{"id":81435,"date":"2026-04-05T21:59:35","date_gmt":"2026-04-06T02:59:35","guid":{"rendered":"https:\/\/lafeber.com\/vet\/?p=81435"},"modified":"2026-06-05T23:27:38","modified_gmt":"2026-06-06T04:27:38","slug":"collapsed-ferret","status":"publish","type":"post","link":"https:\/\/lafeber.com\/vet\/collapsed-ferret\/","title":{"rendered":"The Collapsing Ferret: More Than Insulinoma"},"content":{"rendered":"<p style=\"text-align: right;\"><a href=\"https:\/\/lafeber.com\/vet\/wp-content\/uploads\/2026\/04\/Ferret-burrowing-in-towel-cropped-16-9.png\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-81922 aligncenter\" src=\"https:\/\/lafeber.com\/vet\/wp-content\/uploads\/2026\/04\/Ferret-burrowing-in-towel-cropped-16-9.png\" alt=\"ferret burrowing in towel A. Finkelstein\" width=\"800\" height=\"450\" srcset=\"https:\/\/lafeber.com\/vet\/wp-content\/uploads\/2026\/04\/Ferret-burrowing-in-towel-cropped-16-9.png 1000w, https:\/\/lafeber.com\/vet\/wp-content\/uploads\/2026\/04\/Ferret-burrowing-in-towel-cropped-16-9-400x225.png 400w, https:\/\/lafeber.com\/vet\/wp-content\/uploads\/2026\/04\/Ferret-burrowing-in-towel-cropped-16-9-768x432.png 768w, https:\/\/lafeber.com\/vet\/wp-content\/uploads\/2026\/04\/Ferret-burrowing-in-towel-cropped-16-9-700x394.png 700w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\" \/><\/a><small>Photo credit:\u00a0 Dr. Ariana Finkelstein<\/small><\/p>\n<h2><strong>Abstract<\/strong><\/h2>\n<p>Clinicians are often presented with older ferrets exhibiting <a href=\"https:\/\/lafeber.com\/vet\/presenting-problem-neurologic-deficits-in-ferrets\/\">ataxia<\/a>, intermittent collapse, exercise intolerance, changes in appetite, and muscle mass loss. The immediate jump to a diagnosis of <a href=\"https:\/\/lafeber.com\/vet\/pancreatic-beta-cell-tumors-in-the-ferret\/\">insulinoma<\/a> can unfortunately happen when a quick test with a glucometer measures a blood glucose under 70-90 mg\/dL. Although there has been more testing of these glucometers to show that they are often inaccurate, and no consideration is made towards when, what and how much the ferret ate, the ferret may be placed on prednisone and sent home. Sometimes bloodwork is performed, which may yield a more accurate glucose if it was processed quickly, and radiographs were taken which were inconclusive other than noting splenomegaly and possibly cardiomegaly. The ferret does not respond to the prednisone and signs may even worsen.<\/p>\n<p>This lecture will explore the differentials for a collapsing ferret which include further diagnostics and imaging. Additional potential causes of these clinical signs include dental, cardiac, renal, and musculoskeletal disease as well as other types of. Islet cell disease can be correctly diagnosed, but not on one glucometer reading as normal ferret physiology fluctuates blood glucose differently than dogs and cats. Case reports illustrating more common reasons for collapsing geriatric ferret will be discussed.<\/p>\n<blockquote><p><a href=\"https:\/\/lafeber.com\/vet\/wp-content\/uploads\/2026\/05\/J-D-Ferret-Abstract-Outline.pdf\">Download a PDF<\/a> of Dr. Johnson-Delaney&#8217;s abstract and outline.<\/p><\/blockquote>\n<p>&nbsp;<\/p>\n<h2>Outline<\/h2>\n<ol style=\"list-style-type: upper-roman;\" type=\"I\">\n<li><strong>Learning objectives<\/strong>\n<ol style=\"list-style-type: upper-alpha;\" type=\"A\">\n<li>Understand basic ferret anatomy and physiology as relates to metabolism and disease<\/li>\n<li>Develop an appropriate differential diagnoses list<\/li>\n<li>Identify and obtain appropriate diagnostics, including <a href=\"https:\/\/lafeber.com\/vet\/small-mammal-imaging-and-radiographic-cases\/\">imaging<\/a><\/li>\n<li>Provide urgent care of the ferret<\/li>\n<li>Develop a diagnosis-based treatment plan, including client education<\/li>\n<\/ol>\n<\/li>\n<li><strong>Important anatomy and physiology<\/strong>\n<ol style=\"list-style-type: upper-alpha;\" type=\"A\">\n<li>Species considerations\n<ol style=\"list-style-type: decimal;\" type=\"1\">\n<li><a href=\"https:\/\/lafeber.com\/vet\/basic-information-for-ferrets\/\">Domesticated species<\/a> (<em>Mustela putorius furo<\/em>)<\/li>\n<li>Single global blood type<\/li>\n<li>No true wild \u201cfitch\u201d ferrets<\/li>\n<\/ol>\n<\/li>\n<li>General characteristics of the gastrointestinal tract\n<ol style=\"list-style-type: decimal;\" type=\"1\">\n<li>Simple, relatively short gastrointestinal tract.