Caring for a ferret with insulinoma

This question was posed on a Facebook group and this is my (rather long-winded) reply.

What can I do for my ferret with insulinoma? Our old guy was diagnosed a few months back and for the last few weeks has had diarrhea. The vet thinks it’s a GI infection (he’s been on two different rounds of antibiotics) but he just had a seizure again like he did before he was diagnosed. I believe he’s going to need his dose increased or that the compounded med some how separated out and he’s not getting the correct dose. What have all of you done to get a ferret to take in food if he’s not wanting to? He’ll eat when his sugar gets up but right now he won’t even eat a bandit. And he dislikes duk soup and nupro supplements. Any advice would be greatly recommended as we can’t afford to keep taking him to the vet with me being unemployed (applying for postdocs right now).

Answer:

I make my own version of “duck soup” — a chicken goo made from cooking chicken legs and thighs in the slow cooker (or pressure cooker) until the bones crumble, then blending it up. It’s basically like chicken babyfood but with all the meat, fat, gristle, bones, marrow, etc. included. With all that included, it’s much more balanced than just using baby food meat (which only contains meat).

What I do depends on how old the ferret is and how far along he is with the insulinoma.

First, unless the ferret is crashing, you want to avoid anything with carbs or sugar. That’s because the sugar will momentarily raise the blood sugar but will trigger a release of MORE insulin, and the ferret is very likely to crash afterwards. That’s also why the ferret should be fed a food with little or no carbs (grains are carbs). Bandit treats and most of the less expensive cat foods have way too many carbs and should not be fed to a ferret with insulinoma.

If the ferret is crashing, you give them something sweet (as much as they want) and then immediately give them a high protein meal (like the chicken goo I mentioned or chicken or turkey baby food or Carnivore Care or canned A/D from the vet). I’ve also found that giving extra fluids helps even things out. If the ferret is crashing badly, I give fluids with dextrose under the skin (IV fluids) and that helps bring them out much faster. Again, a high protein meal is crucial.

The rest of the time, I feed them a super high quality dry food (no grains, high fat, high protein, low carbs) and the chicken goo. If you can get them completely off any carbs at all (ferrets do not need carbs like we do) they will usually do better.

Ferretone does not have sugar in it but Ferretvite and many other pastes, do. Hairball remedy has sugar in it. Look for things like raisin juice listed on the pet food. N-Bones and Bandits have a lot of carbs, so basically you usually have to cut out treats. The chew toys called Cheweasels (and maybe Marshall Chews but I’m not sure) are made from gelatin which is just protein.

If a ferret has low blood sugar, it won’t be hungry or thirsty. They are often nauseous and sometimes will paw at their mouth, drool, etc. If a ferret is having a seizure and isn’t able to swallow DO NOT try to make them drink anything or they can drown. You can, however, rub honey (or anything else sweet) on the gums and it will be absorbed through the mucous membranes. You have to *keep* rubbing it on the gums about every 5 minutes. If you have fluids with dextrose, giving 35cc of those fluids under the skin (sub-q) will help. If the ferret seizes for too long, it can suffer brain damage and you won’t be able to bring them back.

The first line of treatment besides removing all carbs from the diet is prednisone or prednisolone. The second one works better in older ferrets because it bypasses the liver and old ferrets (just like old people) often have liver issues. The typical starting dose is 0.25mg twice a day. For a ferret just diagnosed with insulinoma, that usually helps immensely. Pred will make them hungry and thirsty, so it helps both with eating throughout the day AND with keeping the fluids up. As the disease progresses, you have to gradually increase the pred. It’s important to give the doses as close to 12 hours apart as you can. Pred only stays in the system for a certain number of hours, and when it wears off, the ferret can crash from low blood sugar. In some cases, people find that dividing the day’s dose into three doses works better to help keep the blood sugar even.

Some vets who don’t know ferrets well are reluctant to give pred or will tell you to give it once a day. A high dose once a day is nowhere near as good as two (or three) doses. According to my vet, 1mg twice a day is the maximum effective dosage for insulinoma (they go higher for cancers like lymphoma).

One thing to consider is that pred is very hard on the stomach and can cause ulcers. When I give pred I usually hide it in the chicken goo (I warm it, and add a little water to make it a thick broth). Once a ferret likes the soupies, they will take almost any med in soup (except Flagyl). If your ferret is not eating on its own, you MUST force him to eat. The chicken babyfood is a good short term option, especially if he’s eating some dry food, too. It’s not nutritionally complete and shouldn’t be used exclusively for more than a few weeks. Most ferrets will start eating their dry food when they feel better.

