Insulinoma Overview
Jul 3, 2011 0:33:05 GMT -5
vigorousmasterbaker, crazyferretbug, and 2 more like this
Post by Deleted on Jul 3, 2011 0:33:05 GMT -5
INSULINOMA IN FERRETS: By Miamiferret2[/i]
I have had the misfortune of dealing with this horrible disease. This is an overview of the disease and my take on it - what did and did not work for me. This overview is not intended to take the place of your vet diagnosing and treating your ferret.
WHAT IS INSULINOMA:
Small, often microscopic, tumors called “islet tumors,” that are located in the pancreas. These tumors cause the pancreas to excessively produce insulin. Too much insulin lowers the blood glucose levels (“BG”), which is commonly called “blood sugar.” Insulinoma can be thought of as is the opposite of diabetes.
CAUSE:
Many ferret knowledgeable veterinarians are now in agreement that insulinoma is caused by carbs/grains (e.g. corn, wheat, rice, oats, barley, flour, brewer’s yeast, etc.) in the ferret’s food, as well as any treats containing sugar or sugar products.
• Most commercial kibbles made for cats & ferrets contain grains. Be careful of any kibbles that contain the word “maize” as this is corn.
• Many “grain free” kibbles claim to be good for ferrets. However, be aware that these kibbles will often use potatoes (starch) as a binder. Starches (complex carbohydrates) also convert to sugars.
• Be aware that while some products may not flat out read “sugar” on the label, they actually do contain sugar. Stay away from anything on labels that read “molasses”, “fructose”, “syrup”, etc. Some commonly used pet products that contain sugar are: Ferretvite, Nutri-cal and Laxatone, or Ferret-lax. Most of these products contain molasses (i.e. sugar) for taste. These products should only be used when necessary, i.e., to bring a crashing insulinomic ferret out of a seizure or crash.
SYMPTOMS & DIAGNOSIS:
Insulinoma is often a disease that is not diagnosed until hardcore (scary) symptoms appear. However, ferrets will usually show subtle signs before “the big crash.” Keep in mind (I will repeat this alot here) that no two insulinoma ferrets are alike and some ferrets do not shows the “classic signs.” One of my ferrets never showed any of the classic insulinoma symptoms at all. There was no spacing out, no drooling, etc. His diagnosis was made after we came home and found him limp and unable to move.
Signs of Insulinoma are:
• Sleeping a lot
• Frequent “dead ferret” or "ferret coma" sleep.
• “Spacing out”
• Trouble waking up
• Wobbly
• Dragging hind legs
• Unable to use hind legs properly
• Stumbling or falling to the side
• Drooling
• Pawing at the mouth
• Periods of no appetite/no interest in food and then periods of “gorging” on food.
A veterinarian will usually give a diagnosis of insulinoma by testing blood glucose on a 4 hour fast + considering any other outward symptoms that the ferret may be exhibiting.
Most vets will not bat an eye with a BG in the 90’s (or even 80’s). This depends on the vet. However, I would keep an eye on BG's that are in low 90's. A BG in the low 90’s is nothing to panic about, but you should monitor for other signs by watching your ferret’s behavior, retesting after a few months, etc.
• Blood glucose in the 80's I would consider highly suspicious and in my experience, a blood glucose that is in the 70’s and below is a confirmation that something is wrong.
If you read up on the subject you will see that some vets disagree on what a “normal” ferret blood glucose reading is after a 4 hour fast.
The general consensus is that a normal blood glucose on a 4 hour fast is reported to range from 90 to 120 mg/dL (5.0 – 6.6 mmol/L) and that measurements of less than 70 mg/dL (3.9 mmol/L) would be highly suggestive of insulinoma.
Of course, all ferrets are different. A “normal” blood glucose for one may not be normal blood glucose for another. Also, some ferrets are active with a BG in the 60's! some are not so fortunate and are sluggish even with a BG in the 70's. So, it is important to watch for behavior changes and outward symptoms.
You can purchase a home blood glucose tester. These are usually not 100% accurate (they are usually lower than what the reading actually is) and you should take it to your vets office so that you can calibrate it with your vets BG tester.
veterinarians use specific BG testers with different codes for different animal species. A BG tester made specifically for humans will not render the same results and will not be as accurate as one designated for ferrets.
