[2-part post combined. BIG]
 
Thanks to everyone who responded by email so promptly.  Most of your
replies did not include your email addresses so I will respond here:
 
(1) Thanks to Dr Williams and Eydie Fox for info on the article published
in 1994.  The pathologist told our vet that this condition had not been
diagnosed in ferrets before - perhaps he should have specified "in living
ferrets", as the copper accumulation was found only after both ferrets
discussed in the article had died.
 
Our vet found no information on the dosage or toxicity of penicillamine
for ferrets, so we started it very slowly and carefully.  Rascal gets 15 mg
per day and tolerates it well.  Prior to surgery, Rascal showed lethargy
and depression, often waking only briefly then falling asleep again very
quickly.  Our vet did a quick glucose test and diagnosed insulinoma;
exploratory surgery followed.  No quantitative measurement of the copper
content of the liver biopsy was done, and the pathology report does not
list the specific stains used.  It does say that a stain for iron
accumulation was negative and another for copper was positive, with
substantial amounts of copper observed within the liver cells.  I believe
that slides of Rascal's biopsy may have been sent to other pathologists and
vet schools because the final report was not received at our vet's office
until August,but it really told us nothing beyond what had been received in
the preliminary report.  This work was done by the Central Veterinary Labs
in Calgary, Alberta, Canada, but I do not have a phone number or email
address for them.
 
We have had up to 12 ferrets at a time eating the same diet and drinking
the same water, but only Rascal has serious liver disease with copper
accumulation - it must be genetic.  His original owner was selectively
breeding for appearance ( he and his sister are dark sables with black
noses and very white undercoats) and had intended to use Rascal and his
sister as breeders.  I suspect that some inbreeding occurred.  We know that
Rascal's father and a half-brother died of insulinoma.  I have asked for
more information about his pedigree but have had no response.
 
(2) Our vet agrees with Dr Williams that Rascal's hind limb problems were
probably due to the liver disease instead of any central nervous system
copper accumulation or the insulinoma.  I am amazed how much he improves
week by week on the penicillamine: today he was wrestling and dancing
about, chasing his cagemate and running through tunnels for perhaps an hour
before they both tuckered out.  He had shown improvement on prednisone -
increased appetite, reduced lethargy - but today was wonderful.  We will
continue the penicillamine until October before we consider any treatment
for adrenal disease or do liver function tests.
 
(3) We use distilled water specifically because we live in a fairly new
house with copper water pipes, and our tap water leaches substantial
amounts of copper from them.  We used to use boiled tap water after two
tiny females nearly died from giardia in our city tap water (at least, we
could identify no other source of infection).  After Rascal's diagnosis,
we switched to distilled water.
 
I haven't checked the FML or other references regarding distilled water,
but I think I must use it to be sure I am reducing the amount of copper
Rascal ingests, to allow the penicillamine to work most efficiently.  If
I understand the biochemistry of penicillamine correctly, it binds copper
in the bloodstream which allows it to be excreted in the urine.  It also
binds some copper in the gut so it cannot be absorbed into the blood.  As
copper is removed from the blood, more is liberated from the cells to be
bound and excreted in turn.
 
No bottled water lists its mineral content on its label, and so-called
"spring water" may be just as loaded with copper as our tap water is.  I
read an article comparing the chemical and biological content of several
local brands of bottled water - some were city tap water run through a
filter and others contained fecal bacteria!  I can be confident that
distilled water contains no metals, although other ions may remain.  I used
to work in a research lab that used double distilled de-ionized water to
make solutions and to rinse glassware - by comparison, the distilled water
from my local drugstore is far from pure.  I doubt that Rascal is missing
any significant amount of mineral content, especially since he gets calcium
and zinc supplements in his duck soup.
 
(4) Zinc and copper are absorbed from the gut by the same biochemical
transport system.  I increased Rascal's zinc intake to saturate this
system and prevent copper uptake to some degree.  From experience with my
human kid, who has a chronic zinc deficiency, I know how essential zinc is
for the immune system and for liver function.  I have consulted a vet who
uses herbal treatments - she finds no problem with my duck soup recipe and
no conflict with his medication, and my vet does know that my sick ferrets
eat it daily.
 
(5) Ensure and chromium: I know that Ensure and Ensure Plus have high
sugar content, but sugar is a natural food and a quick source of energy.
These products are used by terminally ill human cancer patients who have
difficulty eating other foods according to my pharmacist.
 
Strawberry-flavored Ensure makes a good duck soup base for ferrets that
have completely stopped eating due to illness or post- surgically.  Both
Rascal and the other geriatric ferret I mentioned had to be force fed when
they were sickest - we tried liquified regular ferret food and found that
neither ferret would eat it.  The sugar in Ensure is easily digested and
absorbed - it places little strain on Rascal's liver, and he does like the
taste: I would hesitate to use artificial sweeteners or diabetic drinks (I
am not too keen on the artificial coloring, but it seems to remain in the
gut).  My understanding is that chromium levels out blood sugar highs and
lows, and when given with Ensure, maintains the blood sugar at more normal
levels for a longer time.  In my own experience, the geriatric ferret I
mentioned in my original message did not have any seizures for the last
seven months of his life even though he did not eat and rarely drank during
a 12 to 14 hour stretch each day, although his insulinoma tumor was
definitely growing in size.  In fact, he became quite chubby eating only my
duck soup!  He died 13 months after his insulinoma diagnosis, but not of
insulinoma - his heart failed and his liver lymphoma had spread to his
lungs.  Rascal's Ensure is a treat to take away the smell and taste of
penicillamine.  We used it originally to administer his prednisone
(dissolved in a little water and mixed into the Ensure).  He takes his
penicillamine with only a little gagging as long as he knows that he has
his Ensure coming - previously, much medication was wasted!  We may reduce
the amount of duck soup and of straight Ensure that we give him now that he
is eating on his own again, but he really isn't getting a dangerous amount
of sugar.  I use a very limited amount of chromium and brewer's yeast in
the duck soup, but I would be very interested in reliable biochemical
information on the effects of sugar and chromium on insulinoma in ferrets
 
Thanks again to Dr Bruce Williams, Mary Rogers, Eydie Fox, Mary
McCarty-Houser, Debi Cristy and our friend Lynn Galigan for your interest
and comments.
 
Violet Sparks
[Posted in FML issue 3160]