Tata's Surgery

Dr. Dan Johnson at Avian and Exotic Animal Care in Raleigh performed Tata's surgery today. He removed a very large right adrenal tumor, a fair amount of his pancreas including some large nodules, and a lump from his spleen. All are being sent off for pathology. The good news is Tata came through surgery well, he's awake and his vital signs are strong. For those of you not familiar with ferret medicine, right adrenal surgery is far less common than left and more difficult. Despite all he went through Dr. Johnson said Tata "looks good" and was very upbeat about the result. I'll know tomorrow morning if he gets to come home or spend the weekend in the hospital.

Thank you to everyone who sent good wishes, thoughts and prayers for Tata. A huge thank you to everyone who bought CDs and minidiscs from me on Discogs to offset some of the cost. I'm still in a difficult place financially with this and total costs will likely exceed $2000. I'll be listing more on Discogs shortly and any additional music purchases will still help. I can live with a smaller music collection. I couldn't live with Tata not getting the medical care he so clearly needed.

I'll be posting an update when I know more.

Zephyr: First Playtime, Worries About Post-Surgical Diabetes

Zephyr's blood glucose was 287 last night.  If Dr. Powers was in town she would have gone back to Huntersville and probably would have started on insulin.  Since Dr. Powers is out of town I decided to wait and see what her blood glucose was today. Thankfully it was down to 213.  If it stays below 250 I'll remember that the glucometer we have isn't the most accurate in the world and not overreact to one high number.  If it goes up into the danger zone again I'll have no choice.

We have experienced surgically induced diabetes with pretty much all our ferrets who have had insulinoma surgery over the years. The worst was Chin Soon, who actually had to have insulin injections for about a week. Her pancreas began working normally after that and she made a full recovery.

I did give Zephyr her first playtime last night and she mainly explored for almost half an hour.  She still has some hind end weakness but she didn't fall.  Chin Soon got excited and sniffed and followed and chatted up a storm.  She didn't try to wrestle.  She seems to understand that Zephyr isn't healthy right now, which is good.  Zephyr, for her part, did the litter pan shuffle and begged for treats :) I'll take that as a good sign.

Once Zephyr went into the fleecy blanket Chin Soon wanted lots of attention from me. She's still clearly concerned about her adopted sister. So am I.

Zephyr is Recovering Beautifully

Zephyr, my ferret who had insulinoma surgery yesterday, is making a beautiful recovery so far.  She began eating kibble on her own last night in addition to her gravy and did a very professional job of emptying the food bowl and water bottle.  She has diarrhea but otherwise is eliminating normally.

Zephyr's blood glucose was 269 last night.   Post-surgical diabetes was expected and Dr. Powers called that number borderline but not of enough concern to have to bring her back just yet. This morning my glucometer gave an error and by the time I was ready to try again with another strip I had to prick her tail again.  The problem was she had already just about finished her chicken gravy.  We scruffed her to try that way and the little monster repeatedly broke the scruff.  That's how strong and feisty she is this morning.  I'll give her more gravy in a couple of hours and that should let me try again.

Right now we are weening her from prednisolone, giving her tramadol every 12 hours for pain, and a sliver of Pepcid AC in her gravy to avoid ulcers.

I was told that Chin Soon was really agitated when Zephyr wasn't around last night.  We let them briefly sniff each other through cage bars last night and put the recovery cage next to the main cage so that the two would know the other is there and is OK. That isn't good enough for Chin Soon, who frantically circled the recovery cage this morning looking for a way in and then repeatedly dumped her food bowl and deliberately missed the litter pan in protest.  The next week, while the two have to be separated, is going to be challenging.

All in all, I'm thrilled with how well Zephyr is recovering.

Zephyr: Insulinoma Surgery

Zephyr is now approximately 7½ years old. She was diagnosed with insulinoma before the holidays and has been on prednisolone which did absolutely nothing for her. She had a seizure last week and continued to have severe symptoms. Her blood glucose as of this morning was 36.

Dr. Lauren Powers at Carolina Veterinary Specialists performed insulinoma surgery on Zephyr this morning. This is the third time I've had insulinoma surgery on a ferret Zephyr's age or older and, in all three cases, either Dr. Dan Hudson, Dr. Holly Weston and now Dr. Powers believed it was the only treatment option left.

