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A common cause of death in domestic ferrets is insulinoma, or cancer of the pancreas. Although there may be only one tumor, insulinoma is far more likely to involve several tiny tumors, some of which may even be microscopic in size. The effect of the tumors is to increase the production of insulin, which lowers blood-glucose (blood-sugar) levels.
SYMPTOMS OF INSULINOMA
(Because the blood-glucose level may vary over time, these symptoms may occur occasionally or frequently, rather than being consistently present.)
* weakness in the hind limbs, sometimes accompanied by actual collapse of the hindquarters
* nausea, sometimes indicated by vomiting or excessive salivation
* glazed eyes, or a detached staring off into the distance
* trembling
* significantly decreased energy and stamina
* acute collapse, lasting for minutes or hours
* refusal of food (This symptom, of course, is also associated with other illnesses or conditions.)
DIAGNOSIS
Usually a diagnosis of insulinoma is confirmed by a blood test showing a lowered level of blood glucose, an elevated level of insulin, or both. However, a single blood test might not be conclusive, since blood-glucose and insulin levels may vary over time. If the symptoms persist despite a normal result from a blood test, another blood test, or even several more, may be necessary.
TREATMENT
1. Surgery
If the ferret is relatively young (under five years of age), the preferred treatment is surgery. In an older ferret, the choice of surgery will probably depend on how ill or weak the ferret is by the time of diagnosis, especially since the normal ferret life-span is only five to eight years. The trauma of the surgery itself must also be taken into consideration, especially when the ferret is older, in an advanced stage of illness, or in a particularly weakened condition.
One problem with surgery as an option for treating insulinoma is that by the time of diagnosis, the insulinoma has probably spread. Microscopic tumors that are already present on other organs, such as the liver or spleen, at the time of surgery would not be discovered and removed. Nevertheless, removing visible tumors will slow the spread of the cancer, increase the time left to the ferret, and allow the animal to enjoy better health during that time, until new tumors develop. Most ferrets respond well to the surgery, and although insulinoma is not likely to be cured by surgery, the ferret's life (and well-being) may be extended almost to the outer range of its normal life span by a successful surgery.
Probably the main reason for rejecting surgery as a treatment option for insulinoma is that many ferret owners, however devoted to their pets, simply cannot afford the $1,000-$2,000 cost of the operation.
2. Non-Surgical Approaches to Treating a Ferret with Insulinoma
If surgery to remove visible tumors is not an option, whether because of cost or because of the age or physical condition of the ferret, the primary goal of treatment will be to make the ferret more comfortable during the remainder of its life, and to prevent an unnecessarily early death from secondary effects of the cancer.
Medications such as prednisone can be used to control the insulin level, to prevent sudden drops in blood glucose. Such precipitous drops in blood glucose can produce shock, which, if not counteracted, will progress to coma, and eventually to death. A single prednisone tablet will be divided into six or eight tiny sections, depending on the weight of the ferret, and these small doses will be administered once a day.
Once started, prednisone must be given to the ferret at regular intervals (usually a single daily dose). If the medicine is withdrawn suddenly, the ferret will experience side effects that will cause suffering and that could prove fatal.
Because prednisone has a bitter taste, it is difficult to administer to the unwilling ferret. Some ferrets are easier to "pill" than others, but in many cases two people are needed to get the pill into the ferret--one to hold the ferret, and the other to force its mouth open and to put the pill down its throat. Unfortunately, ferrets, like cats, are quite capable of spitting out a pill, and some ferret owners cannot medicate their pets this way.
Another option is to grind the pill into a very fine powder. Then it can be thoroughly mixed with a strong-tasting substance that the ferret actually enjoys. One possible vehicle for the powdered prednisone is the popular ferret supplement Ferretone. Another option is to use a small amount of soft margarine or softened butter. Occasionally a ferret still will not accept the prednisone. When this happens, it sometimes works to add another strong flavor to help disguise the taste of the pill. Flavored brewers yeast tablets can be found in the dog and cat aisles of most pet stores. One half of such a tablet, finely powdered and mixed with margarine or butter, usually will suffice to disguise the taste of the prednisone. An added benefit to using either brewers yeast or Ferretone is that both offer essential vitamins, minerals, and fatty acids, and this sort of supplement is very helpful to an animal that may often be too sick to eat properly.
3. Diet
Several small meals a day of a high-quality, high-protein ferret or kitten food will help to maintain stable blood-glucose levels. If the ferret suddenly refuses to accept its normal diet, adding water to the dry food might make it more palatable. However, if the ferret continues to refuse its normal food, it might be necessary to find a substitute, either temporarily or permanently.
If simply switching to another brand of high-quality, high-protein food doesn't work, it might be necessary to offer a lower-quality food, such as a regular catfood, in place of a premium kitten food. A ferret's metabolism is much higher than that of a cat, so a regular catfood will not provide sufficient nutrients for a ferret. However, it is better to feed the ferret a lower-quality food than to allow the animal to go without eating, especially since skipping meals can lead to dangerous drops in blood-glucose levels. If this approach is taken, though, it is absolutely essential to supplement the ferret's diet with Ferretone and/or other vitamin and mineral supplements formulated especially for ferrets. With the lower-quality food, it will also be necessary to feed the ferret more frequently, to meet the demands of its rapid metabolism.
Chicken, turkey, or beef babyfood can be used as a protein supplement, and many ferrets accept such food willingly. The consistency of babyfood also means it can be used if a reluctant ferret must be fed with a syringe.
Because a ferret with insulinoma has less stamina than a healthy ferret, its waking and play periods will be shorter, and its sleeping periods will be longer. It is best not to let the ferret go for more than a few hours without food, even if it must be awakened for a feeding. A particularly devoted ferret owner might even choose to wake the animal during the night for a feeding.
4. How to Deal with Collapse Caused By a Sudden Drop in Blood Glucose
For a ferret with insulinoma, going too long without eating can cause a drop in blood glucose sufficient to bring on a sudden collapse, with or without loss of consciousness. If that happens, a very small amount of sugar will raise the blood glucose level enough to revive the ferret and enable it to eat. This is accomplished by putting a small drop of honey or sugar water on or into the ferret's mouth. Another method, if the ferret is conscious, is to mix a small amount of sugar into about one-half a teaspoon of Feretone, since most ferrets will readily accept Ferretone. As soon as the ferret is able to eat a regular meal, it should be encouraged to do so.
The point in managing insulinoma is to maintain as far as possible stable insulin and blood-glucose levels. It is best not to allow such sudden drops in blood glucose to develop, since giving the ferret a dose of sugar will also cause the insulin level to spike again. Sugar is to be used as an emergency measure, when the ferret has reached a point where it cannot eat, or where eating will not bring the blood-glucose level up fast enough to prevent or reverse acute collapse.
Many ferrets with insulinoma suffer unnecessarily and die earlier than they otherwise would because their owners don't recognize the signs pointing to a sudden drop in blood-glucose levels, don't know how to treat such a drop, and can't figure out how to work around a ferret's refusal to eat or to accept medication that might help to regulate insulin levels. Even if surgery is not an option for a ferret with insulinoma, its remaining months can be made more comfortable, and it can be prevented from dying before its time from acute episodes caused by low blood-glucose.
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