From: Lynn McIntosh [faiml@uswest.net]
Sent: Wednesday, October 04, 2000 1:52 AM
To: FAIMLanon; FAIML
Cc: faiml@uswest.net
Subject: FAIML #467; Oct. 3, 2000

Ferret Adrenal/Insulinoma Mailing List (FAIML) #467; Oct. 3, 2000   


There are ten messages in today's list:  

Jonesy up-date STILL URGENT (new post - #4)
Jonesy  URGENT (original post - #1)
Jonesy  URGENT (update - #2)
Jonesy (update - #3) 
Reply: Jonesy  URGENT (Proglycem source)
Reply: Jonesy  URGENT
Reply: Jonesy and Proglycem
Lupron side effects and an introduction
Possible adrenal AGAIN!
lifespan with insulinoma


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Date:  Tue, 3 Oct 2000 21:31:14 -0500
From:  "dook dook" <dookdook@collector.org>
Jonesy up-date  URGENT (new post - #4)

Sue is concerned that the Proglycem is causing his blood sugar to skyrocket 
since the "limp" episodes are following the medication.   Her concern is that his 
body has adjusted to the 40 to 60, an increase to normal 90-120 will be 
extremely high for him.  

The vet has adjusted the dosage to 0.1 ml. twice a day.  Sue has a heavy work 
schedule this week and couldn't post.  

I advised her to start supplemental protein feedings every 3 - 4 hours.   An input 
will be greatly appreciated.  

