To Becki Kain -
 
>The problem is that he is naucous all the time, wimpers, and is not eating
>on his own.  He is often in a dazed state, pulling at his mouth with his
>hands, and drooling.
 
Becky - the drooling and dazed state is probably due to the insulinoma.
However, the nausea may well be the result of the chronic kidney disease.
 
You're definitely in a bit of the bind.  Prednisone which is used to raise
blood glucose in insulinoma patients increases wear and tear on the failing
kidneys.  If the kidneys are really shot, then you can't do the surgery, and
have to administer the pred.  I'm not sure about the Winstrol to treat renal
failure - is Tieke anemic?  Certainly, they are not acting as appetite
stimulants, as they are often prescribed.  They may further decrease the
blood glucose due to their anabolic (muscle-building) process.  If they
aren't adding to the treatment, I would start by removing them for the
regimen.
 
My first thought would be surgery if Tieke is a surgical risk to try and
remove the insulinoma.  It may buy some extra time.....
 
Bruce Williams, DVM, DACVP              Chief Pathologist, AccuPath
[Posted in FML issue 1664]