From: Lynn McIntosh [faiml@uswest.net] Sent: Sunday, August 08, 1999 3:42 PM To: FAIMLanon; FAIML Subject: FAIML #321; August 8, 1999 Ferret Adrenal/Insulinoma Mailing List (FAIML) #321; August 8, 1999 1. Question... 2. need advice re Rustle and insulinoma 3. Bear's adrenal surgery (plus a surprise) 4. Vena cava ligation 5. Vena cava ligation 6. any tips on syringe meds? 7. weaning off duck soup 8. weaning insulinomic ferrets TO POST: Write POST at the end of your subject heading (the more specific you can be in your subject heading, the better) and send to . URGENT POSTS: If you feel the message is urgent please mark it POST URGENT and I'll send it out to subscribers as soon as I can, then include the message in the next list. CALIFORNIA RESIDENTS: Please write POST ANONYMOUS after your subject heading if you don't want your address or last name published. SUBSCRIBE/UNSUBSCRIBE: Just use the one address for posts, subscription questions, requests, cancellations, comments, etc. The list is run by hand so just send me an e-mail. ADRENAL/INSULINOMA WEBSITE: FAIML ARCHIVES/PHOTOS: Past FAIMLs are being archived, with a search feature, on Michael Janke's adrenal/insulinoma web site: . Michael is also kindly posting pictures of FAIML subscribers and the ferrets at this site in the FAIML Album. Check out his site for more info. PAM GREENE's FERRET FAQs: I suggest people read (and reread) Pamela Greene's Disease FAQ's on Insulin and Adrenal diseases, as they offer a good background. I forward them to all new subscribers, and will gladly send them upon request. I also send the "Disease Package", a file that tells how to get all six of Pamela Greene's FAQs on ferret diseases. Pam also has excellent FAQ's about general ferret care as well, and a link to these may be found on the FERRET CENTRAL web site: . THE FERRET MAILING LIST (FML): The FML has 3,000+ ferret-loving subscribers and the topic is simply ferrets, ferrets, and more ferrets. Moderated by Mr. Bill Gruber, it's a good source of ferret entertainment and information. Visit FERRET CENTRAL on the web (see paragraph above) for more info on the FML. To subscribe to the FML, send email to its moderator, Bill Gruber, at and ask to be added. You can also try subscribing automatically by sending email to with the command SUBSCRIBE FERRET in the body of the email. 1. Subject: Question... From: "danielle.phillips" Date: Wed, 04 Aug 1999 17:02:56 -0500 Some of you may remember me asking for help awhile back about She'ra. She is now 8 y/o and all seesm to be going along. A couple of months ago, I took her to the vet because her lymph nodes were swollen. After tests and other things...it was said that she never really had adrenal (that was her surgery last year) but all along she had lymnphoma. Her hair never grew back, actually it got worse, all she had was the hair on her head. BUT now, She'ra has grown most of it back. A new coat has come in and only a little part of her back is bare. My question...saying she didn't have adrenal or did and lymphoma, is this normal. She is a happy little girl...runs, plays, eats like crazy-She is my baby! 2. Subject: need advice re Rustle and insulinoma From: Jeniferret@aol.com Date: Sat, 7 Aug 1999 16:23:12 EDT Hello all... This is my first time posting here, although I have been following things on here for a while, pulling for the little sick ones, and crying for the ones who haven't made it. Here's my questions: Rustle is 4. Over the past three or four months I have noticed little signs that I haven't liked. He isn't as wild and crazy as he used to be, and even seems more subdued than the usually sedate Archie a lot of the time. He takes his good old time coming out of the cage for playtime, whereas he used to rattle the bars as soon as he heard me get up. Twice I found vomit in the cage, and someone, but I am not sure who because it happens at night, has now started pooping outside the litter pan, destroying their 3+ year history of a 100% hit rate. He speed bumps more often but eats fine and never looks as if he is not all there, much less as if he is having a seizure. I made the vet do a glucose level on him... from his claw, and read in the little meter they have in the office. It read 50, so the next step was a four hour fasting level a few days later, with blood drawn from his neck. The reading in the office was 102..... but the blood was then sent to a lab. It came back at some ridiculously low level which would have meant he was dead. The vet says that we should redo, no charge to me, that they mustn't have spun it down soon enough to keep the rbc's from eating the sugar. I hate to put my baby through this again, although they said the blood was drawn smoothly (by a tech, yet, since the dr we see was out sick that day) and he didn't require anesthesia or anything, and he was absolutely fine afterwards. What do you all think? Repeat? By the way, the bloodwork was fine except for the glucose level. My other question is based on me not understanding the role of diet in all of this. Initially I was feeling that I put Russ at risk because I feed him kibble, don't make him chicken gravy, and also give him about a tablespoon of mashed banana a day. I am sorry... he started the banana when he was recovering from ECE a few years ago, and it makes him a happy boy. As soon as I heard the first reading I cut out the banana and started supplementing the kibble with chicken 2 baby food, thinking that the sugar and carbs weren't doing him so much good. If I didn't misunderstand, which is possible, the vet said this would have had no