http://www.smartgroups.com/groups/ferrethealth
 
Author wrote:
> 1- Is it true that in insulinoma cases, a surgery ,If the ferret is
>a good candidate, is ever the best treatment ?  Or this statement is
>valid only for the first one?
 
Surgery is still the best treatment - it is not uncommon for ferrets to
have two or more.
 
>Or putting in another way: Even having already went trough a partial
>pancreatectomy(about 50% of the organ) last year, will be the best
>choice in terms of time and quality of life to make an exploratory and
>try a nodulectomy on the new growths?
 
I think that is a fine idea.
 
>2- What are the elements we can use to establish if she is a good
>surgery candidate anyway?  Is the glucose level one of then?  If yes,
>what can be considered safe?
 
Glucose is not a prognostic factor, ferrets even with minimal glucose
levels can be administered glucose in IV fluids before during, and after
surgery.  The duration of symptoms is probably a more important
prognostic factor.
 
>3- My vet told me that in cases of insulinoma that included
>spleenomegally; if the spleen "shrinks" when Prednisone is introduced
>(which absolutelly did'nt hapen to her untill now) , it could be an
>indicative that a linfoma is present too.  Is it sounds?
 
No - the only way to tell if the spleen has lymphoma is to remove it and
sent it off for pathologic examination.  Spleens often change in size.
 
>Or as I have red many times in this list, the unique way to diagnose
>linfo is with an aspiration or biopsy in a organ or limphnode?
 
Biopsy is best, aspirate is not really adequate.
 
>4- Considering all that we read about growths in the liver rarely
>being primary caused, do you think that the hepatic carcinoma she
>had could be a metastasis from her left adrenal ?
 
Didn't you say that the lesion in the adrenal was hyperplasia - if this
is true, then it isn't metastasis.
 
However, adrenal carcinomas and hepatic carcinomas can look identical,
and only very special tests (not available everywhere) can truly tell
the difference between these two lesions.
 
>5- She has no bold spots, only a slower growht of her fur.  As I said
>her remaining adrenal had grown to 0.8 mm .  Do you think that, going
>to surgery we may think about to remove it?
 
The average size of an adrenal is 0.5 cm - so you may be moving into
dangerous territory.  Most adrenals over 1 cm in diameter contain adrenal
malignancies.
 
>6- She's having black and tarry pooping now (but not all the times) and
>whining when pooping, all times (not when urinating just when pooping) I
>don't now Why.  Must we just start with some ulcer medication?  Or are
>there any specific tests to do before?
 
No, black tarry stools are very characteristic of ulcers - my
recommendations would be to start meds now, and to treat aggressively -
this would be a major complication to her having surgery.
 
With kindest regards,
Bruce Williams, DVM
[Posted in FML issue 4094]