Date: Wed, 3 Jun 2009 21:52:57 -0700
From: Bob C <talktobobc@YAHOO.COM>
Subject: Bob C: Q&A: Sugary Treats (Ferret Project & Insulinoma)
Q: “Quick question….once a week I treat myself to a Krispy Kreme donnut and [my ferret] loves to lick the icing off my fingers. Will that tiny amount of sugar hurt him? My boyfriend is concerned about insulinoma.”
A: If you are that worried about cleaning your fingers, I can stop by and lick the icing off for you. I’ll do anything to help our ferrets. Yuck! I am old and gray and crusty … that image even made me gag a little. My brain is now bleeeeding!
Sorry, this answer cannot be as quick as you would like; I get quoted a lot, even when I ask not to be, so I have been forced to carefully watch what I say and explain things to the final punctuation mark. But, you can skip to the bottom if you prefer.
I am currently in the process of finishing a group of more than 200 ferret necropsies from North American sources, using the identical criteria used when I did hundreds of them on feral ferrets in New Zealand and the scores done in Australia and Europe. While releasing exact numbers is premature until the work is finished and published, and without getting into the math, I’ll just say that there is an extremely significant correlation between diet and the presence of insulinoma, with (so far) a p-value of roughly 0.001 (I am working towards sample redundancy, so do the math with each added sample). The shuttle astronauts should have had it so good; that number is better than expected for rocket science. It means the association between insulinoma and carbohydrate consumption is valid with only an extremely tiny chance of error.
If you can, imagine a straight line that represents a continuum of diet. At one end is a totally raw, whole carcass diet and a diet of high carbohydrate kibble is at the other end. In between are various types of diets that have some proportion of carbohydrates, ranging from zero (the meat end) to perhaps 50% at the “bad kibble” end. What the Ferret Project study is showing is, the closer the diet is to the “bad kibble” end, the higher the relative risk of insulinoma.
The key word is risk, which is why I think some people have a hard time accepting the potential injuries that a long term diet of carbohydrates can cause to the ferret’s pancreas. Risk is a statistical probability, which means that there is only a chance it will result in disease — not a certainty. It’s like baseball; you know a batter hitting .300 will safely whack the ball 3 times out of 10 — you just don’t know WHEN those 3 hits will come or what type of hits they will be. While you can assign risk to a specific activity, it is very difficult to determine when or where that risk will be manifested.
However, to put things in perspective, the risks of your ferret developing insulinoma from a carbohydrate diet is significantly greater than them developing a bacterial disease from a diet of uncooked raw meat. If you think uncooked meat is dangerous, then you really need to rethink feeding ferrets carbohydrates. Seriously. There are several risk factors that contribute to overall disease rates of insulinoma. Obviously, eating carbohydrates is the major one. I could not find a single insulinoma in the pancreas of a ferret weaned on and fed a raw whole carcass diet throughout its lifespan and I’ve done enough to know if they are found, then they are very rare. The data base included New Zealand feral ferrets, Australian ferrets, European ferrets, and, as mentioned, North American ferrets. Interestingly, I found insulinomas in New Zealand feral ferrets that had been captured and fed a kibble diet.
Another risk factor is the length of time eating carbohydrates. The longer the ferret eats carbohydrates, the higher the relative risk. Ferrets switched from a carbohydrate diet to an all-meat diet had a lower risk of disease, although it was obviously higher than the meat-eating control. It is currently on the edge of being a statistically significant finding.
A third factor is the carbohydrate load. Foods with higher carbohydrate loads (amounts of digestible carbohydrates) probably place the ferret at higher risk for insulinoma. I don’t think I can prove or disprove this under the current Ferret Project study.
Age is a fourth factor; the older the ferret, the higher the risk. This is probably nothing more than an epiphenomenon and not a real risk. It is likely that older ferrets have higher rates of insulinoma simply because they have been exposed to risk factors for longer periods of time. Older smokers also show more smoking-related disease or the same reason.
I think physical activity is a fifth factor. I suspect caged ferrets might have a higher risk compared to ferrets with a higher degree of physical activity who may better deal with sugars created by carbohydrate digestion. I have discovered higher insulinoma rates in shelter ferrets compared to private owners, even though they consumed similar diets. I need more data on this question; while not well supported, it could show sick ferrets are more likely surrendered to shelters. I hope a larger sample will define the difference.
It is possible that some breeding lines have higher rates of the disease, but if so, then I cannot find a statistical correlation having any any statistical significance to support it. My observed rates of insulinoma tend to be statistically similar from different gene pools from around the world. This suggests insulinoma is most likely an environmental disease.
It is also possible that specific nutrients consumed at the same time as the carbohydrates might be a factor. Some nutrients might increase carbohydrate digestion, dumping more sugars faster into the blood stream. Others might bind to the carbohydrates, helping transport them out of the body before they are digested. I think I have figured out how to do the latter with ferrets, but that is another study, not this one.
End Part ONE — Part TWO follows [combined into one post. BIG]
So, what does all this mean? Remember, this is preliminary work with at least another year to go for confirming studies. Data is still being entered. I reserve the right to change Ferret Project findings and conclusions without notice or apology.