The good news is that Zephyr came through surgery just fine and is awake. Two very large nodules were removed from Zephyr's pancreas. While nothing was sent off for pathology yet Dr. Powers believes the really huge one is a carcinoma. Dr. Powers also found a small, smooth, round nodule on Zephyr's spleen which she aspirated. She believes it will prove to be benign and did not want to remove the spleen unless it was absolutely necessary so it stayed in. Everything else looked normal, including both adrenal glands and Zephyr's lymph nodes.

I'm never comfortable with surgery on a ferret Zephyr's age but sometimes it is the only good option. When Kodo and Podo had their insulinoma surgeries their quality of life improved dramatically and they lived for roughly two more years. I'm hoping we've bought that much time for Zephyr too.

Goodbye Ella, 2002-2010

Back in February my oldest ferret, Ella, went to the vet for a couple of issues which I wrote about back then. She also had an enlarged spleen for roughly three years up until then. On that
examination found that her spleen was normal size but showed some irregular edges on the ultrasound. Dr. Powers didn't seem overly concerned at the time and we didn't worry about it.

For nearly eight months since then Ella acted like a happy, healthy, affectionate and playful ferret. All seemed right with the world.

Last Saturday night Ella had a little bit of an upset tummy, was moving a bit slowly, and seemed to have some hind end weakness. My first thought was insulinoma since that was what it looked like.

By Sunday evening the diarrhea was much worse, as in almost liquid and Ella had pronounced hind end weakness. She still ate her chicken gravy greedily but had little energy after that. I debated an emergency vet visit but decided she'd probably be OK if I called her regular vet in the morning.

By Monday morning it was obvious something was terribly wrong. Ella could barely move and was incontinent. She couldn't even move from her own waste. She was shivering and cool to the touch. I decided she couldn't take the three hour drive to Huntersville to see Dr. Powers and I called a local vet and got her in there. I kept her warm as best I could and gave her some warm gravy which she ate during the first part of the 45 minute drive.

By the time we arrived at the vet Ella's breathing was labored and she barely responded at all. The vet examined her and the news was terrible: Ella had a very large tumor on her spleen which had ruptured. She was bleeding into her abdomen. We were advised us that the kindest thing we could do was to say goodbye.

Ella was originally rescued in early 2003. She was found as a stray wandering in Chapel Hill in miserable shape. Her first vet appointment was on March 19, 2003 and we always treated that as if it was her birthday. That vet (Dr. Dan Hudson, who has since retired) estimated her age at 1 year old at that time. Dr. Powers saw her later and estimated that she was half a year older than that. Her original owner passed away rather suddenly in late 2004 and we adopted her ferrets, Ella and Zephyr. Ella was somewhere around eight and a half or perhaps nine years old when she died.


This is essentially the same way we lost Romana five years ago. At the time I was away on a business trip and my housemate has long beat herself up for not getting Romana to the vet the second she saw something wrong. I've always told her it wouldn't have made a difference. Suddenly I find myself asking the same question. I raised the issue on the Ferret Health List and the consensus was that it probably wouldn't have mattered. It was Ella's time.

Goodbye, Ella Bear. You will be missed.

Ella, Zephyr and Chin Soon Vet Visit Update -- Good News and Bad

The ferrets and I made the long trip to Carolina Veterinary Specialists in Huntersville yesterday to see. Dr. Lauren Powers. Ella actually has two distinct medical problems. The right eye has an ulcer which has been causing her considerable pain. She is now on both topical and oral antibiotics: one drop of Ofloxacin 0.3% in the injured eye 3-4 times daily and 0.4 ml enrofloxacin. We also have pain meds for her for the next 3-4 days as needed until the eye heals a bit.

The good news here is that after just one day with medication Ella's eye is already improving. Yesterday morning Ella was holding the eye tightly closed and was in obvious pain. She's not holding it closed tonight and is having a nice, normal active evening despite the pain meds. She actually seems far less uncomfortable tonight and was acting more like her normal self.

The ultrasound showed two nodules on Ella's spleen and what Dr. Powers thinks are enlarged illiac lymph nodes. We decided to put Ella under and do aspirates on all three masses. They were sent off for cytology and we should get results by the end of the week. Dr. Powers is still worried about the possibility of lymphoma. The peripheral lymph nodes are not enlarged and the she did say that other things can cause enlarged illiac lymph nodes including IBD and other chronic GI disease. Once we have Ella's lab results back we'll decide how to proceed.

Dr. Powers did check Ella's blood glucose again (was 77 last time) and it was a nice, normal 98. She does not have insulinoma.