<\/li>\n<li>No cecum<\/li>\n<li>Rapid transit time: 1.75\u20133 hours<\/li>\n<\/ol>\n<\/li>\n<li>Nutrition\n<ol style=\"list-style-type: decimal;\" type=\"1\">\n<li>High protein, high fat diet<\/li>\n<li>40\u201345% protein<\/li>\n<li>30\u201340% fat<\/li>\n<li>Limited fiber digestion (&lt;4%)<\/li>\n<li>Avoid carbohydrate-rich diets<\/li>\n<li>Feeding considerations\n<ol style=\"list-style-type: lower-alpha;\" type=\"a\">\n<li>Feed diets supported by feeding trials (avoid boutique diets)<\/li>\n<li>Raw diets: risk of pathogens (e.g., <em>Campylobacter<\/em>, <em>Salmonella<\/em>)<\/li>\n<li>Whole prey: domestic prey higher in fat\/carbohydrates than wild prey<\/li>\n<\/ol>\n<\/li>\n<\/ol>\n<\/li>\n<li>Gastrointestinal tract\n<ol style=\"list-style-type: decimal;\" type=\"1\">\n<li>Gastric physiology\n<ol style=\"list-style-type: lower-alpha;\" type=\"a\">\n<li>Spontaneous acid and proteolytic enzyme secretion<\/li>\n<li>Stimulated by histamine and vagal input<\/li>\n<li>Innervation\n<ol style=\"list-style-type: lower-roman;\" type=\"i\">\n<li>Parasympathetic fibers of vagus<\/li>\n<li>Sympathetic via celiacomesenteric plexus<\/li>\n<\/ol>\n<\/li>\n<li>Histamine effects\n<ol style=\"list-style-type: lower-roman;\" type=\"i\">\n<li>Stimulates acid secretion<\/li>\n<li>Low endogenous histamine levels<\/li>\n<li>Limited histamine-forming enzyme activity (L-histidine decarboxylase)<\/li>\n<li>Histamine H2 receptor antagonists abolish acid secretion response to exogenous histamine (pentagastrin)<\/li>\n<li>Atropine only reduces response 30%<\/li>\n<\/ol>\n<\/li>\n<\/ol>\n<\/li>\n<li>Intestinal anatomy and function\n<ol style=\"list-style-type: lower-alpha;\" type=\"a\">\n<li>Small intestine\n<ol style=\"list-style-type: lower-roman;\" type=\"i\">\n<li>Duodenum (3 sections)\n<ol style=\"list-style-type: lower-roman;\" type=\"i\">\n<li>Major duodenal papilla (~3 cm from pylorus)<\/li>\n<li>Minor papilla may be absent<\/li>\n<\/ol>\n<\/li>\n<li>Jejunum and ileum indistinguishable (jejunoileum)<\/li>\n<li>Innervation\n<ol style=\"list-style-type: lower-roman;\" type=\"i\">\n<li>Vagus nerve<\/li>\n<li>Sympathetic trunk (celiac, cranial mesenteric plexus)<\/li>\n<\/ol>\n<\/li>\n<\/ol>\n<\/li>\n<li>Colon\n<ol style=\"list-style-type: lower-roman;\" type=\"i\">\n<li>Tubular glands and goblet cells<\/li>\n<li>Sulfated mucosubstances (similar to humans)<\/li>\n<\/ol>\n<\/li>\n<li>Motility\n<ol style=\"list-style-type: lower-roman;\" type=\"i\">\n<li>Similar to canine ileum<\/li>\n<li>Vagus-dependent<\/li>\n<li>Mediated by cholinergic and noncholinergic pathways<\/li>\n<li>Sacral innervation is excitatory\n<ol style=\"list-style-type: lower-roman;\" type=\"i\">\n<li>Retroperistalsis contributes to vomiting<\/li>\n<li>Ferrets are used as emetic models<\/li>\n<\/ol>\n<\/li>\n<\/ol>\n<\/li>\n<\/ol>\n<\/li>\n<li>Pancreas<\/li>\n<li>Gallbladder and GI integration\n<ol style=\"list-style-type: lower-alpha;\" type=\"a\">\n<li>Cholecystokinin (CCK) function\n<ol style=\"list-style-type: lower-roman;\" type=\"i\">\n<li>Stimulates gallbladder contraction<\/li>\n<li>Inhibits gastric emptying<\/li>\n<li>Increases intestinal and colonic motility<\/li>\n<\/ol>\n<\/li>\n<\/ol>\n<\/li>\n<li>Overall GI function\n<ol style=\"list-style-type: lower-alpha;\" type=\"a\">\n<li>Highly motile, secretory system<\/li>\n<li>Designed for rapid transit<\/li>\n<li>Requires highly digestible food<\/li>\n<\/ol>\n<\/li>\n<\/ol>\n<\/li>\n<\/ol>\n<\/li>\n<li><strong>Differentials for a collapsed ferret<\/strong>\n<ol style=\"list-style-type: upper-alpha;\" type=\"A\">\n<li>Hypoglycemia\n<ol style=\"list-style-type: decimal;\" type=\"1\">\n<li><a href=\"https:\/\/lafeber.com\/vet\/pancreatic-beta-cell-tumors-in-the-ferret\/\">Islet cell endocrinopathy<\/a> (insulinoma)<\/li>\n<li>Inappetence\/anorexia\n<ol style=\"list-style-type: lower-alpha;\" type=\"a\">\n<li>Systemic illness<\/li>\n<li>Dental disease<\/li>\n<li>Pain<\/li>\n<li><a href=\"https:\/\/lafeber.com\/vet\/gastrointestinal-disease-in-the-ferret\/\">Gastrointestinal disease<\/a> (gastroenteritis, malabsorption, inflammatory bowel disease, etc.)