Chin Soon Update: Insulinoma and Adrenal Disease

Last Tuesday I made the three hour drive to get Chin Soon to a vet I really trust: Dr. Lauren Powers at Carolina Veterinary Specialists in Huntersville.

During the entire time I've been in North Carolina and have owned ferrets Dr. Powers has always been our backup vet, the one Dr. Hudson would send us to when he wanted a second opinion or the one we went to when there was an emergency and a local vet simply wasn't available. She's an outstanding vet with a fantastic reputation in the ferret community but she is just plain far from home. The net result is that she always sees our ferrets when they are on death's door. OK, Pertwee lived for another four years after his visit with Dr. Powers but he wasn't expected to. It was nice, for once, to have Dr. Powers see a ferret she actually could treat. I guess I should point out that Dr. Powers did Ella's entirely successful adrenal surgery more than four years ago. That was a couple of months before I adopted Ella.

Dr. Powers confirmed what I pretty much knew: in addition to insulinoma Chin Soon has adrenal disease. Her nipples are enlarged and her hair loss is starting to look like a classic adrenal pattern. Dr. Powers also said something that Dr. Hudson said to me whenever I caught adrenal disease early: surgery will have to wait a little to make sure that it's clear which adrenal gland is enlarged. The disease has to progress far enough for the surgeon, in this case Dr. Powers, to actually be able to see that one gland is really bigger than the other. Chin Soon is looking at a combined adrenal and insulinoma surgery, essentially the same surgery Lady Ayeka had back in 2004, at a cost of around $900.

Dr. Powers also rechecked Chin Soon's blood glucose. Despite obvious clinical improvement from the pediapred it was still very low: 44. The pediapred dosage was increased to .18ml (5mg/5ml concentation), still less than a fifth of what the nightmare vet wanted to prescribe. Dr. Powers also started Chin Soon on 100mcg of Lupron (the one month depot) to relieve her adrenal symptoms. Lupron worked very well for Podo when his adrenal disease recurred late in his life.

Chin Soon also gained 110 grams in just a week, a side effect of the pediapred. The fact that she is voraciously eating Bob Church's Chicken Gravy twice a day when she gets her medication is almost certainly also contributing. She had actually lost weight this winter due to her illnesses so this weight gain is a good thing.

While the expense of surgery is going to be difficult to meet in the current economic climate at least I know Chin Soon can be treated and is being cared for by a great vet. As I noted in my last post Chin Soon is definitely feeling much better. The net result is that she's bouncing and war dancing and wrestling more. When she plays more Ella and Zephyr get excited and play with her. Things are better all around.

Chin Soon Is Feeling Much Better

Chin Soon is feeling much better since starting on pediapred. I used what our original vet always used as a starting dosage: .01ml twice a day (5mg/5ml concentration) and it's pretty obvious she didn't need 10 times that much. She is very much her old self, ferreting away her favorite toys and running down the hall with abandon and, best of all, no more signs of hind end weakness.

Of course I have no idea what Chin Soon's actualy blood glucose level is at the moment. We'll know on Tuesday when she goes to see Dr. Lauren Powers, the outstanding ferret vet I've mentioned before. Then we'll know whether the pediapred dosage needs to be increased, decreased, or left alone.

Chin Soon Has Insulinoma & A Nightmare Vet Visit

I'm back after a long absence... This post is long but I want to get all the facts out so please bear with me.

Chin Soon is 5½ now and until recently she has had no health problems at all other than minor vaccination reactions. Lately she's had two symptoms: hind end weakness and hair loss, almost entirely on her tail. Chin Soon has rat tail at every coat change and she always grows the hair back quickly. This winter she didn't. My fears were insulinoma and adrenal disease. I've had a couple of ferrets in the past have both at once. I also thought of lymphoma. Anyway, off to the vet...

I've been back in North Carolina for a while now but I was in a quandry about what vet to take Chin Soon too. Our original vet here, Dr. Dan Hudson, retired a few years ago. The vet we used after that rarely sees ferrets now. The other vet I really trust moved all the way across the state a few years back. There are two ferret vets left in my local area. One has a fantastic reputation in terms of care but also has a reputation for being outrageously expensive and for doing everything and anything extra to increase the bill. Another who shall remain nameless was recommended by one of the active members of the local ferret club for both quality care and reasonable prices. In the current economy I decided I really had to go to the second vet.

The new vet checked Chin Soon's fasting blood glucose which was 41 so that confirmed insulinoma. She wants to do an ultrasound to see if an adrenal tumor shows up. All well and good so far. She said some other things vis a vis adrenal treatment that made no sense to me but I filed them for later research. She called in a perscription for Pediapred which I picked up yesterday afternoon. This is where things started to go seriously wrong.

The dosage with the perscription was 1.0ml twice daily, 5mg/ml solution. Yes, 1.0 not 0.1. Every other vet I've dealt with started my ferrets at 0.1ml, rechecked the glucose, and adjusted the dosage. A dosage 10 times higher worried me greatly. I called the vet's office to confirm that this was an error and that someone slipped a digit. No, it turns out that because Chin Soon's blood glucose level was "so low" she really wanted to give her 2mg per day. I wasn't going to give that much without a second opinion
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This morning I called that vet that had moved across the state who I really do trust. She told me that the dosage prescribed was higher than what they give with chemotherapy to destroy a ferret's immune system! While she wouldn't prescribe a dosage without a visit (and I don't blame her for
that) she read me the textbook maximum dosage and it is less than a third of what the new vet prescribed for Chin Soon.

My decision, of course, is to drive three and a half hours and to take Chin Soon to the vet I spoke to today. The new vet's dosage would actually have been dangerous if not eventually life threatening for poor little Chin Soon. Thankfully I knew enough about ferrets after 11 years of having them and going through all their medical issues with them to question that dosage. Imagine if I didn't. Imagine if I just did what the new vet said. Most people would have done just that. I would have 10 years ago.

This incident, this nightmare vet, reinforced my belief that ferret medicine is a specialty and that ferrets have to go to vets who have both experience and a high success rate with ferrets. Thankfully there is an active ferret community online and in most major cities which allows ferret owners to network and get the information I need.

I also realize just how spoiled the ferrets and I were when we were in Green Bay and had a great ferret vet 20 minutes away.