From:
elnrrgby1@aol.com
Date: 2001-05-11 21:31:00 UTC
Subject: questions: blood results and treatment options?
Hello all,
Just got the blood results on one of my ferrets back today.
Dr. Williams is
somewhat familiar with the case, but let me give a quick recap
for anyone
else who might be able to help. 3yr old MF ferret who was
believed to have
Juvenile Lymphoma, or thymic dependent lymphoma, when he was 6
months old.
Had thymic mass, pleural effusion, and ascites (seen on
multiple
radiographs), and elevated lymphocyte counts. Mass was also
seen on
ultrasound. Was started on PediaPred immediately. Thymic mass
resolved after
a couple of months, as did the fluid buildup. He continued on
the PediaPred
(0.75mg once daily) for the next 2.5 years. I weaned him off
the Pred in
December of 2000 figuring that there was no way it could have
ever been JL
since he was still alive and healthy. By January of 2001, all
peripheral
lymph nodes were enlarged. I did go ahead and restart the
PediaPred at this
time, at the same 0.75mg QD. We also did 3 aspirates, all
were inconclusive.
Biopsied full node and had it checked by our regular lab.
Again
inconclusive. Dr. Williams was kind enough to evaluate the
samples for me
(thank you once again Dr. Williams!!!). He found atypical
hyperplasia of the
cells and cautioned me to watch Bhut closely. Lymph nodes did
shrink a bit
initially with restarting the Pred, but became enlarged again
and have
remained so ever since.
On Tuesday of this week, I noticed he was extremely lethargic
and also very
dehydrated. I started him on sub-q fluids (saline only),
started feeding
A/D, and offering Pedialyte. He is still extremely lethargic
and does not
get out of his hammock unless forced. He willingly takes the
A/D, but will
not drink water or Pedialyte on his own (and I don't like to
force oral
liquids). And, despite getting 50-60 cc's of sub-q fluids
twice daily, he's
still got a positive skin tent (very noticeable one) and
somewhat tacky gums.
Just today, I did a B12/B Complex injection figuring it
couldn't hurt. He
is also getting Nutrical in the A/D, and omega 3 and 6 fatty
acids (Derm Caps
liquid).
We ran a "ferret panel" with CBC through our normal lab.
Chemistry had lots
of little changes....low BUN, TP of 8.1, Globulin 5.1, Total
Bilirubin 0.5
and some minor differences with Sodium and Potassium levels
(tenth of a point
off either way). ALT was really elevated at 113, but that
seems to be normal
with this ferret. The sample also was mildly lipemic.
CBC showed the following abnormal values:
MCV 47.5 normal range: 57.9 - 72.0
Platelets 107 170 -
630
RDW 14.2 7.0 -
14.0
Neutrophils % 86.0 14.0 -
50.0
Lymphocytes % 9.0 10.0 - 44.0
Total Lymphocytes 0.5 0.8 - 4.0
The following notes were also included:
WBC Morphology occassional toxicity
RBC morphology normal
PLT morphology platelet clumping and aggregation are
noted likely
affecting the platelet count
and MPV values
I was told by my vet that this most likely either denotes a
marrow
suppressing cancer, or a viral infection of some sort. Given
the history, and
the fact that none of the other 9 ferrets in the house are
ill, the vet is
once again leaning towards the cancer scenario as being most
likely, and I am
inclined to agree. Is this reasonable? Are we missing
something else here?
Are there any other tests we should be doing short of a bone
marrow biopsy?
With the Total Protein and Globulin being off, I probably
should also
mention that he HAS been tested for ADV just a couple of
months ago and it
was negative (Avecon saliva test). Should I retest? Any
suggestions for
treatment options at this point other than what we are doing?
I apologize for the length of this. Just wanted all pertinent
info to be
included.
Any help would be greatly appreciated!!!
Stacia