I lost Sammy to insulinoma.
~~~~~~~~~~~~~~~~~~~~~
Margie
ICQ 67585607
Spoiled Ferret Rescue Stopover.
Never refusing refuge to those in need.
Sammy heaven is yours enjoy it.


Date:  Sat, 30 Sep 2000 22:07:23 -0500
From:  "Sue Stout" <sstout@surfnetinc.com>
Jonesy  URGENT (original post - #1)

MODERATOR'S NOTE:  This message was sent out a couple days ago by 
itself and is being included in this, the following, list as usual.  Updates on Jonesy 
and responses follow.  Lynn

Hi First of all, the vet prescribed 0.25ml of proglycem. The other was a typo 
sorry. My problem is this...I got the proglycem yesterday. Then continued on 
to the Chicago Ferret Show. Talked to alot of people there and noone has 
been giving that much proglycem to their ferrets. The vet where I picked up the 
medicine (Midwest bird and exotic animal hospital) said they usually only start 
out at 0.1 to 1.0ml BID . They said since my vet prescribed 0.25ml BID to 
give it that way. Well, today I got home...Jonesy was active (family had been 
feeding and giving Pred while I was gone). I gave him 0.1ml of proglycem 
when I arrived home. I followed the med with his hills AD. About 1 hour later, 
he was LIMP! I gave him his pred then and followed it with Hills AD after 
really working at waking him up.. He became very active after his pred. IS 
THIS POSSIBLY A REACTION TO PROGLYCEM???? Of course, this is 
Saturday night with only emergency (very expensive) vets available. I don't 
know if I should continue the proglycem. What do all of you think? Please let 
me know as soon as possible. I will hold off on tomorrows first dose until 
afternoon. He is to get it twice a day. Also, does everyone think I should give 
the 0.25ml or just 0.1ml and then call the vet on Monday? Does anyone know 
what the side effects are for proglycem? Please email me with ANY advise as 
soon as possible. Thanks in Advance. Sue and Jonesy   


Date:  Sun, 1 Oct 2000 00:01:55 -0500
From:  "Susan Stout" <sstout@surfnetinc.com>
Jonesy  URGENT (update - #2)

Hello again,

It is in a suspension. But it is 50mg/ml   Went to Midwest because I could
buy it by 1/4 ounce (got 1/2ounce) rather than the entire ounce which
Walgreens wanted $150.00 for.

From: Lynn McIntosh <faiml@uswest.net>
Sent: Saturday, September 30, 2000 10:26 PM
Subject: Re: Jonesy URGENT

> Hi Sue.  The amount you're given depends on the dilution chosen by the
> pharmacist, unless it is the commercial Proglycem, which I use, and that
is diluted
> at 50 mg/ml, which is quite concentrated, and .1 bid is the beginning dose
> for this 


Date:  Mon, 2 Oct 2000 10:01:07 -0500
From:  "Sue Stout" <sstout@surfnetinc.com>
Jonesy (update - #3)

Hi Lynn,  Just wanted to drop you a line and let you know about Jonesy. Gave 
him his proglycem again yesterday. Gave 0.1ml not the 0.25ml followed by 
Hills AD. Within 45 minutes he was limp again. Grabbed him up, talked to and 
loved on him (and gently rubbed him) and he did come around. By coming 
around, I mean that he woke up...took another 30 minutes before he would 
stand up or walk. After he came around, I gave him his prednisolone .5ml and 
more Hills AD. (Time wise, his pred was not late) He had been walking 
aroundand playing a little before I gave the proglycem. I had not given the 
pred before the Proglycem either, since I wanted to see what reaction I would 
get. Vet said it sounds like his Blood sugar dropping low, and that proglycem 
will make the blood sugar higher not lower. He said to halve the dose to 0.1ml, 
give Karo syrup before I give it and see what happens. He said Jonesy may not 
be able to tolerate this drug..that not all ferrets can take it. Also said that 
depression and lethargy are the big side effects of this drug. No seizures or 
frothing at the mouth occurred...he just went limp and in a deep deep unnatural 
sleep.I am going to go give him his dose now, but if this reaction happens 
again... I will seriously think of NOT giving the proglycem at all. At least not 
yet. I checked the records I keep and found that his blood sugar has been as 
low as 20 and never over 60 since the diagnosis of insulinoma. 

Thanks to all who responded. I really appreciate it! 

Sue and Jonesy  


Date:  Mon, 02 Oct 2000 23:47:27 -0400
From:  "Steve Fontneau" <fontneau@worldpath.net>
Reply:  Jonesy  URGENT (Proglycem source)

dear friends,

i get my proglycem from goods pharmacy (on the net) for only $93 an ounce. at 
walmart it is $120. we have been using it successfully for 1 and half years. i do 
have to lower the dose from time to time. i use a needle syringe to pull out a 
drop. too much and my ferrets go limp. it is strong stuff!  

good luck. 

from the warm fuzzy trio, zoey, nueman and lucy  


Date:  Sun, 1 Oct 2000 21:58:33 -0400
From:  "Dan & Mary DeCoff" <tnsamndd@midcoast.com>
Reply:  Jonesy  URGENT

Hi Lynn, Sue,

I used Proglycem for Shuhe.  We started him on o.1ml of the comercial strength 
twice a day.  He weighed just under two pounds.  The weight is a factor.  MI 
would go with this dosage, and call the doctor tomorrow.  Sorry to be so late, 