- I am extremely confident in saying that the longer a ferret consumes carbohydrates, the greater the chance that it will develop insulinoma. Physical activity seems to independently increase those risks. Based on what I have learned, the ferrets with the highest risk of developing insulinoma are those that live in cages and consume a high carbohydrate diet, such as kibble (highest insulinoma rates were found in ferrets in a long-term shelter situation). Those with the least risk are those that eat a whole carcass diet and live in an environment which allows strenuous physical activity, such as climbing, digging, leaping, wrestling, and running. Everything else is somewhere in the middle.
- I can do a single test on a ferret older than 2 years of age and reliably predict their diet (meat vs kibble). The older the ferret, the more reliable the test. THAT is how significant diet is on the ferret. If I combine that test with a dental inspection, I am rarely wrong. People all over the world can confirm this claim.
- There is a striking difference in the number of insulinomas found during necropsies and those reported by owners or vets, suggesting insulinoma is under-reported in North America (and worse world-wide). This makes sense to me because I feel insulinoma is a “threshold disease.” That is, up to a specific threshold, the ferret can tolerate the problem. They may slow down a bit, which can be attributed to all sorts of other things, including age, caging, other illness, or even seasonal physiological changes, so it is not noticed. Also, I suspect a significant number of insulinomas remain undiagnosed because the symptoms are masked by other problems, such as cardiomyopathy or arthritis. If blood sugar tests are not done regularly, the disease is masked by another problem, or the ferret never crosses their specific tolerance threshold, it is unlikely an insulinoma will ever be diagnosed. Many long term FMLers can testify that what appears to be a healthy ferret will suddenly get ill and have a blood sugar crash diagnostic of insulinoma. Well, those pancreatic beasties didn’t grow overnight. The ferrets probably had it for some time, but the recent illness dropped their tolerance threshold and they crashed. The lesson is, if a necropsy is not done and the vet has not inspected the pancreas, it is very likely that a good percentage of insulinomas will be missed. I am currently trying to get a handle on that percentage of misses.
- At this time, I do not feel the genetics of a specific breeding line has a lot to do with the disease, based on my observation that insulinoma rates are statistically uniform across worldwide gene pools when sorted by diet. If Marshall Farms ferrets have a higher rate of the disease (which I still need to determine), it is probably due to those ferrets being most likely to live in cages and consume kibble, placing them at higher relative risk. I *DO* think there is a genetic link, but I think it is essentially species wide and effects all ferrets more or less equally.
So, what do I recommend?
- Feed your ferret a diet with the least amount of digestible carbohydrates possible. The closer that number is to zero, the lower the risk of your ferret developing insulinoma. Note that a low carbohydrate diet may reduce risk, BUT, some ferrets will still develop the disease, so don’t assume “low carbohydrate” means “no disease”.
- House your ferret in an environment that encourages frequent physical exercise, especially running, climbing, digging, wrestling, and leaping. An alternative could be an exercise program that could accomplish the same physical result outside the housing area. I think the final numbers will show this to be an important factor.
- Always ask your vet if they would do a necropsy of your dead ferret. While some vets will demand payment, many will do it for free simply to learn and better their practice. I know a lot of people hate the idea of a necropsy being done on a beloved companion, but it really does help your vet learn. That translates as better care for other ferrets, perhaps one you might never meet.
- I honestly doubt if the occasional carbohydrate treat has *ANY* impact on the development of insulinoma. It is likely that insulinoma is caused by the long-term (chronic) impact of elevated sugar levels on the pancreas (a similar mechanism seen in some types of diabetes), so short term moderate sugar spikes would have relatively little impact. So, the occasional sugary treat will probably not statistically increase risk if your ferret is on a carbohydrate diet, nor should it increase risk for a ferret on a meat diet. Pay attention to the word, “occasional;” if done more than a few times per week, “occasional” morphs to “part of diet” and then it *IS* a problem.
So, to FINALLY answer the question, I don’t think the occasional lick of icing from a donut will cause any longer term problem beyond that which exists for the risk category for the primary diet. It is always better to feed your ferret the best diet possible and there is no dietary or nutritional reason to feed sugar or ANY carbohydrate. Still, the benefits of bonding and shared affection, not to mention the reduction of stress, more than likely far outweighs the risks of disease cause by the occasional sugar fix (providing those treats meet the above caveats). Put simply, if your ferret is at great risk for insulinoma, the occasional sugar treat will probably not raise those risks with any statistical significance. If your ferret is at low risk, the same is also likely to be true. However, if your ferret has been diagnosed with insulinoma, by all means DO NOT give them sugary treats (unless medically warranted for low blood sugar). Consult your vet and have a ferret physical prior any significant changes in your ferret’s diet. Great alternative treats that ferrets like as much (or more) include licks of dairy butter, small meaty treats, bits of chicken gizzards, hearts and livers, and even my ferret’s personal favorite: Jell-o made with pureed chicken or beef liver. That last one makes me gag a bit, but it is all for the ferrets.