<\/li>\n<li><a href=\"https:\/\/lafeber.com\/vet\/lymphoma-in-the-ferret-an-overview-of-diagnosis-and-treatment\/\">Neoplasia<\/a><\/li>\n<\/ol>\n<\/li>\n<li>Poor diet or feeding practices\n<ol style=\"list-style-type: lower-alpha;\" type=\"a\">\n<li>Inappropriate diet<\/li>\n<li>Feeding irregularities, competition, stress at the food bowl<\/li>\n<\/ol>\n<\/li>\n<\/ol>\n<\/li>\n<li><a href=\"https:\/\/lafeber.com\/vet\/cardiac-disease-in-ferrets\/\">Cardiac disease<\/a>\n<ol style=\"list-style-type: decimal;\" type=\"1\">\n<li>Cardiomyopathy (dilated, hypertrophic, restrictive)<\/li>\n<li>Arrhythmias<\/li>\n<li>Heart block<\/li>\n<li>Congestive heart failure<\/li>\n<\/ol>\n<\/li>\n<li>Other causes\n<ol style=\"list-style-type: decimal;\" type=\"1\">\n<li>L-carnitine deficiency<\/li>\n<li>Pain\n<ol style=\"list-style-type: lower-alpha;\" type=\"a\">\n<li>Orthopedic<\/li>\n<li>Spinal<\/li>\n<li>Osteoarthritis<\/li>\n<li>GI<\/li>\n<li>Dental<\/li>\n<li>Neoplasia<\/li>\n<\/ol>\n<\/li>\n<\/ol>\n<\/li>\n<\/ol>\n<\/li>\n<li><strong>Clinical evaluation: symptoms versus etiology<\/strong>\n<ol style=\"list-style-type: upper-alpha;\" type=\"A\">\n<li>Key <a href=\"https:\/\/lafeber.com\/vet\/ferret-history-form\/\">history questions<\/a>\n<ol style=\"list-style-type: decimal;\" type=\"1\">\n<li>Diet and feeding schedule\n<ol style=\"list-style-type: lower-alpha;\" type=\"a\">\n<li>What diet is the ferret eating?<\/li>\n<li>When was the last meal?<\/li>\n<\/ol>\n<\/li>\n<li>Access to food?\n<ol style=\"list-style-type: lower-alpha;\" type=\"a\">\n<li>Is food always available?<\/li>\n<li>Can the ferret get to the food easily?<\/li>\n<\/ol>\n<\/li>\n<li>Clinical signs?\n<ol style=\"list-style-type: lower-alpha;\" type=\"a\">\n<li>Does the ferret paw at its mouth?<\/li>\n<li>Hypersalivate?<\/li>\n<li>Show hindquarter weakness prior to going \u201cflat ferret\/speed bump\u201d?<\/li>\n<li>Show any signs of nausea or pain?<\/li>\n<li>Show inactivity, lack of playing, other limitations?<\/li>\n<\/ol>\n<\/li>\n<\/ol>\n<\/li>\n<li>Measuring blood glucose\n<ol style=\"list-style-type: decimal;\" type=\"1\">\n<li>One low blood sugar result on a collapsed ferret in the exam room should not be a definitive reason to diagnose \u201cinsulinoma\u201d<\/li>\n<li>Ferret normal can be 66\u201369 mg\/dL. Lower than dog\/cat<\/li>\n<li>In clinic blood glucose analyzers \u2013 immediate reading<\/li>\n<li>Greenacre: AEMV 2011\n<ol style=\"list-style-type: lower-alpha;\" type=\"a\">\n<li>Considered most ferrets 66\u201369 mg\/dL on regular lab<\/li>\n<li>Every human glucometer indicated severe hypoglycemia<\/li>\n<li>Alpha Trac C overestimated by 15% but was closest<\/li>\n<li>Alpha Trac F, PBGM One Touch, and AccuChek poor correlation<\/li>\n<\/ol>\n<\/li>\n<\/ol>\n<\/li>\n<li>Alpha Trak 2 \u2013 on C was fairly good, at least for trends<\/li>\n<li>Alpha Trak 3 \u2013 so far hard to correlate<\/li>\n<li>Send out: need to spin immediately, separate serum<\/li>\n<\/ol>\n<\/li>\n<li><strong>Islet cell endocrinopathy<\/strong>\n<ol style=\"list-style-type: upper-alpha;\" type=\"A\">\n<li>Referrals<\/li>\n<li>Signalment: most are older ferrets<\/li>\n<li>History\n<ol style=\"list-style-type: decimal;\" type=\"1\">\n<li>Collapsing episodes<\/li>\n<li>Most not directly related to meals<\/li>\n<li>Many have pattern, often connected to sleeping or inactivity<\/li>\n<li>Many have concurrent diseases and medical treatments<\/li>\n<li>Collapsed or lays around (flat ferret, speed bump, pelt)<\/li>\n<li>May walk a little, play a little then collapses again<\/li>\n<li>Sometimes hypersalivation<\/li>\n<li>Sometimes pawing at the mouth, bruxism<\/li>\n<li>Sometimes gagging or tremors<\/li>\n<li>May\/may not be progressive \u2013 frequency<\/li>\n<\/ol>\n<\/li>\n<li>True testing\n<ol style=\"list-style-type: decimal;\" type=\"1\">\n<li>Feed the ferret<\/li>\n<li>Time 2 hours, 3 hours, 4 hours<\/li>\n<li>Glucose and insulin <a href=\"https:\/\/lafeber.com\/vet\/blood-collection-in-ferrets\/\">blood draws<\/a><\/li>\n<li>When glucose drops below 60 mg\/dL, use serum for insulin \u2013 University of Tennessee Endocrinology Laboratory \u2013 Validated ferret insulin assay<\/li>\n<li><em>NOTE<\/em>: If the blood glucose is below 50 mg\/dL at 2 hrs: high suspicion<\/li>\n<li>If blood glucose is below 40 mg\/dL at 3 hrs \u2013 likely<\/li>\n<li>If blood glucose is over 70 mg\/dL at 4 hours \u2013 unlikely<\/li>\n<li>Interpretation\n<ol style=\"list-style-type: lower-alpha;\" type=\"a\">\n<li>Insulin\n<ol style=\"list-style-type: lower-roman;\" type=\"i\">\n<li>Elevated or \u201cwithin normal limits\u201d<\/li>\n<li>Compare with low blood glucose.