[This was sent in 3 parts which I combined.  BIG]
 
Gary-
 
Thanks again form emailing me privately, but I had really hoped to carry on
this discussion on the FML.
 
To summarize your private message, you incorrectly restated my post that
"your data indicates fructose is absorbed twice as slow as sucrose, so that
may be the key in observable difference of reaction." What I stated in my
last post was that fructose was absorbed into the bloodstream half as fast
as GLUCOSE (not sucrose as you have incorrectly stated above).  I may not
have been perfectly clear, but remember that sucrose is actually a glucose
and a fructose bound together.  The absorption of these two sugars cannot
occur until sucrose is first digested, unlike fructose which can be
absorbed directly without digestion.  The fructose (from either source) is
then mostly converted to glucose, which is what gets into the blood stream.
This whole process is likely species, age, and diet dependendent.  To be
honest, I did find another reference to maize starch being absorbed more
slowly than glucose or sucrose (Levine.  Monosaccharides in health and
disease.  Annual Review of Nutrition. 6:211-24, 1986), so you were
probably correct (even though you misquoted me).  But, maize starch strikes
me as being found in corn syrup which you lumped in with refined sugars as
causing a larger glucose spike, so your statement about the benefits of
honey vs. karo (corn) syrup still don't make sense to me.
 
I did some more literature work and basically found out that this topic is
even more complex than I initially thought.  Not only are glucose and
fructose absorbed by different mechanisms and at different rates, but
fructose absorption is increased in the presence of glucose (in some
species) due to a cotransport mechanism.  Furthermore, fructose (when not
absorbed effectively) may result in abdominal distress (Rumessen and
Gudmand-Hoyer.  Functional bowel disease: malabsorption and abdominal
distress after ingestion of fructose, sorbitol, and fructose-sorbitol
mixtures.  Gastroenterology.  95(3):694-700, 1988).  That citation is for
humans, but I also found it in rats.  Interestingly, both species (humans
and rats) are omnivores and are therefore probably more capable of sugar
(or carbohydrate) digestion than an obligate carnivore (ferret).  Have you
ever seen any GI upset with your ferrets after feeding them honey or
Timmy's Tonic?  You may not have because I also discovered that honey
contains not only fructose (major compenent), but also sucrose and glucose
(probably because it has adulterated - no wonder I didn't really enjoy
nutrition class).  So, honey may have enough glucose to result in the
efficient absorption of the fructose.
 
Now, you said [FERRET-L Digest - 4 Sep 1998 to 5 Sep 1998 (#1998-2422)]:
 
>"Chemically this is what the body does as insulin removes sugar from the
>blood stream.  But, the body is calcuating on the rate of metabolism of
>'natural sugars' which are slower to release than refined, so it thinks
>there is vastly more sugar than really is present, and the insulin released
>is too much for what is needed, so you get a rollar coaster up then too far
>down level in the blood stream.  ... In medicine the principle translates
>to advise to people to eat complex carbohydrates rather than refined sugars
>if you have hypoglycemia."
 
What I actually found was:
"Dietary complex carbohydrates of various type, including those rich in
dietary fiber, which are the cell walls of fruits, vegetables, and cereals,
may slow the rate of absorption of glucose from those diets and contribute
to a lowering of the postprandial glucose peak.  Glycemic responses to
various foods compared to glucose have been studied and show a large
variation, which is dependent upon gastric emptying, overall effects on rate
of hydrolysis and absorption of glucose from food mixtures.  Dietary sucrose
seems to cause a degree of insulin resistance.  The active part of the
disaccharide is fructose, which does not elicit an acute insulin response,
but appears indirectly to increase insulin levels in both animals and man.
Sucrose in animals appears to promote obesity more than glucose because of
its lack of stimulation of thermogenesis (Levine.  Monosaccharides in health
and disease.  Annual Review of Nutrition.  6:211-24, 1986)."
 
This is interesting because I also interpret it to mean that complex
carbohydrates will prevent a "roller coaster ride" of blood sugar.  But
since ferrets are obligate carnivores, why not feed a meat-based diet (with
gluconeogenesis providing the glucose) to prevent the roller-coaster ride of
blood sugars.  Moreover, I haven't found any evidence that the body "thinks
there is vastly more sugar than really is present" nor do I believe that
there is much if any difference between "natural sugars" and "refined
sugars" of the same type (ie. natural sucrose vs.  refined sucrose, etc.)
... afterall, chemically they are the same (carbon, hydrogen, and oxygen).
Furthermore, your "natural" honey was refined by honey bees - truly
"natural" would be if you went out and sucked on a flower.  The above paper
also states that sucrose (one of your "refined sugars") can cause a degree
of insulin resistance.  Whether this means giving sucrose to a insulinomic
hypoglycemic patient is better than a simple sugar like fructose, I don't
know, but it does bring up an interesting clinical point to debate.
 