If you are feeding the babyfood, a ferret needs to eat AT LEAST one whole jar a day. That’s the meat, not the stuff with noodles or vegetables. That’s 60cc (a Gerber babyfood jar filled to the very top is 60cc) a day to maintain their weight. If they need to gain weight, more is better.

If the ferret is resistant, you can scruff them and using a syringe, give them 10cc (cc=ml) of soupies, give the pred, and give 10 more of the soup. A ferret’s stomach can hold 20cc easily. If they are *willing* to eat more that’s fine but if you have to scruff and dribble it into the front of their mouth, then you can give them a break at 20cc. Obviously you need to feed them frequently if they will only take 20cc (or if they really really fight, 10cc) at a time. You want the day’s food to equal 60-90cc. More is okay unless they turn into a butterball.

Getting Them To Eat It

Sometimes ferrets won’t eat something we offer them, even though we know it’s good and most other ferrets like it. In this case, rubbing a bit on the tongue once or twice a day for several days will usually do the trick.

For example, some ferrets don’t know Ferretone is wonderful. Others will gobble it right down, but some will turn up their nose. I’ve never had it take more than 3 days of “taste-testing” to convince a ferret that Ferretone is pretty darn good.

If you’re trying to get them to switch foods, you’ll need to start slowly. Mix the new food into the old at around a 25% to 75% ratio in a small canister or bag. When that’s gone, increase the new to old ratio. Let them eat that. Continue to gradually increase the new food until there is no longer any old food. This will prevent a ferret from going on a hunger strike and refusing to eat, as well as helping to prevent stomach upset from a new diet.

Barb Carlson

Force-Feeding Duck Soup

Okay, so your ferret is sick and won’t eat. You have to force it to eat*, or it will die. By now you have seen the vet, maybe gotten it a water shot and some meds. But the ferret won’t get better if it doesn?t eat. When a ferret is very sick and/or dehydrated, they often won’t eat or drink on their own. They will fight you at first, but usually after a couple days, they’ll be eating on their own (or at least not fighting so badly). Once the ferret is recovered, usually you’ll find (a) it now really likes your duck soup and (b) it thinks you’re a really nice person. You’d think they’d hate you for forcing them to eat, but it doesn’t work that way. They know you’re trying to help.

According to one of my vets, a ferret needs to eat at least 60cc of some kind of duck soup** each day just to keep going. (She was referring to the canned A/D available from the vet, but it also works for the other duck soup mixtures.) I measured out 60cc to see how much that really is, and it turned out to be a Gerber baby food jar full to the very top (to where you can?t fit any more in). So when I have sick ferrets, I make sure they eat *at least* one whole baby food jar’s worth of duck soup every day. More is better. 60cc will just keep them alive. They won’t gain much weight (if any) on that, but they won’t die, either (well, not from malnutrition — something else might get them).

For a sick ferret, a little bit every 2, 3 or 4 hours is best. At the very minimum you should feed them 3 times a day. The sicker they are, the more often they should be fed. I’m lucky in that I can take sick ferrets to work with me. I put them in a carrier under my desk and just feed them every 2 or 3 hours.

The vet said a ferret’s stomach can hold at least 18cc of food per feeding. It won’t pop their tummy if you force them to swallow 18cc worth of food. I found that comforting to know. In actuality, a ferret on the mend may very well eat much more than that! But if they’re sick, you really don’t want to over-stress their system, so frequent small meals are better.

If they refuse to eat on their own, you need a syringe without the needle to squirt the food into their mouth. The easiest ones to use hold 6-10 cc. The mixture needs to be very smooth, moist and warm (but not so hot it burns the mouth). What you do is suck up the goo into the syringe, scruff the ferret and squirt a little into the back of the mouth near the back tooth. Don’t squirt it right down their throat and drown them, but put it back far enough that they have no choice but to swallow it.

Your ferret may very well put up a pretty big fight at first. Just remember they *have* to eat. Your vet will tell you when you should force feed, and probably will have recommendations on what to feed and how much. You and your vet can discuss just how long to force feed before giving up. (Remember, giving up means the ferret dies. Sometimes they can’t be saved, but I give it at least a week, unless the ferret is in severe pain.)

So you squirt a little, let them swallow (and some ferrets will spit a little out, too) and just keep at it until the required amount has been swallowed. You’ll get better as you do it. It takes a few minutes, but you won’t have to do it forever, and it’s worth it if it saves the ferret’s life.

