From:
Dr. Bruce Williams
Date: 2001-03-02 16:29:00 UTC
Subject: FW: Tasi
Dear Jeannie:
Thanks for being patient on this one. I needed to do some review on
lymphangiectasia, to see where we could go with this. I think that I
have at least come up with a game plan.
There are actually two types of lymphangiectasia - primary and
secondary. Primary is actually less common - this is usually an
physicla abnormality of lymph drainage. The second type is
secondary - an artifical blockage of lymph drainage - most often due
to severe inflammation. It is well knwon that ferrets with certain
intestinal disorders get severe inflammation - ECE is probably the
most common. Has Tasi ever had ECE? Was inflammation mentioned in
the biopsy report - sorry, I can't remember if it was. It we have a
concomitant inflammatory reaction, there is a good chance that if we
can get a handle on it, the lymphangiectasia will subside.
If possible, I'd like to look at that slide. There are some
morphologic differences in primary vs. secondary lymphangiectasia
that may help determine what exactly going on here - include the
location of the dilated lacteals. In primary, lymphatics are dilated
throughout the entire wall of the intestine; in secondary, there are
generally dilated only in the inflamed mucosa.
Can you refresh me on her albumin levels - this is a fairly good
indicator of the severity of the condition. Animals with
lymphangiectasia lose protein from the dilated lymphatics into the
lumen, so we can track the severity by something as simple as
albumin - it's a rough indicator, but helpful. Also her weight is an
important indicator. While I know she has loose stools, I'm not as
worried if her albumin stays up and her weight is stable.
Prednisone is recommended in many cases of secondary lymphangietasia,
and I think it may be helpful here. It will help to diminish any
inflammation that may be present. I think a standard dosage of
prednisone which we would use in chronic ECE cases (0.5 mg/lb orally
once daily) may be helpful.
Regarding the modification of fat - it is true that we want to switch
away from long-chain fatty acids, which are the most common in
typical pet foods. These long-chain triglycerides are a major
stimulus for intestinal lymph flow, which may hasten protein loss
into the bowel lumen. Generally, we put them on a low-fat diet (you
can try Hills r/d) to start, or a similar product. Unfortunately,
low fat diets are often not palatable (as I often say, there is
nothing good to eat without fat in it.)
While I am not familiar with coconut oil, there are some supplements
that are available from Mead Johnson (they make a medium chain
triglyceride oil which can be administered at 1 to 2 ml per/kg per
day).
I'd say before we start monkeying around with her diet significantly,
let's take a look at her protein values, her weight, and maybe a good
look at that slide willhelp shed some more light on this unique case.
----- Original Message -----
From: Jeannie
To: Bruce Williams, DVM
Sent: Wednesday, February 21, 2001 1:13 AM
Hi Dr. Williams - I am the person with Taselhauf, the ferret with the
intestinal Lymph problem. This is some information that I received
from a friend of mine. What are your thoughts about this? I would
appreciate your input.
Thanks
Best Regards
Jeannie
Typically cats and dogs with this disorder are fed a very high
protien, low fat diet. I'm not sure how this would translate to
ferrets though. Spurts of not wanting to eat is typical of the
disorder...which would be horrific in a ferret. If she makes chicken
gravy as a duck soup I think a good idea would be to trim off all the
fat, skin and don't add the extra lard to it. Since ferrets tend to
loose weight easily...he will probably be on the thin side on such a
diet. She might try playing with Medium Chain triglicerides...such
is the fat found in coconut oil and milk. I'm afraid ferrets will
do poorly on super low fat, so trying to just go with the medium
chain triglicerdies might make the difference. I totally think she
should talk about this with her vet. If this was a cat or dog...I
would not hesitate cutting fats from the diet. But a ferret, you
will probably want to still have it, but use a different kind.
Maybe Dr. Williams would have some idea's on how a ferret would do on
coconut oils and milk...even if it meant using a human lactose pill
for it.