From:
Bruce Williams, DVM
Date: 2001-03-29 23:13:00 UTC
Subject: Re: A diagnosis for Meg - eosinophilic hepatitisI
--- In Ferret-Health-list@y..., "Diane Burman" <dmburman@r...> wrote:
> The results of Meg's liver biopsies came back yesterday with a
diagnosis of eosinophilic hepatitis. Is this the same thing as
eosinophilic enteritis that has been discussed on this list - just
specifying that in Meg's case the problem is her liver?
It would depend on the severity of the eosinophilic lesion, and I
would probably need to know what the biopsy report said. However,
eosinophilic enteritis can affect the liver, and any other abdominal
organ as well. EE is really a poor choice for moniker for this
disease - the earliest cases of EE were limited to the enteron, but
we know a lot more about it today.
> I have read through to FAQ on EE found on Mike Janke's Ferret
Health website and will search through the archive of this list for
the past posts on EE. I have spoken to the vet about treating Meg
with Ivermectin and we will be doing that when he re-examines her
tomorrow. She is already on 1/4 of a 5mg tablet of Pred 2x/day. Would
that be a reasonable dosage in this case (Meg currently has dropped
down to 1.4lb)? Right now she's getting aluminum hydroxide, Clavamox
& Pepcid A/C. Would any of these medications still be indicated with
this diagnosis? Mike's site only mentions Ivermectin and Pred. I will
be reviewing all her medications with her vet tomorrow.
Aluminum hydroxide, and clavamox are not indicated. Pepcid A/C is
only indicated if the eosinophilic inflammation or concurrent stress
has resulted in ulcers, but it is not a specific treatment for EE.
>
> Just 2 other quick questions:
> 1) I noticed on Mike's site that a bland diet is recommended. All
she is eating right now is A/D, IAMS canned kitten and Gerbers Stage
2 chicken mixed together with hot water. I'm also adding Prozyme
before feeding her. Would this be considered bland enough or should I
be feeding her just the Gerbers alone? Her stool is well formed and
only a little soft, if that information is relevant.
Truly bland is either Gerbers alone or Gerbers with A/D. Any
commecially available pet foods are not considered to be part of a
bland diet. However, there is no cardinal rule that says that a
bland diet has to be used in EE ferrets - but it does often help.
>
> 2) If this problem is caused by an allergy rather than a parasite,
is the allergy something that she was only recently exposed to (say,
within the past few weeks or shortly before I noticed she was ill) or
is has this more likely been a problem she has had for quite some
time and I have only just now noticed? I'm just trying to track down
what might be triggering the allergy and was hoping to narrow down
the time frame a bit.
Good luck. There is no definitive evidence that this is truly an
allergic disease, except for circumstantial. Eosinophils are
mediators of both allergy and anti-parasitic inflammation - so this
is why we treat animals with ivermectin and suspect an allergy at the
root. However, we have made little progress in identifying the true
nature of this disease.
With kindest regards,
Bruce H. Williams, DVM, DACVP
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