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 Insulinoma and teeth grinding?
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vertigofm

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Insulinoma and teeth grinding? - Tuesday, November 29, 2011 5:05 PM
Our ferret has had insulinoma for 2.5 years now (amazing, I know).

Recently, as the disease has gotten worse, she has been grinding her teeth more and more frequently.  At first I went into "blockage mode" and gave her daily pumpkin.  Her stool was fine, solid, large, nothing to suggest a blockage.

I spoke to our vet, who she is going to see in two weeks and he mentioned that insulinoma can cause stomach discomfort- teeth grinding- because of the pancreas.

Then this site listed teeth grinding as a symptom of insulinoma:

http://laughingferret.com/ferret-care/facts-about-ferret-insulinoma/

I've never heard this before...  But I guess high insulin levels could cause nausea, which would lead to teeth grinding...  So it makes sense.

Anyone else have this experience?
vertigofm

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Re:Insulinoma and teeth grinding? - Tuesday, November 29, 2011 5:24 PM
joclyn

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Re:Insulinoma and teeth grinding? - Tuesday, November 29, 2011 6:31 PM
it's not the illness, itself, that causes the stomach upset and the resultant teeth grinding; it's the meds!  prednisolone and prednisone are very rough on the stomach and what you're seeing is precursor to bleeding ulcer.  at this point, an ulcer has formed and it's irritated and she's having pain and that's why she's grinding her teeth.
 
there are a couple things you can do:  make sure to give food before giving the meds and make sure the amount of food you're giving is enough to fill the tummy well (at least 2 tablespoons worth, if not more).  you can also mix the med into the food - easiest way to do it :)  you can also start using carafate (generic is sulcrafate). 
 
this med coats the digestive tract and is extremely effective in helping ulcers heal over.  it needs to be given when the stomach is empty - at least an hour after the ferret has eaten something.  give the med and then wait 20 minutes and then feed.  since this coats the system, you need to give other meds at a different time - so the pred dose shouldn't be given in the food that you give right after the dose of carafate.  other meds should be given at least an hour before or an hour after giving the carafate.
 
you want to start the carafate asap!  right now, she's just at the beginning stage - the ulcer is just starting to cause pain and it hasn't gotten to the point where it's ruptured and is bleeding.  when that happens, you'll see the stool turn to a tarry/black color and it'll be sticky/gooey (that's due to digested blood from the ulcer).
 
i would have the vet call a script for the carafate in to your local pharmacy - now/today!!  this is not something that can wait two weeks for the appt that you have set up!!!!  if the ulcer starts to bleed, she can go down pretty fast.  you've already managed her illness so well,  BIG congrats on 2 1/2 years!!  that it would be a shame to see her taken down by this!! 
 
i use the 250 mg tablet and mix it with water and then give .30 cc's 3x a day (sometimes 4x if the ulcer actually starts to bleed).  iirc, it's 20 cc's of water to the tablet and you just let it sit until dissolved and then shake it well to mix it all up.  might be 10 cc's water - i'm still at work and i've got the formula on the comp at home - ehh, the pharmacist will know; you can just ask him/her.
 
with just the initial signs of ulcer, i give the carafate 2x a day; upping it to 3x if the grinding doesn't go away within a few days and then back to 2x a day once the grinding goes away and stay at that for a couple weeks and then go to once a day. 
 
with bleeding ulcers (the stool is tarry) i give the med 4x a day until the bleeding stops (usually within a week) and then move down to 3x a day for about 10 days and then down to 2x and then stay at that for at least a month and then down to once a day.
 
once they get to the point where they've developed an ulcer that is related to taking pred, i always give the carafate - even after the bleeding has stopped.  why?  because they're more susceptible to the spot becoming irritated again because they're getting the pred all the time. 
 
oh, i almost forgot!  forewarned is forearmed ;)
 
the carafate is bitter and they do usually resist it!   they're such smart little creatures though!!  once you get a couple/three doses into them, they make the connection between the nasty-nasty stuff and the fact that their tummy feels better after they take it!!! 
 
to assist with making it not so nasty, i use two syringes - one with the med and one with plain water and give a little med and then some water to wash away the bitterness and i alternate the syringes until all the med is in.  i also try to shoot the med in under the tongue so that they're already in the process of swallowing before the bitterness is registered.
vertigofm

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Re:Insulinoma and teeth grinding? - Tuesday, November 29, 2011 7:20 PM
But that is what is odd...  The websites and veterinarian mentioned that teeth grinding can be a symptom of insulinoma due to the pancreas and amount of insulin secreted, which (I guess) causes nausea...
vertigofm

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Re:Insulinoma and teeth grinding? - Tuesday, November 29, 2011 7:33 PM
Also, I was waiting 10 minutes after the carafate which the vet said was not long enough.  He suggested 20 at a minimum, but to try to wait 30 minutes.
saphire