effect on the fasting glucose level. And that it wasn't necessary to change his diet at this point. These aren't vets who don't see ferrets.. they are actually the Modern Ferret vets... but I want to know what you guys think. I am still wondering if Russie (and Arch, too) are being shortchanged and put at risk due to their diet, and what you all would advise re feeding a ferret who is suspected of having insulin problems, seeing as the vet thinks their diet is fine. Sorry so long. Thanks a lot, Jennifer 3. Subject: Bear's adrenal surgery (plus a surprise) From: "Steve McMall" Date: Fri, 6 Aug 1999 :39:24 -0500 I wrote last week about Bear losing a bit more hair a short while back. We had already suspected adrenal problems and I had wondered if he could just be shedding late. We took Bear down to Arlington today to Dr. Kendrick. He removed what he said was the second largest adrenal tumor he had ever seen from the left adrenal. We were a bit surprised that it was so large; his symptoms were not very severe, considering that he had only lost about a half-dollar sized section of fur from his rump before last week. The surprise came in the form of about a dozen "lymph sacs" taken from his pancreas. Steve is pretty sure that is what Dr. Kendrick said when he called this evening (he was out when we picked Bear up). I believe that he told Steve that it was unusual to find this many without any symptoms of insulinoma. We are are to keep an eye out for the classic symptoms of staring, pawing at the mouth, ect. Dr. K. believes these little tumors (?) are the reason (in addition to the adrenal tumor) that he has not been able to regain his weight. He only gained about 7 ounces since May, while he was having problems with ECE. Both the adrenal and the lymph sacs are to be sent to the histopathologist for examination. I went back and reread the Insulinoma FAQ. I couldn't find any reference to lymph sacs. But it did mention nodules on the pancreas. Is that the same thing? It referred to insulinoma as the most common neoplasm in the ferret. I had to look up the word "neoplasm". Tumor. Dr. Kendrick mentioned to Steve that after he took off the tumors, he used a laser on the area. For those of you who have had this done......is that to prevent them from growing back? If he has already removed almost a dozen of these, do they continue to grow on other places on the pancreas? To answer my own question, I guess they could, or he wouldn't have told us to watch for the symptoms. I guess I am concerned because he had shown no symptoms before. The only thing close was pawing at his mouth when we were having to force-feed him the duck soup and when we gave him amoxicillin. No staring, no drooling, no back leg immobility. He had started to lose a few ounces before the ECE, but we (and Dr. K) had thought it was related to the adrenal disease. We certainly plan to invest in a scale and watch the weight more closely of all six of our fuzzies now. So, anyone have any suggestions as to a good scale? I know this is getting long, but I wanted to make one more comment. Our year old son asked why we would spend $500 on Bear, when we could buy a new ferret for much less. He basically said the same thing when we had Scamper and Snowball's surgeries done. Steve's comeback was that he probably had spent the same amount on running shoes in the last couple of years. But I calmly explained that Bear is a well loved pet and a member of the family, and we would not sit back and watch him suffer and die when something could be done. Chris has never owned a pet yet, although our cat sure is attached to him and mopes around for weeks whenever he goes off to college. I am hoping it is just his age and that he gains a bit more understanding and compassion when he grows up a bit more. Kids! Hug your babies, even your human ones ;) today Steve, Becky, and six spoiled brats, oh, and a large human brat 4. Subject: Vena cava ligation From: "Michael F. Janke" Date: Wed, 4 Aug 1999 17:54:43 -0400 >2. Subject: Need opinions and help/Squirt update >From: Mohr > >Again, questions first. Squirt no longer has the left adrenal, and >the vet wants to go back in and "debulk" the right adrenal, which >they say will last about six months, then the thing will grow back. >*sigh* The other options are lysodren, which I'm not wild about, or >vena cava ligation. My vet has never done one, and I understand that >they're a bit dangerous. Also, isn't the vena cava a major source of >blood flow to the hind legs? The Vena Cava IS a major source of blood flow. I'm no vet but I believe the only time the Vena Cava is ligated is when the adrenal/tumor has grown into it and obstructed the blood flow anyway. Because this obstruction happens gradually, the body has time to develop other paths for the blood to complete its journey. If the adrenal/tumor has not obstructed the blood flow, then the sudden stoppage of blood through the Vena Cava by ligation is probably not something that you want to do. Again, this is a layman's thoughts on the topic. As for Lysodren... some have used it somewhat successfully, but I have not found it to be worth using. My opinion. For the ferrets, Mike * Michael F. Janke, mjanke@miamiferret.org * Secretary, South Florida Ferret Club & Rescue * A 501(c)3 not-for-profit corporation * * Visit our shelter's web site: http://www.miamiferret.org * Visit the Adrenal/Insulinoma web site: http://www.miamiferret.org/FHC 5. Subject: vena cava ligation From: Clare Sebok Date: Sat, 7 Aug 1999 14:02:58 -0400 (EDT) In response to Tasha's question about vena cava ligation, I'm