when his BG came in at 200, I thought
it would be okey to wean him off the pred.  Now we are at 1/2 ml twice a
day, and HE IS LETHARGIC AGAIN!  He only gets up to eat, then goes back to
bed.  SHOULD I UP THE DOSAGE AGAIN?  I'm afraid you might be right, that
it is the only thing keeping the tumor in check.  PLEASE RESPOND....
 
with gratitude and love,
lizzi and little Fang
[Posted in FML issue 3296]