As far as Timmy's Tonic goes, I wasn't originally interested in discussing
its benefits (only its sugar content).  But, since you bring it up ... I
only hope that in considering all possible therapies, the owner has a good
discussion with an excellent vet who can help them make a decision that is
right for both the client, the pet, and the vet.  If the owner felt that
Timmy's Tonic was the only therapy for them and it worked ... then great.
In fact, because many of the best drugs available are derived or purified
from natural sources (penicillin originally from mold, taxol originally
from the Pacific Yew tree, etc.) or resynthesized into more potent forms
from these natural molecules, I am not willing to overlook
alternative/"natural" therapies.  In fact, I am not even willing to hazard
a guess as to the benefit(s) of Timmy's Tonic as I know very little (other
then what I read on the website) about it.  As several of its components
are likely to have some pharmacological properties, I would not be at all
surprised if there was some benefit under certain circumstances.
Unfortunately, under other circumstances, these same components may have
toxic properties.  You indicate (in your private post to me, that "I don't
have 'studies references' that you seek.  I operate mostly on emperical
evidence."  Because of a lack of clinical information, we would never know
what happened to a patient receiveing Timmy's Tonic (good or bad) because
Timmy's Tonic contains multiple agents and we would have no data.
Conceivably, some components could be beneficial, while others were
harmful.
 
My original point in taking up this discussion was that the information
about sugars seemed misleading (at best) and advice on giving honey (in
Timmy's Tonic) to an insulinomic ferret to prevent a hyperinsulinemia
appears to be counter to traditional medical advice.  I intended to balance
your comments concerning treatment with other references.  In Ferrets,
Rabbits, and Rodents (Hillyer and Quesenberry, 1997, p.89), it is
recommended that "unless ferrets show signs of hypoglycemia, instruct
owners NOT to give simple sugars such as honey or corn syrup because these
foods can stimulate insulin secretion, precipitating a hypoglycemic episode
soon after."  These vets recommmend that ferrets with insulinomas be fed a
meat-based, high-protein cat or ferret food (avoiding high sugar or
carbohydrate foods, including canine or feline semi-moist diets) frequently
and avoid prolonged periods without food.  They also indicate that
prednisone can be used to medically manage mild to moderately hypoglycemic
ferrets because it "acts to increase peripheral blood glucose by inhibiting
glucose uptake in peripheral tissues and increasing hepatic
gluconeogenesis." Other drugs (diazoxide, somatostatin, and octreotide) can
be used in conjunction with predinisone because they inhibit insulin
release.  "Medical management is usually effective in controlling clinical
signs for periods of 6 months to 1.5 years."  With ferrets younger than 6
years of age, the authors recommend surgical therapy (removal of insulin
producing pancreatic nodules) which is usually not curative but may stop or
slow the progression of the disease (H & Q, pp.88-90).  By the way, these
are practicing vets with whom one of my best professors has worked, so I
trust their methods and results.
 
You also indicate that you make statements on your webpage indicating that
"This is not medical diagnosis, or recommendations of treatment.  You
should consult competent health care professionals and do your own research
to understand what is happening."  That's great, but I AM concerned about
your statements stating that there is a conspiracy between the medical
establishment and the pharmaceutical companies.  This kind of biases your
previous statement.  Finally, I am glad to see that you aren't claiming a
cure-all (that would be a lot like snake-oil, right?).  Interestingly
enough, I once heard a vet say that 25% of the animals will get better no
matter what you do, 25% will NOT get better no matter what you do, and 50%
of the animals are depending on what you do do.  I don't know how accurate
this is, but the point is that the medical profession doesn't know
everything, all we can do is try to help, sometimes miracles are going to
happen, and sometimes it is just time.
 
-Sean
 
PS. Thanks for the well wishes on the continuation of my studies.  I have
two huge exams in the next 6 days, plus I have to go to child birth classes
on Saturday.  Talk about no time.
 
******************************
Sean D. Sawyer V'00
SCAVMA Treasurer
University of Pennsylvania
School of Veterinary Medicine
 
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******************************
[Posted in FML issue 2426]