Tata Update: Pathology Result, New Picture

This was Tata yesterday evening. He ran. I don't mean walked around and explored. I mean he ran around like a healthy ferret, at least for a little while. Dr. Dan also called with his pathology results: everything was benign. His blood glucose is slowly dropping towards normal.

Bottom line: Tata is going to be just fine, at least for now.

Tata's bumpy (and expensive) road to recovery

Tata came home yesterday after a very long and trying holiday weekend. I learned yesterday at Avian & Exotic, that Tata's surgery was difficult. This isn't surprising with right adrenal surgery as part of the package. Add insulinoma and a tumor on the spleen and, of course, it was very invasive and difficult. What I learned from one of the vet techs is that they were very worried for Tata on Friday and were absolutely thrilled by what they saw yesterday. What happened in between wasn't so good.

After surgery Tata's blood glucose shot up. Temporary diabetes after insulinoma surgery is pretty normal until the pancreas starts working normally again. The insulinoma cells suppress normal pancreatic function, or so I've been told. Anyway, Tata's blood glucose went up over 500. Dr. Johnson decided to hospitalize him so he went to the Animal Emergency Hospital and Urgent Care in Raleigh. Dr. Wyatt there treated Tata when he had his seizure and also cared for Chin Soon at the end of her life. He's an excellent ferret vet but care at the emergency facility is insanely expensive. For a short emergency visit it's fine. For a long weekend, well...

Tata was put on insulin and his blood glucose came down. As the insulin wore off it would go way back up again. He wasn't stable. Dr. Johnson wanted to put Tata on glargene insulin, which is longer acting (12 hours) and is what Dr. Powers used for Chin Soon when she had the same problem. In Chin Soon's case the insulin was expensive but it worked well for her. Chin Soon only needed it for a few days. Then her pancreas started working again. Tata, unfortunately, did not tolerate the glargene well. His blood glucose crashed to 40 and he needed dextrose to get him back to the normal range. Then it spiked way up again. The very expensive insulin purchased for Tata turned out to be useless for him. He went back on regular, short acting insulin diluted in saline. His dose was one quarter of one unit. His blood glucose roller coaster continued through Sunday.

Tata was doing much better by yesterday but still needed insulin as of 5 AM. Dr. Dan decided to send him home and called in an insulin prescription to a pharmacy here in Eden. I came home with Tata, a shiny new, calibrated AlphaTrack glucometer and anti-inflammatory meds for the next couple of days. This was after getting a refresher course on how to give an insulin injection. I was told only to use the insulin if Tata's blood glucose went over 400 again.

The good news here is that Tata's blood glucose hasn't been that high. The highest reading so far was 320 and it's come down from there today. Dr. Dan's feeling that his pancreas was starting to work again appears to be correct. The hope was that Tata wouldn't need more insulin injections and so far that is what's happening.

The bad news is the cost. Six years ago Chin Soon's surgery, four day hopitalization and aftercare added up to an over $2000 bill. With the emergency clinic rates Tata is already over $4000. Oh, and no, I really couldn't afford that.

Is Tata worth it? Of course, and I hope to have him around for a few more years. He still has earned himself a new nickname: Pertwee Jr., after the most medically challenged and expensive ferret I've ever had.

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.

Five Straight for Zephyr

Zephyr had her fifth straight normal blood glucose reading :) She still slides a bit on the hardwoods and still startles easily but otherwise she's doing great. Dr. Powers does great work. Considering Zephyr's age I consider myself very, very fortunate to have her getting back to normal.

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.

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 Surgery Update

Chin Soon had her surgery yesterday afternoon. Dr. Powers found a small growth on her left adrenal gland. She also found an insulinoma tumor which she described as "huge", "evil", and "very aggressive" which was right next to the vena cava. She was able to remove all of it as well as one more small nodule she found on Chin Soon's pancreas.

As of late last night Chin Soon was recovering well. As of early this morning things are still going well for the most part but she is severely diabetic. Her blood glucose has been as high as 400. She is on IV fluids to avoid dehydration. We've seen this before after insulinoma surgery and normally the blood glucose does come down and return to normal. I'll get another update after noon and I still hope to be able to take her home late this afternoon or this evening.

Please continue to keep Chin Soon in your thoughts. I am hoping for a speedy and complete recovery.