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Constant rate infusion of glucagon as an emergency treatment for hypoglycemia in a domestic ferret (Mustela putorius furo)

Katarina R. Bennett DVM1, M. Casey Gaunt DVM, MVSc2, and Dennilyn L. Parker DVM, MVSc3
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  • 1 Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK S7N 5B4, Canada.
  • | 2 Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK S7N 5B4, Canada.
  • | 3 Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK S7N 5B4, Canada.

Abstract

Case Description—A 3-year-old female domestic ferret (Mustela putorius furo) with an insulinoma was treated because of a hypoglycemic crisis prior to scheduled pancreatectomy with concurrent nodulectomy.

Clinical Findings—Previously, the ferret had clinical signs of lethargy and hind limb weakness; at that time, blood glucose concentration was low, and a tentative diagnosis (subsequently confirmed) of insulinoma was made. Prednisolone treatment (0.3 mg/kg [0.14 mg/lb], PO, q 12 h) did not improve clinical signs; the dosage was gradually increased over a 1-month course (1.8 mg/kg [0.82 mg/lb], PO, q 12 h) and maintained for 10 days. Overall, the treatment was ineffective, and the ferret remained lethargic and developed inappetence. At a reevaluation, the ferret had severe weakness and nonresponsiveness nearing a comatose state. Standard treatment with dextrose (1 mL of 50% solution, IV), and dexamethasone (1 mg/kg [0.45 mg/lb], SC) was administered with resultant improvement in mentation. The ferret was discharged from the hospital and then returned 3 days later for stabilization prior to pancreatectomy with concurrent nodulectomy.

Treatment and Outcome—The day before surgery, the ferret was administered a glucagon constant rate infusion at a rate of 15 ng/kg/min (6.8 ng/lb/min), which resulted in an increase in blood glucose concentration to a euglycemic state and resolution of clinical signs of hypoglycemia.

Clinical Relevance—As illustrated by the case described in this report, a glucagon constant rate infusion can be used successfully for the emergency treatment of hyperinsulinemic-hypoglycemic crisis in insulinomic ferrets.

Abstract

Case Description—A 3-year-old female domestic ferret (Mustela putorius furo) with an insulinoma was treated because of a hypoglycemic crisis prior to scheduled pancreatectomy with concurrent nodulectomy.

Clinical Findings—Previously, the ferret had clinical signs of lethargy and hind limb weakness; at that time, blood glucose concentration was low, and a tentative diagnosis (subsequently confirmed) of insulinoma was made. Prednisolone treatment (0.3 mg/kg [0.14 mg/lb], PO, q 12 h) did not improve clinical signs; the dosage was gradually increased over a 1-month course (1.8 mg/kg [0.82 mg/lb], PO, q 12 h) and maintained for 10 days. Overall, the treatment was ineffective, and the ferret remained lethargic and developed inappetence. At a reevaluation, the ferret had severe weakness and nonresponsiveness nearing a comatose state. Standard treatment with dextrose (1 mL of 50% solution, IV), and dexamethasone (1 mg/kg [0.45 mg/lb], SC) was administered with resultant improvement in mentation. The ferret was discharged from the hospital and then returned 3 days later for stabilization prior to pancreatectomy with concurrent nodulectomy.

Treatment and Outcome—The day before surgery, the ferret was administered a glucagon constant rate infusion at a rate of 15 ng/kg/min (6.8 ng/lb/min), which resulted in an increase in blood glucose concentration to a euglycemic state and resolution of clinical signs of hypoglycemia.

Clinical Relevance—As illustrated by the case described in this report, a glucagon constant rate infusion can be used successfully for the emergency treatment of hyperinsulinemic-hypoglycemic crisis in insulinomic ferrets.

Contributor Notes

None of the authors have any known conflicts of interest relating to the clinical case described in this report.

Address correspondence to Dr. Bennett (krbennett@upei.ca).