Usually what happens is that you have to really force them to eat for the first few days, then they’ll start eating from the syringe willingly, then they’ll eat from your finger or a spoon, and then finally they?ll eat right from the bowl. Some ferrets do this more quickly than others, but so far, every ferret I’ve force-fed has eventually decided duck soup is just wonderful.

One caution: if your ferret starts to feel better, do not discontinue the supplemental feedings right away. Keep it up at least a week after they seem healed. I’ve had ferrets relapse when I stopped feeding them too soon.

If your ferret eats a lot at one sitting, 3 times a day will be okay (just make sure that it adds up to one whole baby food jar). If you’re just supplementing and they’re back on their regular food, twice a day usually is fine and you don?t have to feed as much. Be warned: sometimes it takes a very long time for them to get back on their regular food. Do not despair — when they feel well enough, they will start eating. There might be that one odd ferret who never eats on their own again, but so far all the ferrets I’ve treated have eventually started eating their regular food.

*NOTE: if your ferret has a blockage, you should not force it to eat, but take it to the vet immediately. **See Duck Soup article

Barb Carlson

Duck Soup

Duck soup is the general term for any kind of liquid or near-liquid food fed to ferrets when they’re sick, recovering from surgery, or need to gain weight. My duck soup (otherwise known as “chicken goo” or “yum yums”) is not the dry powder sold as Uncle Jim’s Duck Soup. I don’t like that much and neither do my ferrets. I think it would be fine to add it to my style of duck soup, but I don’t think you’ll get nearly as good results using just the Uncle Jim’s powder as you would using my recipe. Also, we’ve found that the poops are much firmer on this type duck soup than when they are fed just chicken or turkey baby food, canned A/D or a mix of those two foods (commonly prescribed by vets for sick ferrets).

There are many recipes for duck soup out there, some with all sorts of additives. I used to add a lot of things to my duck soup, too, but over the years I’ve found that a basic recipe of chicken and maybe a little liver works quite well. It’s well-accepted by most ferrets (or not that hard to convince them to eat it) and it definitely puts on weight. Since it includes all the bones, gristle, fat, skin, marrow, etc. it’s actually fairly nutritious for them, too. We’ve had ferrets who ate nothing but our duck soup do quite well. The only issue is that the soft food causes tartar, which must be removed. [Daily brushing works best.]

The basic idea is to cook chicken (I use chicken legs and thighs) until the bones get soft. I’m lazy — I cook it in a slow cooker for 24 hours. Some people just cook until the chicken is done, then cook the bones longer. Other people use a pressure cooker (15-20 minutes at 15 pounds pressure seems to work well).

The key to getting it very smooth is to cook until the bones crumble, then scoop out the solids and chill until cold (save all the juice and fat separately). For some reason, the cold chicken (and bones, etc.) process into a smoother, more creamy mixture if you have chilled the cooked chicken first.

I use my food processor and process a big scoop of the cold chicken goop in a food processor until it makes a ball (similar to a dough ball if you’ve used machines to make bread). The ball should race around in a circle. Then add the warmed fat and juice slowly, mixing thoroughly between additions, until it is smooth and creamy. I like to keep it pretty thick, but moist enough to pour out like cake batter.

[You can add a little cooked liver at this point, but if you get all the marrow from inside the bones, it doesn’t seem to be necessary. I used to use 1/3 cup cooked beef liver to 3 cups chicken goo but don’t anymore. If you put in too much liver, the ferrets won’t like it as much. On the other hand, ferrets used to having the liver might balk (at least at first) if you leave it out.]

Pour the resulting goo into a big dish and continue processing the rest of the solids until done. Stir the goo in the big dish (thereby evenly distributing bone, marrow, fat, etc.). Spoon into containers and freeze. If you only have one or two ferrets, you want to freeze it in containers small enough that you can use it all before it spoils. I usually get at least 4 days before it starts to smell weird. Spoiled duck soup reeks, so you can trust your nose. I’ve used empty baby food jars or small plastic snack cups. You can also freeze it in ice cube trays, then transfer to a ziplock.

We warm up about a rounded tablespoon of the soup (when cold, it’s a congealed lump but it will go back to a thick liquid after about 10 seconds in the microwave) then add enough water to make a thick broth. The sicker the ferret, the smoother and thinner they want it. If your ferret refuses to eat it due to lumps, you can press it through a metal sieve (not a colander, but a fine metal mesh sieve) with a metal spoon and get the lumps out that way. Be sure to scrape off the goo that collects on the back of the sieve and stir that in. You’ll end up with leftover tiny bone bits (if you have a dog, he will love you if you let him lick out the sieve). Most ferrets want it nice and smooth at first, but as they get used to it, they will often tolerate a few lumps here and there.

