From:
Bruce Williams, DVM
Date: 2001-07-07 20:53:00 UTC
Subject: Re: Help needed with Path report
--- In Ferret-Health-list@y..., Ruesterx1@h... wrote:
> I assumed he had developed ulcers or had a hairball. After numerous
> tests and medication we finally had to take him for exploratory
> surgery as his last hope, even though he was high risk due to his
> asthma. He made it through the surgery fine, but no blockages or
> ulcers were found in his stomach or intestines. There were no
tumors,
> the only thing my vet found was a very pale liver, and a cyst near
> the rt. adrenal gland, and I believe he said something about the
> medistinal area, but unable to take a biopsy there due to the
amount
> of blood vessels in that region.
Dear Julie:
This sounds very much like an ulcer - most ulcers are not seen at
surgery - many vets do not open the stomach if they do not feel
anything abnormal. If they do, often the small incision does not
facilitate a full 360 degreee examination of the pylorus, where most
ulcers occur. Howeve a diagnosis of ulcer may be made at surgery if
the lumen of the stomach contains black coffee-ground material
(digested blood) which MAY be seen anytime that stomach is open.
The mediastinum is in the chest, and it is doubtful that your vet
went anywhere near there.
> Here are his lab results:
> WBC 1.7 (plt clumping may have lowered result)
> HCT 41.0 L
> Bands 59, Lymphs 23, monos 16
> Glucose 79, Bun 10 L, CA 8.7 L, TP 7.4, Alb 2.2 L, Alt 555 H
Overll not that bad, the WBC is indeed low, but it sounds as if the
blood clotted a bit. I doubt the 59 represents bands, but
neutrophils. (Bands are immature neutrophils, and I've never seen
them go that high in ferrets.) The ALT is elevated, but likely due
to not eating properly.
>
> Path report:
> Diagnosis: 1. Severe hepatic fatty changes with mod to severe
> lymphoplasmacytic histocytic cholangiohepatitis.
> 2. Cyst lined by cuboidal epithelium and mod
> lymphohistiocytic inflammation in cyst wall with mineralization.
>
The fatty change is consistent with not eating and goes along with
the ALT. Fatty change in the liver causes it to turn yellow. The
cyst is actually an adrenal cyst, and is commonly seen at the area
where the liver and ft. adrenal touch. It is of no clinical
significance in this case.
The case sounds very much like a case of gastric ulcers - there is no
indication of any other diseases going on, and it does not appear
that any lung smaples were taken, that might shed light on his
previous lung problems.
With kindest regards,
Bruce Williams, dVM