Lady Tosca

My little girl, Lady Tosca, is nine years old now. Sadly, she is struggling with three common issues ferrets face as they age: adrenal tumors, insulinoma, and possible lymphoma. Ferrets are such joyful, active, playful, adventurous critters that they live much in a short time. Their lifespans are between 7-9 years, on average.

Just over a year and a half ago, Lady Tosca started to show signs of adrenal tumors. These tumors are rarely cancerous but have an impact on the overall health of the ferret. The most frequently noticed symptom is hair loss. The pattern of loss usually starts at the base of the tail and spreads to include the entire body in advanced cases. There is no such thing as a “bald” ferret breed. If a ferret has lost her/ his hair, the little one has adrenal and needs vet care. Sometimes, a ferret might loss hair on the tail. Look closely. If you see black bumps, the ferret has blackheads. These can be treated by washing the tail with gentle soaps and a medicated wipe. Consult your vet.
Other symptoms of adrenal are increased aggression, swollen vulva (female), difficulty urinating (male), and, increased sexual drive, loss of appetite, lethargy, excessive grooming of other ferrets, increase in musky odor,and, increased thirst and urination, weight loss. Most pet ferrets are spayed/neutered. If you see mating behavior, it is a sign of adrenal. Ferrets with advanced adrenal may have a rotund belly and loss of muscle tone. The adrenal glands are located above the kidneys.

Adrenal tumors are treated either by surgery or controlled medically. Surgery involves opening the ferret up, locating the tumor, and removing it. If the tumor is located on the right gland, it may not be possible to remove, due to risk of serious bleeding. The right gland is located near the vena cava. If your ferret is not healthy, surgery may not be the best option. If the left gland has already been removed, most vets will not try to remove the right gland. It increases the possibility of Addingdons.

There are three medications used to control adrenal. Your vet may prescribe a Lupron depot, usually at 1,3, or 4 month intervals. The ferret will need Lupron for the rest of her life. The depot controls symptoms, and perhaps shrinks the tumors, but does not cure it. Melatonin implants are also used to manage symptoms. It is a natural hormone, already in the ferret’s body. The melatonin inhibits the release of the gonadotropin releasing hormone from the pituitary gland. This results in less stimulation of the adrenal glands. There are two ways to introduce melatonin to the ferret. You can give it daily, in a pill or liquid form, or use Ferratonin, which is an implant that releases melatonin over time. When giving melatonin daily, timing is critical. For it to be effective, it must be given 7-9 hours after sunrise to mimic the natural release in the ferret’s body. If you can’t be at home during that time, it is better to use the Ferratonin depot. Melatonin is used in conjunction with other treatments, not as a stand alone. The third medication is relatively new in the US but has been used for years in Great Britain: Deslorelin acetate. The brand name is Suprelorin F. Des works in a similar way to Lupron, by suppressing key hormones that stimulate adrenal function. It is an implant, that is placed under your ferret’s skin. The implant last about 12 months. Again, it doesn’t fix he tumors but controls symptoms and may reduce tumor size.

Tosca is being treated using the Suprelorin implant. Her fur is thick, her appetite improved, she’s less aggressive, and has more energy. She responds well to this treatment. I opted out of surgery due to her advanced age and that she was already showing signs of insulinoma. My vet and I felt she was too fragile to operate. She is doing great on the implants.

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Tosca Resting

Insulinoma is a tumor in the pancreas. The pancreas is a v shaped gland found in the abdomen. One part sits along the stomach, the other part sits on the upper small intestine. The pancreas has two functions in the body. It produces and releases enzymes for the digestion of fats and starches in the intestines. About 2% of the structure are scattered islands of cells. They are called the "islets of Langerhans" and they are responsible for the production of hormones: insulin, glucagon, growth hormones, and pancreatic polypeptide. An insulinoma tumor attacks the beta cells that produce insulin. This is why ferrets often suffer from blood sugar drops. The beta cells overproduce insulin, which is needed to get glucose into the blood cells. If there is too much insulin, your ferret will have hypoglycemia. This often results in neurological symptoms, since the brain does not have enough glucose to function. Hind end weakness, drooling, pancaking, and seizures indicate low glucose.