When you go to the vets office, take your home monitor with you. take the test at the vets with the same blood he uses. Write your number down and when you get the vets number add or subtract the difference that way you can get a more accurate reading at home next time.
Note: The human BG testers are usually off by about 20 points (this would be about 20 points lower than a reading that a veterinarian would get at his office)
The Alpha Trak pet glucose meter can be used at home and it does not have to be calibrated with your veterinarians. this is the blood glucose meter most often used by veterinarians. Be sure to use code "7" for ferrets. [EDIT ADDED ON 6-26-13: PLEASE NOTE THAT THERE IS A NEW ALPHA TRAK METER CALLED THE ALPHA TRAK 2 AND IT USES A DIFFERENT CODE!]
www.americandiabeteswholesale.com/product/alphatrak-pet-blood-glucose-meter_2753.htm?gclid=CMaMmoeUlLACFYic7Qod3RBvoQ
NOTE: While the main cause of low BG in ferrets is insulinoma, keep in mind that there are occasionally other causes of low BG such as lymphomas, renal failure, and infections. For example, my 1.5 year old ferret was acting very lethargic and he was very nauseous. He did not want to eat and he had a low BG in the 60’s. I suspected insulinoma. Because of his young age, the veterinarian did not suspect insulinoma right away. He was right. My ferret did not have insulinoma - blood tests confirmed renal failure (which he died of).
IMPORTANCE OF DIET:
Before my current ferret (who has been on a commercial raw meat diet since about 10 to 12 weeks of age), all of my ferrets ate kibble. Over the years, my ferrets were fed all kinds of kibbles that contained grains (carbohydrates) from corn, flour, wheat, etc. it honestly makes me cringe. I did not know any better.
The last ferret that I had with insulinoma was considered “suspicious” by the veterinarian after his BG tested in the low 90’s and then in the 80’s. One day, the vet came over (he made house calls) and he saw a tube of Ferretvite in my kitchen. He told me “are you using that with your ferret?” I happily responded: “Why yes, doc, he loves it and I give him a little every morning.” He very sternly he said “Do NOT give him any of that. It is confirmed that insulinoma tumors are caused by grains and sugars. Put it away and only use it if you see that he is having signs that his blood sugar is really low and he is crashing.” In 18 years no one had ever said this to me. That day, for the first time ever, someone told me that what I was feeding my ferrets and the treats that I was giving them, were actually making them very sick! So my wheels started turning. Why did this happen? Why do sugars make them develop insulinoma? Then I started finding articles about carbs and grains in kibbles, etc. You can see where this is all going.
Sometime after the vet scolding me about the tube of Ferretvite, my ferret’s BG was tested and it was in the mid 70’s. My vet does not like to use prednisone/pediapred until it is absolutely necessary --and so I control the disease with diet for as long as I can.
So after BG came back in the 70’s, I began to do some more research. I called my vet and I asked him: “If these tumors are caused by sugars then shouldn’t I stop feeding him grains?” And his response was “well, that certainly makes sense, it will probably help to prevent those big ups and downs that we always see.” Feeding an insulinomic ferret a diet that contains grains (i.e., carbs/sugars) will have the same effect as a tired human that drinks a coca cola and eats chocolate to “perk up.” The “carb crash” afterward is drastic. The blood glucose will drop significantly. In a ferret with insulinoma, this is especially dangerous. So, after my talk with the vet, I continued my diet research and I bought a bag of Wysong Archetypal 1 (freeze dried) which I began to mix into his soupies. I bought a bag of Ferret EVO and I began to make his soupies with that instead of with the Totally Ferret Baby formula that I had been using. I slowly added more Wysong. I tried to make a complete switch to Wysong but that was impossible with my stubborn ferret.
I made sure that he ate every 4 to 6 hours. I was able to manage his BG with diet alone for about 1 year which in my opinion is great considering that his tumors were the aggressive kind.
CONTROLLING WITH DIET ALONE:
If BG levels (on a four hour fast) are in the 70's or 80's you can try to manage with diet first. Diet is very important in managing insulinoma in ferrets. In the early stages, feeding a good diet may stall the need for medications. Again, I say “may” because some insulinoma tumors are very aggressive and progress very rapidly. I hate to be repetetive but you must keep this in mind.