I'll post more when the cytology report comes back. Obviously I'm hoping that the masses are benign and that Ella doesn't have lymphoma. FWIW, Ella did have diarrhea this morning but her output was normal later in the day.

The news for Zephyr was also mixed. The good news is that she hasn't actually lost weight. Zephyr has blown her coat at an odd time. What we are seeing is far less hair, not less ferret. The bad news is that her vulva is a bit swollen and that the hair on her belly is thin. We're going to watch and wait and see how symptoms develop. Right now this is looking an awful lot like adrenal disease which would be bad news. At age seven I don't know if we'd do surgery or not. Seeing how Zephyr responds to Lupron is probably the first option if the symptoms of adrenal disease become clear.

Chin Soon's gums are healing. She still has some root exposure but there is definite improvement. Dr. Powers said we should keep doing what we're doing, meaning brushing her teeth regularly, and we'll see how things go over the next two months. Chin Soon's blood glucose was also rechecked and was a nice, normal 91. For Chin Soon yesterday's recheck was all good news.

The cost of all this was almost $700, and almost all of that cost was Ella's diagnostic work. Whatever Ella's diagnosis ends up being we're not done yet.

Ella May Be In Trouble, Zephyr Losing Weight

Due to the winter storm last week the vet appointment for Ella was put off until tomorrow morning. In the meanwhile, over the last couple of days, Ella has become very obviously ill. She can barely open her right eye at all and both eyes are watery. She's also had two serious bouts of diarrhea over the last five days with normal output in between. Ella has also always really loved rough play. The last two nights she's come to me to play with her as always. When she does, though, if I touch her belly much she vocalizes discomfort and play ends. That, combined with her blood test results from January 18th, especially her elevated globulin, have Dr. Powers thinking that Ella may have intestinal lymphoma. That would be truly horrible news.

Dr. Powers will call me back later today with, in her words, "lots of questions" when she's done with her current patient. She doesn't feel like coming in this evening instead of tomorrow morning will make a difference, so for now the plan is to keep tomorrow's scheduled appointment and do more diagnostic work to determine for certain what is wrong with Ella.

In the meanwhile Ella ran around and explored like always last night, is eating and drinking normally, and has plenty of energy so I am hoping against hope for better news when the tests are done.

I am also very concerned about Zephyr who has lost a lot of weight in a very short period of time and also has had on again, off again diarrhea. Like Ella there has been no drop off in Zephyr's activity level and her appetite is just fine. Like Ella she isn't bouncing as much and is avoiding rough play.

Whenever one of the other ferrets is sick Chin Soon tends to stick to them like glue. I saw this with a then eight year old Nyssa during the final month or two of her life. Chin Soon was Nyssa's constant companion then and would curl up and sleep with her. Chin Soon is doing that with Zephyr now which also worries me.

Ella is just two week short of the seventh anniversary of her rescue so she is right around eight years old. Zephyr is six weeks away from the sixth anniversary of her rescue and is roughly seven. Both are considered old in ferret terms. I'm still not ready to lose either one of them.

I'll post more when I know more.

Ella and Chin Soon's Latest Vet Visit

The ferrets and I took a trip to see Dr. Lauren Powers at Carolina Veterinary Specialists in Huntersville a week ago Monday. No, nothing was wrong with any of the ferrets as far as I could tell. They have all seemed blissfully healthy. At their last visit Dr. Powers commented that Chin Soon really needed her teeth scaled. Ella is also somewhere close to eight years old if she's not there already and it's advisable to have checkups and blood work done twice a year for geriatric ferrets. Zephyr came along for the ride since I thought that would be better for her than staying alone in a cage all day.

The good news for Chin Soon is that her fasting blood glucose was a nice, normal 96. This is great news nine months after insulinoma surgery. She also now has nice, clean teeth. The bad news is that her rear teeth have root exposure and pockets which could become infected. The recommendation is that she have those teeth extracted. For right now we're starting antibiotics. I really, really trust Dr. Powers but I was pretty surprised (OK, shocked) by this recommendation. I need to look into it more before allowing her to do something like this to Chin Soon. I know that for human dental care preserving the teeth and doing everything possible to avoid losing them is paramount.

I discussed my concerns with Dr. Powers and her suggested course of action made sense to me. We'll continue brushing Chin Soon's teeth weekly with her Dora the Explorer toothbrush and see if there is any improvement now that the tartar has been removed from her teeth and with antibiotics. If not we'll have to go ahead with the extraction in the next couple of months. If she improves then we can avoid that.

