In the last week or two I have run into three or four cases in which there
was no treating done for insulinoma; either vets didn't know or they or
the people didn't realize how long surgery or meds can give and how they
return quality of life. After over a week of rotting out tonsil nodes
and feveringI am not up to rewriting a lot of info on this esp. since my
ffevers pretty high now, so will just repeat part of something I said
before. Yes, there are many typos today; please, deal with them. Sorry.
[Moderator's note: Formatting I fix... but typos I don't touch! BIG]
The body, including the brain need enough sugar in the blood to function.
Hypo means low, and glycemia refers to the sugar. In insulinoma (insulin
cell tumors) the tumors secrete too much insulin and that forces down the
blood sugar. Surgery cures about 60% of the cases, but in about 40% new
growths appear after surgery.
When a ferret is not a surgical candidate there are two useful
medications: Prednisone and Proglycem. Depending on the individual
situation these are given together from scratch, or Pred may be used for a
while and then Proglycem added later. Prednisone is cheap; Proglycem is
expensive, BTW. There had been a hypothesis that giving dietary sugars
was bad and caused yo-yoing of blood sugar. That might be true for early
cases so dietary precautions might make sense then with sugars eliminated
from diet and surgery/medications used till more is known; for advanced
ones that hypothesis flies out the window because the insulinomae suppress
the normal tissue and insulinomae are not blood-sugar-level dependent in
the amounts they secrete, so for late cases of insulinoma dietary sugar
may be added to hopefully give some extra quality time. At the very
least this ferret should be on Prednisone. According to Karen Purcell's
incredible vet text the dosing for Predisone/Prednisolone is 0.10-2.5
mg/kg q 12-24h PO . Ferrets are not particularly prone to the steroid
problems seen in a number of other mammals. In-house blood testing is
standard and cheap in many, perhaps most, areas now.
Note that those figures were thatabout 60%find surgery curative. Note
that many get a long amount of qualty time with meds.
Our 8 year old Warp doesn't have a long time left in this world; she has
advnaced insulinoma, apparent lymphoma (partr of our clump), an autoimmune
disorder that causes a friable small intestine, and a R adrenal neoplasia.
She isn't a surgical candidate due to past problems iwth srugeries, but
meds have given her over a year. Until her leg nodes got too large this
last week she was still the fastest ferret here -- even at 8 and even with
some true athletes in the bunch. With her nodes up she is bit unstable
and today we saw Ashling running full out next to Warp letting Warp lean
on Ashling on Warp's weker side so that Warp could run. Ferrets are so
marvelous! Oh, nad Warp acted very proud after her foray into the basket
with the newspaper bags in it. Eight years old, all those things wrong,
but meds plus extra sugar (since her's is an advanced case) allowher to
be that active! There's a lot to said for the quality of life aspects of
veterinary care.
-- Sukie
For ferret health information:
http://groups.yahoo.com/group/Ferret-Health-List
http://geocities.com/sukieslist
[Moderator's note: Sukie followed up her post with the following reference
of her "60% curative" quote. I'll just add it on here.
A Golden Oldie:
[From: Dr. Bruce Williams]
Date: Mon Jan 14, 2002 9:23 pm
Subject: Re: Insulinoma - surgical or medical management??
It is no secret - at least on this list, that I far prefer to do surgery
early on, and reserve medical treatment for non-surgical candidates.
It is inevitable that these ferrets will become refractory to the
prednisone over time, and then surgery will be required. However, at
that point they may have become non-surgical candidates.
Surgery gives a 60% chance of cure if done early, and this number
decreases over time. The remaining 40% will develop additional tumors
within the next 10 moths, but that's the equivalent of a 10 year interval
for a human.
With kindest regards,
Bruce Williams, DVM
URL:
http://groups.yahoo.com/group/Ferret-Health-list/message/10123
[Posted in FML issue 3795]
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