• Acting a little more tired than usual, lethargic.
• Weak in the hind legs.
• Staring blankly into space, acting "out of it" for a few moments, then snapping out of it.
• pawing at the mouth.
• foaming at the mouth, or drooling.

Advanced - Severe Symptoms:

• Very wobbly while walking, actually "tipping over"
• seizures
• coma

The more advanced the disease is, of course,  the more frequent the signs and the more severe. As long as the body is able to it will keep counter-acting the low glucose by producing more through the liver primarily...but eventually it will be unable to do so and the ferret may have seizures or go into a coma, which, of course, is life threatening. 

If an Insulinomic can't use its back legs, is very wobbly or goes into a seizure, it can be a very frightening experience, and it will be important that you do not panic. Your ferret may be stretched on its side, have excessive drooling to foaming at the mouth, twitching, shaking, and be unresponsive. Quickly rub karo syrup on the gums.  Honey may be substituted if you don't have karo syrup. Or in a pinch, you can use Ferretvite. Use a q-tip to avoid being bitten if the ferret is seizing. Many ferrets will become alert and act normal within a minute. Follow that with a high protein food such as kibble, chicken baby food, or duck soup without sugar to help stabilize the blood glucose. Contact a ferret knowledgeable veterinarian right away.

When you give a large amount of sugar - in this case karo, honey or Ferretvite, it will quickly raise the blood sugar and the ferret may feel much better, but what goes up must come down, and the blood sugar will soon fall back to its previous level - or even lower. Do not use this as an ongoing treatment! The ferret needs to be treated by a veterinarian.If not, this means that preferred treatments are being withheld from a sick ferret and the ferret may be suffering needlessly.

Diagnosis:

The disease is easily diagnosed with a FASTING blood sugar test. You need to withhold food for 4 to NO MORE THAN 6 hours prior to the test. This will show if the sugar is too low.  Many veterinarians and experienced owners believe a fasting blood glucose reading of between 90-120 is normal. In actuality, a blood glucose level even as high as the low 90s may indicate an early insulinoma, depending on the ferret's history, testing pattern and other symptoms.

Treatment:

If the ferret's insulinoma is caught early and if surgery is done quickly, the results can be great. So surgery is usually the preferred treatment. With a skilled surgeon, removal of the tumors, or a partial pancreatectomy can give increased life span, and often no medicine is needed for a time. A partial pancreatectomy is removal of the tumor(s) and part of the pancreas.  The earlier the partial pancreatectomy is done, the better the results, so don't wait. After surgery is complete, the ferret will most likely be given sub-q fluids and pain medication.

If surgery is not an option, or until it is viable, the drugs of choice are Prednisone, which raises the blood glucose levels by mobilizing carbohydrates and/or Proglycem, which is an antihypertensive drug which decreases the secretion of insulin. Prednisone is usually the first drug used with a typical dosage range of 0.5 - 2.5 mg/kg twice a day. Prednisone can produce what is known as Pred Belly (weight is gained) and over time of usage can cause liver damage. It is important when using this drug to give with food as ulcers can develop.

When using liquid Prednisone it is extremely important that you DO NOT use a generic substitution! Some of these can contain alcohol and a large majority are compounded with sugar!

Too often, it seems that treatment is done backwards. Typically, the ferret gets symptoms and is put on medicine first.  Then,  after the medicine stops working is surgery done. At that point the surgery may not help, so people say that surgery isn't valuable. But during the time the ferret was on medicine, tumors were growing. Also, by now, the ferrets health has deteriorated even more. Surgery needs to be done as early as possible, not as a last resort .

Cure: 

Sadly, there is no absolute cure, and even mild insulinoma will always get worse as tumors grow or seed into new ones.  Insulinomas are frequently a recurring problem. It is important for ferret owners to realize this, as blood glucose levels often start to fall within a few months even following successful surgery. Blood sugar levels can be achieved by frequent small meals which are high in protein and complex carbohydrates, but low in simple sugars.  With carefully supervised treatment consisting of surgery, diet control, and medications an Insulinomic ferret can live comfortably and happily for years, and depending upon when they get sick, may live out a normal life span.

Diet:

No sugar for Insulinomic ferrets! What is sugar or has sugar in it?

• Raisins
• Ferretvite
• Petromalt
• Ensure
• Nutrical
• Pedialyte
• Yogies
• Fruit
• Anything with "ous" in the ingredients, like fructose

Something to think about: For those of you who regularly give your non- Insulinomic ferrets sugar, you might want to consider that insulinoma can stay hidden for a long time. That means sugar is being given to Insulinomic ferrets.

To help stabilize blood glucose, give frequent meals and high protein snacks. You can hand feed ferrets their regular food, sometimes it seems to taste better that way!  Make sure you're feeding them a high protein kibble, like Zupreme, Mazuri, or Totally Ferret. But do not  switch your Insulinomic senior ferret to the senior food, which has lower protein. Chicken baby food with some of their ground up kibble in it is also a good "treat". They may turn their nose up at it at first ... but with time, most ferrets grow to love it.

Something To Keep In Mind:

When a healthy ferret is about three years old, it is a good idea to have a fasting blood glucose test done. This will give you a baseline for what is normal for your ferret, or even could uncover an unsuspected insulinoma.  Sometimes the numbers will tell you even before the symptoms begin. Whatever you do, please don't wait to get treatment for this illness.  Insulinoma can get worse even in a couple of weeks. A month can be to long to wait.

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Research credits given to ~

Dr. Suzanne Lee, DVM

Beth Cameron via consultation with Dr. Charles Weiss

Bruce Williams, DVM

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