re-posting a statement Dr. Weiss wrote last summer. I would also like to add my personal experience with this procedure: our four-year-old Jasmine had this done in June and died two days later. I have never seen a ferret have such a difficult time post-op, and I never want to see a ferret suffer that much ever again. I don't think I'll ever again want one of my ferrets to have such radical surgery. Buttercup is doing well on Lupron (after two adrenal surgeries) and Bridgett, our other ferret who has had two adrenal surgeries, will get a Lupron injection soon. Lupron is not considered a cure, but it sure seems to improve the ferret's appearance and quality of life. Clare Dr. Weiss wrote this post on July 26, 1998, for FML and FAIML readers and their veterinarians. VENA CAVA LIGATION I have performed about 10 of these procedures to date. All the ferrets have survived and are doing well. In my opinion vena cava ligation can be a life saving technique which should be performed with select cases. The right adrenal gland in the ferret is normally attached to the vena cava, which makes it a technically difficult surgery. Although difficult, an experienced ferret surgeon usually can perform this procedure without ligating the vena cava, with very good success. I do not feel the vena cava should be ligated routinely, or because the adrenal tumor is "attached" to the vena cava (it is virtually always attached to the vena cava). On occasion we see very large right adrenal tumors which almost completely occlude (obstruct the blood flow through) the vena cava. In these cases the tumor grows over weeks or months slowly occluding more and more of the blood flow through the vena cava. When this occurs over this time frame the body develops collateral circulation (other small new blood vessels that bypass the vena cava). Therefore when the vena cava is almost completely occluded I feel it is usually safe to ligate it in the ferret. The other alternative is closing the ferret up and calling it an inoperable tumor (which is giving the ferret a death sentence). With the option of vena cava ligation virtually all adrenal tumors are operable. This is really a benefit to the patient since even malignant adrenal tumors rarely spread and complete removal is usually curative. When used appropriately I feel this is a life saving technique which has minimal complications. But, it's important to remember that a ferret with a large adrenal tumor is a very ill animal (even if it comes on so slowly that the owners do not notice many symptoms). Although this is a very stoic species which does not always display pain as we do, this is a life threatening condition. In a case like this there are always risks associated with anesthesia and surgery, because it is such a serious condition. In my opinion, in such a case, surgery with vena cava ligation is the best chance to save the patient's life and give the ferret a good quality of life post- operatively. Charles Weiss, DVM 6. Subject: any tips on syringe meds? From: Apollo174@aol.com Date: Wed, 4 Aug 1999 14:21:24 EDT Hi all, I hope all of you and your fuzzies are doing well. I just was wondering if anyone has had any luck with any gimmicks syringing liquid meds to their ferrets. It is a constant struggle in my house and I really can't find enough scruff on my ferret (Trekkie) to scruff her comfortably. Plus, I hate doing it. So, if anyone has any tips or ideas about how to get her to take medication more painlessly, please let me know. Right now, my biggest problem is with the proglycem which she frequently spits up and gags at the very sight of the syringe. It really seems to bother her more than any other medication. Please, if anyone has had any experience with this, email. PS- Trekkie turned 8 years old officially last week! :) --Marissa apollo174@aol.com 7. Subject: weaning off duck soup From: Moxie Date: Wed, 04 Aug 1999 07:58:55 -0400 Hi, How old is Franny who has insulinoma who will only eat duck soup? Since you realize it is important that she eat every 4-6 hours, I'm afraid you are stuck feeding her the soup if she won't eat kibble. I had to spoonfeed my Slinky the last 6 months of his life, as he would not eat otherwise. Prior to that I did wean him off for a short period by not feeding him during the night and he ate his dry food, but that was short lived. Maybe someone else can offer you a suggestion, but my experience was that an older ferret with health problems could not be weaned off soup. Best wishes, Moxie and Chance -- * Page me online through my Personal Communication Center: http://wwp.mirabilis.com/949746 (go there and try it!) or, * Send me E-mail Express directly to my computer screen 949746@pager.mirabilis.com For downloading ICQ at http://www.icq.com/ For adding similar signatures to your e-mail go to: http://www.icq.com/emailsig.html Moxie 8. Subject: Weaning insulinomic ferrets From: "Amy C. Dempsey" Date: Wed, 04 Aug 1999 11:01:04 -0700 Keiko, I have two little insulinomic girls who only eat their duck soup. Unfortunately with my work schedule I can't come home during the day. I feed my girls (and all my boys who beg for the soup if I don't let them have some) at 6am and 6pm. As long as I am no more than 30 minutes late I have absolutely no problem with them. Longer than 30 minutes late and Little Bear starts getting glassy eyed. Maybe you can gradually try longer intervals between feedings. My ferrets do so well on the duck soup I would never want to wean them off of it. Amy and her 6 fur snakes ----------------- End of FAIML #321 --------------------