• Insulinoma
     - Very common in ferrets
     - Tumor of the beta cells in the pancreas that secrete excessive levels of insulin
     - Results in hypoglycemic episodes
         • Weakness
         • Lethargy
         • Salivation
         • Pawing at mouth
         • Seizures
         • Difficult to awaken from naps*
     - Generally malignant with metastasis to the liver, spleen, and other tissues
     - Presumptive diagnosis based on blood glucose level (<70mg/dl)
More than 1 test: non-fasted and then 4-6 hours fasted
     - Insulin levels can help to distinguish insulinoma from other causes of hypoglycemia
     - Definitive diagnosis based on histopathology of biopsy samples taken at exploratory laporatomy
     - Treatment
          ♦ Surgical
               • Debulk extensive tumor
               • "shell-out" suspicious nodules
               • Pancreatic lobectomy
               • Post-op pancreatitis is rare
          ♦ Medical
               • Dietary management
                    o High protein
                    o High fat
                    o Frequent feedings
                    o High sugar material on hand and to only be used in a hypoglycemic crisis
          • Chromium Picolinate may help in regulating glucose levels
                    o Found in Brewer's yeast
                    o 1/8 – 1/4 tsp per ferret 1-2 times per day
          • Prednisolone
                    o Promotes gluconeogenesis by inhibiting glucose uptake by tissues
          o Raspberry flavored
          o Dose ranges: 0.1mg/kg – 4 mg/kg SID to BID
                    o Start low then raise as needed to maintain adequate glucose levels
          • Diazoxide
                    o Inhibits insulin release and reduces cellular uptake of glucose
                    o Used alone or in conjunction with Prednisolone
                    o Dose : 5-10 mg/kg BID
While insulinomas are rarely cured, most affected ferrets can be reasonably controlled and will often live months to years following diagnosis