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.

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.

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.