To control with diet, you would have to make sure your ferret eats every 4 to 6 hours to maintain BG levels. The goal is to keep BG steady and avoid the roller coaster ups & downs.
If your ferret will not eat voluntarily (insulinoma makes them nauseous and they paw at their mouths, grind their teeth, etc.) you will have to scruff them and syringe feed them. Depending on the size of your ferret, you will need to make sure that they eat 120 to 200cc's of food per day (divide that up into 4 feedings if possible).
If you can switch to a raw meaty bones diet, that would be ideal. Unfortunately, older kibble fed ferrets are very difficult to switch. Wysong Archetypal 1, Stella & Chewy’s freeze dried are excellent alternatives. Wysong has a kibble called Ferret Epigen 90 which looks great for making soupies. If you must feed kibble, I would use Ferret Epigen 90.
Unfortunately, diet only goes so far. The tumors continue to grow and spread throughout the pancreas. The pancreas begins producing even more insulin and lowering BG to the point that you will not be able to manage with diet alone. At this point, you will have to begin meds. I usually decide to use meds when my ferret is not active & not enjoying his life even with frequent feedings. I make the decision to start medications when BG is in the 60's (without fasting). If BG is whacky and unstable even with frequent feedings of high protein food, then it is time.
MEDICATIONS:
Once the tumors become unmanageable with diet, you can usually manage them with meds for about 1 year more or less. This is not set in stone, I have known of ferrets going for several years with meds. Since some tumors seem to be more aggressive than others, survival rate depends.
• I prefer to use pediapred. Pediapred is "prednisolone". It is easier on the liver than prednisone. Pediapred is a liquid form used for infants and ferrets take it a lot easier. They don’t fight you as much. I made the mistake of buying the generic pediapred once (to save money) and my ferret spit it out and he was really stressed out over it. So I had to throw it out and buy the pediapred again. Also, the generic often has alcohol in it.
• Usually a vet will start off on a low dose of prednisolone and work their way up from there when needed until the ferret’s BG is stable. these doses are given usually twice a day.
NOTE: Some vets will advise to give the whole "daily" dose once a day. however, this is often ineffective. It is best to split the daily dose into two doses 12 hours apart.
Remember that different bottles of Pediapred may have different concentrations. always check the bottles and follow your veterinarians instructions as to proper dosing.
• Some ferrets do well with taking meds twice per day, 12 hours apart. Some do better with taking meds three times per day, 8 hours apart. This is a decision that you have to come to with your vet. Call your vet, tell them how your ferret is doing. Don’t be afraid to call your vet to let them know that despite medications, the symptoms are continuing!
• Prednisone tablets or liquid are often started at a "daily" dose of ½ mg/ kg (1 kg = 2.2 lbs). Again, it is more effective in managing BG when the "daily" dose is divided into two doses per day. The prednisone dose can be increased as needed to 2 mg/kg.
Usually, the pred is no longer effective at the 2 mg/kg mark. however, some ferrets do well on doses higher than that.
• The side effects of pred are “pred belly”, muscle wasting and liver damage. Increased urination has also been noted in some ferrets. Not every ferret will have side effects.
• You must always give pred, pediapred, etc. after your ferret eats so as to avoid ulcers. Give your ferret soupies and then give pred. if your ferret is not eating on his own then you will have to syringe feed at least about 30 cc's of food before giving this medication.
• If the pred is causing bad side effects in your ferret, or when the ferret stops responding to even the max dose of pred, your vet will usually add in Diazoxide (proglycem).
• In my experience, the diazoxide has controlled my ferrets BG much better than pred.
• Diazoxide is usually started at 5 mg/kg twice per day and you can go up to 30 mg/kg twice per day. This is used in conjunction with prednisone. The prednisone is not stopped or decreased while giving diazoxide. Diazoxide tastes bitter so it is best to have the compounding pharmacy make it less concentrated and flavor it with something.
NOTE: the downside to prednisolone (or any steroid) and diazoxide is that they both affect blood pressure and this can cause problems for ferrets with cardiomyopathy or other heart conditions. Diazoxide lowers blood pressure and pred raises blood pressure.