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Re:Insulinoma and teeth grinding? - Tuesday, November 29, 2011 7:52 PM
Jocyln is correct. Teeth grinding is do too stomach upset and needs to be dealt with. I have had 3 ferrets with insulinoma and they started grinding their teeth one was so bad she had sores in her mouth. It is not something you want to wait on to take care of. Good luck and keep us updated.
itsnowornever

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Re:Insulinoma and teeth grinding? - Tuesday, November 29, 2011 7:52 PM
For humans, it's 2 hours before a meal and 1 hour after (I've given this like CRAZY!)...being that our digestive system takes hours to empty, 30 min sounds ok for ferrets...howevever...try both, watch her reactions. Grinding can be caused because of drooling in insulinoma (I'm going based off human s/s for hypoglycemia) because the drool and nausea, humans will clamp our teeth to tighten the throat muscle and try to fight off the vomit...I would assume this would be the same as ferrets. That being said, if the Pred is causing an ulcer, then the grinding is still to warrant off the vomiting. Have you checked her sugars recently? Could she need a Pred adjustment?

vertigofm

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Re:Insulinoma and teeth grinding? - Tuesday, November 29, 2011 9:56 PM
We're taking her to the vet soon to look at an adjustment.  It could be the prednisone, as she is on the 1mg/1ml and has to take 0.6ML twice per day which I am sure is tough on her stomach.  We just got the higher concentration so hopefully her new small dose will be easier on her.

While I am aware that teeth grinding is from an upset stomach, what my vet (and the websites) were explaining is that insulinoma can cause stomach discomfort- thus teeth grinding.  

The teeth grinding primarily occurs when drinking water, eating, and taking medicine.  Once it is in her, she stops, which leads me to believe that the presence of food or fluids coming down is painful.

If it was a blockage, I believe she would have more chronic and continual grinding.  She hasn't vomited, no pawing at the mouth, stomach doesn't appear to hurt her, and her poo is solid and of a normal shape.  Plus several doses of pumpkin and nothing came out...  We've had a ferret with blockage before so I'm super super paranoid because I know that I couldn't afford the cost of blockage surgery...  We got lucky with Hal, the ER vet wanted to put him to sleep to stop the pain since we couldn't afford $2,000...  I asked for another hour with pain meds, amazingly...  he passed it.

Anyway, thanks for the help and advice!  I appreciate it!
Snapper13

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Re:Insulinoma and teeth grinding? - Wednesday, November 30, 2011 8:09 AM

While I am aware that teeth grinding is from an upset stomach, what my vet (and the websites) were explaining is that insulinoma can cause stomach discomfort- thus teeth grinding.  

I agree with this statement.  I'm not sure if the pancreatic tumors can cause upset stomachs, but we all know the meds can cause upset stomachs.


I think the 5mg/ml is a good way to go.  I'll be at Ness Saturday morning - will you be there as well?  I get my 5mg/ml prednisolone from Mark Drugs (Deerfield and Roselle locations) and they can compound it into ferretone flavor.  It costs $60 per bottle, but it lasts a long time (since it is a larger bottle than what Ness gives out, and the strength is higher) and all the kids like the flavor.


Another thing to look into is transdermal pred.  Another GCFA member used that with her ferret and she had good success with it.
vertigofm

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Re:Insulinoma and teeth grinding? - Wednesday, November 30, 2011 7:09 PM
Snapper13



While I am aware that teeth grinding is from an upset stomach, what my vet (and the websites) were explaining is that insulinoma can cause stomach discomfort- thus teeth grinding.  

I agree with this statement.  I'm not sure if the pancreatic tumors can cause upset stomachs, but we all know the meds can cause upset stomachs.


I think the 5mg/ml is a good way to go.  I'll be at Ness Saturday morning - will you be there as well?  I get my 5mg/ml prednisolone from Mark Drugs (Deerfield and Roselle locations) and they can compound it into ferretone flavor.  It costs $60 per bottle, but it lasts a long time (since it is a larger bottle than what Ness gives out, and the strength is higher) and all the kids like the flavor.


Another thing to look into is transdermal pred.  Another GCFA member used that with her ferret and she had good success with it.





Wow, that's amazing- I'll check out that pharmacy.  I just picked up the 15mg/5ml.  So now I don't have to give her so damn much.  I'll ask about transdermal.


I won't be at Ness this saturday, the following saturday (17th).  I'll keep you posted on how she is doing.


2.5 years, amazing.  I remember in 2009 thinking "Oh God, she only has another year".  If she can hit three years I'll be very happy.  She's still a beautiful, amazing, and wonderful girl.


Thanks for advice!

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