Treating insulinoma

[Deleted]

Hey guys I'm looking for advice on how to treat insulinoma. I'm going to be working with the vet that I work for who understands the basics but not the specialty care.
Long story short I thought I was at a solid exotic clinic but after they boarded there over the weekend and decided not to feed them this morning I am to say the least livid. Ive gone through two "exotic" vets in the past few months and I'm just figuring they will be better off with more say on my part. (The last vet didn't believe a word I would say)
She's currently on 2.5mg of pred twice a day but still has a low bg. I'm assuming we need to raise the dosage.
I am going to my soon to be former clinic and get all my records as well as speak to the dr and tell them they should not be seeing ferrets to say the least tomorrow.
Once I get those I will know what she is currently reading at. I do have an at home reader but it seems to never work :/ it never recognizes her blood. I'm going to talk to the vet I work for and see if I can get one through the clinic and just bite the loss on the human reader.

My main question is what should my goal be with her bg? What is a proper reading?

Thanks in advance

[Sherry]

Please double check dosage. 2.5 is EXCEEDINGLY high! Even my girl with pancreatic lymphoma never reached that dosage. Judge who is almost 3.5 lbs is 1.2 daily.
I have called my vet to get a starting dosage per kilogram but everyone is too busy with emergencies ATM.
I will respond back here once I get a definitive dosage.

[Sherry]

And with a fuzz with insu my vet likes to see an average of 4 if possible(72)

[Deleted]

Oops! Yeah it's not 2.5 it's .25mg

[unclejoe]

Whew, 2.5 is usually the highest dose they get before adding proglycem. However, .25 is low. They usually start on at least .5 and recheck in a couple weeks, adjusting dosage as needed every month or so. That said, ferrets can adapt to low blood sugar. I don't know what kind of meter you have, but we get tru2go meters from walgreens and they are pretty accurate. I also don't know how much experience you have getting blood. Follow the directions for the meter. Have it set up before drawing blood. on ours, we insert the test strip into the meter first, but not enough to turn the meter on, as it will error in about a minute. It's best if you have 2 people, one to set up the meter and have it ready and one to get the blood sample.

Here is how we get blood from a toe pad:
Either shave the fur around the toe or coat the toe with a little vaseline to prevent the fur from absorbing the blood.
Set the lancet to 4-5 to ensure it punctures the tough ferret skin.
squeeze the toe until you have a decent drop of blood. The meter doesn't need a lot, but you have to have enough for the test strip to suck it up all the way to the meter.
once you have blood, push the strip into the meter to turn it on, wait for it to self check, and immediately put the strip into the blood and hold until the strip has enough.

It takes practice to get the timing right and to get enough blood, which is why 2 people are better. The meter comes with 10 strips for about $10. We could get a good sample 2 out of 3 times after doing a few.

If you already knew all of this, it's there for others.

[Sherry]

Depends on the weight of the ferret. Willow started at .3 2x a day, Judge at .6- he is twice her size, literally.

[Sherry]

Depends on the weight of the ferret. Willow started at .3 2x a day, Judge at .6- he is twice her size, literally.

[Deleted]

I figured out my problem! I've been putting blood on top of the strip instead of letting it soak it up. Dumbie over here!

Anyways I have a Bayer contour next metre
She read a 3.5 before her dinner and pred
And then an hour after dinner and pred she was at 4.1

[Sherry]

Hey- it takes a bit to get used to it Next time you go to the vet take your meter in as compare what the difference is.

[Deleted]

In may I did that but wasn't able to figure out the math she was 0.7 at the vets and read a 3.1 on my metre. So that would mean a difference of 2.4?

So yesterday before food would be 1.1 and after food 1.7 if I'm doing that right so she is still pretty low?

[unclejoe]

I'd say that is low. Ferret BG range is roughly comparable to human. This is from miamiferret.org: 

A normal fasting blood glucose level is in the range of 90-125 mg/dL (4.95 Mmol/L - 6.88 Mmol/L). (Humans normal-range 80-120)According to Katherine Quesenberry, DVM, in Ferrets, Rabbits and Rodents - Clinical Medicine and Surgery --- “Ferrets with blood glucose concentrations lower than 70 mg/dL (3.85 Mmol/L) are suspected of having Insulinoma. In one study of 49 ferrets with confirmed insulinoma, all had blood glucose concentrations lower than 60 mg/dL (3.30 Mmol/L).” Ferrets can often have shockingly low blood glucose levels and have no significant symptoms. Though I have no medical evidence to back this up, I believe this may be due in part to the ferret becoming acclimated to glucose levels that have been decreasing gradually over a period of time.

Many vets assume, rather than just suspect, insulinoma below 70mg/dL.

miamiferret.org/insulinoma.htm

[Sherry]

That is exceedingly low. To the point of active seizures and brain damage low. The very lowest our pancreatic lymphoma girl every got was 1.6 at the vet's. Are you CERTAIN the vet's meter read only .7?

[Deleted]

That's what they told me over the phone :/. I'm going to get copies of the bloodwork this week so I will be able to double check then.

[Deleted]

So I've gotten all the bloodwork

May 2 : 0.7
May 15 : 2.5
May 20 : 3.4
June 24 : 2.9 by idexx and 2.4 by clinic meter
July 16 : 2.9

The other ones are all by idexx. For whatever reason I didn't get records of the clinic meter that had been done in between so I'll have to go back

[Deleted]

But looking at the bloodwork from may 2 about half the results aren't normal so maybe there was something wrong with that when they took it or sent it away