From:
Bruce Williams, DVM
Date: 2001-04-15 00:26:00 UTC
Subject: Re: Big belly question - sick ferret
Dear Mary:
Right now, I don't think that there is a lot more you can really do
until Monday. I think that an X-ray is probably a better way to
screen for abdominal fluid than a 4-quad stick, and gives you a lot
more information. An X-ray can tell you whether the swelling is
fluid, gas, or fat, which is a common occurrence in older animals
with adrenal disease. These animals put on a lot of fat in the
abdomen, giving them a pear-shaped look.
Another concern that I have in your history is the diagnosis of
peritonitis - especially in light of a negative abdominocentesis and
the history of previous abdominal surgery. The presence of pockets
inflamed tissue is not uncommon following surgery, and I would wonder
if this is not what we have seen. These areas of mesenteric
inflammation are usually well-contained by the body, and would not
result in abdominal distention.
On Monday, I would suggest bloodwork and that X-ray. True
peritonitis will often show up on both - as a fuzziness to the
abdomen on the X-ray, and with an elevated WBC count on the blood
count.
Hope all is well with you and Eric,
Bruce Williams, dVM
--- In Ferret-Health-list@y..., "Mary R. Shefferman" <ModFerret@a...>
wrote:
> Hi All -- I've been lurking for a while, trying to catch up from
> the beginning (ha!).
>
> I have a question for the vets or anyone who might have some
> suggestions. A little history: Knuks is a 6.5 year old dark-eyed
> white. She's up to about 1 lb, 7 or 8 oz now -- she's normally a
few
> ounces less. She has a very tiny frame -- so this is a lot of
weight
> for her.
>
> Medical history
> -Left adrenal removed last year (responded beautifully)
> -She has had two severe reactions to Fervac -- the first was in
1997
> the second in 1999 (in 1998 she was pretreated and had no
reaction).
> We haven't vaccinated her for distemper since.
> -Exploratory surgery at the end of February because she had (still
> has) a palpable nodule of some sort in the area of the mesenteric
> lymph node. An area near the lymph node was hemorrhagic with some
> necrotic tissue. This could not be removed. Biopsies came back as
> peritonitis & pancreatitis (no cancer). The right adrenal,
pancreas,
> liver, intestines all looked normal.
>
> Before the surgery Knuks had been having cyclic diarrhea (with her
> stools going from normal to bird-seedy to unformed to green sludge
to
> greenish liquid and back to normal over the course of 4 - 5 days)
for
> which we gave her Kaopectate. She had also been on metronidazole,
> which seemed to help during treatment, but soon after she was back
to
> the diarrhea. During this time she lost only a little weight -- she
> was down to 1 lb at her lightest (again, she's a tiny ferret, so
> 1 lb is a little thin for her, but not emaciated). She was eating
and
> drinking normally and was fairly active. After surgery, she was on
a
> course of amoxy for 14 days. She continued to eat and was active.
The
> episodes of diarrhea became shorter -- she'd have 1 or 2 liquid-
like
> stools instead of 2 to 4 before returning to normal. We stopped
> giving her Kaopectate because it didn't seem to have an effect on
the
> cycle. A while after we stopped the Kaopectate, she began to put on
a
> little weight, but became a little less active. She continued to
eat
> and drink. Her stools became much better. But then, her belly began
> to look disproportionately large -- so our vet checked for fluid (4-
> quad stick, he called it), and there was none. He didn't feel
> anything unusual -- just the same little nodule thing she had
before
> surgery. Temp, heart rate, breathing were fine. This was last
> Thursday (4/5). She just finished a 10-day course of metronidazole.
> Now she's inactive (becoming less active over the past week) and,
we
> noticed last night, is having some difficulty eating (swallowing a
> lot, only eating two or three pieces at a time). Over the last
couple
> of days her stools have gotten a little smaller, though normal --
> which would be explained by her having some difficulty with eating.
I
> spoke with another vet at the office because I'm still concerned
about
> Knuks' big belly and with these other things that have now come up.
> The vet said the bloating/distention could be gas. She suggested SC
> fluids and a bland diet. I've started giving Knuks chicken baby
food,
> which she doesn't quite love, but she's tasting it so she should
> take to it pretty well. I'm going to start SC fluids in a little
> while to see if that helps her. Her nose and gums are a little
pale,
> but her pads are pink. She is also having some episodes of
shivering
> for 15-20 minutes -- we've started putting a warm bottle of water
> in
> with her, which seems to help her. Her stools are normal most of
the
> time, though she does have an occasional dark green mucous stool.
> (Actually, she just had a larger, normal stool a couple of minutes
> ago.)
>
> So the question is: What else can I be doing for her? Obviously
> she's got a bit going on with the peritonitis and pancreatitis --
> I'm
> not looking for miracles. But her big belly worries me and I wonder
> if there's something we can do to make her more comfortable.
> I'm
> planning on taking her over to the vet (our regular vet) on Monday.
> Is there a reason I should do something sooner than that?
>
> Thanks in advance for any suggestions.
>
> --Mary & the Fuzzies