I suppose if i were to have to choose an insulinoma med for a cardio ferret, i would go with the diazoxide. but this is something to discuss with your vet.
• The other treatment is surgery but I am not too keen on this. In the old days, vets used to “pop” the insulinoma tumors that they could see. However, they always grow again because the tumors are usually microscopic. It is often impossible to get them all.
But I hate to put a damper on things, some people have reported success with surgeries to remove insulinoma tumors! If your vet finds one large tumor instead of many smaller ones, and if your ferret is otherwise healthy and can withstand the surgery, then it is something to discuss.
HOLISTIC DONTS:
• Do not use timmy’s tonic for insulinoma. It is sugar. It is made with clover honey.
• Do not use “brewers yeast” or any other kind of yeast.
If you have an adrenal ferret with prostate issues, many of you may try saw palmetto or stinging nettle. Be careful if you use stinging nettle or saw palmetto as they may lower blood glucose. Be careful of extracts as they may contain sugar.
PREVENTION:
Do not feed your ferret any kibbles with any form of grains or starches and don’t give them any sugary treats. If you must feed kibble, use Wysong Ferret Epigen 90 which is grain free and starch free.
The best diet for a ferret are:
• Raw meat/bones
• Whole prey
• Commercial raw (though will require teeth brushing)
• Combination of all three
There is no guarantee that your 12 week old ferret from the petstore will not develop Insulinoma just because you switched them to a raw diet immediately after bringing them home. You cannot undo the fact that the ferret (at least for a small part of his life) was fed kibbles with grains. However, I am sure that if you switch them young enough you will significantly lessen their chances of developing this disease.
I came to the Holistic Ferret Forum (“HFF”) as a desperate “lurker” who was willing to do anything to prolong the life of my old insulinomic ferret. I never created an account. When I did create an account, I never logged on and I never left any posts. But I learned a lot about diet from the nice people here and what I learned here did help me keep my ferret’s BG steady for longer without having to resort to the meds.
Of course, there did come a time when I could no longer manage his BG with diet alone. But I firmly believe that had I continued to feed him the kibble that he was eating before, I would not have had as much time left with him as I did. I believe that he would have gone downhill much sooner and much faster. His diet change helped him tremendously.
I only wish that I had joined the HFF sooner.
Thank you sooo much Miamiferret2 for writing this!!!
I have had the misfortune of dealing with this horrible disease. This is an overview of the disease and my take on it - what did and did not work for me. This overview is not intended to take the place of your vet diagnosing and treating your ferret.
WHAT IS INSULINOMA:
Small, often microscopic, tumors called “islet tumors,” that are located in the pancreas. These tumors cause the pancreas to excessively produce insulin. Too much insulin lowers the blood glucose levels (“BG”), which is commonly called “blood sugar.” Insulinoma can be thought of as is the opposite of diabetes.
CAUSE:
Many ferret knowledgeable veterinarians are now in agreement that insulinoma is caused by carbs/grains (e.g. corn, wheat, rice, oats, barley, flour, brewer’s yeast, etc.) in the ferret’s food, as well as any treats containing sugar or sugar products.
• Most commercial kibbles made for cats & ferrets contain grains. Be careful of any kibbles that contain the word “maize” as this is corn.
• Many “grain free” kibbles claim to be good for ferrets. However, be aware that these kibbles will often use potatoes (starch) as a binder. Starches (complex carbohydrates) also convert to sugars.
• Be aware that while some products may not flat out read “sugar” on the label, they actually do contain sugar. Stay away from anything on labels that read “molasses”, “fructose”, “syrup”, etc. Some commonly used pet products that contain sugar are: Ferretvite, Nutri-cal and Laxatone, or Ferret-lax. Most of these products contain molasses (i.e. sugar) for taste. These products should only be used when necessary, i.e., to bring a crashing insulinomic ferret out of a seizure or crash.
SYMPTOMS & DIAGNOSIS:
Insulinoma is often a disease that is not diagnosed until hardcore (scary) symptoms appear. However, ferrets will usually show subtle signs before “the big crash.” Keep in mind (I will repeat this alot here) that no two insulinoma ferrets are alike and some ferrets do not shows the “classic signs.” One of my ferrets never showed any of the classic insulinoma symptoms at all. There was no spacing out, no drooling, etc. His diagnosis was made after we came home and found him limp and unable to move.
