>Please comment on the nodulectomy vs. a pancreatectomy, the criteria to
>help one decide if a nodulectomy can be safely performed, and whether
>or not you used laser for your nodulectomies...if not, how did you do it
>without removing more pancreatic tissue?
 
Dear Lizzi:
 
Nodulectomy is by far the more common procedure.  When visible insulinomas
are present, sharp dissection with a scalpel point is usually sufficient
to closely excise the tumors.  Bleeding for the most part is minimal.
However, when nodules are not visible or can be felt, an alternative to
simply closing up the animal would be to remove one arm of the pancreas.
Ferrets, who are obligate carnivores with a very rapid GI transit time,
have the largest amount of pancreas pound for pound, of any domestic
species.  They have two arms, one running along the stomach, and one
running along the small intestine, where dogs and cats have only the
gastric arm.  Becuase the gastric arm in the ferret contains all of the
ducts which take the digestive juices produced by the pancreas to the
duodenum, we can't mess with that.  However, we can safely remove the
other 50% of the pancreas (the intestinal arm) without major harm.  That
gives us a 50% chance of removing the problem in insulinomic ferrets.
 
If your ferret has had a true pancreatectomy, then the only recourse left
is to go in, find a nodule if you can, and remove it via nodulectomy.
However, this is a safe procedure in normal healthy ferrets.  Because of
the previous bleeding however, there is some risk associated with it in
your particular ferret.
 
With kindest regards,
Bruce Williams, dVM
[Posted in FML issue 3198]