>We have a ferret named Zini who had Insylinamia surgery in January.
>The vet has gone in once since then and can't find any thing else wrong
>that would be causing his seziers.  He has been on honey water for 5
>months and the segiers have been getting wores.  No we've decided to
>try something different.  We started giving him PHENOLBARBITOL to see
>if it can help with the segiers as, Thursday was one of the wores he's
>ever had.  (Zini is ADV negative,as is the rest of my ferrets.).  So
>far so good, no seziers!!
 
Although insulinoma is the most common cause of seizures in ferrets it
is not the only cause.  Seizures are a neurological symptom based in
the brain so they can be caused by a number of things that affect brain
function in mammals.
 
Epilepsy is one and that also is one disease for which phenobarbital
is used.
 
There are also forms of brain malignancies or other brain based
diseases/disorders which are possible and can cause seizures.
 
Beside the more commonly discussed two infections that can cause a range
of neurological symptoms (Canine Distemper and Rabies) there are a decent
number more that can set up shop in ways that can cause seizures.
 
There is a whole section of Fox's vet text _Biology and Diseases of the
Ferret_ devoted to the neurological signs which sometimes occur along or
in conjunction with other symptoms of ADV (Aleutian Disease virus), and
besides seizures it can cause unexplained extreme weakness or paralysis
(which in turn also have other possible causes from insulinoma, to lympho
in the psinal cord, to...).  It's in a marvelous neuro chapter in there.
 
Did you know that Toxoplasmosis will reproduce in the brain?  I just ran
into that tidbit the other day but do not know how it expresses itself
then.
 
Ferrets can get Transmissible Mink Encephalopathy, a prion spongiform
disease of the brain, but the chances of running into that are about
as rare as winning the big lottery and past cases were typically
caused by the feeding of infected meat and typically encountered on
some fur farms.  It is the mustelid version of CJD.  There have been
three cases of either TME and CJD, or sometimes just ferrets and CJD
in the same households but with some households sharing the same
food sources between the humans and ferrets and humans preparing the
ferret foods that is not a great surprise, and in each of those cases
the ferreting had actually ended 2 to 20 years before the people broke
with symptoms.  These days with so much more known about prion disease
(scrapie, Mad Cow, the encephalopathies which have been found in deer or
elk in some areas, etc.) we know to commonly look to the food with such
prion diseases... The chances of this being what you are seeing in your
home in this area are more rare than being hit by lightning at this time.
 
Meningitis has occurred in ferrets and I guess that I hear about maybe an
average of a case a year of that; with some years having none mentioned
(which interestingly is fewer than the number of canine distemper cases
people send me notes about so use that as a totally non-scientific
possible rate or discussion comparison).  A few such cases have made it
to the FHL and here over, too, I think the years for discussion.  At
least one such case was at first considered to possibly be DIM but then
it showed more about itself.  There are other possible diseases based
there.
 
Of those, I think that it pays to test for ADV/hypergammaglubulinemea
since it is certainly far from unknown in this area, so it is good that
testing was recently done.
 
Other things which disrupt the oxygen flow to the brain can cause
seizures, so also think in terms of oxygen acquisition and transport,
heart arrhythmias, thromboses (which are typically secondary to heart
disease, kidney disease, lympho, etc.) and so on when unexplained
neurological signs are seen.  So, it could well pay to check things
like heart health.
 
When insulinoma, the most common cause of seizures, is present: try using
Diazoxide as well as Prednisolone at some point.  It's the generic name
of Proglycem and is easier to find and cheaper while working as well.
Not all ferrets respond to Diazoxide; some respond well but some don't
respond at all.  If you are using Prednisone try Prednisolone; since it
skips the liver processing step it is sometimes more effective if the
liver is at all compromised.  Some do better longer by having the Pred
divided to three times a day instead of two since the action life of Pred
is about 9 hours, according to a previous pers.  com.  with a vet.  Some
unusual ones have needed Dex instead of Pred, or have tolerated injected
Pred and not minded it, but not tolerated oral Pred.  Some end stage
ferrets get extra quality time by always having something sugary easily
available when the meds max out; the most extra good time we personally
have gotten for a ferret with that approach is 3 months, but it doesn't
work for some at all.  Honestly, if the ferret does not have an ulcer
problem and the vet thinks there is the final stage of insulinoma it
pays to ignore the dose max with Pred and try doses that are higher
in combination with oral sugars.  We have given as high as 5 mgs of
Prednisolone in a day to a small female in that situation with a decent
chunk of extra quality time resulting -- hey, it was that or saying
goodbye, so...
 
With insulinoma there is too much insulin produced.  In some ferrets
when trying to figure out if that is what is causing the seizures it
can pay to test not only blood glucose levels but also blood insulin
levels.  That is not often the case, but if the diagnosis of insulinoma
is questioned then it makes sense and is certainly do- able.  The high
insulin levels cause blood glucose (blood sugar) levels to drop too
low, and that in turn is what causes the brain neurological symptom of
seizures.
 
In general when a ferret has insulinoma ours have done best with some
surgery, but the tumors tend to usually be like little grains of sand
that need to be popped out so unless a vet operates with a microscope
and has a marvelous sense of touch it is incredibly easy to miss many of
them.  Even then and when the surgery is early the recurrence rate is
40%.  That is strongly considered to be because whatever is causing the
insulinoma is still present.  In study by Doctors Charlie Weiss and Bruce
Williams medication along gives by far the shortest survival rate ON
AVERAGE, whereas partial pancreatomy gives the longest, and a simply
lumpectomy inbetween.  That said, there have been individuals who have
had some on meds go for as long as those with the larger surgery, there
have been those who had the larger surgery who turned out to have the
insulinoma by vital pancreatic structures who therefore could nto have
all removed, there have been rare ones who develop A/V Heart Node Block
secondary to insulinoma.
 
BTW, insulinoma has a very low rate of metastasis which is having the
same growth show up in a DISTANT location in the body ( Metastasis is
one of the three needed things to be accurately called "cancer".), but
it has a very high rate of popping up again in the pancreas itself.  On
the other hand, sometimes what is in the pancreas acts like insulinoma
because it is affecting the insulin producing cells, but is actually
lymphoma/lymphosarcoma, or carcinoma.  These are more virulent and they
are malignancies.  They are also harder to treat very often.  A number
of times when a ferret has both the symptoms or insulinoma and adrenal
disease, or growths in multiple places it is one of those two responsible
for everything seen.  With Prednisolone a decent bit of quality time can
often be gotten for ferrets with lympho, but with a metastasized
carcinoma the chances of getting even a few months are very low, though
the Prednisolone may add some time.  Each of these two if based in the
pancreas will at times show no symptoms until causing onset of a sudden
and life threatening grande mal seizure set.  We have had to do mouth to
muzzle gentle cheek puff artificial respiration to get two like this to
the vet in 24 years with ferrets in the family.  One had lymphoma and
required sugars to be always present as well as having Prednisolone and
Diazoxide.  (This was perhaps two decades back -- when the med was so
rare that at first our vet had to arrange to buy human hospital left
overs when a patient's weight left a bottle only partly used because
the med was not sold yet through pharmacies, though that soon changed.)
The more recent one, about a year and half ago, had carcinoma there
which is a lot harder and much faster.
 
-- Sukie (not a vet)
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[Posted in FML issue 4956]