Signs of Insulinoma are:
• Sleeping a lot
• Frequent “dead ferret” or "ferret coma" sleep.
• “Spacing out”
• Trouble waking up
• Wobbly
• Dragging hind legs
• Unable to use hind legs properly
• Stumbling or falling to the side
• Drooling
• Pawing at the mouth
• Periods of no appetite/no interest in food and then periods of “gorging” on food.
A veterinarian will usually give a diagnosis of insulinoma by testing blood glucose on a 4 hour fast + considering any other outward symptoms that the ferret may be exhibiting.
Most vets will not bat an eye with a BG in the 90’s (or even 80’s). This depends on the vet. However, I would keep an eye on BG's that are in low 90's. A BG in the low 90’s is nothing to panic about, but you should monitor for other signs by watching your ferret’s behavior, retesting after a few months, etc.
• Blood glucose in the 80's I would consider highly suspicious and in my experience, a blood glucose that is in the 70’s and below is a confirmation that something is wrong.
If you read up on the subject you will see that some vets disagree on what a “normal” ferret blood glucose reading is after a 4 hour fast.
The general consensus is that a normal blood glucose on a 4 hour fast is reported to range from 90 to 120 mg/dL (5.0 – 6.6 mmol/L) and that measurements of less than 70 mg/dL (3.9 mmol/L) would be highly suggestive of insulinoma.
Of course, all ferrets are different. A “normal” blood glucose for one may not be normal blood glucose for another. Also, some ferrets are active with a BG in the 60's! some are not so fortunate and are sluggish even with a BG in the 70's. So, it is important to watch for behavior changes and outward symptoms.
You can purchase a home blood glucose tester. These are usually not 100% accurate (they are usually lower than what the reading actually is) and you should take it to your vets office so that you can calibrate it with your vets BG tester.
veterinarians use specific BG testers with different codes for different animal species. A BG tester made specifically for humans will not render the same results and will not be as accurate as one designated for ferrets.
When you go to the vets office, take your home monitor with you. take the test at the vets with the same blood he uses. Write your number down and when you get the vets number add or subtract the difference that way you can get a more accurate reading at home next time.
Note: The human BG testers are usually off by about 20 points (this would be about 20 points lower than a reading that a veterinarian would get at his office)
The Alpha Trak pet glucose meter can be used at home and it does not have to be calibrated with your veterinarians. this is the blood glucose meter most often used by veterinarians. Be sure to use code "7" for ferrets. [EDIT ADDED ON 6-26-13: PLEASE NOTE THAT THERE IS A NEW ALPHA TRAK METER CALLED THE ALPHA TRAK 2 AND IT USES A DIFFERENT CODE!]
www.americandiabeteswholesale.com/product/alphatrak-pet-blood-glucose-meter_2753.htm?gclid=CMaMmoeUlLACFYic7Qod3RBvoQ
NOTE: While the main cause of low BG in ferrets is insulinoma, keep in mind that there are occasionally other causes of low BG such as lymphomas, renal failure, and infections. For example, my 1.5 year old ferret was acting very lethargic and he was very nauseous. He did not want to eat and he had a low BG in the 60’s. I suspected insulinoma. Because of his young age, the veterinarian did not suspect insulinoma right away. He was right. My ferret did not have insulinoma - blood tests confirmed renal failure (which he died of).
IMPORTANCE OF DIET:
Before my current ferret (who has been on a commercial raw meat diet since about 10 to 12 weeks of age), all of my ferrets ate kibble. Over the years, my ferrets were fed all kinds of kibbles that contained grains (carbohydrates) from corn, flour, wheat, etc. it honestly makes me cringe. I did not know any better.
The last ferret that I had with insulinoma was considered “suspicious” by the veterinarian after his BG tested in the low 90’s and then in the 80’s. One day, the vet came over (he made house calls) and he saw a tube of Ferretvite in my kitchen. He told me “are you using that with your ferret?” I happily responded: “Why yes, doc, he loves it and I give him a little every morning.” He very sternly he said “Do NOT give him any of that. It is confirmed that insulinoma tumors are caused by grains and sugars. Put it away and only use it if you see that he is having signs that his blood sugar is really low and he is crashing.” In 18 years no one had ever said this to me. That day, for the first time ever, someone told me that what I was feeding my ferrets and the treats that I was giving them, were actually making them very sick! So my wheels started turning. Why did this happen? Why do sugars make them develop insulinoma? Then I started finding articles about carbs and grains in kibbles, etc. You can see where this is all going.
