Introduction
Tumors of the pancreas (insulinoma) can cause
excess secretion of insulin, thus lowering the blood glucose (sugar)
level to a point that a ferret can become ill. Unfortunately, this is
a relatively common problem in middle aged and older
ferrets.
Symptoms
Some ferrets do not show any
symptoms while others exhibit lethargy and weakness. There might be a
decrease in appetite and weight loss. These symptoms might even come
and go over a period of months. Some ferrets will have increased
salivation and even a glazed appearance to the eyes, and might even
collapse or have seizures.
Diagnosis
Some ferrets are diagnosed as having an insulinoma
when an abdominal surgery is being performed for other reasons
(adrenal gland
disease, spay,
liver
disease). This is especially true for the
ferrets that are not showing any symptoms of this disease. For those
ferrets that are symptomatic of insulinoma, the diagnosis is made
based on history,
examination findings, and diagnostic
tests.
Our
laboratory has a special blood panel for ferrets that are
exhibiting signs of insulinoma.
The
diagnosis of insulinoma is verified by a low blood
glucose (sugar) level. This ferret had a blood glucose of
20, and was showing signs of seizures.
Medical Treatment
Medical therapy can be effective at controlling
symptoms, although it can not cure the disease. Food should be fed
frequently, and should consist of cat food or ferret food. Stay away
from high sugar foods that can stimulate the pancreas to secrete
excess amounts of insulin and set the stage for a hypoglycemic (low
blood sugar) episode.
rednisone (cortisone) can be effective at
controlling symptoms for several months to several years. It comes in
a liquid or pill form, and is usually given twice each day, depending
on what your veterinarian determines. It helps raise the blood
glucose level without stimulating excess secretion of insulin like
foods high in sugar.
Other medications can be used if prednisone is not
effective. These drugs are more expensive and have the potential to
cause vomiting and appetite loss. Your veterinarian will let you know
if they are indicated in your situation.
If your pet has an episode of hypoglycemia it
should be given Karo syrup, Nutrical, honey or other foods high in
glucose to temporarily raise the blood glucose level. after giving a
high sugar food feed it its normal diet to minimize excess secretion
of insulin in the long run. If your pet has collapsed and is unable
to swallow, rub a small amount of honey or syrup on its gums. Only
use just enough to wet the gums and take care not to be bitten if
your ferret is having a seizure. When it regains consciousness feed
it its normal diet and bring it to the hospital for an exam and blood
glucose check.
Ferrets
love Nutrical, a high calorie paste like supplement. Put
some on your finger or on a small utensil and usually
they will lick it off. We even use it to distract wiggly
ferrets when we are trying to get them to hold still for
a blood
sample.
Surgical Treatment
Younger ferrets or those that have adrenal gland
disease simultaneously are candidates for surgery. Tumor nodules that
are found on the pancreas are removed, helping to prolong survival
time. In some cases we perform a partial pancreatectomy. In spite of
the fact that surgery is performed some of these ferrets will need
medical management. Survival time is variable after surgery, ranging
from months to years.
Several pecautions must be taken
when this surgery is performed. Ferrets can easily become hypothermic
due to the anesthesia
and the fact that their abdomen will be open during the procedure.
They can also become hypoglycemic due to the stress of the procedure.
Special precautions are taken to help mitigate these
problems.
The following area contains
graphic pictures of an actual surgical procedure performed at the
hospital. It may not be suitable for some children (and some adults
also!). If you do not want to view this surgery click
here
and you will be taken to the end of this page.
This
ferret is anesthetized and just had its fur clipped in
preparation for surgery. The line shows the length and
location of the skin incision. You can see the pad that
is used in this ferret for insulation to prevent
hypothermia. Under the thick pad is a warm water blanket
to give additional warmth.
The
skin incision is made after the final surgical prep has
been applied and the surgical site is draped
off.
There
is a special location on the abdominal muscles called the
linea alba. It is here that our surgeon cuts through the
muscle and enters the abdominal cavity. This location
minimizes bleeding and gives our surgeon acces to strong
tissue that will hold the abdominal sutures and prevent a
hernia that could potentially become
catastrophic.
The
pancreas is rapidly isolated and a insulinoma nodule
(arrow) is found. To help identify structures, the small
intestines (I) and the pancreas (P) are also identified.
The majority of the remainder of the picture is abdominal
fat.
The
nodule is very gently squeezed out of the pancreas. You
can visualize the small intestines under our surgeon's
fingers. In many cases we have to remove more than just
the nodule.
Our
surgeon is carefully palpating the length of the
intestines to feel for any abnormalities, especially
foreign bodies and cancer.
The
spleen is assessed next in this patient. Even though it
is large it is not necessarily diseased.
This
liver lobe is healthy looking. The color is normal and
the edges are very distinct. Compare it to the severely
diseased liver of a ferret in the next
picture.
This
liver lobe is severely swollen and hemorrhagic. This pet
has cancer. To view the exploratory surgery on this
ferret click here.
a
very important organ to check is the adrenal gland since
adrenal
gland disease
is common in ferrets. This one is normal so it is
difficult to visualize (arrow). It is the small pink
circle of tissue that lies at the top of the kidney (K),
which in this picture is surrounded by normal
fat.
If you link to the adrenal
Disease page you will find a short movie showing part of this
surgery.
The
muscle layer is carefully sutured back together at the
linea alba. These sutures are very strong, and will
slowly dissolve over several months. This gives the
muscles more than enough time to heal.
The same suture can be
used in the skin. It will be removed in 7-10 days. Soon
the hair will grow back and only this ferret and his
veterinarian (not his hairdresser) will know for sure
that any surgery was ever done!
Prognosis
Insulinomas are malignant tumors that will
decrease a ferrets life span and compromise its quality of life. This
is a serious disease that does not lend itself to a cure or long term
control. Longevity after diagnosis varies from weeks to years, and
depends on the duration of the problem prior to diagnosis.
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