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.
Graphic photos on this page.
The end of this page has a short video on surgery to remove nodules from the pancreas.
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.
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 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.
The following area contains graphic pictures of an actual surgical procedure performed at the hospital.
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.
This is a sterile abdominal surgery, and our surgeon starts the pre-surgical process by using special soap to clean his hands
While our patient is being anesthetized our surgeon is already in our surgical suite setting up instruments. Our surgeon is ready to start before our patient is at a proper plane of anesthesia. Once the anesthetist gives the green light the surgery starts immediately. We want our surgeon waiting for his patient, not the other way around. All of this is to minimize anesthetic time.
In ferret surgery we have to pay particular attention to low body temperature (hypothermia) and low blood sugar (hypoglycemia). They are placed next to special hot water bottles throughout the procedure.
Our patients are carefully monitored to detect any abnormality before it becomes a problem. This early warning system is important in such a small animal that is ill and undergoing anesthesia and major surgery.
This machine monitors:
Carbon dioxide level
In addition to our monitoring equipment our anesthetist stays “hands on” in monitoring important physiologic parameters. We use a special stethoscope (called an esophageal stethoscope) that is passed down the esophagus and can give us a clear sound of the heart
Once our patient is draped we are ready to proceed
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!
This short video goes through the important points of surgery to remove nodules from the pancreas and also remove an adrenal tumor.
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.