The symptoms of insulinoma can be "silent," where they are barely noticeable, to a ferret having a full seizure. Common signs you can see in your ferret: lethargy, weak rear limbs, difficulty rising from sleep, leg incoordination, collapse, pawing at mouth, seizures, vomiting. Insulinoma can happen with other issues, such as adrenal. A ferret may present with symptoms for more than one health issue.

Insulinoma is diagnosed by blood glucose testing. A normal glucose level in a ferret is over 70 mg/dl. After a 4 hour fast, a ferret with insulinoma will have a glucose under 70 mg/dl. This is a good screening for a healthy ferret but if your ferret is ill, fasting can put the ferret at risk. Talk to your vet about other options. Often, the vet will order other tests to rule out infections, anemia, and other health issues that may not be insulinoma.

Insulinoma is not curable but it is treatable. Some vets will attempt to remove the tumors from the pancreas. This may not effect a cure, as it may not be possible to get all the tumors. Symptoms can be controlled by medication and careful diet/feeding. Corticosteroids are the first line of treatment. Most vets prescribe Prednisone. Diazoxide is a diuretic. It causes increased urination and raises blood sugar. It is added to Predisone treatment. Feeding a ferret with insulinoma is critical to provide a diet with high protein content and low carbohydrates. Many owners make up "duck soup" or "dook soup" that is made from high protein sources, ground together, into a semi-liquid. Carnivore Care is a product that is designed to be high protein to be used for ill carnivores. I use it as a base for my soup recipe. Check out ferret communities on the web or on Facebook for recipes for duck soup. It's important to make sure the ferret eats every 4 hours.

Unfortunately, outcomes with insulinoma are not good. The ferret generally goes to Rainbow Bridge within a year of symptoms. It becomes increasingly difficult to manage blood sugar issues. Tosca was diagnosed with insulinoma 6 months ago. She is on Pred. So far, I have increased her dosage once. She seems stable right now. She is a food Diva. She doesn't eat kibble and only likes duck soup if it is more liquid… In the cage. Out of the cage, she wants it thick, and warmed in the microwave, thank you.

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Tosca and Kaliyah

Lymphoma is cancer of the white blood cells. White blood cells are found in organs of the lymph system and can also be found in skin, blood, and gastrointestinal tract. Lymphoma can effect any of these systems and it can metastasize. This makes it complicated to diagnose.

There are two types that can happen: Classic and juvenile. Juvenile happens to ferret under two years old. It is very aggressive and has a poor prognosis. The health declines rapidly.

Classic lymphoma effects older ferrets and moves more slowly. There are four stages.
Stage 1: involves only a single site or tumor
Stage 2: multiple sites on the same side of the diaphragm.
Stage 3: involvement of spleen and lymph node on both sides of diaphragm
Stage 4: involvement of multiple sites on both sides of the diaphragm

The ferret does fairly well with treatment until the lymphocytes invade visceral organs. At that point, organ failure occurs and the ferret goes onto Rainbow Bridge. Effectiveness of treatment depends on where the tumor is located and what stage the ferret is in.

Symptoms include lethargy, swollen lymph nodes, and weight loss. Ferrets may also present with a swollen spleen. This can indicate lymphoma but there are other causes of swollen spleen in a ferret. The spleen is located in the belly of the ferret. The spleen will be easily felt on palpating or the swelling can also be easily seen. The only way to diagnose lyphoma is with a needle aspirate or biopsy of suspected lymph nodes or organs.

Treatment includes the use of Predisone. However, if a ferret is already being treated for insulinoma by Prednisone, treatment may not be as effective. This does not cure the ferret. It improves quality of life. Ferrets can also be treated with chemotherapy. Using chemotherapy in combination with Prednisone may increase the survival time of the ferret. However, you have to consider quality of life. Will the drugs cause side effects that make life uncomfortable for your ferret? For most ferrants, cost is also prohibitive. Chemotherapy is expensive. Choose what is best for your ferret.

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Tosca playing with Taliesin

It has been a hard few months. While Tosca has insulinoma and adrenal it is not confirmed she has lymphoma. Tosca does have swollen spleen but no swelling in the lymphnodes.

It is hard to love a ferret. They bring so much joy, energy, happiness, playfulness, mischievousness, and love. But, their lives are so short, mainly because of these health issues.
Even with her illnesses, Tosca continues to play and explore. Last night, she stole a clean pair of running socks I dropped, and disappeared under the couch. She also ran through the tube maze.