but my server has been down this weekend. 

Good Luck 
Mary D.  


Date:  Sun, 1 Oct 2000 01:10:34 -0400
From:  "Michael F. Janke" <mjanke@miamiferret.org>
Reply:  Jonesy and Proglycem

>My problem is this...I got the proglycem yesterday. Then continued on to the 
>Chicago Ferret Show. Talked to alot of people there and noone has been 
giving >that much proglycem to their ferrets. The vet where I picked up the 
medicine >(Midwest bird and exotic animal hospital) said they usually only start 
out at 0.1 >to 1.0ml BID . They said since my vet prescribed 0.25ml BID to 
give it that way.  

I don't know if there are variations with Proglycem so I think that needs to be 
clarified before determining how many ml's are appropriate.  The only way I've 
seen Proglycem is in a suspension concentration of 50mg of diazoxide per ml, 
but I don't want to assume that's the only way it comes.  

According to "Ferrets, Rabbits and Rodents - Clinical Medicine and Surgery", 
when pred is no longer effective, Proglycem can be added to the treatment 
protocol at the rate of 5-10mg/kg q12h PO, which means every 12 hours, 
orally, and can be gradually increased to as much as 60mg/kg q24h divided 
equally q8h-12h. So, the first question is, what is Jonesy's weight?  And does 
your Proglycem say 50mg/ml?  

At 50mg/ml, the 0.25ml dosage you're giving Jonesy is a little over 12mg of 
Diazoxide.  Just a small amount over the starting dosages listed in the book I 
mentioned, but no where near the maximum listed.  0.1ml would be the 
minimum dosage of 5mg of Diazoxide.  

Listen to your vet and don't change the dosage based on what you may hear 
from others who are not vets and have not examined Jonesy and do not know 
his medical history and condition.  

With that said... I recently started Beasley on Proglycem and it did not work 
well for him.  The only effect I noticed, other than the fact that it didn't seem to 
help his blood glucose levels, was that it had a negative effect on his appetite.  

Here's a little history of Beasley's battle with Insulinoma.  He contracted ECE in 
March of 1998 and during one of those vet visits, his blood glucose was found 
to be low.  Since that time he has been on prednisone, since I'm not much of a 
believer in surgery for insulinoma.  He has done EXTREMELY well on pred 
and regular, high protein meals.  Over the course of two years, he had perhaps 
3 or 4 hypoglycemic episodes in which he would hypersalivate and paw at his 
mouth.  But that was the extent of it.  No seizures.  His blood glucose hasn't 
been above 50 in I don't know how long.  The only thing we can figure is that it 
has been such a gradual decrease that his body has become accustomed to it.  

In any case, we decided to start him on Proglycem, but after almost two months 
of treatment with it and the effect it had on his appetite, we took him off it and 
increased his pred.  He weighs four pounds and was on a pretty minimal dosage 
of pred so the dose was doubled.  He's doing a lot better since stopping the 
proglycem and increasing his pred to 2mg per day. And there's room to go 
higher on his pred at his weight.  

I wouldn't skip Jonesy's dose or lower it below what your supposed to give him 
until you talk to your vet.  The little bit you're giving him shouldn't be causing 
what you're seeing, even if it's not having the desired effect. But ask your vet.  

For the ferrets,
Mike

* Michael F. Janke, mjanke@miamiferret.org
* South Florida Ferret Help Line, 305-752-7040
*
* Website:  http://www.miamiferret.org
* Adrenal/Insulinoma web site: http://www.miamiferret.org/fhc


Date:  Tue, 3 Oct 2000 18:38:03 EDT
From:  Outlaw50@aol.com
Lupron side effects and an introduction

In a message dated 9/22/00 1:17:16 AM Eastern Daylight Time, Kathy writes:

<< Although I've been reading the FAIML for a while now, I've never yet 
posted. My name is Kathy Salimy (some of you may know me from APF), I'm 
Mom to eleven fuzzies ... one of whom has adrenal disease and one who was 
just recently diagnosed with insulinoma.>>  

Hi, Kathy...I'm sorry about your sick fur kids.  Please make Bob C's chicken 
gravy for your insulinomic baby...it works wonders.  :)  

<<Judy, you asked about Lupron side effects in your last post. My three year 
old JoJo had right adrenal surgery in February but, because there were several 
pinhead sized tumors that could not be removed, he continued to worsen. Once 
I realized the surgery had done no good, I opted for Lupron therapy. JoJo 
received his first injection of the four month depot on July 8. For four weeks, I 
saw no change in him. He was still lethargic, still aggressive toward some of the 
others and still bald. Then, on August 5 ... exactly four weeks after the injection 
... I noticed what at first appeared to be a dark bruising of the skin on his belly. 
Within a day or two, it was obvious this was new hair growth. After that initial 
four weeks, the improvement in JoJo was quite dramatic. His hair came in 
rapidly, the aggressive behavior stopped, he gained weight and his energy level 
