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>my vet was shocked how much weight he lost and how weak he was so she
>said they'll put a drip into him to get glucose into him and stabilise
>his blood sugar.  But when they tested his blood glucose, it was sky
>high... Sort of 309/327mg/dl... So I got a phone call from my vet and she
>said she was going in to see what was going on.  We raced to the vets
>because we wanted to observe the operation and take photos, it was sooo
>weird looking in and everything was moving inside... The pancreas was
>full of tiny insulinomas, when she got to the liver it was riddled with
>tumours as well.  There was a really odd looking lymph node by the liver.
 
Dear Z:
 
I am sorry for your loss.  While I have not looked at the tissues, I am
quite suspect that what you have interpreted as many tumors in the
pancreas and the liver are instead areas of pancreatic hyperplasia (a
common aging change in ferrets and not related to insulin secreting cells
at all) and lipid accumulation in the liver (not tumors.) If you took
tissues I would be happy to look at them, but insulinomas metastasize in
ferrets only extremely rarely, and this is not the pattern.
 
Regarding the odd glucose readings, here is a possible scenario.  In
long-standing insulinoma, normal insulin-secreting tumors wither away,
as there is no longer any call for insulin.  The insulin secreted
sporadically by the tumor results in the hypoglycema (BG from 45-55 in
this case, and one time 25).  So, you went and gave exogenous glucose by
IV and used pred to bump it up even higher.  If during that time the
tumor secreted no insulin, by chance, there were also no normal islets to
secrete it, and the glucose just went sky high.  Eventually if you waited
long enough, the tumor may have secreted insulin and everything would
plunge again, but in this case it didn't.
 
With kindest regards,
Bruce Williams, DVM
[Posted in FML issue 3919]