Ella's weight is down about 100 grams over the past seven months but otherwise Dr. Powers says she's in great physical shape. Pending blood work coming back normal she got a clean bill of health. Based on her initial exam it seemed that Ella is in fantastic shape for an eight year old ferret. It's also been more than five years since Dr. Powers did her adrenal surgery and there is still no sign of recurrence or really any health problems at all. Ella does have some tartar on her teeth so we're going to start brushing hers as well. The plan was to her teeth cleaned when we bring Chin Soon in again but that is now on hold.

Later that evening we got a call with results from Ella's bloodwork. Unfortunately a few values were off, including a blood glucose of 77. Because of the other blood values Dr. Powers and her new intern (who's name escapes me at the moment) are thinking some sort of infection or inflammation. We're taking her back to Huntersville for more diagnostic work next week: abdominal ultrasound and urinalysis. Hopefully that will tell us what's going on.

This was a bit of a surprise because Ella showed no symptoms whatsoever of illness. She plays just like always, has a great appetite and absolutely normal output. I guess I just got a great example of why vets do recommend checkups and bloodwork every six months on the old guys to catch things and treat them before they become serious. Some of the possibilities listed are easily treated with medication while others are more serious. Here's hoping it's one of the easily treatable things.

Chin Soon Is Recovering Beautifully

Chin Soon is doing absolutely brilliantly. Yesterday, after a low blood glucose reading, Dr. Powers decided to discontinue her insulin. Now, more than 48 hours without insulin, Chin Soon has a blissfully normal blood glucose of 105. Her insulin producing cells in her pancreas seem to be working normally again. All her blood glucose readings over the past 48 hours have been either normal or just a bit above normal. It's all good.

Chin Soon is also regrowing hair on her belly and where her forelegs were shaved to insert a catheter. This is a sure sign that her adrenal disease is gone.

Last night Chin Soon ran the most of all the three ferrets. She wants to go a million miles an hour, something I can't let happen just yet. Her incision is healing beautifully but it's not 100% healed yet. Fortunately Chin Soon is like Pertwee in one respect: if I put her on my shoulder and walk around she is happy to take in the world from there and calms right down. Poor Ella got pounced by Chin Soon twice and didn't get to fight back and have a wrestling match because I picked Chin Soon up and put her on my shoulder.

Anyway, I'm thrilled be these results. While Dr. Powers says it's still to early to know for sure everything at this point seems to indicate a completely successful surgery and a full recovery.

Chin Soon Comes Home

After four days in the hospital Chin Soon is finally stable. I brought her home Friday night. She is still on insulin. With a daily insulin injection her blood glucose does still bounce around but does come back into the normal range. What we are hoping is that her blood glucose stops spiking up because her pancreas is producing insulin again. I obviously don't want her to remain diabetic and to need insulin daily and regular blood glucose checks.

Zephyr has been a little out of sorts the last few days. She hasn't been playing or wrestling much and has been clinging to me. I think she missed Chin Soon. Now that she knows Chin Soon is OK things should get better.

I am checking Chin Soon's blood glucose every four hours (yes, including in the middle of the night), giving her frequent feedings of Bob Church's Chicken Gravy, and giving her the insulin injection. These are things I've never had to do before with any of my ferrets and are definitely things I am squeamish about and uncomfortable with. Unfortunately I don't see any other choice.

The good news is that Chin Soon is alert and is acting pretty much like her normal self. When I put her into a Midwest cage (without levels or hammocks) she immediately tried to climb out. After gravy it's supposed to be playtime, right? She still thinks so. Her incision is healing nicely. I'd just like to get her back to a nice, normal life. That's when I get back to a nice, normal life.

Between the surgery and complications, four days of hospitalization, the diabetes supplies, and her prescriptions the total cost is in excess of $1,400. It will get close to $1,500 with at least one follow-up visit to Dr. Powers I'm sure some people would read this and think that I am absolutely crazy to spend this kind of money on a ferret's medical care and to go through all this aftercare as well. Most pet owners will understand perfectly. Chin Soon is part of the family. She gets what she needs. Hopefully she'll end up healthy and happy again and will be around for a few more good years.

Chin Soon Not Doing Well (Post-Surgery Diabetes)

If you've been reading this blog you know that Chin Soon is a 5½ year old spayed female ferret who had insulinoma and adrenal surgery on Tuesday. Her vet, Dr. Powers, found a small left adrenal tumor and an insulinoma tumor she described as "huge", "evil", and "very aggressive". It had grown up against the vena cava. There was also one smaller nodule on Chin Soon's pancreas. Dr. Powers feels she successfully removed all of the tumor and the nodule.