Feeding Duck Soup with syringe

How to feed duck soup using a feeding syringe

If you need to force feed your ferret*, definitely use the sieve trick. It will save you a lot of frustration since the bone pieces plug up the feeding syringe. I use a 10cc “O-ring” feeding syringe — it has a special rubber gasket that doesn’t wear out as quickly as a regular syringe. I sometimes trim the nozzle back on the syringe to where it’s a little wider to help avoid clogs. If I’ve cooked the chicken long enough in the first place (so the bone bits are very small), I can sometimes get away without using the sieve if the syringe nozzle has been cut back. [*NOTE: Do NOT force feed an unconscious ferret, or a ferret with a blockage. Blockages will often make the stomach “blow up” like a balloon. Force feeding will only stretch it out more. Blockages are a severe emergency and you should run, not walk, to the emergency vet.]

If a ferret is not eating hard food, they need to eat 60-90cc’s a day to stay alive (1cc=1ml). More is better. [A Gerber baby food jar, filled to the very top is about 60cc.] Usually I start with 20cc every 3 hours. If they want more, by all means let them eat it, but at least 20cc. As they start to get better, starting eating more each time and/or start eating hard food, you can slowly decrease the number of times you give it duck soup.

After a ferret recovers, do not suddenly stop the duck soup; I’ve had ferrets relapse doing that. Continue the feedings (twice a day) for at least a week after they are eating hard food again. It won’t hurt to give them a little every day anyway, since they most probably love the stuff by now. It’s a great treat — protein and fat with no sugar — and will make your life easier the next time they get sick, since they will just dive right in.

If a ferret is eating duck soup (or other soft food) regularly, you need to be sure to brush his teeth. The soft food causes tartar to build up much faster than hard food alone. Tartar can eventually cause serious tooth and gum disease.

Barb’s Yum-Yum Recipe

Duck soup is the general term for any kind of liquid or near-liquid food fed to ferrets when they’re sick, recovering from surgery, or need to gain weight.

My duck soup (otherwise known as “chicken goo” or “yum yums”) is not the dry powder sold as Uncle Jim’s Duck Soup. I don’t like that stuff much and neither do my ferrets. I think it would be fine to add it to some kind of duck soup, but I don’t think you’ll get nearly as good results using just the Uncle Jim’s stuff as using my recipe.

There are many recipes for duck soup out there, some with all sorts of additives. I used to add a lot of things to my duck soup, too, but over the years I’ve found that a basic chicken-only recipe works quite well. It’s well-accepted by most ferrets (or not that hard to convince them to eat it) and it definitely puts on weight.

The basic idea is to take chicken (I use chicken legs and thighs) and cook it until the bones get soft. I’m lazy — I cook it in a slow cooker for 24-36 hours. Some people just cook until the chicken is done, then cook the bones longer (it even works in a pot on the stove if you cover the bones with water).

The key step is to scoop out the solids and chill them until cold. Save all the juice and fat.

Process the cold solids in a food processor until it makes a ball (similar to a dough ball if you’ve used machines to make bread). Then add fat and juice slowly, mixing thoroughly between additions, until it is smooth and creamy.

Scoop out the goo into a big dish and continue processing like this until done. Stir the goo in the big dish (thereby evening distributing bones, marrow, fat, etc.). Spoon into containers and freeze. Thaw as needed. If you only have a couple ferrets eating it, you might want to use baby food jars. If you have more ferrets, larger plastic containers might work better. The idea is to have a container that you can use up before it goes bad. It lasts about 5-7 days in the refrigerator. You’ll know when it’s bad. Your stomach will instantly clench up at the smell.

We give about 1/2 cup, warmed and with added water to make a soup. The sicker the ferret, the more smooth and watery they want it. If your ferret refuses to eat it due to lumps, you can run it through a sieve (pressing with a metal spoon) and try to get the lumps out that way. Most ferrets want it nice and smooth, but as they get used to it, they will often tolerate a few lumps here and there.

If you need to force feed your ferret, press the soup through a sieve. It will save you lots of frustration since the bone pieces plug up the syringes.

If a ferret is not eating hard food, they need to eat 60-90 cc (same as ml) a day to stay alive. More is better. After a ferret recovers, do not suddenly stop the duck soup as I’ve seen them relapse many times. Continue the feedings until at least a week after they are back to normal. It won’t hurt to give them a little every day anyway, since they most likely love the stuff by now. It’s a good treat — protein and fat with no sugar.

Barb Carlson