I got asked something off-list about a ferret who may be bad shape in
general on large pred doses for insulinoma and I think someone here may
need this info so I am excising my sentences:
 
Sounds very advanced if that much if needed.  (If it is Prednisone,
though, it might pay to try Prednisolone since some ferrets do better
with that since a rare few seem to not process that extra liver step
well.)
 
Has Diazoxide in addition to Pred been tried?  If not, it should be.
 
When we have had ones who were very advanced adding in some sugar given
throughout the day gave extra time and comfort.  We had one get a perked
up last few months that way.
 
I think I know who you mean and I forgot to mention the addition of
dietary sugar if it is the same sweet person.  Either way, could you,
please, mention it?  Late in insulinoma the insulinomae have replaces or
suppressed so much normal pancreatic tissue that there just isn't tissue
which is responding to blood glucose levels.  Insulimomas just always
pump out insulin no matter what the blood glucose levels are.  (New note:
this is as per some work described to me by Dr. Bruce Williams, and the
combo we are using now is to avoid sugar earlier in the disease just in
case yo-yoing can happen, but to add it late in the disease.)
 
If it is far enough along that so much med is needed then surgery might
be an added burden.  It sounds like a hard call.  I'd try seeing if the
ferret might do better with Prednisolone than Prednisone first.  If the
ferret does a LOT better with Prednisolone then perhaps it isn't horribly
advanced and widespread in the pancreas so surgery might be an option for
the treating vets to make the call on.  If there is no huge difference or
no difference I'd add Diazoxide and sugar and try to get as many decent
last weeks or hopefully months those additions sometimes can give.
 
If this is the same person I also forgot to mention that a few rare
ferrets process Prednisolone better than Prednisone and that may be
useful.  (New note: we even had one with IBD for whom Prednisone may
as well have been water but Prednisolone was highly effective.)
 
(New note: Since I didn't know if we were talking about the same person
and I did forget to mention two things to someone here I figured that it
is best if I put this here.
 
Of course, I'm not a vet, but if I have happened to have been in the same
spot and run into something which may be useful then what the heck as
long as someone is helped... worth discussing the things with the vet.)
[Posted in FML issue 4098]