Ferrets are primary (or obligate) carnivores.  They eat animals, and only
consume 5% or less of their diet in plant products.  Kibble contains far
more than 5% plant products; in order to form the biscuit, the kibble must
be about 1/2 plant material, which is loaded with starchy carbohydrates
(polysaccharides).  Both glucose (also known as blood sugar, D-glucose
or dextrose, a simple monosaccharide sugar) and maltose (a complex
disaccharide sugar) are randomly produced when kibble starches are broken
down (hydrolysed) by amylase, a digestive enzyme.  Maltose is broken down
by another digestive enzyme, maltase, resulting in two glucose molecules.
The metabolism of other complex disaccharides, such as sucrose (table
sugar) and lactose (milk sugar) is similar to maltose.  You can see why it
is useless to give complex sugars to offset hypoglycemia; you have to wait
for intestinal digestive enzymes to break the sugars down to glucose,
needed to neutralize insulin.  Glucose goes straight into the blood and
works immediately.  In contrast, table sugar is metabolized to glucose and
frutose in the intestines, taking time which a ferret may not have.  Both
Karo syrup and honey contain large amounts of glucose which is absorbed
directly into the blood stream through the oral tissues (like with nitro
for heart patients.  sort of a 'sugar pop").
 
Primary carnivores eat very little sugar and even less starch; they mostly
consume proteins and fats, with a small amount of starches included in the
intestines of the prey animals and some sugars (mostly frutose) in consumed
fruits.  Digestion of stomach-content starches already started inside the
prey animal, and many have already been converted to monosaccarides.
Kibble starches may have been broken down by cooking, but they are still
polysaccharides, and lots of them.  What this means is, ferrets evolved
eating a high protein, high fat, low sugar, very low starch diet.  I think
the key to insulinoma in ferrets relates directly to the large amount of
carbohydrates included in a kibbled-based diet.  I think the problem is
simply nothing more than the response of a mammal that evolved consuming
animals and recently converted to consuming starches; I don't think their
pancreas is designed to handle it.
 
It is a proven fact that pancreatic diseases can be initiated by diet; just
ask native hunter-gathers introduced to processed sugars.  These unlucky
people have the highest rate of diabetes on the planet, even though
Europeans are generally uneffected.  Why?  Because of the same reason
Europeans tend to be lactose tolerant; they evolved mechanisms to control
the increase in starches (and milk) in the diet long ago, and native
peoples are only dealing with the consequences in the last few centuries.
I think the same type of thing is taking place with ferrets right now in
America; kibble-based diets are introducing an incredible amount of
starches in the diet, and insulinoma is the result.  The supporting
evidence is a low level of the disease exactly in those areas that
historically have not had kibbled foods available.  This means that, as
kibbles are introduced to these countries, insulinoma should increase as
well.  You can see such a trend in the 10 years between the two editions
of Fox's book; during that time, the use of kibbles in ferret diets has
also increased, even to the point of it becomes a weaning food for kits.
 
So why does Bob's Chickey Gravy seem to work so well in insulinoma ferrets?
High quality proteins, fats, trace elements, monosaccharide sugars, few
starches (the recipe allows a small amount of kibble but suggests it be
eliminated when the ferret accepts the food) is the reason.  This diet
is exactly what is needed if starches are the source of the problem.
Objections that the included honey is a problem are obtuse; honey *IS* the
recommended emergency treatment for insulinoma symptoms, it is a simple
monosaccaride sugar complex (mainly glucose with lesser amounts of
frutose), and since it is directly absorbed into the blood stream without
modification, it will *reduce* the amount of insulin present as well as
*increase* blood-sugar levels.  As for the amount, the recipe usually
results in about a gallon of food; 2 tablespoons of honey is really not a
lot.  Conversely, a gallon of kibble-only diet, even if only 40% starch,
converts to sugars in far greater amounts than the honey in my recipe.  If
insulinoma is exacerabated by consumed sugars, why is starch-filled kibble
being fed to the ferrets at all?  *ALL* starches are metabolically reduced
to glucose during digestion.  Remember one of the dietary treatments?
Reduce the amounts of sugar fed the insulinoma patient?  If you feed a
ferret kibble containing carbohydrates of any digestable type, you are,
in essence, feeding it sugar.
 
Does the Chicken Gravy diet really work?  I have email and letters from 8
different people who have been monitoring their ferret's blood sugar while
introducing the Chicken Gravy, and *ALL* of them have had an in increase in
blood sugars, improved activity, and general decrease of symptoms within a
few weeks of starting the diet (I said decrease of symptoms; there is no
claim the diet cures the problem).  There appears to be evidence that it
does work, but since the recipe has only been available for the last few
months, it is too early to tell.
 
The bottom line is, no one has an *ESTABLISHED* cause for insulinoma.
Since there is essentially no cure for the disease, prevention seems the
only course of action.  The problem is, what do we do to prevent it?  Is
kibble the cause?  I don't know.  I think the starches included in the
kibble biscuit are the reason, but while I can argue, I can't prove
anything.  All my evidence is circumstantial at best; no direct links.
But all science must proceed from an idea, and if enough of us change diets
and it has positive results in insulinoma cases, maybe it will spur real
research, or even establish a cause.
 
Bob C and 19 MO' Primary Bobivores
[Posted in FML issue 2644]