I appreciate the time with my older ferrets. There is bonding that happens as the ferret looks to you more for company and food. Tosca eats best when she is sitting on my lap. She eats, then wipes her face off on my clothes, sighs, stuffs her head in the bowl and eats more. At the end of her eat/ wipe cycle, she sighs and starts to groom my fingers.

Tosca is a special ferret to me. I love all my ferrets but some I connect to a little stronger than others. Tosca is deaf. When I got her, she bit, and screamed. It took a while to figure out what she needed. I make sure she sees, or senses me, before I pick her up. I thump the floor so she feels vibrations to call her. She also was the “boss” of her group: Taliesin and Koda Bear. Both the boys wait for her at the Bridge.

Love means being with the ferret through the best and support and care at the end.

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Young Tosca at Play

Connections

Nap time

Ferrets pack so much joy, energy, and love into their days. They are truly a gift to have in the home. Sadly, their lifespans are short. They burn brightly and burn out rapidly, as a small shooting star.

Over the years, five of my ferrets have gone to Rainbow Bridge. There is something special about the elder ferrets. They may not have the same energy for adventure but they find more peaceful pursuits. I formed a special bond with my furkids as they aged. They cuddled more and I could see peace and happiness in their eyes. I provided end of life care. Often, this required hand feeding and medications. They paid me back with love, often grooming me or cuddling for a nap.

Koda had a reaction to his adrenal surgery. The vet thinks he developed pancreatitis. He lost almost a pound in four days, due to serious diarrhea. He was rehydrated at the vet’s office. Unfortunately, there isn’t a treatment for ferrets. We have to wait and hope his pancreas heals. In the meantime, I provide supportive treatments. Koda is handfed a special, high calorie, high protein, “soup” and his hydration monitored. He eats well and drinks. He sleeps inbetween feedings.

Today, his eyes look brighter. He is more interested in his surroundings. But, the diarrhea continues.

I’ll be much happier when his leavings return to normal.

I am honored to have been sent ferrets to care for in this life. Their bright little souls are a gift to everyone around them.

A twist in the road

Koda Bear Ferret had surgery for adrenal tumors on December 22, 2011.  At first, he was recovering well.  He woke up, ate, and was alert soon after the surgery.  At home, he wanted to explore and ate with his usual gusto.  The only issue was diarrhea.  That can be a normal occurance after surgery or a side effect from his pain medications.  The diarrhea didn’t improve consistently.  It actually got worse.  I continued to feed his special high protein “duck soup” for sick ferrets and watched. 

Sunday night, my friend and I put in a call to the emergency vet at the clinic where the surgery was performed.  Koda was lathargic and only eating when hand fed.  His diarrhea was constant.  He still ate well when he did but he lost all interest in kibble.  I was terrified that I was going to loose my Koda so soon after Taliesin.   He lost a lot of weight in 4 days.  The vet told us to have him in the office first thing in the morning.  So, at 7 pm, we jumped in the car and drove two hours to my parents’ house where we stayed until the vet office opened this morning. 

The vet was excellent.  She did a blood panel and an exam.  Koda was dehydrated, which is no surprise given his explosive diarrhea. Koda weighed 1.15 today, down from 2.1 the day of surgery.  Most of his weight loss was over 4 days.    We left him for the day to get IV fluids and be monitored.  He looked better this afternoon.  He was eating his soupie but still not interested in kibble.  The vet thinks he has pancreatitis caused by irritation during his surgery.  His blood sugar was a little low, which could be insulinoma or just not getting enough food digested.  Some of his other blood results indicated problems that indicate the pancreatitis.

We took him home tonight.  I’ll be hand feeding the ferret every 3 hours and monitoring his liquid intake and all output.  His diarrhea is still present.  But, he hasn’t pooed since his last feeding almost three hours ago!  Awesome!  Tomorrow, we’ll check him for dehydration.  If he is, he goes into the vet for fluids.  If not, we keep on the feeding schedule. 

He’s not out of the woods yet.  That was a lot of weight loss.  And there is the possibility of insulinoma and/or lymphoma.  The vet thinks the most likely is the pancreatitis causing the symptoms.

Please keep my little Koda in your thoughts and prayers.