<\/li>\n<\/ol>\n<\/li>\n<li>Normal blood glucose at 2 or 3 hours, but insulin elevated \u2013 suspicious<\/li>\n<li>If BG less than 50 mg\/dL at 2 hrs and high insulin \u2013 likely<\/li>\n<\/ol>\n<\/li>\n<li>Full workup: assess other organs\n<ol style=\"list-style-type: lower-alpha;\" type=\"a\">\n<li>Many have concurrent gastrointestinal, liver, or kidney disease or other endocrinopathies<\/li>\n<li>Most have some degree of <a href=\"https:\/\/lafeber.com\/vet\/adrenocortical-disease-in-ferrets\/\">adrenal disease<\/a>, should have deslorelin implant<\/li>\n<li>CBC, chemistries, radiographs, abdominal ultrasound (may find tumors)<\/li>\n<li>Imaging: large nodules may be seen with ultrasound, sometimes evidence of gastritis\/gastroenteritis, gallstones, changes in liver.<\/li>\n<\/ol>\n<\/li>\n<li>Surgery: If ferret good candidate, remove neoplastic islet cell masses\n<ol style=\"list-style-type: lower-alpha;\" type=\"a\">\n<li>Usually peel out unless adherent adjacent organs, invagination, neovascularization, metastasis<\/li>\n<li>May not be able to find actual nodules<\/li>\n<li>Removal of part of the pancreas? Diffuse changes can metastasize into the liver.<\/li>\n<li>Create diabetes mellitus, exocrine pancreas insufficiency<\/li>\n<li>IV fluids during\/post-surgery should contain glucose<\/li>\n<li>A rebound insulin surge may occur so monitor for several days post-op. May use dexamethasone in fluids post op<\/li>\n<\/ol>\n<\/li>\n<\/ol>\n<\/li>\n<li>Chemotherapy?\n<ol style=\"list-style-type: decimal;\" type=\"1\">\n<li>Doxorubicin 1 mg\/kg IV two to three treatments, 2\u20133 weeks apart has helped slow progression<\/li>\n<li>In some, virtual elimination of symptoms for months<\/li>\n<li>May have cardiotoxic effects: closely monitor with ECG and echocardiography. Do not use if there is concurrent cardiac disease<\/li>\n<\/ol>\n<\/li>\n<li><a href=\"https:\/\/lafeber.com\/vet\/exotic-icu-nursing-care-for-exotic-companion-mammals\/\">Supportive care<\/a>\n<ol style=\"list-style-type: decimal;\" type=\"1\">\n<li>Recognize nausea, <a href=\"https:\/\/lafeber.com\/vet\/sedation-and-pain-management-of-exotic-companion-mammals\/\">pain<\/a><\/li>\n<li>Famotidine at 1\u20132 mg\/ferret q 24h<\/li>\n<li>Maropitant helps with gut pain (?): 1 mg\/kg PO q 24h<\/li>\n<li>Buprenorphine: Ethiqa: 0.6 mg\/kg SC q 72h<\/li>\n<li>Gabapentin: 3\u201310 mg\/kg PO q8\u201312h prn<\/li>\n<li>Make sure eats every 4\u20136 hours<\/li>\n<li>Subcutaneous (SC) fluids prn<\/li>\n<\/ol>\n<\/li>\n<li>Medical therapy\n<ol style=\"list-style-type: decimal;\" type=\"1\">\n<li>Diazoxide PO\n<ol style=\"list-style-type: lower-alpha;\" type=\"a\">\n<li>Published doses seem too low for efficacy in my experience<\/li>\n<li>Start at 10 mg\/kg PO q 12h<\/li>\n<li>Can increase to 30 mg\/kg PO q 12h<\/li>\n<li>Depends on compounding formulation for absorption?<\/li>\n<\/ol>\n<\/li>\n<li>Corticosteroid PO\n<ol style=\"list-style-type: lower-alpha;\" type=\"a\">\n<li>Dexamethasone 0.5\u20131 mg\/kg PO q12h<\/li>\n<li>Prednisone 0.25\u20132 mg\/kg PO q12h\n<ol style=\"list-style-type: lower-roman;\" type=\"i\">\n<li>Can be used with diazoxide up to 2 mg\/kg\/day<\/li>\n<\/ol>\n<\/li>\n<li>Side effects: fatty liver, iatrogenic Cushing\u2019s disease, GI bleeding, hyperactivity, hypertension, alopecia<\/li>\n<li>Contraindicated with cardiomyopathy, renal and preexisting liver disease.<\/li>\n<li>Monitor: CBC, Chems, Imaging, fecal occult blood, cytology, BP, UA with specific gravity<\/li>\n<\/ol>\n<\/li>\n<li>Apocaps<sup>\u00ae<\/sup> (large dog size)\n<ol style=\"list-style-type: lower-alpha;\" type=\"a\">\n<li>Nutraceutical<\/li>\n<li>One-half capsule per day per ferret<\/li>\n<li>Anecdotal action against solid tumors<\/li>\n<li>Can\u2019t hurt \u2013 inhibits neovascularization<\/li>\n<li>Contains antioxidants<\/li>\n<li>Available on Amazon<\/li>\n<\/ol>\n<\/li>\n<\/ol>\n<\/li>\n<\/ol>\n<\/li>\n<li><strong>Cardiac insufficiency<\/strong>\n<ol style=\"list-style-type: upper-alpha;\" type=\"A\">\n<li><a href=\"https:\/\/lafeber.com\/vet\/cardiac-disease-in-ferrets\/\">Cardiac conditions<\/a>\n<ol style=\"list-style-type: decimal;\" type=\"1\">\n<li>Cardiomyopathy: dilated, hypertrophic, restrictive<\/li>\n<li>Cardiomegaly<\/li>\n<li>Hypotension\/poor perfusion<\/li>\n<li>Pulmonary edema<\/li>\n<li>Ascites<\/li>\n<li><a href=\"https:\/\/lafeber.com\/vet\/presenting-problem-cardiac-dysrhythmia-in-the-ferret\/\">Arrhythmias<\/a> \u2013 Grade 2 or 3 heart block, atrial fibrillation, etc.