A recent poster included the following in her plea for help about
insulinoma:
 
>She's been doing well on Pred.  I've heard that there have been a lot of
>ferrets lost during surgery due to complications and the anesthesia.  They
>feel that I should keep her on Pred until it's no longer effective and use
>surgery as a last result.
 
I feel for how the poster is stuggling.  Her instincts are very much on
target (she questioned the above statement).  Do surgery as a last resort,
when the ferret is weak, less stable and has larger or more tumors?  When
I hear something like this I'm terribly saddened.  I don't know who "They"
are, but surgery should be done at the FIRST sign of insulinoma.  (There's
a small paragraph on "Backwards Treatment" in an insulinoma sheet that I'll
email to anyone who wants it.)
 
If the surgeon is a top-notch ferret surgeon, uses isoflurane (if not, walk
quickly to the nearest exit) and has done partial pancreatectomies,
recovery is usually swift and results are far better than with pred, or
pred with surgery done way down the pike.  Surgical problems are because of
wrong anesthesia, vets who do not know the surgery well, ferrets that are
kept under anesthesia too long (this sugery should take 30-45 minutes, not
2-4 hours) or ferrets that have surgery as a last (or second, or third)
resort, rather than at the first possible moment.  Of course surgery isn't
as effective if it's used as a last resort!  Besides, you then have to wean
the ferret off pred - which is the only thing controlling the BG and
seizures - before doing the surgery.
 
The best surgical results come with early detection and early surgery - a
partial pancreatectomy done as soon as the ferret is stable enough to have
it.  There should be a 3-4 hour fast before surgery (and careful monitoring
if the ferret has been taken on pred) and no food/liquid given for 14-18
hours post- op.  Pain medication and sub-q fluids given by the vet should
keep them very comfortable.  Our ferrets come home late on the day of
surgery to eliminate the effects of stress at the hospital (I realize most
vets don't allow this) and are up and around by the time we pick them up.
They sleep soundly, and are more than ready to eat (except our one
non-eater) when I set the alarm for 4:00 a.m. to feed them.  4 days without
ramps or wrestling and they're *back.*
 
What "They" are telling the poster is irresponsible and inhumane, in my
book.  I'd suggest that people ask their vets to contact Charles Weiss,
DVM, in Maryland, for more information about how to treat this disease.
 
And please - consider stopping the honey and sugar and other stop-gap
measures that ultimately hurt these little patients far more than they
help.
 
NOTE: None of our insulinomic ferrets have ever had a seizure.  All have
had surgery.  One is on pediapred after approximately 2 1/2 years
medicine-free.
 
Beth, abandoning some diplomacy, with Miska (insulinoma survivor since
1995), Gabby (insulinoma survivor since 1998) and Pads (insulinoma survivor
since 1998), all dancing and acting ferrety.
[Posted in FML issue 2497]