From:
Bruce Williams, DVM
Date: 2001-10-07 14:26:00 UTC
Subject: Re: hepatitis in ferrets
--- In Ferret-Health-list@y..., "Lisa" <fer8queen@h...> wrote:
> He had a bilateral adrenectomy last month. While the
> doctor was in there, he found that Gavin had white spots all over
his
> liver. Additionally several of his lymph nodes in that area were
> enlarged.
>
> These were biopsied and the diagnosis on the liver spots was: "Mild
to
> Moderate multifocal, chronic-active, lymphocytic, portal hepatitis.
>
> He recommended that my local vet begin treatment for the hepatitis
with
> 3 weeks of Clavamox .5ML twice daily, two weeks of Pedia-pred .3ML
twice
> daily, and then four weeks of Pedia-Pred .3Ml once daily.
>
> At the four week mark, he wanted to do a CBC and check his liver
values.
> He said that if they are normal, then the hepatitis is considered
cured.
> If not, we'd have to try another medical avenue.
>
> Here is my problem: Gavin had a CBC done the day of his surgery -
all
> liver values were normal. He also had a CBC done yesterday. We
started
> treatment for the hepatitis yesterday and wanted to measure if his
> values had elevated since the surgery. They remain normal.
>
> My vet who did the surgery said that there isn't much, if anything,
> written about hepatitis in ferrets. Does anyone have experience
with
> hepatitis in ferrets? Or a bit of a better way to determine that
the
> hepatitis is "cured"? Short of doing another surgery, we couldn't
think
> of a way and that is too drastic to do again.
>
Dear Lisa:
Portal hepatitis is a common incidental finding in ferrets which is
seen in association with any chronic inflammation of the bowel in
ferrets (which, as you say, Gavin likely has, as evidence by his
chronic diarrhea). In general, it is not worth treating.
Additionally, it is not the cause of the white spots seen n the
liver. These spots are small accumularions of fat in hepatocytes -
fat in the liver is commonly seen in ferrets who are not eating
well. Once again, not something that gets any definitive treatment.
I am not surprised that Gavin's baseline liver values are normal -
neither of these problems generally result in any elevation. it is
uually only when you see distention of all of the hepatocytes by fat
(diffuse hepatic lipidosis) that you will see elevations of hepatic
enzymes.
By far, changes in the liver cause more confusion among veterinarians
than any other, and it is the most common area of misdiagnosis. We
tend to overtreat "liver problems" far too often. In this case,
there is no evidence of a definitive liver disease ongoing in Gavin,
only changes secondary to his bowel inflammation. Let's go after the
bowel changes, and the liver will clear itself up.
With kindest regards,
Bruce Williams, DVM