Sometime after the vet scolding me about the tube of Ferretvite, my ferret’s BG was tested and it was in the mid 70’s. My vet does not like to use prednisone/pediapred until it is absolutely necessary --and so I control the disease with diet for as long as I can.
So after BG came back in the 70’s, I began to do some more research. I called my vet and I asked him: “If these tumors are caused by sugars then shouldn’t I stop feeding him grains?” And his response was “well, that certainly makes sense, it will probably help to prevent those big ups and downs that we always see.” Feeding an insulinomic ferret a diet that contains grains (i.e., carbs/sugars) will have the same effect as a tired human that drinks a coca cola and eats chocolate to “perk up.” The “carb crash” afterward is drastic. The blood glucose will drop significantly. In a ferret with insulinoma, this is especially dangerous. So, after my talk with the vet, I continued my diet research and I bought a bag of Wysong Archetypal 1 (freeze dried) which I began to mix into his soupies. I bought a bag of Ferret EVO and I began to make his soupies with that instead of with the Totally Ferret Baby formula that I had been using. I slowly added more Wysong. I tried to make a complete switch to Wysong but that was impossible with my stubborn ferret.
I made sure that he ate every 4 to 6 hours. I was able to manage his BG with diet alone for about 1 year which in my opinion is great considering that his tumors were the aggressive kind.
CONTROLLING WITH DIET ALONE:
If BG levels (on a four hour fast) are in the 70's or 80's you can try to manage with diet first. Diet is very important in managing insulinoma in ferrets. In the early stages, feeding a good diet may stall the need for medications. Again, I say “may” because some insulinoma tumors are very aggressive and progress very rapidly. I hate to be repetetive but you must keep this in mind.
To control with diet, you would have to make sure your ferret eats every 4 to 6 hours to maintain BG levels. The goal is to keep BG steady and avoid the roller coaster ups & downs.
If your ferret will not eat voluntarily (insulinoma makes them nauseous and they paw at their mouths, grind their teeth, etc.) you will have to scruff them and syringe feed them. Depending on the size of your ferret, you will need to make sure that they eat 120 to 200cc's of food per day (divide that up into 4 feedings if possible).
If you can switch to a raw meaty bones diet, that would be ideal. Unfortunately, older kibble fed ferrets are very difficult to switch. Wysong Archetypal 1, Stella & Chewy’s freeze dried are excellent alternatives. Wysong has a kibble called Ferret Epigen 90 which looks great for making soupies. If you must feed kibble, I would use Ferret Epigen 90.
Unfortunately, diet only goes so far. The tumors continue to grow and spread throughout the pancreas. The pancreas begins producing even more insulin and lowering BG to the point that you will not be able to manage with diet alone. At this point, you will have to begin meds. I usually decide to use meds when my ferret is not active & not enjoying his life even with frequent feedings. I make the decision to start medications when BG is in the 60's (without fasting). If BG is whacky and unstable even with frequent feedings of high protein food, then it is time.
MEDICATIONS:
Once the tumors become unmanageable with diet, you can usually manage them with meds for about 1 year more or less. This is not set in stone, I have known of ferrets going for several years with meds. Since some tumors seem to be more aggressive than others, survival rate depends.
• I prefer to use pediapred. Pediapred is "prednisolone". It is easier on the liver than prednisone. Pediapred is a liquid form used for infants and ferrets take it a lot easier. They don’t fight you as much. I made the mistake of buying the generic pediapred once (to save money) and my ferret spit it out and he was really stressed out over it. So I had to throw it out and buy the pediapred again. Also, the generic often has alcohol in it.
• Usually a vet will start off on a low dose of prednisolone and work their way up from there when needed until the ferret’s BG is stable. these doses are given usually twice a day.
NOTE: Some vets will advise to give the whole "daily" dose once a day. however, this is often ineffective. It is best to split the daily dose into two doses 12 hours apart.
