Insulinoma...? (Please Help)

[connieb]

My mistake, actually it is Prednisolone syrup. When I got the medication, I only glanced at the label, believing it was prednisone.

I'm feeding Blizz some a/d by syringe twice a day. He has been eating his dry food as well. He is finally able to walk normally. It's still a little wobbly, but it's a great improvement from just a couple days ago. I will be bringing him back to the hospital tomorrow morning for a glucose check. He seems to be doing quite well though. His face looks much brighter and more alert.

[joclyn]

good to know it is the prednisolone rather than prednisone...i always mention it because some vets do still use the pred tablets and it's just better in the long run to use the other formulation...

until he gets situated, feed him soft food (a/d or whatever else you want to try) at least 4x a day and more often if you can do so. that'll help bring his bg level up and keep it up. once the med really starts to kick in, you can pare back on the additional feedings...and, of course, leave kibble available 24/7 and monitor how much he's eating and how much water he's taking in, too.

soft-food feedings should be at least a tablespoonful and 2 if he'll take that much. the more the better. try giving it to him on a dish and see if he'll take it on his own - maybe water it down a bit so it's easier to lap up. add some tone, too, to entice him to eat it. they do tend to eat more if it's from a dish/bowl.

it's also easier on both of ya if he can and does eat on his own. i only ever feed with syringe if they're just too weak to eat on their own. once you get in the habit with it, they come to rely on it and i've known some that refused to eat at all unless fed with syringes! so, best to not go down that road if you can avoid it!

i'm again dealing with insu - my taco was just diagnosed last tuesday, so, we're also in the beginning phases.

i've been giving a/d or baby food or other canned food (i need to make more gravy) frequently. initially, every couple hours - i could only get about a teaspoonful into him, so it was rough there for a few days cuz he wasn't eating much of the kibble. i did the feedings around the clock (i can take him to work with me) and just had one 5-6 hour stretch while i slept that he didn't have anything other than kibble. by thursday night he was taking in more at the feedings so i pushed them back to every 4 hours on friday. by saturday morning, you could see he was feeling better. and i'm really glad he was because, if he wasn't, i would have scratched him from the show...very glad i didn't have to cuz he took 1st in his color class!

you can easily get a glucose meter - they're not that expensive (it's the strips that are kind of pricey) - and test him at home. have the vet show you how to get blood from a foot pad as well as from the tail. easiest to get the same kind of meter the vet uses - if you can't, have the vet run the test and also run the test with your meter so you know how the two differ in what they show. some have variances, so, you need to know if yours reads higher or lower than the one the vet uses so you don't end up having false good or bad readings.

oh, and if you see he's not doing well (symptoms more evident and/or bg level goes down a bit), go back to more frequent feedings of the soft food...that will help to avoid a full crash.

also, make sure to give the prednisolone with food or after he's had some food. it's rough on the stomach, so, shouldn't be given when it's empty.

[connieb]

Thanks for the helpful information, joclyn. You seem very knowledgable in this area. Are you a vet tech or have you gained a lot of experience with previous ferrets having insulinoma? How old is Taco?

I dropped Blizzard off at the hospital this morning and his glucose level was 95. I didn't have any problems with him over the weekend. The vet said that he looks great and "really beat the odds". When I brought him in last week, she didn't feel confident that he was going to make it, and I admit, a couple of times, I didn't feel he was going it either. He's a fighter though.

How long should I feed him the a/d? He's been eating it for about a week now. I usually give him his medications first and then I will give him a/d. I'll place a tablespoon of it plus a half tablespoon of water to make it soupy. He'll eat it willingly now. No more force feeding with syringes. Yay.

Blizz is also starting to walk normally now. He's falling over a lot less. He hasn't been dragging his feet at all. He even did a little jog this morning around the room. ;D

[joclyn]

i'm always glad to be of help if my experiences can be of assistance to someone else

i'm not a vet tech; just an owner that ended up with a fuzzy with insulinoma about 6 weeks after i adopted her and her cagemate. and, of course, when i realized she had it, it was the week of thanksgiving and i couldn't get an appt at the vets office until right after christmas (combo of holidays and people traveling and updating shots and/or getting clean bill of health certs and vacation time being taken). so, i had to learn - a lot and real quick! i'm good at research and had enough good feedback from people on various forums that i managed to get her situated pretty well by the time we had the appt - just with dietary changes. and then there are the various ups/downs over time and you learn a bit more as each crisis happens...

lil bear lived a good life with the insu - 2 1/2 years - and would have been around longer if her buddy hadn't passed away. she was 4 1/2 when diagnosed and just past 7 when she died.

taco is a rescue, so i don't know his age for sure - he's about 5 tho.

the key with any disease that these little ones get is catching it early! the sooner an issue is id'd and treatment is started, the better chance of a good outcome. by that i mean condition brought under control and a good quality of life maintained and, of course, longevity increased.

this disease is one of the easier to manage. once you get tuned into behaviours presented with different bg levels, it's really easy to spot when the level is out of whack/going down and you can then adjust diet and meds to compensate and keep them from going further down.

the thing with insu is to keep them from crashing. crashes aren't good and if left in a crash too long, they can start having seizures. and that is not something you want to see happen.