<\/li>\n<\/ol>\n<\/li>\n<li>Cardiomyopathy\n<ol style=\"list-style-type: decimal;\" type=\"1\">\n<li>Clinical signs\n<ol style=\"list-style-type: lower-alpha;\" type=\"a\">\n<li>Weakness, collapse<\/li>\n<li>Arrhythmias<\/li>\n<li>Dyspnea<\/li>\n<li>Poor perfusion<\/li>\n<\/ol>\n<\/li>\n<li>Diagnostics\n<ol style=\"list-style-type: lower-alpha;\" type=\"a\">\n<li>ECG<\/li>\n<li>Echocardiography<\/li>\n<li>Radiographs<\/li>\n<li>Blood pressure measurement<\/li>\n<\/ol>\n<\/li>\n<li>Treatment\n<ol style=\"list-style-type: lower-alpha;\" type=\"a\">\n<li>Pimobendan<\/li>\n<li>ACE inhibitors (enalapril, benazepril)<\/li>\n<li>Diuretics (furosemide)<\/li>\n<li>Terbutaline for heart block<\/li>\n<li>Pacemaker for complete heart block<\/li>\n<\/ol>\n<\/li>\n<li>Emergency cardiac management\n<ol style=\"list-style-type: lower-alpha;\" type=\"a\">\n<li>Acute cardiac arrest (CPR may be effective)<\/li>\n<li>Stabilize before major diagnostics\n<ol style=\"list-style-type: lower-roman;\" type=\"i\">\n<li>Heat<\/li>\n<li>Oxygen<\/li>\n<li>Get IV access as soon as possible<\/li>\n<li>Can do SC fluids while getting IV<\/li>\n<\/ol>\n<\/li>\n<li>Dobutamine\n<ol style=\"list-style-type: lower-roman;\" type=\"i\">\n<li>0.01 mg\/kg slow bolus IV to increase HR, stabilize rhythm<\/li>\n<li>May need constant rate infusion for 24\u201372 hours<\/li>\n<\/ol>\n<\/li>\n<\/ol>\n<\/li>\n<\/ol>\n<\/li>\n<\/ol>\n<\/li>\n<li><strong>Additional differentials<\/strong>\n<ol style=\"list-style-type: upper-alpha;\" type=\"A\">\n<li>L-carnitine deficiency\n<ol style=\"list-style-type: decimal;\" type=\"1\">\n<li>Older ferrets<\/li>\n<li>Metabolism abnormality linked to skeletal muscle weakness<\/li>\n<li>Hindquarters paresis, collapse<\/li>\n<li>Supplement with L-carnitine<\/li>\n<\/ol>\n<\/li>\n<li>Pain\n<ol style=\"list-style-type: decimal;\" type=\"1\">\n<li>Orthopedic<\/li>\n<li>Spinal<\/li>\n<li>Osteoarthritis<\/li>\n<li>Dental disease, especially fractured canines, periodontal<\/li>\n<li>Neoplasia<\/li>\n<li>Gastrointestinal<\/li>\n<li>Spleen, splenomegaly<\/li>\n<li>Chordoma<\/li>\n<li><a href=\"https:\/\/lafeber.com\/vet\/gastrointestinal-disease-in-the-ferret\/\">Gastrointestinal disease<\/a><\/li>\n<li><a href=\"https:\/\/lafeber.com\/vet\/urolithiasis-in-ferrets-rabbits-and-rodents\/\">Urolithiasis<\/a><\/li>\n<li>Gallstones<\/li>\n<\/ol>\n<\/li>\n<\/ol>\n<\/li>\n<li><strong>Case-based applications<\/strong>\n<ol style=\"list-style-type: decimal;\" type=\"1\">\n<li>Case 1: Misdiagnosed insulinoma \u2192 cardiac disease<\/li>\n<li>Case 2: Dilated cardiomyopathy with arrhythmia<\/li>\n<li>Case 3: Severe arrhythmia with cardiomyopathy<\/li>\n<li>Case 4: Cardiac disease misdiagnosed as insulinoma<\/li>\n<\/ol>\n<\/li>\n<li><strong>Conclusion<\/strong>\n<ol style=\"list-style-type: decimal;\" type=\"1\">\n<li>Perform thorough diagnostic evaluations<\/li>\n<li>Islet cell endocrinopathy\n<ol style=\"list-style-type: lower-alpha;\" type=\"a\">\n<li>Confirm with controlled testing<\/li>\n<li>Recognize limitations of glucometers<\/li>\n<li>Address concurrent disease<\/li>\n<\/ol>\n<\/li>\n<li>Consider major differentials\n<ol style=\"list-style-type: lower-alpha;\" type=\"a\">\n<li>Insulinoma<\/li>\n<li>Cardiac disease<\/li>\n<li>L-carnitine metabolism disruption<\/li>\n<li>Pain<\/li>\n<\/ol>\n<\/li>\n<\/ol>\n<\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<blockquote><p><a href=\"https:\/\/lafeber.com\/vet\/wp-content\/uploads\/2026\/05\/J-D-Ferret-Abstract-Outline.pdf\">Download a PDF<\/a> of Dr. Johnson-Delaney&#8217;s abstract and outline.<\/p><\/blockquote>\n<p>&nbsp;<\/p>\n<h2><strong>About the presenter<\/strong><\/h2>\n<p>Currently partially retired, Cathy Johnson-Delaney practiced avian, exotic and laboratory animal medicine in the greater Puget Sound area of Washington State for over 30 years. Dr. Johnson-Delaney was a founding member of the Washington Ferret Rescue &amp; Shelter. \u00a0She was named the 2003 Exotic DVM of the Year and she received the 2009 Oxbow Exotic Mammal Health Award. Dr. Johnson-Delaney is also a Past President of both the Association of Avian Veterinarians and the Association of Exotic Mammal Veterinarians. Cathy is the principal author and editor of the textbook <em>Ferret Medicine and Surgery<\/em>, and she has written and lectured extensively [<a href=\"https:\/\/lafeber.com\/vet\/johnson-delaney\/\">MORE]<\/a><\/p>\n<p>&nbsp;<\/p>\n<h2><strong>Webinar recording<\/strong><\/h2>\n<p><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/1196316338?dnt=1&amp;app_id=122963\" width=\"640\" height=\"344\" frameborder=\"0\" allow=\"autoplay; fullscreen; picture-in-picture; clipboard-write; encrypted-media; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\"><\/iframe><\/p>\n<p>&nbsp;<\/p>\n<h2><strong>Post-test<\/strong><\/h2>\n<p>Take the brief post-test to earn 1 hour of continuing education credit. With a passing grade, you will receive a continuing education certificate in jurisdictions that recognize AAVSB RACE approval.