Regarding the possibility of post-surgical diabetes - this is
occasionally seen in ferrets with long-standing insulinoma.
 
How does this happen?  Well, ferrets with insulinoma have elevated levels
of insulin (duh!) This high level of insulin causes the rest of the islet
cells in the pancreas (the ones that are responsible for secreting insulin)
to atrophy - there's enough insulin around, so they're not needed.
 
Unfortunately, when you remove the tumor, that source of insulin, the rest
of the islets are at a disadvantage - they're atrophied, and they may not
be able to secrete enough insulin to keep the glucose at a normal level.
In most cases, diabetes, if it is seen, is transient.  These sleepy islet
cells will wake up and get back on the job.  Depending on the duration and
level of insulin secreted by the tumor, some cases need insulin therapy
on a temporary basis until the cells can kick in.  Rarely, the cells
have atrophied or there is additional disease in the pancreas (usually
inflammatory) that there is nothing left to come back, and permanent
insulin therapy is needed.
 
There is no way to tell which situation you will run into, but the odds
are in your favor - only a small percentage of post-surgical ferrets will
become hyperglycemic, and even fewer will become permanently diabetic.
This is one reason to do surgery early on insulinoma cases - even a good
response to prednisone and proglycem will not forestall the feedback
mechanism that is put into place by prolonged insulin secretion.
 
With kindest regards,
Bruce H. Williams, DVM, DACVP
 
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[Posted in FML issue 3371]