Chin Soon was recovering well yesterday. She had post-surgery diabetes which is something we've seen before. Her blood glucose night before last was 400. It dropped to 280 by yesterday morning and 232 by yesterday evening. Then things started going backwards. She was up to 320 by yesterday evening and the levels have kept going up. Her blood glucose this morning was 432.

Dr. Powers tells us that in cases like this, after a very large and aggressive insulinoma tumor is removed, sometimes diabetes is a permanent but manageable consequence. She is starting Chin Soon on insulin today and holding her over one more night to see how she responds. Then Chin Soon will come home but we will have to monitor her blood glucose regularly and give her a small quantity of insulin daily. She'll have to go back to Dr. Powers for a recheck her next week.

This is a setback we really did not expect or plan for. I'll post more when I know more.

Chin Soon Update: Surgery Next Tuesday

Chin Soon is going back to see Dr. Lauren Powers at Carolina Veterinary Specialists in Huntersville again next Tuesday. She will have surgery for both insulinoma and adrenal disease.

At her last recheck her blood glucose was still only 57. She's gained a fair amount of weight, a side effect of the pediapred (prednisolone) as well as a consequence of eating lots of high calorie chicken gravy. As a result we could increase her pediapred dosage again a little. It's still not enough. Yes, Chin Soon is bouncy and playful but her stamina still isn't what it used to be and she still slips and has hind-end weakness. Her insulinoma can't be controlled with a moderate dose of pediapred and that means it's time for surgery. We no longer have any other good options.

Her adrenal disease is progressing as well despite increasing her lupron dosage to 200mcg. She's still losing hair all over the place. The only cure for adrenal disease is surgery. The only good thing about having both diseases at once is that she will only have to go through one surgery instead of two.

I'm worried, of course. This is major surgery and there is always a risk that something can go wrong. At least I have complete confidence in Dr. Powers. She did Ella's adrenal surgery more than four years ago and Ella has been fine ever since. I'm hoping the surgery will give us several more good years with Chin Soon.

The cost? Depending on what Dr. Powers finds and how well things go it will be anywhere from $850 to $1175. There is no getting around the fact that ferrets are expensive pets and that the average ferret will have at least once health crisis requiring surgery and costing $1000 or more during their lifetime.

Anyone who is a pet owner knows that pets become family members. Medical care like this is, unfortunately, a mandatory part of being a responsible pet owner.

Please keep Chin Soon in your thoughts over the next week.

Pressure Cooker On The Stove For Bob Church's Chicken Gravy

Next week will be five and a half years since Ella's first vet visit after Celia Wright rescued her. At that time the vet guesstimated her age to be one year old. Yep, she's definitely a senior ferret now.

Let's assume that guess on her age was spot on. Ella was an adult ferret at the time so she couldn't be much younger. She's also a Marshall Farms ferret. I've had ferrets live to be up to 10 years old but I've never had a Marshall's see their seventh birthday. Whether that's just plain bad luck or something about the way the country's largest ferret breeder raises their kits is an open question.

I'm also certainly more knowledgeable about ferret health and nutrition than I once was. I'd like to believe I can keep my current ferrets, all of whom were bred by Marshall Farms, healthy and happy a bit longer simply by doing preventative things and giving them the best possible food.

I've mentioned Bob Church's Chicken Gravy before as something I give ailing and recovering ferrets. I've also mentioned Pam Sessoms' Pressure Cooker Method as the easiest way to make it. A number of ferret owners in the area, including Pam, do give gravy in limited quantities to their healthy ferrets each day. Pam did this for both Ella and Zephyr in the time she took care of them after Celia Wright became ill and before I adopted them. Since they already had the gravy habit I kept it going.

Here we are, nearly four years later, and all three ferrets have been happy and healthy pretty much the whole time. Ella has had no recurrence of adrenal disease in nearly four years and neither Zephyr nor Chin Soon has had any serious health problems as of yet. Does feeding them a little gravy every day in addition to kibble help? A lot of ferret owners and some vets seem to think so. It's certainly worth the extra bit of work every month or two to make it for them.

I know one thing for certain: I'd like to see these three Marshall Farms bred ferrets all have seventh birthdays. I'd like them to be happy and healthy at eight and nine too.