From:
dori garro
Date: 2001-06-05 01:17:00 UTC
Subject: summary - ferret with enlarged prostate
thanks to those who assisted with the ferret with
prostate enlargement (had a pu surgery done and now
was blocked up)
the question was also posted on another list so some
of the responses came from vets not on fhl.
it was pretty unanimous that we were on the right
track with adrenal disease as the primary problem with
secondary prostatic disease and obstruction.
one person suggested that insulinoma was also likely
but on rechecks of the blood sugar with 4 hour fast
the glucose remained in the 90 to 100 range.
another suggested testing for aleutian disease; this
we did not do.
original question and summary follow:
> original post was:
> saw a male castrated 4 year old ferret today. first
> visit to our clinic. in january had a cystotomy and
> perineal urethrostomy done; struvite stones; put on
> a/d diet (if anyone can comment on this choice of
> food
> that would be appreciated -- appropriate, not
> appropriate, other preferred choices).
> doing well until this morning; owner noted: no feces
> and no urine since cleaning litter last night;
> dragging self around, not able to use rear limbs.
> caged on his own, multi levels; can't rule out a
> fall
> (but aren't ferrets indestructible? joking).
>
> physical exam: bladder is full, easy to express
> urine;
> foul odor (horrendous is a better word) to the
> urine;
> pyuria with bilirubin crystals present (0-2/hpf),
> rod
> shaped bacteria. able to move rear limbs, but
> basically keeps them behind him so laying on his
> belly; has superficial pain; conscious
> proprioception
> is questionable. no pain on palpation of spine.
> rest
> of exam is okay. ferret did defecate after getting
> rectal temp.
> blood glucose = 101 (normal basically 90 to 150 in
> my
> mind)
>
> rads - no stones; enlarged prostate
>
> i understand that the most common cause of
> prostatomegaly and urethral obstruction in the
> ferret
> is secondary to adrenocortical tumors; i understand
> that a urinary tract infection would be common post
> p.u.; my ferret knowledge starts to wear thin
> there.
>
> would you expect neuro signs with prostate disease
> secondary to adrenal tumor? or would you have to
> think prostatic neoplasia with mets to the spine?
> would love to narrow down to one disease process,
> but
> can't get spinal trauma/disc disease out of my head
> in
> this case?
> bilirubin crystals in ferrets - definitely abnormal?
> (will likely run bloodwork in the morning if owner
> allows)
> any thoughts?
>
> received half a dozen responses or so.
> turns out we have a couple of vets on the list
> with some special powers (note liver mass
> and heart disease). nearly everyone suggested
> adrenal disease with secondary prostatomegaly
> and urinary outflow obstruction. recommended
> exploratory if all else looked okay and take care
> of the adrenal problem. few words on lupron
> and proscar also included.
> ultrasound was done the following morning.
> both adrenals were enlarged; prostate was
> big and cystic; there was a mass on the liver;
> there was also another mass noted in the
> abdomen. internist took a quick peek at the
> heart; dilatory cardiomyopathy; fractional
> shortening seemed okay. bloodwork was
> fairly unremarkable if i remember correctly????
> owners opted to skip surgery due to other
> masses and concern with heart; the vet who
> took over the case was going to start lupron
> and proscar, but before she could get it in
> he wound up with congestive heart failure;
> he died later that day (2 to 3 days post
presentation). very sad; lots of problems all at once
for the poor little guy.
> some parts of the responses:
>
> Did you ultrasound his adrenal glands and liver?
> Possibly the right adrenal gland cancer has
> spread to his liver and is causing the bilirubin
> crystals. I would suggest a blood profile and
> adrenal gland surgery. If surgery is not an
> option then Lupron can be used to control
> the adrenal gland disease, and Propecia
> can be used to control the prostate. Plus
> an antibiotic for the bladder (and possible
> prostate infection) such as Clavamox
> and/or Baytril.
> -----------------------------------------------
> Before doing surgery on one of the glands
> it's maybe good to check for heart deseases.
> -------------------------------------------------
> Hindlimb weakness is a non-specific sign
> of illness, and should not be interpreted
> as a ture neurologic sign. The syndrome
> that you are seeing is very consistent with
> adrenal disease - squamous metaplasia of the
> prostate, prostatomegaly, outflow obstruction,
> cystitis, even the bacterial overgrowth.
>
> Ferrets normal have a +1 urobilinogen,
> so I would not go too far out on a
> limb there.
> In this case, adrenalectomy, probably coupled
> with some form of hormonal therapy (Lupron,
> propecia, casodex is probably appropriate,
> and should be accomplished ASAP.
>
----------------------------------------------------->
some additional notes:
> one vet commented on the food choice; she
> did not like a/d for the long term; suggested
> getting him on a good ferret diet such as
> totally ferret.
>
----------------------------------------------------->
nobody really felt the "neuro" signs were
> truly neurologic in origin.
thanks for your help
rob garro dvm
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