95 is a good reading so early on with the meds!!! that means the dose is working and it also probably means you caught this pretty early on. both are big plusses!! and it's great to hear he's perking up and that the symptoms are starting to go away!! you're doing a good job, mommy!!

as for the a/d, you can continue to use it daily so that he's got something in his tummy to soften the effects of the med. it can be frozen in ice cube trays and stored in plastic zip bags in the freezer. just take out a cube or two each night and let them defrost in the fridge. you can even defrost them in the microwave right before giving it to him.

you can also make 'gravy' and use that, too. or even some of the various all-meat canned foods that are available - before grain or evo (although, natura - makes evo - just sold out to procter & gamble, so, formula's and/or quality of ingredients may change once they take over production, so, may want to avoid evo products so you don't have to make a change later).

the other things with giving a/d, homemade gravy or some kind of canned food is that you will be providing a high protein meal - and that works to keep the bg level up. and then there's the extra calorie intake provided...the tend to lose weight in the time period before it's evident there's an issue, so, these extra feedings help to get that weight back on them.

with lil bear, i gave homemade gravy twice a day with her meds and the portion size was at least one cube and sometimes two cubes. during those periods where her levels were off i would add in an extra feeding and sometimes (during a crash) would feed this soft food every 4 hours or more frequently if things were really really bad. for the cube trays i have, each cube is a couple tablespoons worth - so, one cube is a decent-sized meal.

for the majority of the time, it was just the 2 feedings a day as she really responded so well to the dietary changes and with the addition of the meds, really leveled up and stayed steady for a long time. she only had one really bad crash (had a couple not-so-bad crashes also) and that's mostly due to the fact that once the bg starts going too low and staying low, they just don't have the energy/desire to make the effort to go eat the kibble unless they're really, really hungry - so, the bg goes even lower and it turns into a nasty circle that is self-propelled.

keeping up these high protein feedings daily will avert some of that. keep an eye on the amount of kibble intake, too - and if it seems like it's decreasing, you can make adjustments in how much/how frequently you give the soft food until things get on track again.

[connieb]

Well, my doctor finally received the test results back to verify insulinoma.

The results were negative.

Now, I'm confused. Blizz has been responding really well to the medication and is acting more normal now. So, what else could it be? Based on the results, his insulin level wasn't even anywhere near the range that would indicate he has insulinoma. My vet and I are both baffled. I'm going to still keep him on his meds since he's doing so well, and then we'll see how it goes from there. They would like to wait until he gains more weight and possibly do an exploratory on him. I will drop him off again on Monday for another glucose check.

[joclyn]

you test for blood glucose level, not insulin level. the vet ran the wrong test, sounds like.

didn't he run a quick test with a glucose meter??? before and after meds were started? what were those readings - especially the one done before meds were started.

[connieb]

The vet sent the blood sample to a laboratory and had a specialist check for insulinoma. Initially, the doctor had a blood test done and noticed that the glucose level was too low, and assumed that it might be insulinoma. So, then she sent to the lab to verify. Maybe I misunderstood...

Before the meds, his glucose was 55 and after, it was 95.

[Cinnamon Sprite]

Ferret's with insulinoma can have normal insulin levels. Testing when glucose is very low, especially when it's been low for a while, may give a falsely low blood insulin level. This does not mean the ferret does not have insulinoma. A glucose level of 55 does indicate insulinoma, regardless of insulin level.

[connieb]

Thanks for the information, Cinnamon.

Another update: We checked his glucose today and it's 98, which is great. I'm going to have my vet do another test to check for insulinoma. I mentioned what you stated, Cinnamon, and the doctor believes that it could've been inaccurate since his glucose level was low when the blood was taken. I've noticed that Blizz has been scratching himself more than usual. I'm thinking it's a side effect from his medication. So, we will be decreasing the pred from 0.3 mL twice a day to 0.4 mL once a day. The other meds will be given at its previous amount. He has gained 100 grams and loves his a/d. He's doing great though.

[Cinnamon Sprite]

May 17, 2010 16:46:56 GMT -5 @connieb said:

I've noticed that Blizz has been scratching himself more than usual. I'm thinking it's a side effect from his medication. So, we will be decreasing the pred from 0.3 mL twice a day to 0.4 mL once a day. The other meds will be given at its previous amount.

Pred is actually used to treat allergic reactions and not likely to cause itching. I'm not sure what other meds your boy is on, perhaps they may be to blame. However, you should keep in mind the most ferrets with insulinoma also have adrenal disease, which will cause excessive itching (and you don't need to see any other symptoms). Your vet can test for this (via the U of Tenn) if you want to be sure.

[goingpostal]

What test is your vet running for insulinoma? What did they do xrays for? Blood glucose is all you need to run, at his levels he has it. Given that your vet wanted to do surgery for it I would really question their ferret experience. Surgery is not an answer for insulinoma, it will just come back. Also don't give him the dextrose unless he is seizing and then follow right up with some soupies, giving it will shoot his BG throw the roof and then bottom out which is dangerous. I would really recommend finding a better vet IMO.

All of mine have been treated with pred and soupies before they get the meds. I use high quality canned cat foods for soft foods, switch it up so they don't get stuck on one and like joclyn, feed several times a day at first until meds fully kick in and your ferret gets to eating good on his own.

[unclejoe]

When I suspected Icy had insulinoma, we used a home BG meter to test him and his BG was 45. He had stopped eating, lost weight and had the classic hind end weakness. Of course this all got my attention on a friday night after vet hours. I had some pred on hand, gave him half a 5 mg tablet that night and half twice a day until I got him to the vet on Monday. I told her my suspicions. She just checked his BG and confirmed. By then he had started eating again, and his BG was up to 60. She said starting him on pred probably saved him. I gave him extra chicken in his soups. In 3 days he was back to playful/normal, and in 2 months he had gained back a lot of weight. And then I killed him...