Just a few answers to questions to bring this series of posts to a close.
 
1) I am not a vet.  I am not qualified nor licensed to treat animals.  I
cannot nor will not diagnose your ferret via email or any other means.  If
you think your ferret has insulinoma (or any other disease), you need to
see a vet immediately.  Please, don't wait.  Go now.
 
2) My description of the digestion of starches was, for purposes of the FML
extremely condensed and simplified.  Fats and carbohydrates are not the
same thing.  All starches are carbohydrates, but not all carbohydrates are
starches (see below).  Polysaccharide starches are digested to a random
mixture of disaccharides (complex sugars; mostly maltose) and
monosaccharides (simple sugars; mostly glucose).  This takes place in
microscopic areas of the small intestine called "brush borders." When a
ferret has hypoglycemia, the brain is starved for sugar, and organ systems
start shutting down to preserve brain function.  Complex sugars, such
as table sugar (sucrose), must be broken down to glucose before it is
effective.  A very small amount does occur in the mouth, but most occurs
at the brush borders of the small intestine.  So complex sugars have a
two-fold problem; 1) they have to get to the small intestine (via the
esophagus and stomach) to be metabolized to glucose, and 2) hypoglycemia is
shutting down organ activity to preserve brain activity, so what you may
want to go to the intestines, is now stored in the stomach and not doing
much of anything.  Use honey or Karo syrup in emergencies.
 
3) Glucose is a simple monosaccharide sugar, and is the source of mammalian
energy.  Insulin controls glucose metabolism (and the production of
glucogen and triglycerides), as well as the transport of glucose to body
cells.  Within a minute of the presence of glucose, insulin is released,
which is why hypoglycemic ferrets should not have sugars except in
emergencies.  So think about it for a moment.  If starchy carbohydrates
are eaten in kibble, what are they broken down into?  Sugars; ultimately
glucose.  When?  Continously.  Each time and every time the ferret eats
starches are converted to sugars.  That means a ferret that eats lots of
starches, such as from kibble, will constantly produce glucose from the
starch, and constantly stimulate insulin production.
 
Now, quite honestly, sudden and large amounts of sugar would probably
trigger a hypoglycemic event once insulinoma is a problem, and I do not
advocate feeding sugars to ferrets suffering from the disease.  However,
I believe it is the CONTINUOUS production of insulin from the continuous
ingestion of starchy kibble which is the problem in the *origin* and
*control* of insulinoma.  Think about the evolutionary history of the
ferret, and it doesn't make sense that a continuous insulin supply would
be healthy.  Polecats eat fruit on occasion; not constantly.
 
4) Fructose (I didn't notice I misspelled it in my previous post) is a
simple sugar, but according to biochemists, it still must be converted to
glucose before it can be utilized.  This is the sugar most commonly found
in fruits, and would be the sugar most often encountered by a free-living
polecat (the ferret's ancestor).  I do believe that IF you desire to give
your ferret a sugary treat, fructose would be the best sugar to give, BUT
that is an opinion, not a fact.  Galactose is another simple monosaccharide
sugar, also reduced to glucose in the intestines.
 
5) Sucrose (table sugar) is a COMPLEX or disaccharide sugar, composed of
one glucose and one fructose.  Sucrase is the enzyme produced at the brush
border of the intestine which metabolizes sucrose.  Maltose is a complex
disaccharide sugar composed of two glucose molecules, and maltase found
in the brush border digests it.  Lactose is a complex disaccharide sugar
composed of a glucose and a galactose, and is broken down by lactase at the
brush borders.  As you can see, complex sugars are primarily metabolized in
the intestines, which is why they are essentially useless in hypoglycemia.
 
6) A saccharide is any substance made up of sugars.
 
A monosaccharide is a simple sugar, such as glucose.
 
A disaccharide is a complex sugar (actually two simple sugars stuck
together), such as sucrose.
 
A polysaccharide is a long chain of glucose sugars, such as starch and
celluose.
 
Oligosaccharides are essentially polysaccharides but yields less
monosaccharides when broken down.
 
A carbohydrate is a little different.  For *our* purposes, we need to
consider two types, digestible and nondigestible.  Digestible carbohydrates
include saccharides, such as starch or sugar.  Nondigestible carbohydrates
include cellulose and other stuff.  So while the digestion of
polysaccharides (starches) is slower than the digestion of mono- or
disaccharides, they still all end up as sugar.  And remember, it is sugar
that stimulates insulin production.
 
7) My Chicken Gravy is not a cure-all.  In fact, while I am convinced it
is pretty darn good, it is really no better than intact mature rodent
carcasses, or fat whole rabbits.  Remember, one of the treatments for
insulinoma is a high quality protein diet.  That is what the gravy is.
 
8) I DO NOT know what causes insulinoma.  I cannot find a single paper that
specifically says, "Insulinoma is caused by...."  But I think there is a
good chance diet is the reason, because the composition of kibbled diets do
not adhere to the evolutionary history of the ferret.  I can be wrong, and
quite likely insulinoma has multiple causes.  But if it does nothing more
than make a sick ferret feel a little bit better, what's wrong with that?
And if it does nothing but give your ferts something new or different to
eat, is that so bad?  As it has often said before me, "It can't hurt," and
just maybe we can learn something from it.
 
Bob C and 19 Mo' Bootivores
[Posted in FML issue 2645]