Date: 2001-04-12 00:03:00 UTC
Subject: Re: [Ferret-Health-list] AIHA (Dr. Williams back online,
but a bit slow)
Although I know we are not supposed to drop sympathy notes here, I am so very
sorry for your loss of Tasha, Bruce. Autoimmune hemolytic anemia is so
devastatingly swift, it gives you no time to prepare yourself for the
Your description of what happened with Tasha is hauntingly familiar.
Hopefully, most here will never experience this devastating killer. But if
you do, it is important that you know, as Bruce described, there is simply
nothing the best vets in all the world can do. And nothing that you can do
that would change the outcome.
Two of my ferrets, sometime apart, have been lost to AIHA. The first was a
rescue Canadian kit who grew to be the smartest ferret I have ever known.
Not only was he a beautiful black blaze, but his energy level approached a
sonic boom. As an example, he would steal a Nutri-Cal tube, one time
standing on the sink on his hind legs and opening the medicine cabinet, and
then he would unscrew the top with his teeth, and stand on the tube to get
the goody. He was 18 months old when it hit. The night before, he was
playing and teaching other ferrets bad tricks. The following morning, he was
pale, listless, and cool to the touch. I raced him to the first ferret vet
who was open - he shook his head and referred me to one of my regular vets.
By the time we reached that office, he was developing a yellowish cast. I
knew he was dying. I was referred to yet another of my vets and by the time
I reached there toting x-rays & bloodwork - he was almost dead. All of the
vets suspected AIHA. The last vet called Bruce - neither thought there was
anything that could be done. He died about 30 minutes into the visit. He
was bleeding out in all of his organs. Bruce did the pathology with a dx of
Autoimmune Hemolytic Anemia confirmed. But I did not believe there was
anything that could take a ferret so fast....tox screen was included because
I believed he must have inadvertently poisoned himself - I found a tube
chewed up. At that time Nutri-cal came in metal tubes. Although I write
stories about ferrets lost - it was a long time before I could talk about
Sweet Hart. It has been years now and I still find it difficult. It also
took the good Dr. Williams a bit to convince me that the body could turn on
itself so viciously and essentially kill itself by autoimmune attack in a
matter of hours.
The second was Zoe, a nine month old beautiful black sable. Although she was
not bred by me, she was directly in my (and others) black line. She was one
of the best blacks I have ever seen. I found her lying in the middle of the
floor late on a Friday afternoon. Rushed to her vet - bloodwork showed
virtually no red blood cells. However, all other factors were normal.
Profile was normal. How could a ferret have such an RBC with all other blood
factors normal including WBC & differential -- didn't seem to compute. She
was given transfusions through the weekend. She died early Monday morning.
Transfused whole blood was also attacked - but just the red cells. My vet
still remembers that I commented that "all the internal organs will be found
in pristine condition since the profiles were normal" and so it was. Again,
Bruce did the pathology. Again, AIHA - but this was so swift it did not
leave clues except for no red blood cells - suffocation. Now, this is not
quite the end of the story.
When Bob C. acquired Carbone, he also took home a little black jill he named
Jet was related to Zoe but bred by me and down a different tree branch and a
difference of her father being a German black instead of an American black as
was Zoe's. There were also a number of generations between. Bob was posting
about Jet on the FML, but I missed his first post - a friend let me know.
The symptoms were a mirror of Zoe's. It was thought that Jet might be in
silent heat and an emergency spay was planned. I frantically tried to reach
Bob because I knew she would be anaestrus, but by the time I caught up with
him, Jet was spayed - and nothing. Jet was exactly the same age as Zoe when
struck down. Both were beautiful with shinny coats and for all the world in
excellent health. On both, nothing was affected except the red blood cells.
A death gene? I gave Bob the complete family trees on both the girls -
worried that it might be genetically linked. Still don't know. Only two
ever reported in this long line. It has been 4-5 years now since and it has
not occurred in the line again. There has been no inbreeding in the line.
It is so hard to lose a ferret in this manner that it defies words.
I am sorry for such a gloomy report and one that is painful reading. But by
speaking about it, perhaps it might help another. And by sharing cases,
perhaps it might give more clues. I do wonder though if an
immunosuppressant, such as Arava that modifies T-cells, might help. But I
know they some have been tried without affecting the outcome. Should I ever
have another ferret collapse to AIHA, I will elect for immediate euthanasia
to spare suffering. Regards, Meg
In a message dated 4/10/01 10:49:28 PM Eastern Daylight Time,
<< I have returned, although my connection is now through NetZero, as my
ISP is down since Friday. Hopefully, hey will get it straightened
out soon, as 28.8 baud is a difficult adjustment to make.
This past Friday, one of our dogs, Tasha, presented after a day of
not eating with pale mucous membranes and a slight yellow tinge.
Fearing the worst, I took Tasha over to Charlie Weiss' and we
confrimed my immediate and worst fear - autoimmune hemolytic anemia -
a disease that has no definitive etiology, no prevention, and as of
yet, no effective treatment. After 48 sleepless hours and every
treatment that we could think of, including a liter of synthetic
hemoglobin (currently retailing at about $1200 a liter), we could not
save her. Needless to say, we are devastated.
AIHA is also a disease of ferrets which we have also discussed on
this list. AIHA is essentially identical to that seen in Tasha and
other of her species - unremitting destruction of the red blood cells
by the bodies' own mechanisms, with an unrelenting progression toward
organ failure and death. What causes it? We don't know - probably a
number of things. Vaccinations, antibiotics, drug reactions -
anything and everything. Something turns the body against it's own
People tend to think we know a lot more about this disease in dogs
than we do in ferrets, and wonder why we don't do more with AIHA in
ferrets. Basically, we don't have a direct test (known as a Coomb's
test) to detect antibodies in ferrets, but that's about it. We
pulled the test on my dog - she was dead before it came back. We
knew it was AIHA as soon as the blood results came back, or maybe it
was after the second CBC - her PCV dropped by 33% in 18 hours.We do
the same treatments in dogs as in ferrets, and unfortunately, they
don't often work.
AIHA is still relatively uncommon in domestic species, and luckily
for us. The hematocrit drops like a rock, and we pump steroids, and
other immunosuppressants and it rarely responds. Doesn't matter
which species. As we were applying heroic measures to Tasha, a
member of the species in which we know the most about AIHA, two other
dogs in the clinic were also being treated for this disease. None
One day we will know more about AIHA. But today, we must still
consider it a diagnosis with one of the poorest prognosis around.
With kindest regards,
Bruce Williams, DVM