<\/p>\n<p><a class=\"btn\" href=\"https:\/\/lafeber.com\/vet\/collapsed-ferret-quiz\/\"><strong>Test your knowledge<\/strong><\/a><\/p>\n<p>&nbsp;<\/p>\n<h2><strong>Expert Q&amp;A<\/strong><\/h2>\n<p>Most questions were addressed during the live event, however, remaining questions were answered by email. Questions answered in writing by Dr. Johnson-Delaney during intermission are also listed below.<\/p>\n<blockquote><p><em>Italicized text represents answers provided by Dr. Johnson-Delaney.<\/em> Regular font indicates information provided by the moderator, Dr. Christal Pollock.<\/p><\/blockquote>\n<p>&nbsp;<\/p>\n<p>PANCREATIC BETA CELL TUMORS<\/p>\n<p><strong>What levels of glucose in ferrets with insulinoma are considered as stabilized? <\/strong><\/p>\n<p><em>[The goal is to] <\/em><em>keep [blood glucose] above 60 after 4 hours and\/or [ensure the ferret is] asymptomatic<\/em><\/p>\n<p><strong>What are normal values for insulin in blood? What is an elevated value?<\/strong><\/p>\n<p>The following information on normal insulin levels is taken from Table 7.3 of Schoemaker NJ, van Zeeland YRA. Endocrine diseases of ferrets. In:\u00a0 Quesenberry KE, Orcutt CJ, Mans C, Carpenter JW (eds). <em>Ferrets, Rabbits, and Rodents: Clinical Medicine and Surgery<\/em>, 4th ed. Elsevier, St. Louis, MO; 2021:85-88.<\/p>\n<p><a href=\"https:\/\/lafeber.com\/vet\/wp-content\/uploads\/2026\/04\/Table-7.3-Insulin-Ferrets.png\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-82037 size-full\" src=\"https:\/\/lafeber.com\/vet\/wp-content\/uploads\/2026\/04\/Table-7.3-Insulin-Ferrets.png\" alt=\"Pink Book Table 7.3\" width=\"1000\" height=\"159\" srcset=\"https:\/\/lafeber.com\/vet\/wp-content\/uploads\/2026\/04\/Table-7.3-Insulin-Ferrets.png 1000w, https:\/\/lafeber.com\/vet\/wp-content\/uploads\/2026\/04\/Table-7.3-Insulin-Ferrets-400x64.png 400w, https:\/\/lafeber.com\/vet\/wp-content\/uploads\/2026\/04\/Table-7.3-Insulin-Ferrets-768x122.png 768w, https:\/\/lafeber.com\/vet\/wp-content\/uploads\/2026\/04\/Table-7.3-Insulin-Ferrets-700x111.png 700w\" sizes=\"auto, (max-width: 1000px) 100vw, 1000px\" \/><\/a><\/p>\n<ul>\n<li><small>(40) Mann F.A, Stockham S.L, Freeman M.B, et al. Reference intervals for insulin concentrations and insulin:glucose ratios in the serum of ferrets. J Small Exot Anim Med . 1993;2:79\u201383.<\/small><\/li>\n<li><small>(41) Marini R.P, Ryden E.B, Rosenblad W.D, et al. Functional islet cell tumor in six ferrets. J Am Vet Med Assoc. 1993;202:430\u2013433.<\/small><\/li>\n<li><small>(a) Clinical Endocrinology Laboratory. College of Veterinary Medicine. University of Tennessee<\/small><\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><strong>If you are presented with a collapsed ferret of unknown cause, at what BG reading would you supplement with dextrose if you&#8217;re not sure if the low glucose is physiological or pathological?<\/strong><\/p>\n<p><em>[If] the ferret just came in; [the] first question is when did it last eat? If it is less than 2-3 hours, take the BG and put dextrose on the gums and retake in 15-30 minutes. It is all dependent on when their last meal was.<\/em><\/p>\n<p>&nbsp;<\/p>\n<p>CARDIAC DISEASE<\/p>\n<p><strong>Several attendees asked about the Cardiac Formula mentioned during Dr. Johnson-Delaney\u2019s presentation<\/strong><\/p>\n<p>The Cardiac Formula is referenced in Johnson-Delaney CA (ed). <em><a href=\"https:\/\/www.taylorfrancis.com\/books\/edit\/10.1201\/9781315371504\/ferret-medicine-surgery-cathy-johnson-delaney?refId=84896d88-79b6-4a07-92a4-82a6352fa98d\" target=\"_blank\" rel=\"noopener\">Ferret Medicine and Surgery<\/a>.<\/em> Boca Raton, FL: CRC Press Taylor &amp; Francis Group; 2017. Dr. Johnson-Delaney shared:<\/p>\n<p><em>I researched\/developed [the formula], and you make it up for the client. [This formula] is also mentioned in a number of proceedings on nutraceuticals and herbals that Susan Orosz and I have taught, as well as my ferret cardiology lectures. <\/em><em>I recommend only using products in the Cardiac Formula that are <\/em><em><a href=\"https:\/\/www.usp.org\/\" target=\"_blank\" rel=\"noopener\">labeled U.S. Pharmacopeia<\/a> <\/em><em>(USP) or reviewed and approved by <\/em><em><a href=\"https:\/\/www.consumerlab.com\/\" target=\"_blank\" rel=\"noopener\">ConsumerLab.com<\/a>.