Remember that different bottles of Pediapred may have different concentrations. always check the bottles and follow your veterinarians instructions as to proper dosing.
• Some ferrets do well with taking meds twice per day, 12 hours apart. Some do better with taking meds three times per day, 8 hours apart. This is a decision that you have to come to with your vet. Call your vet, tell them how your ferret is doing. Don’t be afraid to call your vet to let them know that despite medications, the symptoms are continuing!
• Prednisone tablets or liquid are often started at a "daily" dose of ½ mg/ kg (1 kg = 2.2 lbs). Again, it is more effective in managing BG when the "daily" dose is divided into two doses per day. The prednisone dose can be increased as needed to 2 mg/kg.
Usually, the pred is no longer effective at the 2 mg/kg mark. however, some ferrets do well on doses higher than that.
• The side effects of pred are “pred belly”, muscle wasting and liver damage. Increased urination has also been noted in some ferrets. Not every ferret will have side effects.
• You must always give pred, pediapred, etc. after your ferret eats so as to avoid ulcers. Give your ferret soupies and then give pred. if your ferret is not eating on his own then you will have to syringe feed at least about 30 cc's of food before giving this medication.
• If the pred is causing bad side effects in your ferret, or when the ferret stops responding to even the max dose of pred, your vet will usually add in Diazoxide (proglycem).
• In my experience, the diazoxide has controlled my ferrets BG much better than pred.
• Diazoxide is usually started at 5 mg/kg twice per day and you can go up to 30 mg/kg twice per day. This is used in conjunction with prednisone. The prednisone is not stopped or decreased while giving diazoxide. Diazoxide tastes bitter so it is best to have the compounding pharmacy make it less concentrated and flavor it with something.
NOTE: the downside to prednisolone (or any steroid) and diazoxide is that they both affect blood pressure and this can cause problems for ferrets with cardiomyopathy or other heart conditions. Diazoxide lowers blood pressure and pred raises blood pressure.
I suppose if i were to have to choose an insulinoma med for a cardio ferret, i would go with the diazoxide. but this is something to discuss with your vet.
• The other treatment is surgery but I am not too keen on this. In the old days, vets used to “pop” the insulinoma tumors that they could see. However, they always grow again because the tumors are usually microscopic. It is often impossible to get them all.
But I hate to put a damper on things, some people have reported success with surgeries to remove insulinoma tumors! If your vet finds one large tumor instead of many smaller ones, and if your ferret is otherwise healthy and can withstand the surgery, then it is something to discuss.
HOLISTIC DONTS:
• Do not use timmy’s tonic for insulinoma. It is sugar. It is made with clover honey.
• Do not use “brewers yeast” or any other kind of yeast.
If you have an adrenal ferret with prostate issues, many of you may try saw palmetto or stinging nettle. Be careful if you use stinging nettle or saw palmetto as they may lower blood glucose. Be careful of extracts as they may contain sugar.
PREVENTION:
Do not feed your ferret any kibbles with any form of grains or starches and don’t give them any sugary treats. If you must feed kibble, use Wysong Ferret Epigen 90 which is grain free and starch free.
The best diet for a ferret are:
• Raw meat/bones
• Whole prey
• Commercial raw (though will require teeth brushing)
• Combination of all three
There is no guarantee that your 12 week old ferret from the petstore will not develop Insulinoma just because you switched them to a raw diet immediately after bringing them home. You cannot undo the fact that the ferret (at least for a small part of his life) was fed kibbles with grains. However, I am sure that if you switch them young enough you will significantly lessen their chances of developing this disease.
I came to the Holistic Ferret Forum (“HFF”) as a desperate “lurker” who was willing to do anything to prolong the life of my old insulinomic ferret. I never created an account. When I did create an account, I never logged on and I never left any posts. But I learned a lot about diet from the nice people here and what I learned here did help me keep my ferret’s BG steady for longer without having to resort to the meds.
Of course, there did come a time when I could no longer manage his BG with diet alone. But I firmly believe that had I continued to feed him the kibble that he was eating before, I would not have had as much time left with him as I did. I believe that he would have gone downhill much sooner and much faster. His diet change helped him tremendously.
I only wish that I had joined the HFF sooner.
Thank you sooo much Miamiferret2 for writing this!!!
