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Insulinoma and Diabetes in Ferrets

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Insulinoma

  • Beta cell tumors of pancreas producing insulin and resulting in hypoglycemia
  • Common disease in ferrets
  • Unlikely to metastasize in the ferret
  • Etiologies-unknown but suspected include:
    • Genetic
    • Lack of natural lighting
    • Diet

Clinical signs
* May start out mild and episodic or present as acute collapse/seizure
* Include
** Staring into space
** Difficult to awake from sleep
** Lethargy
** Weight loss
** Collapse
** Seizure

Treatment
* Medical
* Long survival and disease free interval
* Pediapred®
* Diazoxide®
** High incidence of side effects (inappetence, vomiting, diarrhea, bone marrow suppression)

Surgical

  • Preferred, much longer average survival time compared to medical treatment
  • Best if instituted early in course of disease (prior to prednisolone therapy)
  • Complete exploratory advocated
  • Most ferrets recover well from surgery
  • Metastasis uncommon

Recommended Surgical Procedure

  • Fluid therapy
  • Antibiotic therapy
  • Intubation
  • Gas anesthesia (sevoflurane)
  • Ventilation
  • Careful examination of entire pancreas with gentle palpation
  • Partial pancreatectomy more effective with longer survival than nodulectomy
  • Post-op transient hyperglycemia can occur but persistent hyperglycemia (requiring insulin is uncommon)

Post-op Complications

  • Hypoglycemia-extremely uncommon immediately post-op (blood glucose level begins to climb as soon as 20 minutes post-op)
  • Inappetence-owner must hand feed if ferret is not eating well for first 1-2 weeks after surgery
  • Hyperglycemia
    • Transient hyperglycemia is not uncommon-should resolve in 2-4 weeks
    • Persistent hyperglycemia is rare-may need to be treated with insulin
  • Pancreatitis
    • Rare

Diabetes

  • Iatrogenic
    • Rare complication of partial pancreatectomy
  • Spontaneous diabetes mellitus

Treatment

  • Ultralente or Lente insulin