Insulinoma

Insulinoma involves the beta cells in the pancreas of the ferret that develop into tumor(s), and is unfortunately fairly common in ferrets aged 2-4 and up. It is this tumor(s) that causes the excess production of insulin (a hormone which allows cells in the body to use glucose in the blood), causing a dangerously low blood glucose level (due to the high absorption), also known as hypoglycemia (opposite of diabetes). The nodules (tumors) can typically range in size from 2mm - 1cm, may occur singularly or as a group of small nodules, and are a recurring problem. There are also many cases of diffuse hyper beta cell proliferation, where there are no visible nodules or tumors. In this case, treatment would be removal of part of the pancreas.

Many veterinarian's feel that as a strict carnivore the pancreas are very sensitive to sugar, that giving sugar may even cause insulinoma's (perhaps for genetic reasons, some are more sensitive than others). It is important to NEVER provide any sugary treats or snacks which includes: raisins, Pedialyte, Ensure, fruit, honey, etc., whether or not your ferret has insulinoma, and limit the amount of Petromalt and Nutrical.

Sugars rapidly convert into glucose providing major energy sources for the bodies cells. High glucose levels in the bloodstream create high demand on the pancreas to produce insulin allowing the cells to use glucose. The chronic high levels of blood sugar and stimulation of the pancreas to produce and release insulin (caused by high carb diets) is strongly believed to contribute to the development of this disease. The islet cells tumors then produce excess amounts of insulin leading to hypoglycemia (low blood sugar).

The best and most healthiest treats you can offer are those that are animal protein based. Unfortunately, there is no absolute cure for this disease, however with carefully supervised treatments consisting of surgery, diet control and medicines, a ferrets life span can be increased by 3 years or more.

The most common early sign of insulinoma is "staring into space", blank expressions, etc. Other signs and symptoms include: depression, weight loss, foaming and pawing at the mouth, lack of appetite, lethargy, salivation, difficulty in using hind legs, vocalization, and in severe cases seizures and/or coma. As the disease progresses, the signs and symptoms will also increase and become more and more severe.

If your ferret goes into a seizure, it can be a very frightening experience, and it will be important that you do not panic. Your ferret can be stretched on its side, have excessive drooling to foaming at the mouth, twitching, shaking, and be unresponsive. During this time, you will need to apply a small amount of honey or karo syrup (should always have on hand) on their gums and inner lips with a Q-tip (to avoid accidental biting). You might have to repeat this every few minutes for up to 20-30 minutes, at which time your ferret should start becoming alert again. At this point you will need to provide a high protein snack (ie; meat based baby food, softened kibble, etc.), as the protein will act to stabilize the glucose levels. You should NOT provide honey or karo syrup to your ferret at any other time!

At one time, it had been suggested that supplementing their food with Brewers Yeast helps regulate their insulin and glucose levels; it has now been proven not useful and should be avoided. Brewer's Yeast contains chromium, which will actually lower (not raise as originally thought) the glucose level, which is the last thing you want to do for a ferret that is suffering from insulinoma. It is strongly recommended that you have routine blood glucose tests for your ferret. This will provide you with the needed information to stabilize (with drug), a ferret already diagnosed, as well as those in the early stages of the disease for monitoring and preventive measures. You can try performing the blood glucose tests at home after discussing it with your veterinarian.

For ferrets with hind-end weakness, you can help them get around by providing a ferret specific wheelchair, which will assist them while they can still use they back legs some as well as when they no longer can. I personally recommend the Ferret Flyer, which is individually made by very dedicated ferret lovers.

The most accurate test to diagnose confirm Insulinoma is to measure the "FASTING" blood glucose levels by a lab, which is accomplished by a blood test. The normal range for a ferret is 80-120 mg/dl, with anything under 70 (by lab test) strongly indicating the possible presence of one or more tumors, and surgery should be scheduled as quickly as possible providing your ferret has no other health concerns.

Your veterinarian might request several tests to obtain a mean average, as the the values can fluctuate. Prior to each test you will need to fast your ferret between 4 - 6 hours. Once Insulinoma has been confirmed, the "FASTING" blood glucose test should be repeated every 4-12 weeks. You can also test at home after consulting with your veterinarian.

Surgery as early as possible is the treatment of choice. A partial Pancreatectomy often provides increased survival and often no additional medicine is need for a time (can be years). A partial Pancreatectomy consists of the removal of the tumor(s) and part of the pancreas (no more than 50-70% can safely be removed). The earlier the procedure is performed, the better the results, so you should NOT put this off!

If you decide to wait on the surgery and go with the drug treatment until it's no longer beneficial, chances are it may not help your ferret that much, as during this time the tumors are continually growing. The drugs have no effect on the cause of the problem which are the growing tumors.

A large majority of vets, including Dr. Bruce Williams, DVM, feel it is important to consider that drug therapy is only a temporary remedy and rarely effective in controlling the hypoglycemia for a long period of time. It is important at this time, that you ensure your ferret is receiving a high quality/protein diet such as Duck Soup, Gerber's chicken stage 2 baby food or Prescription Diet AD.

If surgery is not an option, or until it is viable, the drugs of choice are Prednisone, which raises the blood glucose levels by mobilizing carbohydrates and/or Proglycem, which is an antihypertensive drug which decreases the secretion of insulin.

Prednisone is usually the first drug used (and is relatively inexpensive), with a typical dosage range of 0.5 - 2.5 mg/kg twice a day. Prednisone can produce what is known as Pred Belly (weight is gained) and over time of usage can cause liver damage. It is important when using this drug to give with food as ulcers can develop.

Proglycem is usually prescribed when Prednisone is no longer working and usually added to the treatment regimen, lowering the Prednisone dosage. Dosages range from 5 - 10 mg/kg twice a day. Side effects can include anorexia and vomiting. The drawback to this regimen is the costly price of Proglycem, with a one month supply costing approximately $130 per ferret.