From:
Bruce Williams, DVM
Date: 2001-04-04 21:17:00 UTC
Subject: Re: Two sick ferrets -- one urgent question
--- In Ferret-Health-list@y..., Lisa Sanchez <lchez1965@y...> wrote:
> Hi, Dr. Williams, et al:
>
> Tigger's blood work results are as follows:
>
> ALT (SGPT) 378
> AST (SGOT) 126
> CK 476
> AMYLASE 35
> LIPASE 1930
> ALBUMIN 2.8
> TOTAL PROTEIN 9.1
> GLOBULIN 6.3
> TOTAL BILIRBIN 0.3
> DIRECT BIBLRUBIN 0.1
> BUN 21
> CREATININE 0.3
> CHOLESTEROL 231
> GLUCOSE 70
> CALCIUM 9.1
> PHOSPHOROUS 4.9
> TCO2 (BICARBONATE) 7
> A/G RATIO 0.4
> B/C RATIO 70.0
> INDIRECT BILIRUBIN 0.2
> CBC COMPREHENSIVE:
> WBC 2.8
> RBC 14.40
> HGB 24.2
>
> HCT 69.5
> MCV 48
> MCH 16.8
> MCHC 34.7
> NEUTROPHIL SEG 67
> LYMPHOCYTES 19
> MONOCYTES 12
> EOSINOPHIL 1
> BASOPHIL 1
> PLATELETS ADEQUATE
>
> ABSOLUTE NEUTROPHIL SEG 1876
> ABOLUTE LYMPHOCYTE 532
> ABSOLUTE MONOCYTE 336
> ABSOLUTE EOSINOPHIL 28
> ABSOLUTE BASOPHIL 28
>
> The diagnosis and comments on Tigger's ultrasound are
> as follows:
>
> DIAGOSIS:
> 1) Splenomegaly
> 2) Nodular region within the pancreas of unknown
> etiology.
>
> COMMENTS:
> The enlargement to the spleen is not uncommon to see
> in the ferret; however, the prominent lymph node and
> discrete area within the right pancreas are
> concerning. I understand the patient's glucose level
> is normal. I would closely monitor this patient for
> potential signs of hypoglycemia. A baseline insulin
> level may be helpful, but will be diifcult to
> interpret if the concurrent glucose level is normal.
> A splenic aspirate is recommended due to the irregular
> boarders and prominent lymph node. The area within
> the pancreas may be an incidental finding. Normal
> echocardiogram.
>
> In view of this information, do you have any thoughts
> on what Tigger may have? He is really doing so well
> now, but, of course, we wonder what is happening
> inside of him. Do you think there is any concern for
> ADV? What about hypoglycemia? Should he be on pred?
>
Looking atthe level of globulin - I am concerned about ADV and would
suggest that that particular test be done. The current level of
globulins is approximately 40-50% higher than it should be. The
glucose at this point is low, and could represent insulinoma,
however, without characteristic clinical signs, I would recommend
either an insulin test, or to take a "wait and see approach". It is
not low enough to warrant surgery at this point. The presence of
a "discrete area" in the pancreas also suggests the possibility of
insulinoma - but the key is still that there are no definitive
clinical signs.
Without a diagnosis of insulinoma, I wouldn't start pred just yet.
With kindest regards,
Bruce H. Williams, DVM, DACVP
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