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Post by EiraoLaska on Mar 27, 2021 9:29:01 GMT -5
I have an elderly ferret who is estimated to be at least 6 years old. He's had insulinoma since September of 2019 and was diagnosed with congestive heart failure about 2 weeks ago. Last night when he was supposed to get his evening doses of prednisolone and lasix my husband noticed he was very limp and just didn’t look right. He was dehydrated, having diarrhea, no interest in food, or water. His blood sugar was 59mg/dl and he had almost no coordination in his back legs. His poop was also still showing up bright orange like an egg poop despite his last egg having been more than 24 hours ago.
We rushed him to the emergency vet, where he was seen immediately. They have him on IV fluids, a heating pad (his temp was low), benebac, and meds for the diarrhea. As of this morning there is no change in his condition. His blood sugar is down to 46mg/dl. They’re having trouble getting him to eat. He still needs a heating pad and IV fluids, and he is still very weak.
Hoping some experienced owners might know what’s going on? We don’t have any answers right now for what could be causing this. There has been a small change in diet recently; they’re on nutrience subzero Fraser Valley and Prairie Red. I had about a ¼ extra bad of the Prairie Red and mixed it in with their remaining ‘old’ food before mixing up a new 50/50 batch of the Fraser Valley and Prairie Red. So there’s more Prairie Red than normal but it is a food they’ve been eating fine for months. None of my other four ferrets have had digestive issues. I wouldn’t expect a food change like this to cause such severe issues though, is that wrong? Could this just be his insulinoma getting worse?
---- Update: His blood sugar is up to 60mg/dl! He's starting to eat on his own but is still having diarrhea. We'll be calling back this evening. There's a chance he might be coming home tonight!
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Post by unclejoe on Mar 27, 2021 10:56:20 GMT -5
Hi there. Wish we had met under better circumstances. It could be the insuolinoma worsening. Those are all signs. If so can the pred dosage be increased? The other option is to add diazoxide to his treatment.
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Post by EiraoLaska on Mar 27, 2021 12:08:56 GMT -5
I'm not sure about getting his pred increased. So far both our primary vet and the vet at this emergency clinic have said the pred is bad for his heart. Gods willing he pulls through he's supposed to go back to our primary vet this Wednesday for follow-up xrays for his heart. I can talk to her about his insulinoma meds then.
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Post by EiraoLaska on Mar 30, 2021 8:52:39 GMT -5
Well he's back home. It's been a horrible weekend. After improving all day Saturday, we opted to leave him there another night just to be safe. Come Sunday he was getting worse again. He'd stopped eating on his own and his blood sugar was still in the 50's. The vet called me that evening, saying he thinks the insulinoma has metastasized to his liver and there was pretty much no chance he would come home. The only thing he could do was up his prednisolone with the risk it could overload his heart.
That night we went to visit him. He looked miserable and tired. I signed a DNR for him. My husband and I hugged him and cried and basically said goodbye, thinking he'd die overnight. I came very close to putting him down, feeling like I was prolonging his suffering by trying the pred increase. Monday morning there is no change. His blood sugar had gone up to 87, then back down to 56. He "just won't eat" unless he's syringe fed still. We go there Monday morning and I have to argue with them to bring him home. He was off IV fluids, off the heating pad. There was nothing they were doing that I couldn't do at home. We're told we'll likely be bringing him home only to take him back to the vet to put him down same day. Sure. fudge it. Let me give him a few hours at home with his humans and the other ferrets then.
So we get him home....this little fuzzy drama queen hobble-runs to his food bowl and starts eating like he's famished. Then he drinks longer than I've ever seen him drink before. You'd think he had no food or water access all weekend. I'd been wondering if he was not eating for them due to stress but I didn't want to be that owner that thinks they know more than the vets.
He saw our primary vet that afternoon. She checked his bloodwork and liver enzymes and doesn't think it's anything to be too worried about. She obviously didn't want to tell me he wasn't going to die soon, but she thinks this is all something he can get over. We still don't know what caused the diarrhea in the first place though. He's on metronidazole and amoxicillin. His prednisone has been upped by 50%.
She confirmed another thing that had me worried too. The emergency vet clinic had him on nutrical every few hours. It likely caused a rebound blood sugar drop. That's likely why his blood sugar shot up then dropped again. It was 75mg/dl this morning, but I don't know how recently he'd eaten. I'm not comfortable fasting him just yet. If he wants to eat I want to let him eat. I'm syringe feeding him a/d canned food every 4 hours on top of what he's eating on his own. Want to try and grind his normal food up fine enough to use that instead since the a/d has corn flour as a higher up ingredient. He looks like he's had the h*ll beaten out of him. His neck and arm are all bruised up from the IV and needles for blood draws. His back legs are also very bruised, which might explain why his legs seem weaker than normal. I'm guessing it's from the restraining he needed for them to get the IV in, hoping it's not from his heart. This morning he felt good enough to play, and get stuck in, my sandals. I am exhausted and I still can't let myself feel better because I fear another nosedive.