\u00a0<\/em><\/p>\n<ul>\n<li><em>1000 mg L-carnitine<\/em><\/li>\n<li><em>1000 mg taurine<\/em><\/li>\n<li><em>1000 mg CoQ10<\/em><\/li>\n<li><em>400 IU Vitamin E<\/em><\/li>\n<li><em>+\/-160-200 mg Hawthorn if there is no arrythmia or hypertrophic cardiomyopathy<\/em><\/li>\n<\/ul>\n<p><em>These ingredients are placed in a balanced omega 3-6-9 oil, like <\/em><em><a href=\"https:\/\/vetomega.com\/\" target=\"_blank\" rel=\"noopener\">VetOmega<\/a>, <\/em><em>which is currently unavailable, so use salmon oil to equal 30 mLs instead. <\/em><\/p>\n<p><em>Keep the mixture refrigerated.<\/em><\/p>\n<p><em>Do not stir or shake as this reportedly breaks fatty acid bonds. <\/em><em>\u00a0<\/em><\/p>\n<p><em>The dose is usually 0.5 ml per ferret per day. <\/em><\/p>\n<p>&nbsp;<\/p>\n<p><strong>What is the recommended ratio of omega 3:6 fatty acids<\/strong><\/p>\n<p><em>The ratio of omega-3 to Omega 6 should be 3:1<\/em><\/p>\n<p>&nbsp;<\/p>\n<p>MISCELLANEOUS<\/p>\n<p><strong>Any tips for conscious blood sampling? We usually sedate and [use the] cranial vena cava<\/strong><\/p>\n<p>This attendee was provided with the venipuncture section from Dr. Johnson-Delaney&#8217;s <a href=\"https:\/\/www.taylorfrancis.com\/books\/edit\/10.1201\/9781315371504\/ferret-medicine-surgery-cathy-johnson-delaney\" target=\"_blank\" rel=\"noopener\" data-auth=\"NotApplicable\" data-linkindex=\"1\">Ferret Medicine and Surgery<\/a>.<\/p>\n<blockquote><p>The LafeberVet video <a href=\"https:\/\/lafeber.com\/vet\/blood-collection-in-ferrets\/\">Blood Collection in Ferrets<\/a> may also be useful.<\/p><\/blockquote>\n<p><strong>Any suggestions to prevent dental problem in ferrets?<\/strong><\/p>\n<p><em>Brushing the teeth with a hydrolyzing toothpaste, like we use in cats, [and] dental cleaning under sedation\/anesthesia, like we do in other carnivores. [Ferrets fed] kibble diets may have less calculi but more tooth wear.<\/em><\/p>\n<p>&nbsp;<\/p>\n<h2><strong>RACE approval<\/strong><\/h2>\n<p>This program is approved by the American Association of Veterinary State Boards (AAVSB) Registry of Approved Continuing Education (RACE) for 2 hours of continuing education credit for veterinarians and veterinary technicians in jurisdictions that recognize AAVSB RACE approval.<\/p>\n<p>&nbsp;<\/p>\n<h2><strong>Acknowledgements<\/strong><\/h2>\n<ul>\n<li>Clinical collaborators and institutions\n<ul>\n<li><a href=\"https:\/\/www.washingtonferret.org\/index.php\" target=\"_blank\" rel=\"noopener\">Washington Ferret Rescue &amp; Shelter<\/a><\/li>\n<li>Staff of many clinics I\u2019ve worked with<\/li>\n<\/ul>\n<\/li>\n<li>\u00a0Diagnostic equipment providers\n<ul>\n<li>\u00a0<a href=\"https:\/\/www.trivitron.com\/products\/ultrasound\/aloka-trivitron\" target=\"_blank\" rel=\"noopener\">Aloka Trivitron Advanced Ultrasound System<\/a>, Clarius<\/li>\n<li><a href=\"https:\/\/vetronic.co.uk\/\" target=\"_blank\" rel=\"noopener\">Vetronics Services Ltd<\/a>, Keith Simpson; Vmed\/Vchek<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ol type=\"A\">\n<li style=\"list-style-type: none;\"><\/li>\n<\/ol>\n<h2 class=\"ref\">References<\/h2>\n","protected":false},"excerpt":{"rendered":"<p>View this webinar recording presented by Cathy Johnson-Delaney, RACE-approved for 2 credit hours. Clinicians are often presented with older ferrets exhibiting ataxia, intermittent collapse, exercise intolerance, changes in appetite, and\/or muscle mass loss. This virtual master class explored the differential diagnoses for the collapsing ferret. Case reports illustrating other common reasons for the collapsing geriatric ferret were also discussed. <\/p>\n","protected":false},"author":35,"featured_media":81464,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[112],"tags":[1384,1113,5984,1412,1106,1107,1105],"class_list":["post-81435","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-event","tag-arrhythmia","tag-cardiomyopathy","tag-collapse","tag-geriatrics","tag-glucose","tag-hypoglycemia","tag-insulinoma","content_types-article","content_types-video","content_types-webinar","topics-anatomy-physiology","topics-cardiology","topics-critical-care","topics-dental-oral","topics-endocrinology","topics-gastroenterology","topics-musculoskeletal","topics-neurology","topics-supportive-care","topics-supportive-care-2","topics-therapeutics","procedures-clinical-pathology","procedures-diagnostics","procedures-radiology","procedures-supportive-care-therapeutics","procedures-therapeutics","species-ferret","species-mammals","channel-emergency-medicine","channel-resources-education","contributor-johnson-delaney"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.7 