FERRET-SEARCH@LISTSERV.FERRETMAILINGLIST.ORG
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Date: | Wed, 26 Dec 2001 14:27:47 -0500 |
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>Hi, I'm doing some research for my vet who will be performing insulinoma
>surgery on my 3 year old Chance in January. He has done a ton of adrenals
>but has limited experience with pancreas surgery. He would like to know
>what to do if no nodules are visible, should he close and try again at a
>later date? He mentioned he experienced a problem with leakage (I believe
>he used this term) after removing nodules and infection set in afterwards.
>Any suggestions on how to avoid infection? How long should a ferret fast
>prior to surgery and is there a waiting period after surgery? I think I
>recall something on this list about that but couldn't locate it. Any
>tips I can pass along to my vet will be appreciated. He has read the
>Weiss/Williams article. Also, what is the initial dose of pred after
>insulinoma is diagnosed? I'm only giving Chance .1 once a day. His
>blood glucose was 52 last time we tested. He seems to be doing o.k.
Dear X:
My general recommendation is that if no nodules are visible, then a
partial pancreatectomy should be performed - that will take care of the
problem in 50% of the cases, and the post-surgical disease free interval
is longer than nodulectomy.
Infection is generally not a problem - your vet may be concerned about
inflammation and post-surgical peritonitis, but this is really not a
major concern if technique is good and excision is precise (usually these
nodules just shell out very nicely.)
Fasting should be 3-4 hours, tops, and dextrose can be given at surgery in
very hypoglycemic animals.
The appropriate dose of prednisone is the one that keeps the blood glucose
at a level that no clinical impairment is noted. (Note that I did not say
blood glucose is in the normal range, as this can be difficult to achieve.
0.1 ml is pretty low, and a BG of 52 can be worrisome - I might double it
and see where that takes the glucose. If you can get the glucose over 60,
then that would be appropriate.
With kindest regards,
Bruce Williams, DVM
[Posted in FML issue 3644]
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