Here is an update on my sweet old blind girl Sonic. She's the one who had
been on pred and diazoxide for insulinoma for months and then suddenly
became diabetic, complete with large amounts of sugar in her urine and
trace ketones. We stopped the diazoxide and weaned her off of the pred but
didn't want to put her on insulin unless the ketones became significant; it
seems like ferrets can bottom out on insulin fairly easily, so we wanted to
avoid it unless the ketones became dangerous.
The GREAT news is that her blood sugar came down on its own as the meds
were taken away. She hasn't had any sugar or ketones in her urine in
about 4 or 5 days now, and her blood sugar is running in the upper 100's.
Still above normal, but not anywhere near what it was (300-570). We're
monitoring her VERY closely for return to hypoglycemia from the insulinoma.
The less good news is that she developed a yeast/bacterial bladder
infection, probably from all the urine sugar, and is on meds for that. She
was having painful urination and acted pretty "blah." She's having less
pain and is stronger and more active now, so hopefully that is going away.
The even less good news is that she is *really, really* not wanting to
eat. Not Bob's gravy, not chicken baby food, not kibble mush, nothing.
When healthy she eagerly eats all of those. If scruffed, she will usually
grudgingly lick tiny bits from my fingers several times a day, but that's
it. She even went off ferretone, but her taste for that came back
yesterday. Before the diabetes saga, she went off of kibble and had some
mild ulcer signs, and we treated her for Helicobacter with Biaxin, amoxi,
and carafate, and after that she again was eating kibble in addition to her
gravy (she's a MAJOR addict usually). I'm getting enough down her now to
keep her weight reasonable, but it is a struggle. She also sometimes needs
SQ fluids because she's not drinking very well. I'm giving her carafate
now, in case she's having ulcer trouble with all the stress she's been
having, and part of the bladder infection treatment is amoxi. But she's
not tender over her stomach, and I am wondering if the not eating is from
some other cause. Her appetite hasn't improved so far with the treatment
for the bladder infection (we're about four days in).
Here are lab values of particular interest, if this doesn't scramble too
badly. (others were normal):
now Dec4 normal range
Glucose 191 567 80-120 mg/dl
BUN 3 27 10-33 mg/dl
Creatinine 0.6 1.2 0.2-0.8 mg/dl
Total Protein 7.4 8.4 5.5-7.6 g/dl
Total Bilirubin 0.2 0.3 (prev 1.0) 0.0-1.0 mg/dl
Alk Phosph 104 114 (prev 130) 15-45 U/L
ALT 432 498 (prev 665) 10-280 U/L
Calcium 9.0 7.2 7.7-11.0 mg/dl
Sodium 140 153 140-160 Meq/L
Potassium 4.2 5.4 4.3-5.8 Meq/L
Does the low BUN (3) mean anything really bad? Could it be from the fluids
diluting things (I don't think I'm giving too much, but it's the only thing
I could think of)? A quick web search showed it might mean liver damage,
but I don't know enough to say if there are other causes. My vet's great
and we'll talk about it, but she's out of town til Tuesday. ALT and
AlkPhos have been high for some time now, but the feeling was that it was
from her irregular eating schedule when she was off of kibble, or perhaps
from the pred. And both of those *are* coming down, and total bilirubin,
which seems to be the one to watch, is normal. I'm supplementing potassium
a bit.
Sorry for the length! I really do hope her appetite comes back as the
bladder infection goes away. Besides the lack of appetite, she's doing
GREAT, very steady on her feet and getting more and more active. Any
other thoughts?
I hope everyone has a great holiday!
-Pam S.
[Posted in FML issue 3276]
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