increased drastically. It has now been nine weeks since the injection and JoJo is 
back to his old dancing, dooking self ... and sports a full coat of soft new fur. 
With the exception of a lump between his shoulder blades at the site of the 
injection that appeared after six weeks, he has had no side effects at all. The 
lump is to be expected ... it's the Lupron. When it appears, just leave it alone ... 
if you remove it, you remove the drug ... it will correct itself in a few weeks. 
Three weeks after it first appeared, JoJo's lump is now beginning to decrease in 
size.   >>  

Thanks for the info.  It will be 4 weeks on Friday that Russian had his Lupron 
injection.  So far, he still has some aggressive days.  I'm a bit concerned, 
though, because the last few days, he is sleeping an awful lot.  I know I took a 
chance giving him the Lupron since no studies have been done on it in ferrets 
with Aleutian Disease, but I absolutely had to try something, and he can't have 
surgery.  <sigh>  

I'm just praying that now that the *time* is here when the Lupron may be 
"kicking in", that it isn't going to hurt him.  I've never seen him quite this lethargic. 
 He's still eating fine, he just seems so tired.  

Again, thanks for your help.

Judy


Date:  Tue, 3 Oct 2000 21:05:28 EDT
From:  KFor651676@aol.com
Possible adrenal AGAIN!

I hope our little Ellie who is about 2 1/2 (not positive, she was adopted) She is 
having hair loss on her belly which is how Phoebe our almost 5yr old had when 
she first showed signs.  I think it is coat changing time but she is shedding so 
much more than our other 3?  I hope I'm not in denial!  To make it worse I just 
realized they have fleas!  We have no other pets but our friend brought her dog 
over one day and I guess they got them from the dog.  My poor babies.  I will 
start them on the Program.  Ellie does not have a swollen vulva.  I will wait and 
watch I Dred having to go through this again. Phoebe ended up having both her 
adrenals removed and I have just been going through so many health problems 
with all of them.  All strange, out of the norm things!  My big boy Sid has been 
vomiting on and off for several months but eats and plays and seems fine except 
for when he throws up.  It is always in the middle of the night or when we are at 
work!  Vet does not have a clue.  

He is on amoxi right now.  I hope it is nothing serious.  He has no weight loss?  
Sorry for the long post.  Please e-mail me directly with any advice, I don't 
always get a chance to read all of the posts daily.  

Thanks
Kelly
Mother of Phoebe, Molly, Sid and Ellie


Date:  Mon, 2 Oct 2000 16:59:48 -0600 (CST)
From:  "John Rosloot" <john@cs.uregina.ca>
lifespan with insulinoma

>    Ulrike wrote:" But yesterday I found her limp and totally >"out of it" but a 
bit of honey on her gums brought her round. >So I guess she has insulinoma for 
sure.  My question is, how >long do ferrets live for on avergae once they've got 
that far >advanced that they become unconscious?"  

>    I read somewhere on the net that our fuzzies live, on average, >465 days 
after being diagnosed with insulinoma.  That, of course, >is an average.  My vet 
tells me that he has been treating three >fuzzies for insulinoma for over three 
years that had a documented >age of five years when they were diagnosed.  

I wanted to add my $0.02; Sammy had his first obvious insulinoma attack in 
April 1999 (problems with back legs, disorientation, drooling). He had surgery 
the following month and the vet removed 3 or 4 nodules from his pancreas, but 
he didn't seem to improve much. Over the course of the next year I started 
Sammy on prednisone and was giving him supplemental feedings 4 times daily. 
By early this year he was getting worse, and increasing his pred dosages never 
seemed to help for long.  

In April 2000 Sammy had his second insulinoma surgery (had to remove
his adrenal anyway). This time the vet did a partial pancreatomy,
removing about 1/3 of Sammy's pancreas where the nodules had clustered.

The difference was remarkable. Two weeks later Sammy's blood glucose
reading was completely normal (100, compared to having dropped as low
as 20 at times before the surgery).

We stopped the prednisone and the supplemental feedings. It's been six months 
now since that surgery, and a year and a half since Sammy's initial diagnosis, 
and his blood glucose still reads completely normal. I'm *so* pleased with the 
results. Of course I don't know how long this will last, but for now Sammy is 
perfectly healthy again.  

Sammy is currently 6 years and 5 months old by the way.  

I don't know if all ferrets respond so well, but I'd recommend the surgery (the 
partial pancreatomy; as I said, just removing the nodules in the first surgery 
didn't seem to help Sammy much).  

--
John Rosloot, Caregiver to Sammy
With loving memories of my dear departed Buddy,
and my precious little Cassie-angel
http://www.cs.uregina.ca/~john/ferrets
john@cs.uregina.ca


----------------------- End of FAIML #467 -------------------------