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Post by Corvidophile on Mar 30, 2021 10:09:45 GMT -5
Sometimes they won’t eat or drink in strange places. If you feel like he’s better off at home then he probably is, than just waiting at the vet to die. I hope he recovers at home.
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Post by EiraoLaska on Mar 30, 2021 13:32:53 GMT -5
Thanks Corvid! I hope he recovers too. He certainly seems a lot better already! He's sleeping a lot but it's a normal tired ferret sleep, not a miserable sick ferret sleep, if that makes sense.
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Post by unclejoe on Mar 30, 2021 19:22:15 GMT -5
maybe the increased pred is helping. I don't see where you mentioned the little guy's name...
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Post by Charlie on Mar 31, 2021 19:49:49 GMT -5
Well he sure does seem better at home, he's with his family and in his familiar place. I hope he continues to improve.
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Post by EiraoLaska on Apr 1, 2021 11:54:56 GMT -5
Unclejoe, his name is Affliction! We mostly call him "Affy" or "Polar Bear" though.
Thanks Charlie! He's definitely doing better back home.
He's still slowly improving. His diarrhea is gone. I'm seeing how he does getting his supplemental feedings every 6 hours instead of ever 4. I feel like I haven't slept since Friday and I don't think he's too happy about being woken up every 4 hours either. He's still sleeping most of the time. He gets up for food, water, and to use the litterbox. After his syringe feedings he'll hang about and claw the bed for a minute, then he hobbles back to bed. He's eating/drinking fine on his own too, usually he'll grab more food after his syringe feedings. When he is up his eyes are open and alert, he's clearly interested and paying attention to what's going on around him. He wants attention and cuddles like normal. He's getting himself all the way onto puppy pads again instead of pooping nearby them. He's tired, but not lethargic.
I asked my vet about diazoxide. She's hesitant to put him on it how because it can suppress his appetite. He went from 2.2 to 1.9lbs over the weekend, so we're going to see how he does regaining the weight. He's at 1lb 15.5 oz according to my scale now, up from 1lb 14.3oz the day he got back home. I'm hoping he can go on it, since it should let us decrease his pred which'll be better for his heart. He goes back to the vet on the 12th!
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Post by unclejoe on Apr 1, 2021 19:14:06 GMT -5
I'm glad he's doing better. Diazoxide is kinda the last step with insulinoma. The longest I've had an insulinoma patient on pred was a little over 2 years. Abita was about 7 1/2 when it finally caught up with her. She did very well on the pred and just suddenly was gone in a couple days. I wish ferts could live as long as kats, but it is what it is.
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Post by Sherry Stone on Apr 1, 2021 22:37:15 GMT -5
Unfortunately with insulinoma, meds do need to be increased over time Maybe talk to the vet about trialing diazoxide along with the pred. That can often result in decreasing the pred.
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Post by EiraoLaska on Apr 2, 2021 3:30:48 GMT -5
Thanks Unclejoe! I'm so sorry to hear about Abita. I haven't lost a ferret yet, and I don't know how I'm going to handle it when someone finally crosses over. My oldest just turned 7(assuming Affliction isn't older) last month and thankfully is doing well! The vet at the emergency clinic couldn't believe Affliction had been going strong for over a year with the insulinoma! Before this illness his fasted blood glucose was routinely in the 80's! I know my time with him is limited, I'm still in shock he seems to be pulling through this! I'm not fasting him yet, but I took his blood glucose last night for the heck of it. I'm sure the reading is meaningless since I don't know when he'd last eaten but it was 106! I want to get him off the syringe feedings before I get a fasted blood glucose reading. Sherry, I'll be discussing it with my vet again soon! She wants his weight back up first. This is the first time he's had his pred increased since he was diagnosed. It got bumped up by 50% so he's now on .5ml twice a day. So far so good with it, he hasn't been coughing and his xrays back on Monday showed a marked decrease in fluid around his lungs! This past evening I was surprised to catch him 'running' towards me! He's not staggering and falling over every few steps anymore, though he still walks flat-footed on his hind legs. Dare I hope he may get into a playful dooking mood again, even just one more time?
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Post by EiraoLaska on Apr 2, 2021 6:38:43 GMT -5
If anyone checks back on this; should I be concerned about Affliction shivering? I know it's normal when they wake up, I've got a couple who shiver like they're gonna phase through your hands every morning. He never did though, not until recently. Now he shivers every time he wakes up.
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Post by Sherry Stone on Apr 2, 2021 12:15:36 GMT -5
When they wake up, it is normal. If they start shivering/trembling at other times it can be a sign of pain.
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Post by EiraoLaska on Apr 2, 2021 12:27:41 GMT -5
He sleeps so much now it's pretty much always when he wakes up, and he's only awake for a couple minutes at a time. Only today has he started to get up and stay up for a short bit. Guess it'll be one more thing I talk to the vet about on his follow-up visit on the 12th!
Another bit of good news, he broke 2lbs today! That's 2oz. gained in 5 days! He no longer feels like an empty bag of bones!
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