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>The Collapsing Ferret: More Than Insulinoma - LafeberVet<\/title>\n<meta name=\"description\" content=\"View this webinar recording presented by Cathy Johnson-Delaney, RACE-approved for 2 credit hours. Clinicians are often presented with older ferrets exhibiting ataxia, intermittent collapse, exercise intolerance, changes in appetite, and\/or muscle mass loss. This virtual master class explored the differential diagnoses for the collapsing ferret. Case reports illustrating other common reasons for the collapsing geriatric ferret were also discussed.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/lafeber.com\/vet\/collapsed-ferret\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"The Collapsing Ferret: More Than Insulinoma - LafeberVet\" \/>\n<meta property=\"og:description\" content=\"View this webinar recording presented by Cathy Johnson-Delaney, RACE-approved for 2 credit hours. Clinicians are often presented with older ferrets exhibiting ataxia, intermittent collapse, exercise intolerance, changes in appetite, and\/or muscle mass loss. This virtual master class explored the differential diagnoses for the collapsing ferret. 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Case reports illustrating other common reasons for the collapsing geriatric ferret were also discussed.","og_url":"https:\/\/lafeber.com\/vet\/collapsed-ferret\/","og_site_name":"LafeberVet","article_published_time":"2026-04-06T02:59:35+00:00","article_modified_time":"2026-06-06T04:27:38+00:00","og_image":[{"width":700,"height":700,"url":"https:\/\/login.lafeber.com\/vet\/wp-content\/uploads\/2026\/04\/Ferret-burrowing-in-towel-cropped-square-looking-left.png","type":"image\/png"}],"author":"Cathy Johnson-Delaney, DVM","twitter_card":"summary_large_image","twitter_misc":{"Written by":"Cathy Johnson-Delaney, DVM","Est. reading time":"12 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/lafeber.com\/vet\/collapsed-ferret\/#article","isPartOf":{"@id":"https:\/\/lafeber.com\/vet\/collapsed-ferret\/"},"author":{"name":"Cathy Johnson-Delaney, DVM","@id":"https:\/\/lafeber.com\/vet\/#\/schema\/person\/6bc4b1257591e53bd3e0f9330a7c4818"},"headline":"The Collapsing Ferret: More Than Insulinoma","datePublished":"2026-04-06T02:59:35+00:00","dateModified":"2026-06-06T04:27:38+00:00","mainEntityOfPage":{"@id":"https:\/\/lafeber.com\/vet\/collapsed-ferret\/"},"wordCount":2248,"image":{"@id":"https:\/\/lafeber.com\/vet\/collapsed-ferret\/#primaryimage"},"thumbnailUrl":"https:\/\/lafeber.com\/vet\/wp-content\/uploads\/2026\/04\/Ferret-burrowing-in-towel-cropped-square-looking-left.png","keywords":["arrhythmia","cardiomyopathy","collapse","geriatrics","glucose","hypoglycemia","insulinoma"],"articleSection":["Event"],"inLanguage":"en-US"},{"@type":"WebPage","@id":"https:\/\/lafeber.com\/vet\/collapsed-ferret\/","url":"https:\/\/lafeber.com\/vet\/collapsed-ferret\/","name":"The Collapsing Ferret: More Than Insulinoma - LafeberVet","isPartOf":{"@id":"https:\/\/lafeber.com\/vet\/#website"},"primaryImageOfPage":{"@id":"https:\/\/lafeber.com\/vet\/collapsed-ferret\/#primaryimage"},"image":{"@id":"https:\/\/lafeber.com\/vet\/collapsed-ferret\/#primaryimage"},"thumbnailUrl":"https:\/\/lafeber.com\/vet\/wp-content\/uploads\/2026\/04\/Ferret-burrowing-in-towel-cropped-square-looking-left.png","datePublished":"2026-04-06T02:59:35+00:00","dateModified":"2026-06-06T04:27:38+00:00","author":{"@id":"https:\/\/lafeber.com\/vet\/#\/schema\/person\/6bc4b1257591e53bd3e0f9330a7c4818"},"description":"View this webinar recording presented by Cathy Johnson-Delaney, RACE-approved for 2 credit hours. Clinicians are often presented with older ferrets exhibiting ataxia, intermittent collapse, exercise intolerance, changes in appetite, and\/or muscle mass loss. This virtual master class explored the differential diagnoses for the collapsing ferret. 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