title: Diabetic ketoacidosis with concurrent pancreatitis, pancreatic β islet cell tumor, and adrenal disease in an obese ferret (Mustela putorius furo).
abstract: A 5.5-y-old spayed female ferret (Mustela putorius furo) with a history of adrenal disease, respiratory disease, and chronic obesity was evaluated for progressive lethargy and ataxia, diminished appetite, and possible polyuria and polydipsia. Physical examination revealed obesity, lethargy, tachypnea, dyspnea, a pendulous abdomen, significant weakness and ataxia of the hindlimbs, prolonged skin tenting, and mild tail-tip alopecia. Clinicopathologic analysis revealed severe hyperglycemia, azotemia, an increased anion gap, glucosuria, ketonuria, proteinuria, and hematuria. Abdominal ultrasonography showed hyperechoic hepatomegaly, bilateral adrenomegaly, splenic nodules, mild peritoneal effusion, and thickened and mildly hypoechoic limbs of the pancreas with surrounding hyperechoic mesentery. Fine-needle aspirates of the liver were highly suggestive of hepatic lipidosis. In light of a diagnosis of concurrent diabetic ketoacidosis and pancreatitis, the ferret was treated with fluid therapy, regular and long-acting insulin administration, and pain medication. However, electrolyte derangements, metabolic acidosis, dyspnea, and the clinical appearance of the ferret progressively worsened despite treatment, and euthanasia was elected. Necropsy revealed severe hepatic lipidosis, severe suppurative pancreatitis and vacuolar degeneration of pancreatic islet cells, a pancreatic β islet cell tumor, bilateral adrenal cortical adenomas, and myocardial fibrosis. To our knowledge, this case represents the first report of concurrent diabetes mellitus, pancreatitis, pancreatic β islet cell tumor (insulinoma), and adrenal disease in a domestic ferret. The simultaneous existence of 3 endocrine diseases, pancreatitis, and their associated complications is a unique and clinically challenging situation.
authors.affiliation: Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas, USA. kaphair@gmail.com
authors.forename: Kristen A
authors.initials: KA
authors.lastname: Phair
authors.forename: James W
authors.initials: JW
authors.lastname: Carpenter
authors.forename: Thomas
authors.initials: T
authors.lastname: Schermerhorn
authors.forename: Chanran K
authors.initials: CK
authors.lastname: Ganta
authors.forename: Brad M
authors.initials: BM
authors.lastname: DeBey
mesh_terms: D000307:Adrenal Gland Diseases / Q000150:complications / Q000473:pathology / Q000662:veterinary*; D000818:Animals; D001774:Blood Chemical Analysis / Q000662:veterinary; D016883:Diabetic Ketoacidosis / Q000150:complications / Q000188:drug therapy / Q000473:pathology / Q000662:veterinary*; D005260:Female; D005289:Ferrets; D005440:Fluid Therapy / Q000662:veterinary; D007328:Insulin / Q000627:therapeutic use; D007340:Insulinoma / Q000150:complications / Q000473:pathology / Q000662:veterinary*; D009765:Obesity / Q000150:complications / Q000473:pathology / Q000662:veterinary*; D010190:Pancreatic Neoplasms / Q000150:complications / Q000473:pathology / Q000662:veterinary*; D010195:Pancreatitis / Q000150:complications / Q000188:drug therapy / Q000473:pathology / Q000662:veterinary*; D014463:Ultrasonography; D016482:Urinalysis / Q000662:veterinary; D014781:Viscera / Q000000981:diagnostic imaging
chemical_list: D007328:Insulin