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>A 5yr old male ferret recently was turned over to me.  He has had
>insulinoma for at least a year and been maintained fairly well on pred.
>The pred is beginning to be less effective now.  My question is would
>surgery at this point do him any good, since the consensus seems to be
>that the sooner to surgery the better?
 
There are a number of issues which you deal with in older ferrets that
have been living with insulinoma for a while.  The first issue is that of
insulin resistance, or islet depletion.  When a ferret has been putting
out high levels of insulin for a period of time, the body tends to
compensate, and the most common sequela is that the rest of the normal
islets tend to atrophy.  What happens at this point is that the risk of
post-surgical diabetes is increased, so that the chances of rebound
hyperglycemia and possible long-term diabetes is increased.
 
There is also a likelihood of several insulinomas being present in a
significant number of animals being operated on later in life - the vet
needs to carefully evaluate the pancreas, and these are animals that may
profit from a partial pancreatectomy in the long run.
 
The third thing to consider is that the longer you wait, the less of a
surgical candidate this particular ferret will be.  Other concurrent
illness and aging changes continue to degrade the animals overall
condition - this may be minimal, or it may be a true concern - it is
nothing I can predict in any one individual over the internet.  But it
should be a consideration.  The adage early to surgery should not be
ignored - if this ferret has just come into your hands, then you still
have that option.
 
With kindest regards,
Bruce Williams, DVM
[Posted in FML issue 3837]